Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is offering an All Copay Plan Design within our existing Blue Options^® and BlueHPN^® networks for the small group ACA segment effective January 1, 2024.

The plan design is simple and easy to understand. It eliminates the complexities of deductible and coinsurance cost share mechanisms. With an All Copay plan design, a member will always know their liability amounts for in-network (INN) service before the service is rendered. 

The All Copay Plan offers INN coverage for:  

• Preventive care / screenings / immunizations, including hospice care  
• Primary care and labs 
• Specialist and urgent care 
• Imaging services 
• Outpatient facility 
• Inpatient facility 
• Emergency room services 
• Pharmacy 

The Blue Cross NC All Copay medical plan is paired with a different pharmacy design with copays for each tier.  

All Copay Plans 

The intent of the All Copay plan design is to charge a single copay for any given encounter that includes multiple services or a bundled procedure. Members will have no deductible or coinsurance for services rendered INN. Members who seek out-of-network care (OON) will be subjected to a deductible and coinsurance for certain services. 

Member ID Cards 

Members will continue to be issued ID cards as with any plan type or product. There will not be cards created specifically referencing this plan design type. Cost share information will show copays only for INN and deductible and coinsurance for OON visits.  

Claims 

Nothing will change regarding submitting claims. The process will remain in the current standing. 

More Information 

Additional info can be found on The Blue Book Supplement (PDF). 

If you have any additional questions, please call the Provider Blue Line^℠ at 800-214-4844.