For your business

• Blue Value features the quality coverage you've come to expect from BCBSNC and access to many quality, cost-effective providers. By visiting participating Blue Value providers, easily located through our Find a Doctor tool, your employees will enjoy significant savings.
• Blue Value is designed for businesses who:
  • Want to maximize health care spend
  • Have employees located in the targeted Blue Value markets
  • Want to avoid cutting benefits
  • Are comfortable with a provider network smaller than the full BCBSNC provider network. See a list of participating hospitals [PDF]

For your employees

• Employees may receive care in or out-of-network and don't need a referral to see a specialist.² There are no claims for members to file for in-network care. Those who choose to use out-of-network providers are responsible for submitting their own claims to BCBSNC in accordance with our procedures. Employees enjoy the best benefit value by choosing providers within the network.
• Offers a more affordable choice for employees who may not have strong provider preferences.

Blue Value benefits summary

This summary shows the range of coverage available.

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.

Blue Value (Copayment/Coinsurance) Benefit Options
	In-Network	Out-of-Network
Preventive	100%	70% after the deductible*
Office Visit (Primary)	from $10 to $40	from 30% to 70% after the deductible
Office Visit (Specialist, such as therapies)	from $20 to $80	from 30% to 70% after the deductible
Inpatient Care	from 60% to 100%	from 30% to 70% the after deductible
Emergency Room	$150 first visit; $500 for second and subsequent visits or deductible/coinsurance**
Individual Deductible	from $0 to $10,000	from $1,000 to $30,000
Coinsurance	from 60% to 100%	from 30% to 70%
Individual Coinsurance Maximum	from $0 to $10,000	from $2,000 to $20,000

^* Only state-mandated benefits are covered out-of-network.

^** For copayment purposes, the first claim received by BCBSNC will be considered the first visit.

Blue Value (1-2-3) Benefit Options
		In-Network	Out-of-Network
In-network copayment or coinsurance amounts	Level 1 - Primary care	$20 or $25	from 40% to 70% after the deductible
	Level 1 - Preventive care	100%	70% after the deductible*
	Level 2 - Inpatient care	from 70% to 100% after the deductible	$500 for each inpatient stay plus from 40% to 70% after the deductible
	Level 3 - Outpatient care/Professional specialist care	from 50% to 80% after the deductible	from 40% to 70% after the deductible
Individual deductible		from $500 to $5,000	from $2,000 to $20,000
Individual coinsurance maximum		from $1,000 to $10,000	from $4,000 to $20,000

^* Only state-mandated benefits are covered out-of-network.

View Plan Summary

Blue Value Prescription Drug Information:

Blue Value Prescription Drug Options (In-network and Out-of-network)
Prescription drugs	Deductible	$0; $100; $200; $300
	Tier 1* Preferred Generic	$4	$10	$10
	Tier 2* Non-Preferred Generic	$25	$25	$25
	Tier 3 Preferred Brand	$35	$40	70%
	Tier 4 Non-Preferred brand	$75	$80	60%
	Tier 5 Specialty Drug**	75%	75%	60%

* Deductible does not apply to Tier 1 and Tier 2.
** There is a $100 per drug minimum and a $200 per drug maximum for each 30-day supply of Tier 5 Specialty Drugs.

This product offers a 5-Tier benefit option available on our Basic formulary which is a closed formulary. Only the drugs and devices listed on our formulary will be covered under this plan.

Blue Select and Blue Value health plans include a limited network of pharmacies. To see which pharmacies are in-network, please choose one of the following options:

North Carolina Pharmacies

Outside North Carolina Pharmacies