Once enrolled in NC SmartChoice, how will a members current CMM benefits be affected?
The NC SmartChoice effective date is October 1, 2006. Current CMM plan members will continue to use the CMM plan until September 30, 2006. Effective October 1, 2006, members may begin utilizing services under their NC SmartChoice plan. Any deductibles or coinsurance satisfied under the CMM plan between July 1, 2006 and September 30, 2006 will be credited towards the in-network NC SmartChoice deductible and coinsurance. All prior authorizations will be rolled over to NC SmartChoice; however, NC SmartChoice benefits will be applied. Appeals will be handled within the benefits under which the appeal was submitted and may not necessarily be transferred to the NC SmartChoice plan if the timeframe was prior to the NC SmartChoice effective date. There will be no changes to members’ pharmacy benefits. However, diabetic supplies and specialty pharmacy on the NC SmartChoice plans will be covered under the pharmacy benefit and subject only to a copayment as opposed to being subject to a deductibl
Related Questions
- If services have already been authorized for State employees currently in the CMM plan but enrolling in an NC SmartChoice plan option, will BCBSNC carry over the authorization?
- Will State members still have prescription benefits with the NC SmartChoice PPO plans?
- Once enrolled in NC SmartChoice, how will a members current CMM benefits be affected?
