Full statewide network with the most provider choice
Blue Advantage gives you access to our largest statewide network. This is a good option if you want a broad choice of in-network doctors, specialists and hospitals.
More than 95% of doctors and 98% of the hospitals in North Carolina are in-network A1
Blue Advantage gives you access to our largest statewide network. This is a good option if you want a broad choice of in-network doctors, specialists and hospitals.
Availability
Blue Advantage is available on and off Marketplace to residents in all North Carolina counties EXCEPT the following, where it is available only off Marketplace: Alamance, Anson, Cabarrus, Caswell, Chatham, Cleveland, Davidson, Davie, Durham, Forsyth, Franklin, Gaston, Johnston, Lee, Lincoln, Mecklenburg, Orange, Person, Rowan, Stanly, Stokes, Surry, Union, Wake, and Yadkin.
Blue Home with Novant HealthB2 is a good option if you wish to get care from Novant Health's provider network and its affiliated doctors and hospitals. Since the majority of doctors in this plan are in the same network, it's easier for them to work together on your behalf.
BLUE HOME with Novant Health offers:
Novant Health's network of hospitals and providers including over 2,300 physicians B2
A provider network that includes nearly 800 locations, including Novant Health's not-for-profit integrated system of 18 medical centers B2
All doctors outside the Novant Health provider network are considered out-of-network for Blue Home with Novant Health, including: Atrium Health, Cone Health, CaroMont Health and Wake Forest Baptist Health. Out-of-state providers are also out-of-network. When traveling outside of North Carolina or the U.S., only emergency services will be covered at the in-network benefit level. All other non-emergency covered services will be covered at the out-of-network benefit level.
Availability
Blue Home with Novant Health is available on and off Marketplace to residents of these North Carolina counties: Cabarrus, Davidson, Forsyth, Mecklenburg, Rowan, Stokes, Union, and Yadkin.
Local network using only Atrium Health and its affiliates
Blue Local with Atrium Health C1 is a good option if you wish to get care from Atrium Health and its affiliated doctors and hospitals. Since the majority of doctors in this plan are in the same health care system, it’s easier for them to work together on your behalf.
BLUE LOCAL with Atrium Health offers:
Atrium Health's comprehensive regional network of doctors and hospitals
A provider network that includes Atrium Health Levine's Children's Hospital, which is nationally ranked in eight specialties; C2 Carolinas Medical Center, which was named the "Best Hospital" in the Charlotte metro region for the fifth straight year; C3 and more than 42 hospitals and 13,500 care locations. C4
All doctors outside the Atrium Health provider network are considered out-of-network for Blue Local with Atrium Health, including: CaroMont Health, Novant Health and their affiliated providers. Out-of-state providers are also out-of-network. When traveling outside of North Carolina or the U.S., only emergency services will be covered at the in-network benefit level. All other non-emergency covered services will be covered at the out-of-network benefit level.
Availability
Blue Local with Atrium Health is available on and off Marketplace to residents of these North Carolina counties: Anson, Cabarrus, Cleveland, Gaston, Lincoln, Mecklenburg, Rowan, Stanly, and Union.
Blue Local with Wake Forest Baptist Health D1 is a good option if you wish to get care from Wake Forest Baptist Health and its affiliated doctors and hospitals. Since the majority of doctors in this plan are in the same system, it’s easier for them to work together on your behalf.
BLUE LOCAL with Wake Forest Baptist Health offers:
Wake Forest Baptist Health’s local network of hospitals and providers including 2,100 physicians. D2
A provider network that includes Wake Forest Baptist Hospital; an academic medical center; five community hospitals; Brenner Children’s Hospital; more than 300 primary care and specialty clinics; and one of only 3 comprehensive cancer centers in North Carolina D2
All doctors outside the Wake Forest Baptist Health provider network are considered out-of-network for Blue Local with Wake Forest Baptist Health, including: Cone Health and Novant Health. Out-of-state providers are also out-of-network. When traveling outside of North Carolina or the U.S., only emergency services will be covered at the in-network benefit level. All other non-emergency covered services will be covered at the out-of-network benefit level.
Availability
Blue Local with Wake Forest Baptist Health is available on and off Marketplace to residents of these North Carolina counties: Davidson, Davie, Forsyth, Guilford, Randolph, Stokes, Wilkes, and Yadkin.
Limited statewide network that balances access and cost
Blue Value is a good fit if you are flexible about which doctors you see – or if your doctor or hospital is part of this smaller network. The network is statewide, making it easy to get in-network care if you travel or have a child away at college.
BLUE VALUE offers:
A limited statewide network for savings
Network includes, but is not limited to, CaroMont Health, Frye Regional, New Hanover Regional, Novant Health, UNC Health Alliance and Wake Forest Baptist Health
The following doctor/hospital networks are considered out-of-network for Blue Value: Atrium Health, Catawba Valley Health System, Duke Health and WakeMed. Out-of-state providers are also out-of-network. When traveling outside of North Carolina or the U.S., only emergency services will be covered at the in-network benefit level. All other non-emergency covered services will be covered at the out-of-network benefit level.
Availability
Blue Value is available on and off Marketplace to residents of these North Carolina counties: Alexander, Brunswick, Burke, Caldwell, Catawba, Cleveland, Columbus, Duplin, Gaston, Iredell, Lincoln, New Hanover, Onslow, Pender, and Surry.
Blue Home with UNC Health AllianceE1 is a good option if you wish to get care from UNC Health, UNC Health Alliance and its affiliated doctors and hospitals. Since the majority of doctors in this plan are in the same network, it’s easier for them to work together on your behalf.
BLUE HOME with UNC Health Alliance offers:
UNC Health Alliance’s network of hospitals and providers including over 1,200 primary care providers E2
A provider network that includes UNC Medical Center, nationally ranked in 4 adult and 7 pediatric specialties by U.S. News E3; along with UNC Rex, rated by U.S. News as high performing in 17 adult procedures and conditions E4
All doctors outside the UNC Health Alliance provider network are considered out-of-network for Blue Home with UNC Health Alliance, including: Cone Health, Duke Health and WakeMed. Out-of-state providers are also out-of-network. When traveling outside of North Carolina or the U.S., only emergency services will be covered at the in-network benefit level. All other non-emergency covered services will be covered at the out-of-network benefit level.
Availability
Blue Home with UNC Health Alliance is available on and off Marketplace to residents of these North Carolina counties: Alamance, Caswell, Chatham, Durham, Franklin, Johnston, Lee, Nash, Orange, Person, and Wake.
Why Choose Blue
There's a lot to think about when it comes to choosing health insurance. As the only homegrown, local insurer in all 100 counties of the state, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is here for you. With over 85 years of experience in the market and our broad range of plans F1, you can find the coverage that's right for you. The benefits that are important for getting and staying healthy are at the core of all of our plans. Advantages of health care coverage with Blue Cross NC include:
No referrals needed to see a specialist
Coverage in- and out-of-network
24/7 telehealth care options for behavioral and physical health, available in English and Spanish F2
Convenience of 90-day coverage of prescription mail-order option
No waiting periods for pre-existing conditions F3
Annual wellness visits covered at 100%
Programs to help you control your type 2 diabetes F4
Programs to help you quit smoking F4
Access to Blue365®, which offers special member discounts on vitamins, healthy food delivery, fitness resources, and more from the national health and wellness retailers F5
Affordable dental and vision plans available to complement your medical plan and support your whole health
Three Blue Cross NC Centers and six Authorized Agent Retail Stores located around the state, where you can get one-on-one assistance and take advantage of special classes offered at the Centers
A1. Blue Cross NC Provider Internal Data; percentages indicated represent Blue Cross NC's PPO Network as of July 22, 2022. Note: Not all plans are available in all areas.
B1. Blue Cross NC has collaborated with Novant Health to bring you Blue Home with Novant Health. Blue Home with Novant Health is a health insurance plan offered by Blue Cross NC that provides access to a limited network of providers. Novant Health is an independent company that is solely responsible for the physicians and medical facilities it owns and operates. Novant Health does not offer Blue Cross or Blue Shield products or services.
B2. NovantHealth, www.novanthealth.org/home/about-us/company-information.aspx (Accessed August 2022).
C1. Blue Cross NC has collaborated with Atrium Health to bring you Blue Local with Atrium Health. Blue Local with Atrium Health is a health insurance plan offered by Blue Cross NC that provides access to Atrium Health’s limited network of providers. Atrium Health is an independent company that is solely responsible for the physicians and medical facilities it owns/operates and does not offer Blue Cross or Blue Shield products or services.
C2. U.S. News & World Report, www.health.usnews.com/best-hospitals/area/nc/levine-childrens-hospital-PA6360280 (Accessed September 2022).
C3. AtriumHealth, www.atriumhealth.org/about-us/newsroom/news/2020/07/atrium-health-earns-multiple-honors-by-us-news-world-report (Accessed September 2022).
C4. AtriumHealth, www.atriumhealth.org/about-us (Accessed September 2022).
D1. Blue Cross NC has collaborated with Wake Forest Baptist Health to bring you Blue Local with Wake Forest Baptist Health. Blue Local with Wake Forest Baptist Health is a health insurance plan offered by Blue Cross NC that provides access to a limited network of providers. Wake Forest Baptist Health is an independent company that is solely responsible for the physicians and medical facilities it owns and operates. Wake Forest Baptist Health does not offer Blue Cross or Blue Shield products or services.
D2. WakeForestBaptistHealth, www.wakehealth.edu/-/media/WakeForest/Clinical/Files/About-Us/2019FactBook.pdf (Accessed September 2022).
E1. Blue Cross NC has collaborated with UNC Health Care to bring you Blue Home with UNC Health Alliance. Blue Home with UNC Health Alliance is a health insurance plan offered by Blue Cross NC that provides access to a limited network of providers. UNC Health Care is an independent company that is solely responsible for the physicians and medical facilities it owns and operates. UNC Health Care does not offer Blue Cross or Blue Shield products or services.
E2. UNC Health, www.unchealthcare.org/health-alliance/ (Accessed August 2022).
E3. U.S. News and World Report, www.health.usnews.com/best-hospitals/area/nc/university-of-north-carolina-hospitals-6360260 (Accessed September 2022).
E4. U.S. News and World Report, www.health.usnews.com/best-hospitals/area/nc/rex-healthcare-6361210 (Accessed September 2022).
F1. All information discussed in this brochure pertains to Blue Cross NC individual market, medical health insurance plans that are eligible for sale in 2022 and meet Affordable Care Act guidelines. The information contained does not apply to plans that are transitional, group, dental- only or other plan types. All details regarding plan benefits and design contained herein are for informational purposes only. Please see the product benefit booklet for all terms and conditions that apply.
F2. Telehealth benefits are available on all plans either from Blue Cross NC or through the provider network. Blue Cross NC provides the telehealth program for your convenience and is not liable in any way for the goods or services received. Blue Cross NC reserves the right to discontinue or change the program at any time without prior notice. Decisions regarding your care should be made with the advice of a doctor. Depending on your plan, selected programs may not be available to you at this time. Check with Blue Cross NC Customer Service to determine your eligibility. Blue Cross NC has contracted with a third-party vendor independent from Blue Cross NC to bring you telehealth benefits.
F3. Eligibility requirements apply. See benefit booklet for details.
F4. Blue Cross NC provides tobacco cessation and diabetes reversal programs for your convenience. Blue Cross NC is not liable in any way for the goods or services received through the respective vendors. Blue Cross NC reserves the right to discontinue or change the program at any time without prior notification. Decisions regarding your care should be made with the advice of your doctor. Check with Blue Cross NC Customer Service to determine your eligibility. Blue Cross NC has contracted with a third-party vendor independent from Blue Cross NC to bring you these offerings.
F5. Blue365 offers access to savings on items that members may purchase directly from independent vendors, which are different from items that are covered under the policies with your Blue Cross NC plan. Any disputes regarding these products and services may be subject to the Blue Cross NC grievance process. The Blue Cross and Blue Shield Association (BCBSA) may receive payments from Blue365 vendors. BCBSA does not recommend, endorse, warrant or guarantee any specific Blue365 vendor or item.
U9144b, 9/22