Health Plans for Individuals and Families

Shopping for health insurance invites a lot of questions:

  • How much will it cost?
  • Can I still see my doctor?
  • What benefits does it include?
  • Are my prescription drugs covered?

We can help you answer those questions and help you find a health insurance plan that suits you best.


Are you looking for a Dental, Medicare or Business plan?

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Benefits of Buying a BCBSNC Plan


Here's what you get with a BCBSNC health plan:


All fully insured health plans are ACA (Affordable Care Act) compliant


Plans with coverage statewide, across the country and around the world1


100% preventive care coverage2


Health and wellness programs like our free 24/7 nurse health support line


Online tools to find doctors and compare health care costs


Voted one of the world's most ethical companies3

How to Shop for a Health Plan


When you're shopping for a health plan, there are four things to think about:





Network



The larger the network, the more doctors and drugstores there are in that network. Larger networks tend to have fewer limits when you need to find a doctor or prescription drugs. But, it also means the health plan may cost more.

Keep in mind that even though we offer out-of-network coverage too, you'll save the most money when you see a doctor or visit a pharmacy in your plan's network.

If you have a doctor you'd like to keep seeing, you can use our Find a Doctor search tool to be sure your doctor is in that network. You can also look up the cost of a medication with our Find a Drug tool.

Please enter your zip code and county to view networks available for your area:


Copayments, Deductibles and Coinsurance


Health plans are available with a couple of payment combinations and options. The type you choose determines how much you'll pay for care when you go to the doctor, pharmacy or hospital.

Copayments

A copayment is a fixed dollar amount you pay for a covered service at the time you receive it.

For example, you may have a plan that charges a $20 copay for a regular doctor visit. All you'll need to pay is your $20 copay. Plans with copays tend to be more expensive. But, you'll know the cost of the visit before you go.

Deductibles

A deductible is the amount you owe for covered health care before your health insurance company starts to pay.

For example, let's say you have a $3,000 deductible and you've paid $2,000 toward it. You just had an MRI that costs $1,500. You'll have to pay $1000 to reach your deductible. After that, you'll only pay part of the remaining $500 based on your coinsurance percentage.

Coinsurance

Coinsurance is your share of costs for health care expenses based on a percentage of those costs.

After you've met your deductible, you may be charged coinsurance for health care services. The cost of the service will be split between you and your insurance company.

So, if you get a $100 bill for a chest X-ray and you have a 30% coinsurance amount, you'll need to pay $30 and your insurance company will pay the rest.

Metallic Levels


As you shop, you'll notice all of our plans are available in three metallic levels: bronze, silver, and gold. As part of the ACA health care reform, these levels were created to show the value of coverage within a plan.

The levels vary by how much of your medical costs a plan will pay on average. This can help you compare plans with various deductibles, copayments and coinsurance.

metallic level bronze
Bronze plans pay 60% of medical costs on average.5, 6

Good for people who typically don't need a lot of medical care and want lower premium payments.
metallic level silver
Silver plans pay 70% of medical costs on average.5, 6

Good for people who are relatively healthy and want to balance monthly premium payments with out-of-pocket expenses.
metallic level gold
Gold plans pay 80% of medical costs on average.5, 6

Good for people who go to the doctor or receive medical care regularly and are okay with a higher monthly premium to have more health care costs covered.

Subsidies



To help make health plans more affordable, the federal government offers subsidies and cost sharing reductions for plans purchased on the Health Insurance Marketplace. A subsidy (financial aid) from the federal government is available to help low and middle-income Americans with their health insurance premiums. The amount of the subsidy is based on you/your family's earnings and household size4.

These subsidies can help you afford a health plan that you may have considered outside of your budget.

Start shopping to see if you qualify for a subsidy.

86%

86% of those who enrolled in a health plan on the Health Insurance Marketplace qualified for subsidies in 20157.

Health & Wellness


As a member, you'll have access to an array of benefits and programs designed to make it easy to stay fit and healthy.

Health Line BlueSM


Health Line BlueSM connects you to a trained nurse, 24/7, to get your healthcare questions answered





Blue365®


Blue365 has great deals on fitness gear, personal care, gym memberships, family activities, vision and hearing products9




Healthy Outcomes


Healthy OutcomesSM wellness program10 and fully integrated case management, condition care





Coaching


Assistance with health issues with one-on-one coaching








Catastrophic Health Plans


Are you under 30 or qualify for a hardship through the federal government? You may be eligible for catastrophic coverage.11

Catastrophic plans have a high deductible and offer minimum coverage at a lower price. These plans have the most restrictions, but your monthly payments will be lower than most other plans.

Plan benefits include:

  • 100% preventive care coverage2
  • Essential Health Benefits covered after deductible is met
  • Plans meet ACA bronze-level requirements

Example Plans

If you you're healthy, see a doctor less than a couple of times a year and don't have a specific doctor you want to keep, you may want to consider a plan with these features12:

  • Network: Smallest
  • Deductible: High
  • Doctor's office visits: Not covered until full deductible is met (coinsurance may be required)
lower monthly premiums, you pay more when you get sick

If you go to your doctor many times a year, want to keep seeing your doctor and have a chronic condition like diabetes, you may want to consider a plan with these features12:

  • Network: Largest
  • Deductible: Low
  • Doctor's office visits: Covered (copay and/or coinsurance may be required)
higher monthly premiums, you pay less when you get sick
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