Blue OptionsSM is a Preferred Provider Organization (PPO) deep-network plan that offers flexible and convenient copayment and coinsurance options for primary care, specialist office visits and prescription drugs.
How It Works
For Your Business
- Blue Options' familiar plan design takes the guesswork out of health care choices for employees leading to high satisfaction with the plan.
For Your Employees
- Our network covers all 100 counties in North Carolina.1
- Employees may receive care in- or out-of-network.2
- There are no claims for employees to file for in-network care.
Blue Options Benefits Summary
This summary shows the range of coverage available. Your plan benefits can be customized to the needs of your business and employees.
NOTICE: Your actual expenses for covered services may exceed the stated coinsurance percentage or copayment amount because actual provider charges may not be used to determine the health benefit plan's and member's payment obligations. For costs and further details of the coverage, including exclusions, and reductions or limitations and terms under which the policy may be continued in force, see your agent or contact BCBSNC.
|In-Network (Member Liability)||Out-of-Network (Member Liability)|
40% or 70%
depending on plan purchased
depending on plan purchased
|Coinsurance for inpatient services and outpatient procedures||10%-50% after deductible||40%-80% after deductible|
|Individual Out-of-Pocket Limit||$1,500-$6,350||$3,000-$12,700|
|Family Out-of-Pocket Limit||
Options available for coinsurance plans and 4-Tier coverage
Why Blue Options?
Is it right for your business?
Blue Options could be right for your business if you're looking for a plan with the advantages of a traditional PPO plan, including copayments for routine care like primary care and specialist visits and access to in and out-of-network providers.2 Blue Options is the easiest health plan to manage and administer.
Is it right for your employees?
Employees can receive in- or out-of-network care.2 And employees never have to go far to find a doctor; you're covered in all 100 counties in North Carolina.1 Plus, there are no claims for employees to file in-network.
- BCBSNC is the No. 1 choice of small businesses in North Carolina3
- Most preferred health insurance company in North Carolina4
- Now small businesses have access to wellness resources and health assessments with reporting
- New! HRA options now available for small businesses
BCBSNC offers support and programs for members, including:
- Web and mobile access to benefits and claims information at mybcbsnc.com
- Health Line BlueSM, our 24/7 nurse line providing support at no additional cost to members
- Fully integrated case management, condition care and the Healthy Outcomes wellness program5
- Exclusive member discounts from top retailers on fitness gear, gym memberships, family activities, healthy eating options and much more with Blue365SM,6
- Access to valuable health improvement resources for those who are healthy or those who may need additional support.
1. Health Plans, Inc., MarketQuest Network Compare, April 2013.
2. Some services and supplies received by members in an office setting or in connection with an office visit are in fact outpatient hospital-based services provided by hospital-owned or operated practices. These services and supplies may be subject to your deductible and coinsurance. Certain preventative care services are limited to in-network benefits. Members should refer to the Benefit Booklet for complete details
3. NAIC 2012 Supplemental Health Care Exhibit Report.
4. BCBSNC Brand Tracking Study; Prophet; March 2013.
5. BCBSNC contracts with Alere Health Improvement Company, an independent third party vendor, for the provision of certain aspects of Healthy Outcomes programs.
6. Blue365 offers access to savings on items that Members may purchase directly from independent vendors, which are different from items that are covered under the policies with BCBSNC. Blue Cross and Blue Shield Association (BCBSA) may receive payments from Blue365 vendors. Neither BCBSNC nor BCBSA recommends, endorses, warrants or guarantees any specific Blue365 vendor or item. This program may be modified or discontinued at any time without prior notice.