Blue AssuranceSM
Type of plan
Blue Assurance is a health plan that does not require medical underwriting for individuals who meet eligibility guidelines under HIPAA (Health Insurance Portability and Accountability Act) or who are not medically eligible for coverage under other individual health plans offered by BCBSNC.
For individuals
Get coverage even if previously medically denied along with the freedom to choose providers and facilities.
Basics of the plan
Blue AssuranceSM includes coverage for doctor visits, emergency care, hospital stays and prescription medication. The plan also includes maternity care,1 inpatient and outpatient surgical care and physical therapy.2 Individuals get a choice of deductibles: $100, $500 or $1,000. Plan savings are available if provider is in the Classic Blue® network. For more information about Blue Assurance and how to apply for this coverage, call 1-800-324-4973, Monday - Friday, 8 a.m. - 5 p.m.
Blue Assurance benefits summary
| Individual or family deductible | $100, $500 or $1,000 |
| Coinsurance after deductible is met | Plan member pays 20% up to $1,000 for individuals or $3,000 for family per benefit period. Coverage is 100% after. |
| Prescription drugs | No deductible for prescription medication. Coinsurance applies. |
* 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.
* Deductible does not apply to your coinsurance maximum. Mental health, substance abuse and prescription drug charges also do not apply to your coinsurance maximum. Individual must meet his or her own coinsurance maximum and members of the family plan must meet the combined family coinsurance maximum.
Rates3
| Deductible | $100 |
$500 |
$1000 |
| Individual | $1,506 |
$1,307 |
$1,247 |
| Parent / Child | $2,259 |
$1,961 |
$1,871 |
| Family | $3,313 |
$2,875 |
$2,743 |
* NOTE: Your actual rate is based on the deductible and plan you choose and the number of family members covered. Deductibles, coinsurance, limitations and exclusions apply to this coverage. Pre-existing condition waiting periods may also apply.
1 Maternity coverage is available to all adult female subscribers or enrolled spouses age 18 and over; maternity benefits for dependent children cover only treatment for complications of pregnancy.
2 Skilled nursing facility care is limited to 60 days per benefit period. Short-term therapy is limited to 30 visits per benefit period for speech therapy and 30 visits per benefit period for combined physical therapy and occupational therapy.
3 Rates are effective through December 31, 2013. Member's premiums may be adjusted with 30 days notice. After the first premium adjustment, the premium cannot be adjusted more frequently than 12 months and will not be changed at any other time unless an adjustment is required by law, or you make changes to your policy.