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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With this plan option from Blue Cross and Blue Shield of North Carolina (Blue Cross NC), you'll get care from Atrium Health, which includes:
- Atrium Health Carolinas Medical Center – named “Best Hospital” in the Charlotte metro region2
- Atrium Health Wake Forest Baptist, an academic health system3
- Two children’s hospitals: Levine Children’s Hospital (nationally ranked in 10 specialties)4 and Brenner Children’s Hospital
- Atrium Health Wake Forest Baptist Comprehensive Cancer Center – 1 of only 3 comprehensive cancer centers in North Carolina5
- 26 hospitals and more than 712 care locations in NC and SC6
Since most doctors in this plan are in the same health care system, it's easy for them to work together to help you stay healthy.
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 level7.
| Plans | Bronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | With Atrium Health | Bronze Standard | With Atrium Health | Bronze Complete | $60 PCP | $20 Tier 1 Rx | With Atrium Health8 | Bronze HSA Eligible9 | Integrated | With Atrium10, 11 |
|---|---|---|---|---|
| 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 / $10012 | $50 | $60 | Ded / 0% |
| Specialists and urgent care | $150 | $100 / $75 | $120 | Ded / 0% |
| Prescription drug deductible13 | Integrated14 | Integrated14 | $1,000 | Integrated14 |
| Prescription drug benefit | $2015 / 50% / 50% / 50% / 50% | $2515/ $50 / $100 / $500 | $2015/ $25 / $75 / $150 / 50% | 0% after deductible |
| Plans | Silver Access | 3 Free PCP | $15 Tier 1 Rx | With Atrium Health11 | Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | With Atrium Health | Silver Standard | With Atrium Health | Silver Choice | 3 Free PCP | $15 Tier 1 Rx | With Atrium Health8 |
|---|---|---|---|---|
| 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 / $2512 | 3 x $0 / $5512 | $40 | 3 x $0 / $4512 |
| Specialists and urgent care | $150 | $110 | $80 / $60 | $90 |
| Prescription drug deductible13 | $300 | Integrated14 | Integrated14 | $250 |
| Prescription drug benefit | $1515 / $25 / $60 / $120 / 50% | $1015 / 50% / 50% / 50% / 50% | $2015 / $4015 / $80 / $350 | $1515 / $30 / $40 / $80 / 50% |
| Plans | Gold Premier | 3 Free PCP | $10 Tier 1 Rx | With Atrium Health | Gold Standard | With Atrium Health |
|---|---|---|
| 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 / $1012 | $30 |
| Specialists and urgent care | $40 | $60 / $45 |
| Prescription drug deductible13 | $400 | $0 |
| Prescription drug benefit | $1015/ $25 / $40 / $80 / 50% | $1515 / $3015 / $6015 / $25015 |
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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