Blue Advantage®

Blue Advantage® features a provider network that covers all 100 counties in the state at an affordable price.1

  • 91% of doctors and 99% of hospitals in the state are covered2
  • Coverage in North Carolina, the United States and worldwide3
  • More pharmacy and prescription drug options
  • Flexibility in how much you pay for doctor visits and prescription drugs
  • Preventive care covered at 100%4

Blue Advantage is ideal for those who want choices: choices in which provider to see and choices for how much to pay for doctor visits and prescription drugs.

Benefit Choices

Blue Advantage offers a variety benefit choices to give you options for how much you pay for medical expenses: copayments, and deductible and coinsurance plans.

Copayment plans are what most people think of as traditional plans. They offer a fixed copayment for things like primary care office visits and prescriptions. While you’ll know what you’re going to pay with copayment plans, they come at a higher premium. These plans are ideal for someone who wants predictable costs and doesn’t mind paying more in premiums.

Deductible and coinsurance plans have lower premiums than copayment plans. If you don’t expect a lot of medical expenses and want to save money on premiums, these may be the plans for you. For these plans, you pay the full cost of your medical expenses until you meet your medical deductible. Then you pay a coinsurance percentage, sharing the cost with Blue Cross and Blue Shield of North Carolina (BCBSNC) until you reach your out-of-pocket limit. After that, BCBSNC pays all covered costs.

Two of our Blue Advantage deductible and coinsurance plans have a $0 deductible. That means you start paying toward coinsurance rather than meeting a deductible. From Day 1 BCBSNC shares your expenses until you reach your out-of-pocket limit.

For more options for your budget and your needs, some plans offer a combination of copayments, and deductible and coinsurance.

Health Savings Account (HSA)

Certain plans are also eligible for an HSA.

  • The money you contribute to your HSA is tax-deductible.5
  • When you need to pay for eligible medical services, you can pay for them with your HSA funds.
  • Your HSA rolls over from year to year. That means you keep what you put into it. It’s your HSA - it’s your money.

Metallic Levels

Blue Advantage plans are available in all metallic levels: bronze, silver, gold and platinum. The levels differ by how much of your medical costs a plan will pay on average. They are based on approximate values for standard medical expenses.6 7

  • Bronze plans pay 60%
  • Silver plans pay 70%
  • Gold plans pay 80%
  • Platinum plans pay 90%

All plans have a maximum out-of-pocket (OOP) limit of $6,350. Some plans have an even lower OOP limit.

  1. Health Plans, Inc., MarketQuest Network Compare, April 2013.

  2. CHP Market Quest. Network Compare. July 2012 (data as of May 9, 2012).

  3. Covered in more than 200 countries and territories worldwide through BlueCard® program. Blue Cross and Blue Shield Association.

  4. Certain preventive care services are covered at 100% before deductible when received in an in-network office or out-patient setting. Other covered services may be subject to deductible and coinsurance. When you receive preventive care out-of-network, you may pay more. Visit bcbsnc.com/preventive for a full list of preventive services.

  5. HSA contribution amounts are limited to the amount established by the IRS for each year for single or family coverage.

  6. The Center for Consumer Information and Insurance Oversight. Centers for Medicare and Medicaid Services. “Actuarial Value and Cost-Sharing Reductions Bulletin.” http://cciio.cms.gov/resources/files/Files2/02242012/Av-csr-bulletin.pdf. Accessed April 29, 2013.

  7. These are approximate values with a +/- 2% variation.