Health Plans of NC

Blue Cross NC Authorized Agency

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Blue AdvantageBlue LocalBlue ValueBlue Select
Blue Advantage
More than 95% of doctors and 98% of the hospitals in North Carolina are in-network1

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 in all North Carolina counties except: Alamance, Anson, Cabarrus, Caswell, Chatham, Cleveland, Durham, Franklin, Gaston, Johnston, Lee, Lincoln, Mecklenburg, Orange, Person, Rowan, Stanly, Union, and Wake.

Blue Local
Atrium Health’s smaller, local network of hospitals and providers

Blue Local with Atrium Health (formerly Carolinas HealthCare System) is a good option if you wish to get care from Atrium Health (and its affiliated doctors and hospitals). Since the majority of the doctors in this plan are in the same health care system, it’s easier for them to work together on your behalf. Just make sure any doctors and hospitals you currently use, or wish to see, are in the Blue Local with Atrium Health network.

  • Atrium Health’s smaller, local network of hospitals and providers
  • A provider network that includes Atrium Health‘s Levine Children’s Hospital that’s nationally ranked in six specialties,2 the region’s only level 1 trauma center and more than 200 primary care and urgent care locations3
  • A network that does not include Novant Health or CaroMont Health
Availability

Blue Local with Atrium Health is available to residents of these metro-Charlotte area counties: Anson, Cabarrus, Cleveland, Gaston, Lincoln, Mecklenburg, Rowan, Stanly, and Union

Blue Value
A limited statewide network for savings

UNC Health Alliance is our Blue Value partner in the Triangle area. Blue Value is a good fit if you want lower monthly premiums and 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.

  • A limited statewide network for savings
  • In the Triangle area, our preferred Blue Value partner is UNC Health Alliance, which includes hospitals throughout the state such as Rex (Duke Health and WakeMed are out-of-network)
  • In the Charlotte/Gastonia area, our preferred Blue Value partners are Novant Health and CaroMont Health (Atrium Health is out-of-network)
Availability

Blue Value is available to residents of these North Carolina counties: Alamance, Alexander, Anson, Brunswick, Burke, Cabarrus, Caldwell, Caswell, Catawba, Chatham, Cleveland, Columbus, Davidson, Davie, Duplin, Durham, Forsyth, Franklin, Gaston, Iredell, Johnston, Lee, Lincoln, Mecklenburg, New Hanover, Onslow, Orange, Pender, Person, Rowan, Stanly, Stokes, Surry, Union, Wake, and Yadkin

Blue Select
Two tiers of benefits. Preferred Care (Tier 1) offers the savings that make this plan a lower-cost option than Blue Advantage.

Choose Blue Select if you want savings along with access to our largest network of doctors, specialists and hospitals. This plan offers two tiers of in-network benefits. You may choose from either tier, but for the highest quality and the most savings, choose from Preferred Care (Tier 1).

  • Two tiers of benefits. Preferred Care (Tier 1) offers the savings that make this plan a lower-cost option than Blue Advantage. How tiers work
  • Preferred Care (Tier 1) doctors and hospitals have received our top ratings for quality outcomes, cost-efficiency and accessibility.
  • Standard Care (Tier 2) doctors and hospitals meet our standards for quality outcomes, cost-efficiency and/or accessibility.
  • In-network providers located outside the state are Preferred Care (Tier 1) through the BlueCard® program.
  • Doctors and hospitals that are not Preferred Care (Tier 1) or Standard Care (Tier 2) will be covered as out-of-network.
  • The following network providers are designated as either Preferred Care (Tier 1) or Standard Care (Tier 2): hospital facilities, gastroenterology, cardiology, general surgery, obstetrics/gynecology, orthopedic surgery, neurology and endocrinology. All other providers are designated as Preferred Care (Tier 1).
Availability

Blue Select is available in all North Carolina counties except: Alamance, Anson, Cabarrus, Caswell, Chatham, Cleveland, Durham, Franklin, Gaston, Johnston, Lee, Lincoln, Mecklenburg, Orange, Person, Rowan, Stanly, Union, and Wake

Blue Cross and Blue Shield of North Carolina Plans Offer Key Benefits4

The benefits that are important for getting and staying healthy are at the core of all of our plans. We offer a wide range of options to help you find what fits your needs. It’s what makes Blue Cross and Blue Shield of North Carolina (Blue Cross NC) the right choice for you.

  • No waiting period for pre-existing conditions – All Blue Cross NC health benefit plans are available with no pre-existing condition(s) waiting periods.5

  • Preventive care benefits – For all Blue Cross NC individual plans mentioned in this brochure, preventive services are covered at no charge when you go to an in-network doctor.6 These covered services include annual exams, screenings for diabetes, mammograms and more. See bluecrossnc.com/preventive for a full list of preventive care services.

  • Essential health benefits – All Blue Cross NC plans mentioned in this brochure provide coverage for essential health benefits. These services include:

    • Preventive care
    • Professional services
    • Hospital services
    • Outpatient services
    • Urgent and emergency services
    • Maternity services
    • Mental health/chemical dependency services
    • Pediatric dental and pediatric vision care
  1. Blue Cross NC Provider Internal Data; Percentages indicated represent Blue Cross NC’s PPO Network as of May 11, 2018. Note: Not all plans are available in all areas.

  2. U.S. News & World Report, http://health.usnews.com/best-hospitals/area/nc/levine-childrens-hospital-PA6360280 (Accessed September 2017).

  3. Atrium Health, https://atriumhealth.org/locations/carolinas-medical-center (Accessed September 2018).

  4. All information discussed in this brochure pertains to Blue Cross NC individual-market, medical health insurance plans that are eligible for sale in 2019 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.

  5. Eligibility requirements apply. See benefit booklet for details.

  6. Preventive care services as defined by recent federal regulations are covered at no charge to you. For Blue Advantage, Blue Select and Blue Value and Blue Local: Coverage for certain preventive care services (such as routine physical exams, well-baby and well-child care and immunizations) is limited to in-network benefits only. However, state-mandated preventive services are available out-of-network, for which members will pay deductible and coinsurance, plus charges over the allowed amount. Visit BlueCrossNC.com/Preventive for more details.

NOTICE: Deductibles, coinsurance, limitations and exclusions may apply to coverage. Further costs and details of coverage, limitations and exclusions, and terms under which the policy can be continued in force will be provided in your free information package.

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