2019 Open Enrollment Season Is Here

Enroll for 2019 Coverage on HealthCare.gov from November 1, 2018 through December 15, 2018

Now is the time to make important decisions about your and your family’s health care coverage for 2019. To make your choice easier, we’ve listed below all of the insurance plans in which Duke will participate in 2019. You’ll also find tips and resources to help you navigate open enrollment.

The plans and coverage available on HealthCare.gov are changing for 2019

In particular, Blue Cross and Blue Shield of North Carolina (BCBSNC) will no longer offer the Blue Local with Duke Health and WakeMed plan. If you live in Durham or Wake counties, you can keep in-network coverage for Duke doctors and facilities by enrolling in the Ambetter of North Carolina plan from HealthCare.gov before December 15, 2018. Visit ambetterofnorthcarolina.com for more information. If you live in Caswell, Chatham, Franklin, Johnston, Lee, Orange or Person counties, please see information below regarding your enrollment options. Other BCBSNC plans are not affected. See our FAQ below for more information.

Accepted Health Insurance Plans

Duke Health contracts with most major health insurance carriers and transplant networks. Click the buttons below to see the full list of plans we will accept in 2019 from each carrier or network.

  • Aetna Choice POS, Aetna Choice POS II
  • Aetna Elect Choice HMO, Aetna Open Access Elect Choice
  • Aetna Health Network Only, Aetna Health Network Option
  • Aetna HMO
  • Aetna Limited Benefit Insurance PPO
  • Aetna Managed Choice POS
  • Aetna Medicare HMO Open Access
  • Aetna Medicare Plan (HMO, PPO)
  • Aetna Medicare Premier Plan (PPO)
  • Aetna Medicare Prime Plan (HMO, PPO)
  • Aetna Open Access HMO, Open Access Aetna Select, Aetna Open Access Select, Aetna Open Access Managed Choice
  • Aetna Open Choice PPO
  • Aetna PCP Coordinated POS Plan
  • Aetna Quality Point of Service (QPOS)
  • Aetna Select HMO
  • Aetna Traditional Choice
  • Aetna Voluntary Indemnity Group Plan
  • Aetna Whole Health – Duke WakeMed WKCC
  • Ambetter of North Carolina
  • Blue Advantage
  • Blue Medicare (HMO, PPO)*
  • Blue Options (123, PPO, HSA)
  • Blue Select
  • NC State Employees Health Plan
*Duke HomeCare and Hospice does not participate in the plan.
  • Cigna Choice Plus
  • Cigna Open Access
  • Cigna Open Access Plus
  • Duke Basic
  • Duke Select
  • Gateway Health Medicare Assured Prime (HMO)
  • Gateway Health Medicare Assured Select (HMO)
  • Humana Choice (PPO)
  • Humana ChoiceCare (PPO)
  • Humana Gold Choice (PFFS)
  • Humana Gold Plus (HMO)
  • First Medicare Direct*
  • Medicare Part A
  • Medicare Part B
*This is for Wake County only.
  • NC Medicaid*
* Not all Duke locations and doctors participate in this plan. Please contact the location you will be visiting to determine what is accepted.
  • FAMIS
  • Optima Family Care (Medicaid HMO in VA)
  • Optima Individual & Family (On & Off Exchange Plans)
  • Optima Plus (PPO)
  • Optima Vantage (HMO)
  • TRICARE Extra*
  • TRICARE for Life*
  • TRICARE Prime*
  • TRICARE Prime Remote*
  • TRICARE Standard*
*Duke Primary Care does not participate with the plan.
  • AARP Medicare Complete (HMO, PPO)
  • AARP Medicare Complete Essential (HMO)
  • All Savers Alternate Funding
  • All Savers Fully Insured
  • State Employee Health Plan (for retirees)
  • UnitedHealthcare (HMO, PPO, POS)
  • UnitedHealthcare Charter/Charter Balance/Charter Plus
  • UnitedHealthcare Choice/Choice Plus
  • UnitedHealthcare Core/Core Essential
  • UnitedHealthcare Navigate/Navigate Plus/Navigate Balanced
  • UnitedHealthcare of the River Valley
  • UnitedHealthcare Option PPO
  • UnitedHealthcare Options PPO with Harvard Pilgrim
  • UnitedHealthcare Passport Connect Choice/Choice Plus
  • UnitedHealthcare Passport Connect Options PPO
  • UnitedHealthcare Select/Select Plus
  • United Medical Resources (UMR)
FAQs About Open Enrollment on HealthCare.gov
If I am in the Blue Local with Duke Health and WakeMed plan and want to continue using Duke providers and facilities, what are my options for 2019?

It depends on where you live.

  • If you live in Durham or Wake counties:

    If you don’t enroll in a new plan on HealthCare.gov by December 15, 2018, Blue Cross and Blue Shield of North Carolina will automatically enroll you in the Blue Value plan, and Duke doctors and hospitals will be considered out-of-network providers as of January 1, 2019.

    You can keep in-network coverage for Duke doctors and facilities by enrolling in the Ambetter of North Carolina plan through HealthCare.gov before December 15, 2018. Visit ambetterofnorthcarolina.com for more information.

  • If you live in Granville or Vance counties:

    If you don’t enroll in a new plan on HealthCare.gov by December 15, 2018, BCBSNC will automatically enroll you in the Blue Advantage plan, which includes Duke. BCBSNC will also offer Blue Select, which includes Duke, to residents of Granville and Vance counties, but you will need to enroll on HealthCare.gov by December 15, 2018, if you want Blue Select.

  • If you live in Alamance County:

    If you don’t enroll in a new plan on HealthCare.gov by December 15, 2018, Blue Cross and Blue Shield of North Carolina will automatically enroll you in the Blue Value plan. Providers at Kernodle Clinics are included in the BCBSNC Blue Value plan. However, Duke hospitals and facilities are out-of-network.

  • If you live in Caswell, Chatham, Franklin, Johnston, Lee, Orange, or Person counties:

    If you don’t enroll in a new plan on HealthCare.gov by December 15, 2018, Blue Cross and Blue Shield of North Carolina will automatically enroll you in the Blue Value plan, and Duke doctors and hospitals will be considered out-of-network providers as of January 1, 2019. In spite of our best efforts, Duke will not be in-network for a plan available on HealthCare.gov in these counties in 2019. Our patients are our first priority, and we will work closely with you to transfer your records to another provider. Call 919-241-5775 for assistance.

If I am pregnant or in the middle of treatment for a condition like cancer, is there any way to continue my care at Duke and have it considered in-network?

BCBSNC has said it may authorize continued in-network benefits for certain patients. To find out if you qualify, please call BCBSNC customer service at 888-206-4697.

Can I speak with someone else about this?

The decision to discontinue the Blue Local with Duke Health and WakeMed plan was made by BCBS, and we do not have any additional information at this time. You can voice your concerns by contacting Blue Cross and Blue Shield of North Carolina Customer Service at the number on the back of your card, or the NC Department of Insurance at 855-408-1212.

Are other BCBSNC plans affected?

No, Duke still participates in many BCBSNC plans. Please refer to the list above to see the plans in which Duke participates.

How can I get help enrolling in a new plan?

The North Carolina Department of Insurance has Patient Navigators available to help you enroll in a new plan. Please call 1-855-733-3711.

More Information

Don't see your plan? Give us a call:

Need more help choosing a plan?

GetCoveredAmerica.org

Want to learn more about open enrollment?

Articles & Tips