Quality Care That’s Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Learn more about our Total Care and Blue Distinction® Specialty Care designation programs and find a designated doctor or hospital that meets your needs. Show Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. Member LoginLog in to your account to get the most accurate, personalized search results based on your plan. You’ll see details that may help you lower health care costs.
Member LoginForgot user name or password Don’t have an account? Register now *In addition to staying in network, you or your doctor may need to get benefit approval or “prior authorization” before you get treatment for certain services for them to be covered. Please check your benefit booklet or your plan's terms if you are unsure. Guest SearchEven if you’re not a member, you can search for doctors, hospitals and other providers. If you need help, we’ve created these helpful guides: Step-by-Step PDF Search as a GuestIn-Network ProvidersUse our National Doctor and Hospital Finder tool to see if your doctor is in our network or to find a doctor, specialist or urgent care center near you. Our network includes 96% of hospitals, 95% of doctors and over 55,000 retail pharmacies in the U.S. You also never need a referral to see a specialist. If you’re a member and logged in to MyBlue, you can access additional provider information (such as procedure cost estimates) by searching here. Find a Doctor Overseas Providers (adsbygoogle = window.adsbygoogle || []).push({});Find the best doctors, clinics, specialists and hospitals outside the U.S. Our overseas network includes over 14,000 providers. If you’re a member, you can access additional provider information (such as address, phone number and specialty) by searching for providers using your MyBlue account here. Find an Overseas Provider As a Service Benefit Plan member, you can choose your own physician, hospitals, and other healthcare providers. To get care, simply call the provider’s office to set up an appointment. You do not need a referral. If you need care after hours, call your doctor or go to an in-network urgent care center. In the case of a life-threatening emergency, always call 911 or your local emergency services. Your doctor will usually arrange any hospital care that you need. All inpatient hospital care except for emergency services must be pre-approved (also known as precertification) by your health plan. Learn more here. If you or someone you know needs help right now, please call the 988 Suicide & Crisis Lifeline. Call, text or chat 988 for free and confidential support 24/7. You can also call 1-800-237-TALK (8255). Section hidden in CSS: https://www.bluecrossnc.com/admin/appearance/settings/bcbsnc
Behavioral Health Services
Blue Cross NC wants to make sure you have the most accurate and up-to-date information. But, because we often add new providers to our network, we can’t guarantee all the information in your search will be current. Call our customer service number on the back of your ID card to report information that is wrong. The Blue Cross and Blue Shield Association nor its licensees are liable for losses, damages, or charges as a result of using our provider search or from receiving provider care. You can refer to your Member Guide for information on if a service is covered on your plan. Quartet Health is an independent company providing behavioral health care support services on behalf of Blue Cross NC. Quartet Health does not offer Blue Cross or Blue Shield products or services. Additional Plan InformationDrug List OverviewBlue Cross and Blue Shield of North Carolina offers three drug formularies (drug lists) so Medicare beneficiaries can have options for their prescription needs. Blue Medicare HMO Enhanced, HMO Essential and Blue Medicare PPO Enhanced share the same Medicare prescription drug list. This list is based on a preferred list of FDA-approved prescription drugs and was developed using guidelines from the federal government. The drug list includes many highly utilized generic drugs and some brand name and specialty drugs. This list also includes a lower cost tier for some maintenance medications related to High Blood Pressure, High Cholesterol and Diabetic conditions. Blue Medicare Rx (PDP) Standard Plan prescription drug list is also based on a preferred list of FDA-approved prescription drugs and was developed using guidelines from the federal government. The drug list for this plan has many highly utilized generic drugs and some brand name and specialty drugs. Many of the most popular generic prescriptions are included. The Blue Medicare Rx (PDP) Enhanced prescription drug list is based on a preferred list of FDA-approved prescription drugs and was developed using guidelines from the federal government. The drug list includes more generic, brand name and specialty drugs. Generic drugs have the same active ingredient formulas as brand name drugs. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs. Certain vaccinations, insulin and insulin injection supplies are also covered on all formularies. Over-the-counter drugs are not covered because they are excluded by Medicare. To encourage the appropriate use of prescription drugs, some quantities are limited and some drugs must be approved before they will be covered. For more information, see prior authorization, step therapy, and quantity limitations. Like most insurance coverage, our Blue Medicare HMO, Blue Medicare PPO and Blue Medicare Rx plans have some limitations and exclusions. Recent Drug List ChangesThe drugs listed below have been removed from the specified formularies (drug lists). Please ask your doctor to prescribe a drug that is on the formulary to treat your condition. Your drug cost will depend on your specific prescription drug plan and the formulary alternative prescribed by your doctor. If you are affected by a change to the formulary, you will receive a written notice regarding the change at least 60 days before the change will take effect. Blue Medicare Rx Standard These drugs have been withdrawn or discontinued by the manufacturer:
The drug manufacturers have discontinued participation in the Coverage Gap Discount Program for these drugs:
Blue Medicare HMO/PPO and Blue Medicare Rx Enhanced These drugs have been withdrawn or discontinued by the manufacturer:
The drug manufacturers have discontinued participation in the Coverage Gap Discount Program for these drugs:
Questions about Drug CoverageIf you can't find your drug, your drug may not be covered. To verify whether a drug is covered, you may call Customer Service seven days a week from 8 am - 8 pm.
If your drug is not covered, you have the right as a member to request that an exception be made to the formulary or to request a transition supply while you find an appropriate alternative prescription. For instructions on how to request a transition supply or an exception to the formulary and instructions on how to appeal a decision about an exception or to file a grievance if you are dissatisfied for any reason, please review the following documents:
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