- General benefits information
- Claims status
- Explanation of Benefits (EOB) letters, which summarize your benefits applied to your claims after you have been to the doctor or hospital
- Current deductible balance
- Out-of-pocket estimates for medical services and doctors
- Temporary member ID card, if you need one
- Contact information for BCBSNC
- Access to the home-delivery pharmacy service, PrimeMail
- Nearby doctors and specialists
- Information about health and wellness programs
- Routine Changes - Things like changing your method of payment, updating your contact information and changing your address (unless it's a change in your zip code). These changes can be made at any time.
- Qualifying Life Event Changes - Things like adding a dependent, moving to a new state and getting married. These changes can be made only in certain situations. (For more information on Qualifying Life Events, refer to your benefits booklet.)
- If you purchased your plan through healthcare.gov, call the Health Insurance Marketplace at 1-800-318-2596.
- If you purchased your plan through BCBSNC or one of our agents, visit Blue Connect. Or call the number on the back of your member ID card.
The annual enrollment period is the time when you can make changes to your policy or enroll in different coverage. You can make changes to your plan for 2016 from Oct. 15, 2015 to Dec. 7, 2015. You can also make changes to your policy at other times during the year if you have a Qualifying Life Event, such as adding a dependent, moving to a new state or getting married. (For more information on Qualifying Life Events, refer to your benefits booklet.)
You do not have re-enroll in your plan each year. If you don't make any changes during the annual open enrollment period and you are still eligible for coverage, your plan will renew automatically.
- Online by credit or debit card. To choose this option, log in to Blue Connect and click on Billing.
- Bank drafts through automatic withdrawal. To schedule automatic payments, log in to Blue Connect and click on Billing.
- Mail by sending a personal check, money order or certified check.
- Phone by providing your checking or savings account information.
- In person by visiting our customer service center in Durham or at a local BCBSNC store.
Your monthly premium will not change during the year unless you make adjustments to your policy. (Adjustments can be made only as a result of a Qualifying Life Event, such as adding or removing a dependent.) Any changes you make to your policy will be reflected the following month.
- If you purchased your plan from BCBSNC, log in to Blue Connect or call the number on the back of your member ID card within 30 days of the date the policy was terminated.
- If you purchased your plan on healthcare.gov, call the Health Insurance Marketplace at 1-800-318-2596 for reinstatement options.
- Annual Enrollment Period - An established period of time during the calendar year in which you can purchase a health insurance plan. While there are a few exceptions to this rule - such as losing a job, getting married or moving to a new state - if you don't buy your health insurance during the Annual Enrollment Period, you will have to wait until the next year.
- Benefit period - The specified period of time during which charges for covered services provided to a policy member must be incurred in order to be eligible for payment.
- Coinsurance - Your share of the costs of covered services, after you've met your deductible. (Your deductible is the amount you must pay before your insurance begins to pay.) Coinsurance is usually stated as a percentage of the allowed amount. For example, if BCBSNC lists coinsurance at 20 percent of covered medical expenses after you've met your deductible, then BCBSNC pays 80 percent of covered services and you pay 20 percent until you reach your out-of-pocket limit.
- Copayment - A fixed dollar amount you may pay for a doctor's visit or health care services. Copayments can vary depending on the service.
- Deductible - The amount you owe for certain covered services during a benefit period before your health insurance begins to pay.
Explanation of Benefits (EOB) - After you visit a doctor, hospital or other health care provider, you may receive an EOB. This document provides a summary of your benefits applied to your claims. For more information, visit
Be sure to compare your EOB with the bills you receive from your doctor or health care facility. If something doesn't look right to you, contact the health care provider who filed the claim or BCBSNC customer service to discuss the claim in question.
- Generic drug - A non-brand name drug that has the same active ingredient, strength and dosage form and which is determined by the FDA to be therapeutically equivalent to the brand-name drug specified in your prescription.
- In-network provider - A provider that has been designated as a participating or contracted provider by BCBSNC for the member's specific health insurance product. Using an in-network provider is less expensive than using an out-of-network provider.
- Network - A group of physicians, hospitals and other health care providers working with a health care plan to offer care at negotiated rates and at other agreed upon terms.
- Out-of-network provider - A provider that has not been designated as a participating or contracted provider by BCBSNC for your specific health insurance plan. Using an out-of-network provider is more expensive than using an in-network provider.
- Out-of-pocket limit - The maximum you will pay from your own funds for covered services in a benefit period. Once you have met this amount, BCBSNC will pay 100% of your remaining covered services. Deductibles, copayments and coinsurance for covered medical and drug benefits apply to this limit. Premiums and non-covered services as well as out-of-network charges beyond the allowed amount do not apply to the out-of-pocket limit.
- Premium - The amount paid, typically on a monthly basis, to keep an insurance policy active.
- Prescription - A written order or refill notice issued by a licensed medical professional for drugs that are available only through a pharmacy.
- Preventive care - Medical services related to the prevention of disease, provided by or upon the direction of a doctor or other provider. Visit Staying Health for more information.
- Primary care physician - A doctor selected by the enrollee to be the first physician contacted for any medical problem. The doctor acts as the patient's regular physician and coordinates any other care the patient needs, such as a visit to a specialist or hospitalization.
- Qualifying Life Event - A change in your life that can make you eligible to enroll or change your health coverage outside of the standard annual enrollment period. Examples include a change in family size, a move to a new state or a change in income.
- Specialist - A provider whose practice is limited to treating a specific disease (e.g., oncology), specific parts of the body (e.g., ear, nose and throat), or specific procedures (e.g., oral surgery).
Where can I access my insurance information?
How can I make changes to my BCBSNC account?
Click here for an infographic that explains common terms you should know related to your coverage.
Common Terms You Should Know
When can I make changes to my plan?
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When are my monthly BCBSNC health insurance premiums due?
Will my monthly payment always be the same?
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