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Shop Plans Blue Home® with Cone Health Plan

Blue Home with Cone Health1 gives you to access care from Cone Health’s network of doctors.

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Plan highlights

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) offers Blue Home with Cone Health plans. This plan gives you access to:

  • One of the region’s largest and most comprehensive health care networks, with more than 150 locations, including five hospitals,
    six ambulatory care centers, three outpatient surgery centers, 11 urgent care centers, and more than 120 physician practices.2
  • Hospitals that have been recognized by U.S. News & World Report as “High Performing” in key areas of care, and a network that
    has been ranked as the top hospital system in the Greensboro/Winston-Salem metro area.2
Availability and coverage
Available in these NC counties

Blue Home with Cone Health is only available in certain North Carolina counties:

  • Guilford
  • Randolph
  • Rockingham
In-network and out-of-network coverage

  • All providers outside the Cone Health provider network, including out-of-state providers, are considered out-of-network (OON) and not covered for Blue Home with Cone Health
  • Some of these OON providers include: Atrium Health, Novant Health, and UNC Health along with any of their affiliated providers
  • Out-of-network coverage is not included, except for emergency and urgent care services which will be covered at the in-network benefit level3
Limitations and Exclusions Understanding metallic plan levels

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 level

Bronze plans typically pay 60% of covered medical costs on average, and you pay 40%.
Silver level

Silver plans usually pay 70% of covered medical costs on average, and you pay 30%.
Gold level

Gold plans generally pay 80% of covered medical costs on average, and you pay 20%.
Blue Home with Cone Health Bronze plan options
PlansBronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | with Cone HealthBronze Standard | with
Cone Health		Bronze HSA Eligible | Integrated | with Cone Health4 5
Individual deductible (family=2x)$7,000$7,500$8,500
Individual out-of-pocket limit (family=2x)$10,600$10,000$8,500
Coinsurance50%50%0%
Primary care provider (PCP)3 x $0 / $956$50Ded / 0%
Specialist / urgent care$175$100 / $75Ded / 0%
Prescription drug deductible7Integrated8Integrated8Integrated8
Prescription drug benefit$259 / 50% / 50% / 50% / 50%$259 / $50 / $100 / $5000% / 0% / 0% / 0% / 0%
Blue Home with Cone Health Silver plan options
PlansSilver Access A | 3 Free PCP | $15 Tier 1 Rx | with Cone Health5Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | with Cone HealthSilver Standard | with Cone Health
Individual deductible (family=2x)$1,400$2,800$6,000
Individual out-of-pocket limit (family=2x)$10,600$10,600 $8,900
Coinsurance50%50%40%
Primary care provider (PCP)3 x $0 / $2563 x $0 / $406$40
Specialist / urgent care$150$80$80 / $60
Prescription drug deductible7$300Integrated8Integrated8
Prescription drug benefit$159 / $25 / $60 / $120 / 50%$109 / 50% / 50% / 50% / 50%$209 / $409 / $80 / $350
Blue Home with Cone Health Gold plan options
PlansGold Premier A | 3 Free PCP | $10 Tier 1 Rx | with Cone HealthGold Standard A | with Cone Health
Individual deductible (family=2x)$1,800$2,000
Individual out-of-pocket limit (family=2x)$10,600$8,200
Coinsurance30%25%
Primary care provider (PCP)3 x $0 / $156$30
Specialist / urgent care $40$60 / $45
Prescription drug deductible7$400$0
Prescription drug benefit$109 / $25 / $35 / $75 / 50%$159 / $309 / $609 / $2509
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Disclosures:

Benefits and premium depend on plan selected.

This webpage contains information only. It is not your insurance policy. Your policy and application are your contract. If there is any difference between this webpage and the policy, the provisions of the policy will control.

  1. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has collaborated with Cone Health to bring you Blue Home with Cone Health. Blue Home with Cone Health is a health insurance plan offered by Blue Cross NC that provides access to a limited network of providers. Cone Health is an independent company that is solely responsible for the physicians and medical facilities it owns and operates. Cone Health does not offer Blue Cross or Blue Shield products or services. 

  2. About Cone Health. Cone Health.  (Accessed August 2025).

  3. Out-of-network benefit coverage for Blue Home with Cone Health is not available except for emergency services, urgent care, and for medically necessary covered services when an in-network provider is not reasonably available per access to care standards of Blue Cross NC. Out-of-network urgent care and emergency services are covered at the same cost share level as in-network urgent care and emergency services

  4. Members on a family HSA plan will have an individual deductible and a family total deductible. Any member of the family will only have to pay the individual amount to meet their deductible.

  5. This plan is available off Marketplace only.

  6. Primary care provider (PCP) step down benefits: 3 x $0 for PCP office visits, followed by standard PCP benefit (at the member level).

  7. Prescription drug deductible must be met before your plan begins to pay for prescriptions except when indicated otherwise.

  8. Prescription drug costs are subject to the medical deductible, coinsurance, and out-of-pocket (OOP) limit.

  9. Prescription drug costs are not subject to the deductible.

NGFEPO-I, 5/25; U48888, 10/25

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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