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.
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Plan highlights
Blue Home with UNC Health Alliance from Blue Cross and Blue Shield of North Carolina (Blue Cross NC) gives you access to:
- UNC Health’s network of hospitals and providers, including more than 1,800 primary care providers2
- UNC Medical Center, which is nationally ranked in 1 adult and 9 pediatric specialties by U.S. News & World Report3
- UNC Rex Hospital, rated by U.S. News & World Report as high performing in 16 adult procedures and conditions
Available in these NC counties
Blue Home with UNC Health Alliance plans are only available in certain North Carolina counties4, including:
- Alamance
- Caswell
- Chatham
- Durham
- Franklin
- Johnston
- Lee
- Nash
- Orange
- Person
- Wake
In-network and out-of-network coverage
All providers outside the UNC Health Alliance provider network, including out-of-state providers, are considered out-of-network and not covered with Blue Home with UNC Health Alliance.
Some of these out-of-network providers include: Cone Health, Duke Health, WakeMed.
Out-of-network coverage is not included, except for emergency and urgent care services which will be covered at the in-network benefit level.
| Plans | Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | With UNC Health Alliance | Bronze Standard | With UNC Health Alliance | Bronze Complete | $60 PCP | $20 Tier 1 Rx | With UNC Health Alliance | Bronze HSA Eligible5 | Integrated | With UNC Health Alliance6, 7 |
|---|---|---|---|---|
| Individual deductible (family = 2x) | $7,000 | $7,500 | $4,000 | $8,300 |
| Individual out-of-pocket limit (family = 2x) | $9,200 | $9,200 | $9,200 | $8,300 |
| Coinsurance | 50% | 50% | 50% | 0% |
| Primary care provider (PCP) | 3 x $0 / $1008 | $50 | $60 | Ded / 0% |
| Specialists and urgent care | $150 | $100 / $75 | $120 | Ded / 0% |
| Prescription drug deductible9 | Integrated10 | Integrated10 | $1,000 | Integrated10 |
| Prescription drug benefit | $2011 / 50% / 50% / 50% / 50% | $2511 / $50 / $100 / $500 | $2011 / $25 / $75 / $150 / 50% | 0% after deductible |
| Plans | Silver Access | 3 Free PCP | $15 Tier 1 Rx | With UNC Health Alliance7 | Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | With UNC Health Alliance | Silver Standard | With UNC Health Alliance | Silver Choice | 3 Free PCP | $15 Tier 1 Rx | With UNC Health Alliance |
|---|---|---|---|---|
| Individual deductible (family = 2x) | $1,400 | $1,575 | $5,000 | $3,000 |
| Individual out-of-pocket limit (family = 2x) | $9,200 | $9,200 | $8,000 | $9,200 |
| Coinsurance | 50% | 50% | 40% | 50% |
| Primary care provider (PCP) | 3 x $0 / $258 | 3 x $0 / $558 | $40 | 3 x $0 / $458 |
| Specialists and urgent care | $150 | $110 | $80 / $60 | $90 |
| Prescription drug deductible9 | $300 | Integrated10 | Integrated10 | $250 |
| Prescription drug benefit | $1511 / $25 / $60 / $120 / 50% | $1011 / 50% / 50% / 50% / 50% | $2011 / $4011 / $80 / $350 | $1511 / $30 / $40 / $80 / 50% |
| Plans | Gold Premier | 3 Free PCP | $10 Tier 1 Rx | With UNC Health Alliance | Gold Standard | With UNC Health Alliance |
|---|---|---|
| Individual deductible (family = 2x) | $1,800 | $1,500 |
| Individual out-of-pocket limit (family = 2x) | $9,100 | $7,800 |
| Coinsurance | 30% | 25% |
| Primary care provider (PCP) | 3 x $0 / $108 | $30 |
| Specialists and urgent care | $40 | $60 / $45 |
| Prescription drug deductible9 | $400 | $0 |
| Prescription drug benefit | $1011 / $25 / $40 / $80 / 50% | $1511 / $3011 / $6011 / $25011 |
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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