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
- Employees may receive care in or out-of-network and don't need a referral to see a specialist.1 There are no claims for employees to file for in-network care.
- Our network includes 95% of all doctors practicing in North Carolina.2
Blue Options in-network benefits summary
This summary shows the range of coverage available. Your plan benefits can be customized to the needs of your business and employees.3
Two or three times individual deductible
|Coinsurance for inpatient services and outpatient procedures
|Individual coinsurance maximum||
|Family coinsurance maximum||
Two or three times individual coinsurance
Options available for both copayment/coinsurance 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.4 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. No referral is needed to see a specialist.1 And employees never have to go far to find a doctor; our network is the largest network in North Carolina.2 Plus, there are no claims for employees to file in-network.
- BCBSNC is the No. 1 choice of small businesses in North Carolina5
- Rated #1 in customer satisfaction in North Carolina6
- 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
- Exclusive member discounts from top retailers on fitness gear, gym memberships, family activities, healthy eating options and much more with Blue365SM8
- Fully integrated case management, condition care and the Healthy Outcomes wellness program7
- Access to valuable health improvement resources for those who are healthy or those who may need additional support.
1. Referrals may be needed for mental health and substance abuse services.
2. MarketQuest Network Compare: December 2011.
3. 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.
4. 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. Preventative care is limited to in-network benefits. Members should refer to the Member Guide for complete details
5. Triangle Business Leader, "Top 100 North Carolina Small Businesses" June 2010 and Internal BCBSNC data, June 2010.
6. Frederick Polls, April 2011.
7. BCBSNC contracts with Alere Health Improvement Company, an independent third party vendor, for the provision of certain aspects of Healthy Outcomes programs.
8. 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. Any disputes regarding these products and services may be subject to BCBSNC's grievance process. Blue Cross and Blue Shield Association (BCBSA) may receive payments from Blue365 vendors. BCBSA does not recommend, endorse, warrant or guarantee any specific Blue365 vendor or item.