Blue Options HSA

Experience HSA

Take the mystery out of health savings account (HSA) plans - learn everything you need to know at ExperienceHSA.
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A plan that gives you more control over your health care dollars

  • Save more money with low monthly premiums
  • Enjoy tax savings with a health savings account
  • HSA funds can be used tax-free to pay for eligible medical expenses

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How It Works

Combine a high-deductible health plan (HDHP) with a health savings account (HSA) and you can potentially reduce your monthly premium significantly and save money.1

  • Coverage for preventive care and catastrophes.2
  • The money you contribute to your HSA is tax-deductible.3
  • When you need to pay for medical services, you can pay for them with your HSA funds.
  • Your HSA rolls over from year to year. That means you keep what you put into it. It's your HSA - it's your money.

Typical Health Insurance Plan

You pay a monthly premium, regardless of whether you use the health benefits.

Monthly premium for regular copayment health insurance plan.

After 12 months, you would have spent

$3,000 on monthly premiums.

Blue Options HSA

You could save significantly on monthly premiums and invest the premium difference you save in an HSA.

Each month, you put $150 into your HSA and use that money to pay for eligible medical expenses.

Monthly premium for comparable HSA plan

After 12 months, you would have spent

$1,200 on monthly premiums and have

$1,800 in your HSA to use for future medical expenses.4

Let's say that over the course of a year:

Blue Advantage 0% coinsurance plans

Deductible: $2,500

Monthly Premium: $283

Blue Options HSA 5000

Deductible: $5,000

Monthly Premium: $100

You see your doctor for your annual physical

$15 copayment ($0 in 2011)

$0

A minor accident sends you to an urgent care clinic

$30 copayment

$300

You fill a prescription for a generic allergy medication

$120

$200

Your total out-of-pocket medical expenses:

$165

$500

Your annual premium (over 12 months):

$3,396

$1,200

Total annual out-of-pocket expenses:

$3,561

$1,700

Money left over in your HSA account:5

N/A

+$1,465

If you put the $150 you saved on premiums each month in your HSA, you would have $1,100 left over at the end of the year that you could use next year or save to gain tax-free interest. Expenses are for illustrative purposes only.

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.

  1. Tax savings are not guaranteed. Blue Options HSA combines a high-deductible health 0% coinsurance plansnd a health savings account (HSA). BCBSNC does not administer the HSA and is not affiliated with your HSA custodian or administrator. The HSA custodian is The Bank of New York Mellon. Consult your tax advisor for information on tax savings.
  2. 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.
  3. Blue Options HSA contribution amounts are limited to the amount established by the IRS for each year for single or family coverage. Anyone age 55 or older can contribute an additional $1,000 to their HSA in 2011.
  4. A full list of qualified medical expenses can be found in IRS publication 502, available at irs.gov.
  5. BCBSNC internal data, 2010: Compares rates for Blue Advantage 0% coinsurance plans $2,500 deductible / 80% coinsurance and Blue Options HSA $5,000 deductible / 100% coinsurance for a 45-year-old male in Wake County on Preferred Risk Tier based on 2010 rates. Most commonly chosen plans were selected for comparison.
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Benefits

Benefits Summary

Review complete in-network and out-of-network benefits in the Summary of Benefits and Coverage.

0% coinsurance plans
20% coinsurance plans
50% coinsurance plans
Available Deductibles $2,700 or $5,000 (individual)
$5,450 or $10,000 (family)		 $2,700 (individual)
$5,450 (family)		 $2,700 (individual)
$5,450 (family)
Coinsurance You pay 0% You pay 20% You pay 50%
Coinsurance Maximum You pay 0%
(after deductible is met)		 $2,300 individual
$4,550 family		 $2,300 individual
$4,550 family
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*

Hide

 You pay 0%
(after deductible is met)

With this plan you pay:

Before Deductible: $106

After Deductible: $0

 You pay 20%
(after deductible is met)

With this plan you pay:

Before Deductible: $106

After Deductible: $21.20

 You pay 50%
(after deductible is met)

With this plan you pay:

Before Deductible: $106

After Deductible: $53
Specialist Physician

What would it cost if...?

You see an orthopedic specialist for knee pain.

Average billed amount: $125*

Hide

 You pay 0%
(after deductible is met)

With this plan you pay:

Before Deductible: $125

After Deductible: $0

 You pay 20%
(after deductible is met)

With this plan you pay:

Before Deductible: $125

After Deductible: $25

 You pay 50%
(after deductible is met)

With this plan you pay:

Before Deductible: $125

After Deductible: $62.50
Prescription Drugs You pay 0%
(after deductible is met)		 You pay 20%
(after deductible is met)		 You pay 50%
(after deductible is met)
Urgent Care You pay 0%
(after deductible is met)		 You pay 20%
(after deductible is met)		 You pay 50%
(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*

Hide

 You pay 0%
(after deductible is met)

With this plan you pay:

Before Deductible: $1,381

After Deductible: $0

 You pay 20%
(after deductible is met)

With this plan you pay:

Before Deductible: $1,381

After Deductible: $276.20

 You pay 50%
(after deductible is met)

With this plan you pay:

Before Deductible: $1,381

After Deductible: $690.50
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*

Hide

 You pay 0%
(after deductible is met)

With this plan you pay:

$2,700 - $5,000 (individual) or $5,450-$10,000 (family) depending on the plan deductible

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

 You pay 20%
(after deductible is met)

With this plan you pay:

$5,000 (individual) or $10,000 (family)

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

 You pay 50%
(after deductible is met)

With this plan you pay:

$5,000 (individual) or $10,000 (family)

This amount assumes you have not paid anything toward your deductible for the year.
Vision You pay 0%
(after deductible is met)		 You pay 20%
(after deductible is met)		 You pay 50%
(after deductible is met)
Mental Health and Substance Abuse You pay 0%
(after deductible is met)		 You pay 20%
(after deductible is met)		 You pay 50%
(after deductible is met)
Other Services You pay 0%
(after deductible is met)		 You pay 20%
(after deductible is met)		 You pay 50%
(after deductible is met)
Summary of Benefits and Coverage
Deductible
$5,000 (individual)/
$10,000 (family)		Summary of Benefits and Coverage
$2,700 (individual)/
$5,450 (family)		Summary of Benefits and Coverage
Deductible
$2,700 (individual)/
$5,450 (family)		Summary of Benefits and Coverage
Deductible
$2,700 (individual)/
$5,450 (family)		Summary of Benefits and Coverage

Review complete in-network and out-of-network benefits in the Summary of Benefits and Coverage.

Available Deductibles
0% coinsurance plans $2,700 or $5,000 (individual)
$5,450 or $10,000 (family)
0% coinsurance plans $2,700 (individual)
$5,450 (family)
0% coinsurance plans $2,700 (individual)
$5,450 (family)
Coinsurance
0% coinsurance plans You pay 0%
20% coinsurance plans You pay 20%
50% coinsurance plans You pay 50%
Coinsurance Maximum
0% coinsurance plans You pay 0%
(after deductible is met)
20% coinsurance plans 2,300 individual
$4,550 family
50% coinsurance plans 2,300 individual
$4,550 family
Preventive Care
0% coinsurance plans You pay $0
20% coinsurance plans You pay $0
50% coinsurance plans You pay $0
Primary Physician

What would it cost if...?

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

Average billed amount: $106*

Hide
0% coinsurance plans You pay 0%
(after deductible is met)

With this plan you pay:

Before Deductible: $106

After Deductible: $0
20% coinsurance plans You pay 20%
(after deductible is met)

With this plan you pay:

Before Deductible: $106

After Deductible: $21.20
50% coinsurance plans You pay 50%
(after deductible is met)

With this plan you pay:

Before Deductible: $106

After Deductible: $53
Specialist Physician

What would it cost if...?

You see an orthopedic specialist for knee pain.

Average billed amount: $125*

Hide
0% coinsurance plans You pay 0%
(after deductible is met)

With this plan you pay:

Before Deductible: $125

After Deductible: $0
20% coinsurance plans You pay 20%
(after deductible is met)

With this plan you pay:

Before Deductible: $125

After Deductible: $25
50% coinsurance plans You pay 50%
(after deductible is met)

With this plan you pay:

Before Deductible: $125

After Deductible: $62.50
Prescription Drugs
0% coinsurance plans You pay 0%
(after deductible is met)
20% coinsurance plans You pay 20%
(after deductible is met)
50% coinsurance plans You pay 50%
(after deductible is met)
Urgent Care
0% coinsurance plans You pay 0%
(after deductible is met)
20% coinsurance plans You pay 20%
(after deductible is met)
50% coinsurance plans You pay 50%
(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*

Hide
0% coinsurance plans You pay 0%
(after deductible is met)

With this plan you pay:

Before Deductible: $1,381

After Deductible: $0
20% coinsurance plans You pay 20%
(after deductible is met)

With this plan you pay:

Before Deductible: $1,381

After Deductible: $276.20
50% coinsurance plans You pay 50%
(after deductible is met)

With this plan you pay:

Before Deductible: $1,381

After Deductible: $690.50
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*

Hide
0% coinsurance plans You pay 0%
(after deductible is met)

With this plan you pay:

$2,700 - $5,000 (individual) or $5,450-$10,000 (family) depending on the plan deductible

This amount assumes you have not paid anything toward your deductible for the year.
20% coinsurance plans You pay 20%
(after deductible is met)

With this plan you pay:

$5,000 (individual) or $10,000 (family)

This amount assumes you have not paid anything toward your deductible for the year.
50% coinsurance plans You pay 50%
(after deductible is met)

With this plan you pay:

$5,000 (individual) or $10,000 (family)

This amount assumes you have not paid anything toward your deductible for the year.
Vision
0% coinsurance plans You pay 0%
(after deductible is met)
20% coinsurance plans You pay 20%
(after deductible is met)
50% coinsurance plans You pay 50%
(after deductible is met)
Mental Health and Substance Abuse
0% coinsurance plans You pay 0%
(after deductible is met)
20% coinsurance plans You pay 20%
(after deductible is met)
50% coinsurance plans You pay 50%
(after deductible is met)
Other Services
0% coinsurance plans You pay 0%
(after deductible is met)
20% coinsurance plans You pay 20%
(after deductible is met)
50% coinsurance plans You pay 50%
(after deductible is met)
Summary of Benefits and Coverage
0% coinsurance plans
Deductible
$5,000 (individual)/
$10,000 (family)		Summary of Benefits and Coverage
$2,700 (individual)/
$5,450 (family)		Summary of Benefits and Coverage
20% coinsurance plans
Deductible
$2,700 (individual)/
$5,450 (family)		Summary of Benefits and Coverage
50% coinsurance plans
Deductible
$2,700 (individual)/
$5,450 (family)		Summary of Benefits and Coverage

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
Eligible Medical Expenses for HSA Plans

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.

More on our maternity rider option

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

Learn more about Dental Blue

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How To Apply

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Get a free rate quote on your mobile device.

Click the Free Rate Quote button and enter a little information about yourself so we can list the right plans for you.
Use the tools and tips on the rate quote results page to compare prices and plan details. We also provide links to more information about our plans and advice on how to pick the right plan.
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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.

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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.

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.
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U7318, 09/10

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