Blue Advantage Saver

A plan featuring more cost-saving options

  • Limited office visit copayments for those who don't need to visit the doctor as often
  • Lower monthly premiums
  • More choices in how you pay for doctors visits and prescription drugs
 

With Blue Advantage Saver:

  • You get many of the features found in Blue Advantage
  • You have more flexibility, getting just the coverage you need at a lower monthly premium
  • Preventive care is covered at 100%1

How Blue Advantage Saver Works2

Going to a
Doctor or Specialist

All plans offer comprehensive coverage for preventive care. Some Blue Advantage Saver plans offer limited office visits. If you go more than the set number of visits, you'll have to pay out of pocket toward your deductible.

Going to the Pharmacy

You pay a copayment for your prescription drugs. In some cases, you may also have to pay a separate prescription drug deductible first before you can pay copayments toward prescription drugs.

Going to the Hospital

You pay toward hospital costs until your deductible is met. After that, you and BCBSNC share the medical costs (this is known as coinsurance) until your coinsurance maximum is met. After that, BCBSNC pays for all of your covered medical services (except for copayments).

1 Certain preventive care services are covered at 100%, before deductible, when received in an in-network office or outpatient setting. Other covered services may be subject to deductible and coinsurance. When you receive preventive care out-of-network you may pay more. Visit bcbsnc.com/preventive for a full list of preventive services.

2 The figures on this page are for illustrative purposes only. The examples provided on this page relate to in-network services only. When using out-of network providers, in addition to deductible and coinsurance amounts, you may be responsible for the difference between the BCBSNC allowed amount and the provider's actual charge.

Benefits Summary

Saver 1
Saver 2
Saver 3
Available Deductibles $1,000-$5,000
(Per Person)
$1,000-$20,000
(Per Person)
$10,000-$20,000
(Per Person)
Coinsurance You pay 30% You pay 0% or 40% depending on the plan you select. You pay 0%
Coinsurance Maximum $3,000 individual
$6,000 family
$4,000 individual
$8,000 family
Or $0, depending on the plan you select.
You pay $0 after deductible is met
Preventive Care You pay $0 You pay $0 You pay $0
Primary Physician

What would it cost if...?

You see your primary care doctor for flu-like symptoms.

Average billed amount: $106*

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$25 copayment

With this plan you pay:

$25 copayment

$25 copayment
(4 visits at $25 copayment)
Additional visits: you pay 0% or 40% after deductible is met depending on the plan you select.

With this plan you pay:

$25 copayment

Note: this would count as 1 of your 4 primary care visits for the year. After 4 visits you would be charged the full billed amount until your deductible has been met.

You pay 0% after deductible is met

With this plan you pay:

Before Deductible: $106

After Deductible: $0

Specialist Physician

What would it cost if...?

You see an orthopedic specialist for knee pain.

Average billed amount: $125*

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You pay 30% after deductible is met

With this plan you pay:

Before Deductible: $125

After Deductible: $37.50

You pay 0% or 40% after deductible is met depending on the plan you select.

With this plan you pay:

Before Deductible: $125

After Deductible: $50.00 ($0 for the $10,000 or $20,000 deductible plans)

You pay 0% after deductible is met

With this plan you pay:

Before Deductible: $125

After Deductible: $0

Prescription Drugs
Rx Deductible: $500
Generic: $10
Preferred: $45
Brand: $65
Specialty: You Pay 25%
After $2,000 brand benefit is met you pay 50% of brand drugs
Rx Deductible: $0
Generic: $10
You pay 100% for all brand name drugs
Rx Deductible: $0
Generic: $10
You pay 100% for all brand name drugs
Urgent Care You pay 30% after deductible is met You pay 0% or 40% after deductible is met depending on the plan you select. You pay 0% after deductible is met
Emergency Room

What would it cost if...?

A minor injury requires a visit to the emergency room.

Average billed amount: $1,381*

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You pay 30% after deductible is met

With this plan you pay:

Before Deductible: $1,381

After Deductible: $414.30

You pay 0% or 40% after deductible is met depending on the plan you select.

With this plan you pay:

Before Deductible: $1,381

After Deductible: $552.40 ($0 for the $10,000 or $20,000 deductible plans)

You pay 0% after deductible is met

With this plan you pay:

Before Deductible: $1,381

After Deductible: $0

Hospitals and Major Medical Procedures

What would it cost if...?

A heart attack and coronary artery bypass requires an inpatient hospital stay.

Average billed amount: $68,563*

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You pay 30% after deductible is met

With this plan you pay:

$4,000 - $8,000 depending on the plan deductible

This amount assumes you have not paid anything toward your deductible for the year.

You pay 0% or 40% after deductible is met depending on the plan you select.

With this plan you pay:

$5,000 - $20,000 depending on the plan deductible

This amount assumes you have not paid anything toward your deductible for the year.

You pay 0% after deductible is met

With this plan you pay:

$10,000 - $20,000 depending on the plan deductible

This amount assumes you have not paid anything toward your deductible for the year and is based on your in-network benefits.

Vision $25 copayment $25 copayment You pay 0% after deductible is met
Mental Health and Substance Abuse You pay 50% after deductible is met You pay 50% after deductible is met You pay 50% after deductible is met
Other Services You pay 30% after deductible is met You pay 0% or 40% after deductible is met depending on the plan you select. You pay 0% after deductible is met
Download Plan Summary/Limitations and Exclusions

* Figures are for illustrative purposes only. The examples provided in the chart relate to in-network service only. When using out-of network providers, in addition to deductible and coinsurance amounts, you may be responsible for the difference between the BCBSNC allowed amount and the provider's actual charge.

Maternity Rider Option

BCBSNC offers a maternity rider option to females (policy holder or spouse) ages 18 and over who aren't pregnant when they apply for coverage, unless their most recent coverage was underwritten by BCBSNC and included maternity coverage. If you choose not to purchase the maternity rider when you first apply, you can add the option at the following times, so long as you aren't pregnant at the time:

  • During the annual renewal period (November for a January 1 effective date), as long as the policy has been in effect for at least 6 months
  • Within 30 days following marriage (this requires a copy of the marriage certificate)
  • Upon adding your spouse as a dependent for reasons other than marriage (this requires supporting documentation)

Here are some additional things to consider:

  • The maternity rider option covers maternity services under the core health plan's deductible and coinsurance. There are usually no office visit copayments and no separate deductible for maternity coverage.
  • Complications from pregnancy are covered even if you don't have the maternity rider option.
  • You can add your newborn to your existing policy within 30 days of the date of birth (without medical underwriting), regardless of whether you have the maternity rider option. Coverage will be effective as of the baby's date of birth, so long as your policy was active on the day of birth.
  • Many people see the maternity option simply as a means to help pre-pay and choose to purchase it only if they're planning on getting pregnant in the near future.

Optional Dental Coverage

Dental Blue
  • Includes coverage for basic services like routine fillings and extractions and major services like crowns, dentures and bridges
  • You pay no deductible for preventive services
  • Plus there's no waiting period on pre-existing conditions

Get a free, no-obligation rate quote by visiting our full website at www.bcbsnc.com. Get started by clicking the free rate quote button. Use your computer or laptop (non-mobile device) to best refine your search results, compare prices and explore plan details.

Find a plan that interests you? Great. Simply continue to apply online. The application process takes about 20 minutes.

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Rate quotes are estimates only. Final rates are determined after you complete an application. Actual rates are based on the deductible and plan you choose, your age, the number of family members covered, and your county of residence. Deductibles, coinsurance, limitations and exclusions apply to this coverage. Preexisting condition waiting periods may also apply.

Contact Us

If you have questions, we've got answers.
Phone

Give us a call at 1-800-324-4973.

Hearing and speech impaired (TDD/TTY), please call 1-800-922-3140.

Licensed agents are available to assist you Monday - Thursday, 8 a.m. - 6 p.m. and Friday, 8 a.m. - 5 p.m.

Give us a call at 1-800-324-4973. Licensed agents are available to assist you Monday - Thursday, 8 a.m. - 6 p.m. and Friday, 8 a.m. - 5 p.m.

Please do not send membership, claims, billing or benefit inquiries by email. For questions about your plan, please call the phone number on the back of your Member ID card.

U7317, 09/10

What you pay each year for covered medical expenses before your health insurance begins paying toward those expenses. A general rule of thumb: The higher your deductible, the lower your premium.

A fixed-dollar amount that's payable at the time a covered service is provided.

The amount you pay for covered services before your health insurance plan pays for all or part of the remaining covered services.

The percentage you pay for covered services after you meet your deductible.

The total amount of coinsurance you have to pay for covered services per benefit period. Deductibles, copayments and amounts exceeding the allowed amounts for covered services don't apply.

Routine physical exams, including gynecological exams, well-child and well-baby care, including periodic assessments and immunizations.

Routine eye exams

Includes surgery, lab work, therapy and radiology performed by the same doctor on the same day in office. Copayments do not apply to deductible.

Includes surgery, lab work, therapy and radiology performed by the same doctor on the same day in office. Copayments do not apply to deductible.

No annual limit for generic drugs. For brand name drugs, the following benefits apply:

Blue Advantage A, B, C and Blue Advantage Saver 1 -- Brand name drugs are covered at 50% after $2,000 in brand name drug coverage per person, per benefit period. Blue Options HSA prescription drug benefits are subject to the plan deductible and coinsurance. Brand name drugs are not covered on Blue Advantage Saver 2 and 3.

Services provided for a sudden or unexpected condition requiring prompt diagnosis or treatment to prevent chronic illness, prolonged impairment or a more hazardous treatment.

Health care items and services furnished or required to screen for or treat an emergency medical condition until the condition is stabilized.

Inpatient and outpatient facility services, drugs, blood, supplies, medical care, surgical care, therapy services, diagnostic test, x-rays, lab work.

Five inpatient days and 10 outpatient visits per person, per benefit period.

Durable medical equipment, home health care, home infusion therapy, hospice care, private duty nursing, ambulance services, skilled nursing facilities (to 60 days per year) and dental accident.

Before you met the plan's deductible, you would pay the full billed amount. The amount you pay would go toward your deductible.

After you met your plan's deductible, you would pay a percentage of the full billed amount (coinsurance) until you reached the coinsurance maximum for the year. Then, all covered expenses are covered 100% by your plan.

The family deductible is met after three family members have each met their individual deductibles.

The family deductible is met after three family members have each met their individual deductibles. For $10,000 and $20,000 deductible options, the deductible is satisfied after two family members have each met their individual deductible.

The family deductible is met after two family members have each met their individual deductibles.