Skip to main content

2023 Plan Management

Make the most of your benefits

Put the YES! plan to work for you.

YES! To more value by knowing your plan

When you know your plan, you know how to make the most of it. That includes getting the best care for the best cost and taking advantage of built-in benefits, programs and member-only discounts. Let’s get started by learning more about your Blue Cross and Blue Shield of North Carolina (Blue Cross NC) plan.

Your member ID card

Keeping your ID card with you at all times ensures that you have all your plan information on hand should you need it. You can also download a digital ID card on Blue Connect℠, your member website, or through the Blue Connect Mobile℠ app.

Key don’t-miss benefits

100% coverage for preventive care

Annual physicals and many other routine screenings and services are covered at no cost.

 

No-cost COVID-19 testing and vaccines

FDA-approved COVID-19 vaccines are available at no additional cost to all Blue Cross NC members. Most testing is also covered. To learn more about the COVID-19 virus and how coverage for testing is determined, visit our COVID-19 FAQ page.

3 free primary care provider (PCP) visits

Your first three in-network PCP visits are on us with select plans.

3 free behavioral health visits

Your first three in-network behavioral health or substance use visits are no additional cost with select plans. 

100% coverage for preventive prescriptions

No-cost preventive drugs for certain chronic conditions at in-network pharmacies for those with bronze HSA-eligible plans.

Prenatal and postpartum care

Healthy babies start with healthy parents. To help make sure you get the care you need, prenatal and postpartum care are included as part of your plan.

Pediatric dental care

Did you know that your Blue Cross NC medical plan includes dental coverage for dependents up to age 19? It covers a range of dental services including evaluations, cleanings, fillings, extractions, surgeries, crowns and more. It also covers orthodontic services if necessary, under certain conditions. 

Health insurance explained

Everyone has questions about health insurance. It can be a complicated topic. Understanding Health Insurance explains how your insurance works and answers many common questions.

Important terms

Your copayment is the amount you pay for medical services and prescriptions when you check out. Not all plans have copays.

Your deductible is the set amount you pay toward medical services and prescriptions before Blue Cross NC starts paying toward those services during your benefit period.

Your coinsurance is your share of medical costs and some prescriptions after you’ve met your deductible for your benefit period.

The maximum you will pay from your own funds for covered services in a benefit period. Once met, Blue Cross NC will pay 100% of your remaining covered services. Deductibles, copayments and coinsurance for covered medical and drug benefits apply to this limit. Premiums and non-covered services, as well as out-of-network charges beyond the allowed amount, do not apply.

An EOB shows how medical claims were processed by your plan. It includes the price of the service, how much your health plan paid, member savings and any amount you may owe. See How to Read Your EOB (PDF) for details.

Blue Connect logo

Connect to your plan online

The fastest, easiest way to access your health plan is through Blue Connect or the Blue Connect Mobile app. So, log in or sign up today. With Blue Connect, you can:

Make It Simple

Receive important plan information quickly and easily and be the first to know about wellness tools and resources. Opt-in to get text messages.

Receive electronic communications for less clutter and anywhere access to your plan-related documents.

Have one less thing to remember each month with AutoPay. Set up recurring automatic payments using a bank draft or credit card.

Lower Your Out-of-Pocket Costs

Staying in-network lowers your costs and allows doctors to provide you with coordinated care. Find in-network care and choose a PCP to get more coordinated care.

Costs for the same medical procedure can vary greatly depending on where you get care. With SmartShopper, you can:

  • Compare costs of 100+ common procedures – including mammograms, colonoscopies, MRIs and more
  • Receive care from a SmartShopper recommended, lower-cost provider
  • Get a cash reward up to $1,000!

Get SmartShopper options through the Find a Doctor tool on Blue Connect or by phone using the Personal Assistant Team (PAT) at 877-702-6661, Monday through Thursday 8 a.m. to 8 p.m., and Fridays 8 a.m. to 6 p.m. ET.

Already connected?

Take a moment to make sure your info is up to date.

Download the Blue Connect Mobile app to access your digital ID card.

YES! To personalized care with a primary care provider

It’s important to have a doctor you see regularly, and when they’re in-network, your out-of-pocket costs are lower. Think of your PCP as your medical “home.” Your PCP's job is to handle most of your medical needs, including routine tests and preventive care, which is 100% covered. To help you achieve the best health possible, they work together with any other doctors or specialists you see. That’s why the first thing you should do on Blue Connect is select a PCP. Don’t wait until you’re sick. Choose your doctor now, so you’re ready to go when the need arises.

Connect with your partner in health

Earn a $35 gift card when you get a wellness exam!

Here's how it works:1
  • Make an appointment with your in-network PCP for a wellness exam.
  • Have your annual wellness exam.
  • Ask for preventive care screenings and tests that are 100% covered by your plan.

Once we process the claim, we'll notify you by mail, email and/or text when you can go online to get your $35 gift card in the Blue Connect Activity Center.1 Please allow 4 to 6 weeks for your doctor to send us the wellness exam claim.

Get 3 free doctor visits!

Members with select plans can receive their first three PCP visits (in person, by video or on the phone) at no charge. You can also get your first three behavioral health or substance use doctor visits at no charge. Check your benefit booklet to see if you are eligible.

Can't get to the doctor?

Your plan covers virtual visits just like in-person visits. Most providers offer telehealth as an option for your convenience. So, if you can’t make it into the office, try a telehealth visit instead.

YES! To discounts and savings from Blue365, MedsYourWay and Amazon Pharmacy

Blue 365 logo
Meds your way logo
Amazon Pharmacy logo

Blue 365

Blue365 is your member-only discount program. When you sign up, you’ll have access to exclusive savings on all sorts of products and services to help you live a well-balanced life. New deals are available each week as well as regular everyday discounts.

Weekly deals

  • Apparel & footwear, Fitness, Healthy eating, Hearing & vision, Home & family, Personal care, Travel

Everyday discounts

  • 40% off hotels
  • Up to 35% off rental cars
  • 30% off select Skechers®
  • 20% off Fitbit® devices
  • 5% off travel insurance

MedsYourWay

Get the lowest price on your prescriptions the easy way with MedsYourWay. It automatically compares medicine prices from drug discount cards and your health plan benefit.2 By simply showing your Blue Cross NC member ID card at the pharmacy, you will pay the best price available on most medicines.

Let MedsYourWay find the best price for you

  • Available at most major pharmacies
  • Just show your Blue Cross NC member ID card
  • Over-the-counter drugs may also qualify for a discount

Use the Find a Drug tool on Blue Connect to see which of your medications are available for a discount.

Amazon Pharmacy

Home delivery – and savings up to 80%@3

Blue Cross NC now offers access to Amazon Pharmacy, which lets you easily order and quickly get non-specialty medicines delivered at home. Plus, MedsYourWay can save you up to 80% on generic and up to 37% on brand-name medicines. It’s seamlessly built right into the Amazon Pharmacy experience. No extra steps are needed to use it. With Amazon Pharmacy you get:

  • An Amazon shopping experience with free shipping
  • Easy, online sign up
  • Option for 90+ day fills
  • Pharmacists on call 24/7
  • Ability to manage your medicine and order history

YES! To better health with more programs, tools and resources

Dental Blue

Dental health is an important part of your overall health and impacts more than just your teeth. In fact, 100+ diseases can show symptoms in the mouth.4 Add dental coverage to your plan at any time.

Blue 20/20

Regular eye exams don't only address vision health. They can also reveal many underlying health concerns such as heart disease, diabetes and cancer before other symptoms arise.5 You can add vision coverage at any time.

Support to quit tobacco

Ready to leave tobacco behind? QuitlineNC can help you succeed with counseling and nicotine replacement therapy – and it won’t cost you a thing! Call 844-862-7848 to get started.

24/7 pregnancy support

We’re with you every step of the way with the free and confidential My Pregnancy app. This helpful app offers tools, resources and support from your first trimester through baby’s first years.

Nurse Support Program

If you are living with or have been recently diagnosed with a chronic condition (such as diabetes or heart disease), it might feel challenging to manage. Your doctor can provide a lot of helpful information, but sometimes it can be hard to remember what to do once you leave the doctor’s office, or between visits. This is where the Nurse Support Program can help.

The Nurse Support Program team includes:

  • Nurses
  • Dietitians
  • Diabetes educators
  • Pharmacists
  • Social workers

Get started:

Call the Nurse Support Program at 888-229-8510, or download the Wellframe® app to work with the team right from your smartphone:

  1. Download the app
  2. Open the app to sign up
  3. Your access code should autofill (if not, use this code ncdmablewell)

Disclosures:

  1. Members can earn a one-time reward for completing an in-person wellness visit by 12/15/2024. Note that in-network providers have up to 180 days from the date of service to file a claim with Blue Cross NC, which can affect how quickly you receive your reward.

  2. Drug discount card pricing is not insurance.

  3. Source: Patients can save up to 80% on brand and generic medications with an average of 50% savings on brand-name diabetes medicines. Actual savings will vary. Source: insiderx.com/help (Accessed December 2022).

  4. Source: heart.org/en/news/2022/08/11/health-conditions-a-dentist-might-find-that-have-nothing-to-do-with-your-teeth (Accessed December 2022).

  5. American Optometric Association. n.d. “See the Full Picture of Your Health with an Annual Comprehensive Eye Exam.“ www.aoa.org/healthy-eyes/caring-for-your-eyes/full-picture-of-eye-health. (Accessed December 2023.)

Your chance to earn Blue Rewards may be available for a limited time only. Please note that it may take time for activities to show as completed in the Blue Connect℠ Activity Center and for you to receive the certificate to redeem your gift card. All federal, state and local taxes on gift cards, if applicable, are the sole responsibility of the member. Members should consult their tax professional for any advice on whether or not gift cards are considered reportable income. Rally Health is an independent company that is solely responsible for the gift card services it is providing. Rally Health does not offer Blue Cross or Blue Shield products or services. Must be at least 18 years old to participate. Participation restrictions apply based on plan type, and rewardable activities are not available for all plan types. Visit the Activity Center on Blue Connect for activities currently available to you. Blue Cross NC reserves the right to change or discontinue Blue Rewards at any time, including changing dollar amounts and available rewards, without prior notification. Visit BlueCrossNC.com/BlueRewards for full program terms and conditions. Consult with your benefits administrator or contact Blue Cross NC Customer Service for questions or support.

Blue Cross NC offers several decision support tools, such as Find a Doctor and Find a Cost, to aid members in making decisions around their health care experience. These tools are offered for member convenience and should be used only as reference tools. Members should consult their own legal counsel, tax advisor or personal physician as applicable throughout their health care experience.

Message and data rates may apply for SMS texting. Read the SMS Terms and Conditions to learn more.

Blue Cross NC offers wellness programs as a convenience to aid members in improving their health; results are not guaranteed. Blue Cross NC may contract with independent third-party vendors for the provision of certain aspects of our wellness programs and is not liable in any way for goods or services received from them. These vendors do not offer Blue Cross or Blue Shield products or services. Blue Cross NC reserves the right to discontinue or change our wellness programs at any time. These programs are educational in nature. They are intended to help members make informed decisions about their health and comply with their doctor’s plan of care. Decisions regarding care should be made with the advice of a doctor.

Wellframe is an independent company solely responsible for the services it provides and does not offer Blue Cross or Blue Shield products or services. The purpose of the program is to assist you in maintaining and improving your health. The services and information provided by the Blue Cross and Blue Shield of North Carolina (Blue Cross NC) nurse advocates are intended as a resource and are not intended to provide medical advice. Results are not guaranteed. Before making any decisions regarding changes in your care or medications, be sure to consult your doctor.

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 Blue Shield Association (BCBSA) may receive payments from Blue365 vendors. BCBSA does not recommend, endorse, warrant or guarantee any specific Blue365 vendor or item. This program may be modified or discontinued at any time without prior notice.

MedsYourWay is a registered trademark of Prime Therpeutics®, LLC. (Prime), MedsYourWay is a prescription drug discount card, administered by Inside Rx® LLC. MedsYourWay-Retail product compares several discount card prices on a list of qualifying drugs to offer members the lowest available price for their medication. Drug lists are subject to change. MedsYourWay discount card pricing is built into the Amazon Pharmacy shopping experience. You are responsible for the cost of your prescription(s) when using the MedsYourWay card. Limitations apply. Amazon Pharmacy does not dispense controlled substances (Schedule 2 medications). Prime, Inside Rx and Amazon Pharmacy are independent companies that are solely responsible for the services they provide. Prime, Inside Rx and Amazon Pharmacy do not offer Blue Cross or Blue Shield products or services.

FitBit, QuitlineNC, Skechers and The Produce Box are independent companies that are solely responsible for the products and/or services they provide. They do not offer Blue Cross or Blue Shield products or services.

All other marks and trade names are the property of their respective owners.

U42178a, 2/23