If you’re on the NC State Health Plan, two big changes are coming: a new tiered provider network on January 1, 2027, and Blue Cross NC replacing Aetna as the plan’s administrator on January 1, 2028. The good news for chiropractic patients is that the Plan has said chiropractor office visit copays won’t be affected by the new tiers and will stay the same as they were in 2026. Sitzmann Chiropractic accepts the State Health Plan, so teachers, state employees, and retirees looking for a State Health Plan chiropractor in Lincolnton NC can keep getting care with us.
Who Is Covered by the NC State Health Plan?
The State Health Plan covers roughly 750,000 people across North Carolina. A lot of folks don’t realize they’re on it until they look closely at their insurance card.
If you work in one of these roles, there’s a good chance you’re a member:
- Public school teachers, teacher assistants, and school administrators
- School bus drivers, cafeteria staff, and custodians
- Community college instructors, office staff, and maintenance crews
- UNC System faculty and staff
- State agency employees
- Judges, magistrates, clerk of court staff, and other courthouse employees in the state court system
- State retirees and their covered family members
- Some local government employees, depending on whether their employer participates
Not sure if your plan counts? Your HR or benefits office can tell you in about two minutes. You can also call our office and we’ll help you check.
What’s Changing in 2027: The New Tiered Provider Network
Starting January 1, 2027, the State Health Plan is moving to a four-tier provider network. Providers will be grouped as Preferred, Access, Non-Preferred, or Out-of-Network. For many types of care, what you pay will depend on which tier your provider falls into.
That’s a real shift. For years, members didn’t have to think much about which in-network provider they chose. Now the Plan is encouraging members to shop around for certain types of care.
The Part That Matters Most for Chiropractic Patients
Here’s the reassuring news. According to the State Health Plan’s 2027 open enrollment information, chiropractor office visit copays are not impacted by provider tier placement. They’ll stay the same as they were in 2026.
The same goes for physical therapy, behavioral health, and a few other office visit types. So if you’re already coming in for back pain, neck pain, or headaches, the new tier system shouldn’t change your chiropractic copay.
Premiums are a separate story. The Plan’s board approved premium increases for 2027, so your overall costs may still change depending on the plan you choose during open enrollment.
What’s Changing in 2028: Blue Cross NC Returns
In July 2026, the State Health Plan Board of Trustees voted to bring Blue Cross NC back as the plan’s third-party administrator starting January 1, 2028. Blue Cross ran the plan for more than 40 years before Aetna took over in 2025.
The third-party administrator is the company that processes your claims and builds the provider network. Blue Cross NC is also set to take over as the plan’s pharmacy benefit manager in 2028. Aetna remains the administrator through December 31, 2027.
What We Can Reasonably Infer (And What We Don’t Know Yet)
Based on what’s been publicly announced, here’s how we read it:
- Nothing changes with Aetna for the rest of 2026 or all of 2027.
- You may get a new insurance card and member materials before the 2028 switch.
- Provider networks could shift during the transition, so it’s smart to confirm your providers when the time comes.
What we don’t know yet are the finer details, like exact network lists and any benefit changes under the new contract. Plan details are always subject to change, and we’ll share updates as they become official.
What This Means for Your Care at Sitzmann Chiropractic
We accept the State Health Plan today, and Dr. Sitzmann plans to continue accepting it through the transition to Blue Cross NC. Our goal is simple: if you’re a teacher, courthouse employee, or state retiree in Lincoln County, you shouldn’t have to hunt for a new chiropractor every time the plan changes hands.
When you come in, we’ll help you understand how your chiropractic benefits apply before your first adjustment. No surprises and no guesswork. Our care process starts with a conversation, and that includes a clear talk about coverage.
Retirees on Medicare
Many State Health Plan retirees move to Medicare-based coverage once they become eligible. Sitzmann Chiropractic accepts Medicare, so retirees can continue their care with us after that transition too.
Medicare plans vary, so bring your card to your first visit and we’ll walk through what’s covered. If you’re dealing with stiffness or joint pain as you get older, our post on chiropractic care for seniors is a good place to start.
Why So Many State Employees End Up Needing a Chiropractor
The jobs covered by this plan are some of the hardest on the body. We see it every week in our Lincolnton office.
Teachers spend all day on their feet, bending over desks and carrying supplies. Bus drivers sit for hours on seats that don’t do the lower back any favors. Community college maintenance crews lift, twist, and climb. And judges, clerks, and office staff often sit for long stretches, which can lead to neck pain and tight shoulders by the end of the day.
Over time, that wear and tear shows up as back pain, tension headaches, and sore joints. If your job involves physical strain, our post on chiropractic care for work injuries covers how we help people get back to feeling like themselves.
Frequently Asked Questions
Will my chiropractic copay go up in 2027?
Based on the State Health Plan’s published 2027 information, chiropractor office visit copays aren’t affected by the new provider tiers and stay the same as 2026. Your premium may still change, so review your options during open enrollment.
Do I need to do anything right now because of the Blue Cross switch?
For now, no. Aetna administers the plan through the end of 2027. Watch for official mail from the State Health Plan as 2028 gets closer.
Does Sitzmann Chiropractic accept the State Health Plan?
Yes. We accept the State Health Plan and plan to continue accepting it through the transition. We also accept Medicare and most major insurance plans.
How do I know if I’m on the State Health Plan?
Check your insurance card or ask your employer’s HR or benefits office. You’re also welcome to call us, and we’ll help you figure it out. Our FAQ page covers more common insurance questions.
Keep Your Care Consistent Through the Changes
Insurance changes are stressful enough without worrying about your chiropractor. Schedule online or call us at (980) 284-2525, and we’ll help you make sense of your coverage.
This post reflects publicly announced State Health Plan information as of September 2026. Plan details are subject to change. This is general information, not insurance or legal advice. For questions about your specific coverage, contact the State Health Plan or your benefits office directly.
