Our Blue Advantage® plans for individuals and families give you access to our largest nationwide network of doctors, specialists, and hospitals.
With our Blue Advantage plan options from Blue Cross and Blue Shield of North Carolina (Blue Cross NC), you can get:
- More in-network providers in North Carolina, with over 92% of doctors and 97% of hospitals in-network1
- Fewer restrictions on which providers you can see
- Nationwide access to in-network providers through BlueCard®2
- Emergency services covered at the in-network benefit level regardless of where you go for care
Blue Advantage plans are available in most North Carolina counties.3 Use our plan finder tool to see if Blue Advantage plans are available in your area.
Blue Cross NC offers health plans in 3 metallic levels. The Affordable Care Act (ACA) created metallic levels to help show the value of coverage within different plan offerings and give you a way to compare them.
Bronze plans typically pay 60% of covered medical costs on average, and you pay 40%.
Silver plans usually pay 70% of covered medical costs on average, and you pay 30%.
Gold plans generally pay 80% of covered medical costs on average, and you pay 20%.
| Plans | Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | Nationwide doctors | Bronze Standard | Nationwide doctors | Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide doctors | Bronze HSA Eligible4 | Integrated | Nationwide Doctors5, 6 |
|---|---|---|---|---|
| Individual deductible (family = 2x)7 | $7,000 | $7,500 | $4,000 | $8,300 |
| Individual out-of-pocket limit (family = 2x)7 | $9,200 | $9,200 | $9,200 | $8,300 |
| Coinsurance8 | 50% | 50% | 50% | 0% |
| Primary care provider (PCP)9 | 3 x $0 / $10010 | $50 | $60 | Ded / 0% |
| Specialists9and urgent care11 | $150 | $100 / $75 | $120 | Ded / 0% |
| Prescription drug deductible12 | Integrated13 | Integrated13 | $1,000 | Integrated13 |
| Prescription drug benefit | $2014/ 50% / 50% / 50% / 50% | $2514/ $50 / $100 / $500 | $2014/ $25 / $75 / $150 / 50% | 0% after deductible |
| Plans | Silver Access | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors6 | Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors | Silver Standard | Nationwide Doctors | Silver Choice | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors |
|---|---|---|---|---|
| Individual deductible (family = 2x)7 | $1,400 | $1,575 | $5,000 | $3,000 |
| Individual out-of-pocket limit (family = 2x)7 | $9,200 | $9,200 | $8,000 | $9,200 |
| Coinsurance8 | 50% | 50% | 40% | 50% |
| Primary care provider (PCP)9 | 3 x $0 / $2510 | 3 x $0 / $5510 | $40 | 3 x $0 / $4510 |
| Specialists9and urgent care11 | $150 | $110 | $80 / $60 | $90 |
| Prescription drug deductible12 | $300 | Integrated13 | Integrated13 | $250 |
| Prescription drug benefit | $1514 / $25 / $60 / $120 / 50% | $1014/ 50% / 50% / 50% / 50% | $2014/ $4014/ $80 / $350 | $1514/ $30 / $40 / $80 / 50% |
| Plans | Gold Premier | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors | Gold Standard | Nationwide Doctors |
|---|---|---|
| Individual deductible (family = 2x)7 | $1,800 | $1,500 |
| Individual out-of-pocket limit (family = 2x)7 | $9,100 | $7,800 |
| Coinsurance8 | 30% | 25% |
| Primary care provider (PCP)9 | 3 x $0 / $1010 | $40 |
| Specialists9 and urgent care11 | $40 | $60 / $45 |
| Prescription drug deductible12 | $400 | $0 |
| Prescription drug benefit | $1014 / $25 / $40 / $80 / 50% | $1514 / $3014 / $60 / $250 |
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
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