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Shop Plans Blue Local with Atrium Health Plan

Blue Local℠ with Atrium Health1 could be a good option if you want to get care from Atrium Health and its affiliated doctors and hospitals.

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Plan highlights

Blue Local with Atrium Health from Blue Cross and Blue Shield of North Carolina (Blue Cross NC) gives you access to:

  • Two children’s hospitals: Levine Children’s Hospital (nationally ranked in 10 specialties)2 and Brenner Children’s Hospital
  • Atrium Health Wake Forest Baptist Comprehensive Cancer Center – 1 of only 3 comprehensive cancer centers in North Carolina3
  • 20 hospitals and more than 712 care locations in NC and SC4
Availability and coverage info
Available in these NC counties

Blue Local with Atrium Health plans are available in these NC counties:

  • Anson
  • Cabarrus
  • Cleveland
  • Davidson
  • Davie
  • Forsyth
  • Gaston
  • Guilford
  • Lincoln
  • Mecklenburg
  • Randolph
  • Rowan
  • Stanly
  • Stokes
  • Union
  • Wilkes
  • Yadkin
In-network and out-of-network coverage

All providers outside the Atrium Health provider network, including out-of-state providers, are considered out-of-network and not covered with Blue Local with Atrium Health.

Some of these out-of-network providers include:

  • CaroMont Health
  • Cone Health
  • Novant Health
  • As well as 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 level.5
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 Local with Atrium Health Bronze plan options
PlansBronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | With Atrium HealthBronze Standard | With Atrium HealthBronze Complete | $60 PCP | $20 Tier 1 Rx | With Atrium Health6Bronze HSA Eligible | Integrated | With Atrium Health7, 8
Individual deductible (family = 2x)$7,000$7,500$4,000$8,500
Individual out-of-pocket limit (family = 2x)$10,600$10,000$10,600$8,500
Coinsurance50%50%50%0%
Primary care provider (PCP)3 x $0 / $959$50$60Ded / 0%
Specialist / urgent care$175$100 / $75$120Ded / 0%
Prescription drug deductible10Integrated11Integrated11$1,000Integrated11
Prescription drug benefit$2512 / 50% / 50% / 50% / 50%$2512 / $50 / $100 / $500$2012 / $25 / $75 / $150 / 50%0% after deductible
Blue Local with Atrium Health Silver plan options
PlansSilver Access A | 3 Free PCP | $15 Tier 1 Rx | With Atrium Health8Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | With Atrium HealthSilver Standard | With Atrium HealthSilver Choice A | 3 Free PCP | $15 Tier 1 Rx | With Atrium Health6
Individual deductible (family = 2x)$1,400$2,800$6,000$3,000
Individual out-of-pocket limit (family = 2x)$10,600$10,600$8,900$10,600
Coinsurance50%50%40%50%
Primary care provider (PCP)3 x $0 / $2593 x $0 / $409$403 x $0 / $459
Specialist / urgent care$150$80$80 / $60$90
Prescription drug deductible10$300Integrated11Integrated11$250
Prescription drug benefit$1512 / $25 / $60 / $120 / 50%$1012 / 50% / 50% / 50% / 50%$2012 / $4012 / $80 / $350$1512 / $30 / $40 / $80 / 50%
Blue Local with Atrium Health Gold plan options
PlansGold Premier A | 3 Free PCP | $10 Tier 1 Rx | With Atrium HealthGold Standard A | With Atrium 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 / $159$30
Specialist / urgent care$40$60 / $45
Prescription drug deductible10$400$0
Prescription drug benefit$1012 / $25 / $35 / $75 / 50%
$1512 / $3012 / $6012 / $25012
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Disclosures:

Benefits and premium depend on plan selected.

How to pick a health insurance plan: The health plan categories: Bronze, Silver, Gold & Platinum (healthcare.gov)

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 NC has collaborated with Atrium Health to bring you Blue Local with Atrium Health, a health insurance plan offered by Blue Cross NC that provides access to Atrium Health's comprehensive network of providers. Atrium Health is an independent company and is solely responsible for the physicians and medical facilities it owns/operates. Atrium Health does not offer Blue Cross or Blue Shield products or services.

  2. U.S. News & World Report, health.usnews.com/best-hospitals/area/nc/levine-childrens-hospital-PA6360280 (Accessed January 2025).

  3. Atrium Health Wake Forest Baptist, www.wakehealth.edu/locations/facilities/comprehensive-cancer-center (Accessed January 2025).

  4. Atrium Health, atriumhealth.org/locations (Accessed January 2025).

  5. Out-of-network benefit coverage 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.

  6. These plans are only available in the following counties: Cleveland, Gaston, Lincoln, and Wilkes.

  7. 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.

  8. This plan is available off Marketplace only.

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

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

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

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

NGFEPO-I, 5/25. U46972, 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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