Temporary DME exceptions for members impacted by Hurricane Helene

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is deeply concerned about our members and communities in Western North Carolina and other impacted states after the devastation of Hurricane Helene and is taking action.

To provide immediate relief, we have taken steps to help customers in affected areas that may have lost or had their Durable Medical Equipment (DME) destroyed due to Hurricane Helene.

For dates of service September 25 through November 29, Blue Cross NC will allow commercial plan members to replace damaged or lost equipment without being subject to the customary waiting period or item limitation. Coinsurance will still apply according to a member’s benefits.

Members that need to replace DME sooner than expected due to loss in the storm should contact Blue Cross NC at 800-672-7897 and choose option 3 for precertification. If available, members should have their member ID and a list of the equipment they need to replace when they call.

In addition, we are also providing Case Management support for members needing assistance in locating equipment. Case Managers can be reached during normal business hours at 800-218-5295.

Providers submitting DME replacement exception requests on behalf of their patients via fax (800-228-0838) please denote “DME Hurricane Damage Replacement” on the cover sheet.

This DME replacement exception applies to Fully Insured plans, Administrative Services Only (ASO) plans (unless the Plan Administrator has opted-out), and State Health Plan (SHP). Medicare Advantage plans, including Experience Health, and Federal Employee Program (FEP) health plans are excluded from this DME replacement exception.

Note that this DME replacement exception applies to Blue Cross NC members receiving care in North Carolina and impacted surrounding areas only. This DME replacement exception does not apply to Blue Cross NC members receiving care in areas not impacted by Hurricane Helene. It also does not apply to InterPlan Program (IPP) members receiving care in North Carolina.