Blue Value℠ offers a limited statewide network within North Carolina. It might be good fit if you are flexible about which providers you see.
With our Blue Value plan options from Blue Cross and Blue Shield of North Carolina (Blue Cross NC), you get:
- A limited network of hospital systems and doctors
- Lower monthly premiums compared to other plans
Blue Value plans are only available in certain North Carolina counties:
- Alexander
- Brunswick
- Burke
- Caldwell
- Catawba
- Cleveland
- Columbus
- Duplin
- Gaston
- Iredell
- Lincoln
- New Hanover
- Onslow
- Pender
- Surry
The Blue Value network includes, but is not limited to, the following providers:
- Atrium Health Wake Forest Baptist
- CaroMont Health
- Duke LifePoint Healthcare
- Novant Health
- UNC Health Alliance
The following providers are considered out-of-network for Blue Value:
- Atrium Health (not including Atrium Health Wake Forest Baptist)
- Duke Health (not including Duke LifePoint Healthcare)
- WakeMed
Outside of NC, emergency services and urgent care will be covered at the in-network benefit level. All other non-emergency covered services will be covered at the out-of-network benefit level.
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 | Limited Statewide Doctors | Bronze Standard | Limited Statewide Doctors | Bronze Complete | $60 PCP | $20 Tier 1 Rx | Limited Statewide Doctors | Bronze HSA Eligible1 | Integrated | Limited Statewide Doctors2, 3 |
|---|---|---|---|---|
| Individual deductible (family = 2x)4 | $7,000 | $7,500 | $4,000 | $8,300 |
| Individual out-of pocket limit (family = 2x)4 | $9,200 | $9,200 | $9,200 | $8,300 |
| Coinsurance5 | 50% | 50% | 50% | 0% |
| Primary care provider (PCP) 6 | 3 x $0 / $1007 | $50 | $60 | Ded / 0% |
| Specialists6and urgent care | $150 | $100 / $75 | $120 | Ded / 0% |
| Prescription drug deductible8 | Integrated9 | Integrated9 | $1,000 | Integrated9 |
| Prescription drug benefit | $2010 / 50% / 50% / 50% / 50% | $2510 / $50 / $100 / $500 | $2010/ $25 / $75 / $150 / 50% | 0% after deductible |
| Plans | Silver Access | 3 Free PCP | $15 Tier 1 Rx | Limited Statewide Doctors3 | 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)4 | $1,400 | $1,575 | $5,000 | $3,000 |
| Individual out-of-pocket limit (family = 2x)4 | $9,200 | $9,200 | $8,000 | $9,200 |
| Coinsurance5 | 50% | 50% | 40% | 50% |
| Primary care provider (PCP)6 | 3 x $0 / $257 | 3 x $0 / $557 | $40 | 3 x $0 / $457 |
| Specialists6 and urgent care | $150 | $110 | $80 / $60 | $90 |
| Prescription drug deductible8 | $300 | Integrated9 | Integrated9 | $250 |
| Prescription drug benefit | $159 / $25 / $60 / $120 / 50% | $1010 / 50% / 50% / 50% / 50% | $2010 / $4010 / $80 / $350 | $1510 / $30 / $40 / $80 / 50% |
| Plans | Gold Premier | 3 Free PCP | $10 Tier 1 Rx | Limited Statewide Doctors | Gold Standard | Limited Statewide Doctors |
|---|---|---|
| Individual deductible (family = 2x)4 | $1,800 | $1,500 |
| Individual out-of-pocket limit (family = 2x)4 | $9,100 | $7,800 |
| Coinsurance5 | 30% | 25% |
| Primary care provider (PCP)6 | 3 x $0 / $107 | $30 |
| Specialists6 and urgent care | $40 | $60 / $45 |
| Prescription drug deductible8 | $400 | $0 |
| Prescription drug benefit | $1010 / $25 / $40 / $80 / 50% | $1510 / $3010 / $6010 / $25010 |
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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