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
How It Works
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
Benefits Summary
Review complete in-network and out-of-network benefits in the Summary of Benefits and Coverage.
Saver 1 |
Saver 2 |
Saver 3 |
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| Available Deductibles |
$1,000-$5,000 (Per Person) |
$1,000-$20,000 (Per Person) |
$10,000-$20,000 (Per Person) |
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| 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 | $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 | ||||||||||||||||||||||||||||||
| Specialist Physician | You pay 30% after deductible is met | 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 | ||||||||||||||||||||||||||||||
| Prescription Drugs |
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| 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 | You pay 30% after deductible is met | 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 | ||||||||||||||||||||||||||||||
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Hospitals and Major Medical Procedures
A heart attack and coronary artery bypass requires an inpatient hospital stay. Average billed amount: $68,563* |
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. |
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| 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 | ||||||||||||||||||||||||||||||
| Summary of Benefits and Coverage |
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Review complete in-network and out-of-network benefits in the Summary of Benefits and Coverage.
| Available Deductibles | |
|---|---|
| Saver 1 | $1,000-$5,000 (Per Person) |
| Saver 2 | $1,000-$20,000 (Per Person) |
| Saver 3 | $10,000-$20,000 (Per Person) |
| Coinsurance | |
|---|---|
| Saver 1 | You pay 30% |
| Saver 2 | You pay 0% or 40% depending on the plan you select. |
| Saver 3 | You pay 0% |
| Coinsurance Maximum | |
|---|---|
| Saver 1 | $3,000 individual $6,000 family |
| Saver 2 | $4,000 individual $8,000 family Or $0, depending on the plan you select. |
| Saver 3 | You pay $0 after deductible is met |
| Preventive Care | |
|---|---|
| Saver 1 | You pay $0 |
| Saver 2 | You pay $0 |
| Saver 3 | You pay $0 |
| Primary Physician | |
|---|---|
| Saver 1 | $25 copayment
With this plan you pay: $25 copayment |
| Saver 2 | $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. |
| Saver 3 | You pay 0% after deductible is met |
| Specialist Physician | |
|---|---|
| Saver 1 | You pay 30% after deductible is met |
| Saver 2 | 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) |
| Saver 3 | You pay 0% after deductible is met |
| Prescription Drugs | |||||||||||||
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| Saver 1 |
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| Saver 2 |
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| Saver 3 |
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| Urgent Care | |
|---|---|
| Saver 1 | You pay 30% after deductible is met |
| Saver 2 | You pay 0% or 40% after deductible is met depending on the plan you select. |
| Saver 3 | You pay 0% after deductible is met |
| Emergency Room | |
|---|---|
| Saver 1 | You pay 30% after deductible is met |
| Saver 2 | 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) |
| Saver 3 | You pay 0% after deductible is met |
| Hospitals and Major Medical Procedures
A heart attack and coronary artery bypass requires an inpatient hospital stay. Average billed amount: $68,563* |
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|---|---|
| Saver 1 | 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. |
| Saver 2 | 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. |
| Saver 3 | 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 | |
|---|---|
| Saver 1 | $25 copayment |
| Saver 2 | $25 copayment |
| Saver 3 | You pay 0% after deductible is met |
| Mental Health and Substance Abuse | |
|---|---|
| Saver 1 | You pay 50% after deductible is met |
| Saver 2 | You pay 50% after deductible is met |
| Saver 3 | You pay 50% after deductible is met |
| Other Services | |
|---|---|
| Saver 1 | You pay 30% after deductible is met |
| Saver 2 | You pay 0% or 40% after deductible is met depending on the plan you select. |
| Saver 3 | You pay 0% after deductible is met |
| Summary of Benefits and Coverage | |||||||||||||||
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| Saver 1 |
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| Saver 2 |
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| Saver 3 |
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Notice: Your actual expenses for covered services may exceed the stated coinsurance percentage because actual provider charges may not be used to determine the health benefit plan's and member's payment obligations.
* 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.
Download Plan Summary/Limitations and Exclusions
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
- 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
How To Apply
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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
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.
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