Blue Advantage Health Plans from Blue Cross NC

in North Carolina
Blue Cross NC Authorized Agency
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Blue Advantage

Nationwide

Nationwide (BlueCard®)

Network
Anywhere in the U.S. and abroad; 95%+ of NC doctors
Out-of-area care
Covered (lower benefit level)
Best for
Frequent travelers, dual-state families, anyone wanting the most choice

Blue Advantage is a PPO health plan from Blue Cross and Blue Shield of North Carolina (Blue Cross NC) offering the company's largest nationwide network of doctors, specialists, and hospitals. More than 95% of North Carolina doctors and 98% of North Carolina hospitals are in-network, and coverage travels with you nationwide through the BlueCard® program, which is accepted in nearly 200 countries and territories worldwide.

Because it's a PPO, Blue Advantage gives you the fewest restrictions on which doctors you can see: no referrals to see a specialist, and out-of-network care is still covered (at a lower benefit level). It typically carries a higher premium than Blue Cross NC's in-state-only plans, so it's the plan we recommend when provider choice and nationwide access matter more than getting the lowest possible premium.

Highlights

  • PPO plan — see any provider, no referrals needed
  • 95%+ of NC doctors and 98% of NC hospitals in-network
  • Nationwide in-network access through BlueCard®
  • Out-of-network care is covered at a lower benefit level
  • Emergency care covered at the in-network rate worldwide
  • Available in all 100 NC counties
  • Offered in Bronze, Silver, and Gold tiers

A good fit if

Blue Advantage is built for people who want the fewest restrictions on which doctors they can see. It's a strong fit if you travel frequently for work or split time between two states, have an established specialist relationship you don't want to disrupt, want emergency care covered at the in-network rate anywhere in the world, or simply value provider choice over the lowest possible monthly premium.

Not a good fit if

It's a weaker fit if you rarely leave North Carolina and don't need nationwide access. In that case, Blue Care offers nearly identical in-state provider access at a lower premium, and one of the regional Blue Home plans may lower your premium even further if your doctors belong to a single health system.

Network type
Nationwide PPO
Out-of-network care
Covered at a lower benefit level
Out-of-state care
Covered nationwide

Network

Nationwide network – Nationwide (BlueCard®)

  • Network: Anywhere in the U.S. and abroad2; 95%+ of NC doctors.1

  • Out-of-area care: Covered (lower benefit level).

  • Offered in Bronze, Silver, and Gold tiers.

Notes

  1. Blue Cross NC Provider Internal Data; percentages indicated represent the Blue Cross NC PPO Network as of April 7, 2025.

  2. Covered in nearly 200 countries and territories worldwide through the Blue Cross and Blue Shield Association BlueCard program. www.geo-blue.com/ (Accessed March 2025). BlueCard coverage varies for each Blue Cross and Blue Shield plan. For more complete details, including benefits, limitations, and exclusions, please refer to your certificate of coverage.

Availability

Blue Advantage Availability Map

Blue Advantage is available on and off Marketplace in all North Carolina counties, except the following where it is available only off Marketplace: Alamance, Caswell, Chatham, Durham, Franklin, Johnston, Lee, Orange, Person, and Wake.

How Blue Advantage works

Blue Advantage is a PPO, which means you don't need a referral to see a specialist, and you're never limited to a single network — you're just paying more if you step outside it. If you see an in-network provider, you get the plan's full benefit level. If you see someone out-of-network, the plan still pays, just at a reduced benefit level, and you're responsible for the difference.

Because Blue Cross NC has more than 95% of North Carolina doctors and 98% of North Carolina hospitals in-network, most members rarely need to use that out-of-network benefit — but it's there if your situation calls for it.

Coverage that travels with you

Blue Advantage is the only Blue Cross NC individual plan built for people who leave the state. Through the BlueCard® program, your in-network benefits travel with you anywhere in the U.S. — so if you split time between two states, have kids away at college, or travel for work, you're not stuck finding a new plan or a new doctor.

Emergency care is covered at the in-network rate worldwide, including in nearly 200 countries and territories through BlueCard Worldwide®.

What it costs, and why

Blue Advantage typically carries a higher premium than Blue Cross NC's in-state-only plans like Blue Care or the regional Blue Home plans. That's the trade-off for the broadest network and out-of-network safety net Blue Cross NC offers. Like every Blue Cross NC ACA plan, it's available in Bronze, Silver, and Gold tiers, and most applicants qualify for a premium tax credit that lowers the monthly cost based on income and household size.

If nationwide access isn't something you need, it's worth comparing Blue Advantage against Blue Care or a Blue Home plan first — you may get nearly identical in-state coverage for meaningfully less.

Enrolling in Blue Advantage

You can enroll during the annual Open Enrollment Period (November 1 – January 15) or during a Special Enrollment Period if you've had a qualifying life event — a job change, a move, a new dependent, or losing other coverage.

A licensed Health Plans of NC agent can confirm your specific doctors are in-network, check what subsidy you qualify for, and compare Blue Advantage against the other six Blue Cross NC plans with you — at no cost. Call 800-797-0327.

Blue Advantage questions

Is Blue Advantage a PPO or an HMO?

Blue Advantage is a PPO (Preferred Provider Organization) plan. That means you can see out-of-network providers — you’ll just pay more — and you generally don’t need a referral to see a specialist. It’s the most flexible network Blue Cross NC offers.

Does Blue Advantage cover me if I travel out of state?

Yes. Blue Advantage includes nationwide in-network access through the BlueCard® program, and emergency care is always covered at the in-network benefit level no matter where you are — including in nearly 200 countries and territories worldwide.

Is Blue Advantage available in every NC county?

Yes, Blue Advantage is available in all 100 North Carolina counties. In 25 of them it’s available off-Marketplace only, meaning you’d enroll directly (through an agent or Blue Cross NC) rather than through HealthCare.gov. A Health Plans of NC agent can handle either path for you.

How is Blue Advantage different from Blue Care?

Both give you nearly the same broad in-state network (about 95% of NC doctors), but Blue Advantage is a PPO that adds nationwide out-of-network coverage, while Blue Care is an HMO limited to North Carolina with no out-of-network benefit except emergencies. Blue Advantage costs a bit more for that added flexibility.

Our recommendation: choose Blue Advantage if you travel, split time between states, or want maximum provider choice; choose Blue Care if you stay in NC and want to save on premium.

What do the Bronze, Silver, and Gold plan tiers mean?

Every Blue Cross NC individual plan comes in three “metal” tiers that describe how you and the plan split covered costs. Bronze plans have the lowest monthly premium but pay about 60% of covered costs, so you pay roughly 40% when you use care. Silver plans pay about 70% (you pay ~30%), and Gold plans pay about 80% (you pay ~20%) in exchange for a higher premium.

As a rule of thumb: Bronze suits people who rarely use care and want the lowest premium, Gold suits people who use regular or ongoing care, and Silver is the middle ground. Silver is also the only tier that unlocks Cost-Sharing Reductions (CSRs) — extra savings on deductibles and copays if your income qualifies — so many subsidy-eligible shoppers get the best overall value from a Silver plan. A licensed Health Plans of NC agent can run the numbers for your situation at no cost.

How do I know if my doctors and hospitals are in-network?

The most important step before choosing any plan is confirming your doctors, specialists, and preferred hospitals are in that plan’s network. Networks differ a lot between Blue Cross NC plans — a doctor who is in-network on one plan may be out-of-network, and far more expensive, on another.

You can check each plan’s provider directory on bcbsnc.com, or — the easier route — call a Health Plans of NC agent at 800-797-0327 and we’ll verify your specific providers before you enroll, at no charge.

Will I qualify for financial help to lower my premium?

Most North Carolinians who buy their own coverage qualify for a premium tax credit — a subsidy based on your income and household size that lowers what you pay each month. Subsidy amounts and eligibility rules can change from year to year, so the only way to know your real price is to run a personalized quote.

Health Plans of NC can check your subsidy eligibility and show you the after-subsidy premium for any of these plans for free. Call 800-797-0327 or request a quote online.

When can I enroll in a Blue Cross NC individual plan?

You can enroll during the annual Open Enrollment Period, which runs each fall (generally starting November 1) for coverage that begins the following year. Outside that window, you can still enroll if you have a qualifying life event — such as losing other coverage, moving, marriage, or having a baby — which opens a 60-day Special Enrollment Period.

Because enrollment dates and rules can change, it’s worth confirming the current deadline. A Health Plans of NC agent can tell you whether you’re eligible to enroll right now — call 800-797-0327.

How much does it cost to use a Health Plans of NC agent?

Nothing. Health Plans of North Carolina is an independent, authorized agency licensed to sell Blue Cross NC plans, and our help — comparing plans, checking your doctors, estimating subsidies, and enrolling — is completely free to you. Agents are paid by the insurance company, and the plan price is the same whether you enroll with us or on your own.

Call 800-797-0327 to talk with a licensed local agent.

See what Blue Advantage costs for you

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