Blue Home with Cone Health1 gives you to access care from Cone Health’s network of doctors.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) offers Blue Home with Cone Health plans. This plan gives you access to:
- One of the region’s largest and most comprehensive health care networks, with more than 150 locations, including five hospitals,
six ambulatory care centers, three outpatient surgery centers, 11 urgent care centers, and more than 120 physician practices.2 - Hospitals that have been recognized by U.S. News & World Report as “High Performing” in key areas of care, and a network that
has been ranked as the top hospital system in the Greensboro/Winston-Salem metro area.2
Blue Home with Cone Health is only available in certain North Carolina counties:
- Guilford
- Randolph
- Rockingham
- All providers outside the Cone Health provider network, including out-of-state providers, are considered out-of-network (OON) and not covered for Blue Home with Cone Health
- Some of these OON providers include: Atrium Health, Novant Health, and UNC Health along with any of their affiliated providers
- Out-of-network coverage is not included, except for emergency and urgent care services which will be covered at the in-network benefit level3
Blue Cross NC offers health plans in 3 metallic levels. The Affordable Care Act (ACA) created metallic levels to help show the value of coverage within different plan offerings and give you a way to compare them.
Bronze plans typically pay 60% of covered medical costs on average, and you pay 40%.
Silver plans usually pay 70% of covered medical costs on average, and you pay 30%.
Gold plans generally pay 80% of covered medical costs on average, and you pay 20%.
| Plans | Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | with Cone Health | Bronze Standard | with Cone Health | Bronze HSA Eligible | Integrated | with Cone Health4 5 |
|---|---|---|---|
| Individual deductible (family=2x) | $7,000 | $7,500 | $8,500 |
| Individual out-of-pocket limit (family=2x) | $10,600 | $10,000 | $8,500 |
| Coseguro | 50% | 50% | 0% |
| Primary care provider (PCP) | 3 x $0 / $956 | $50 | Ded / 0% |
| Specialist / urgent care | $175 | $100 / $75 | Ded / 0% |
| Prescription drug deductible7 | Integrated8 | Integrated8 | Integrated8 |
| Prescription drug benefit | $259 / 50% / 50% / 50% / 50% | $259 / $50 / $100 / $500 | 0% / 0% / 0% / 0% / 0% |
| Plans | Silver Access A | 3 Free PCP | $15 Tier 1 Rx | with Cone Health5 | Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | with Cone Health | Silver Standard | with Cone Health |
|---|---|---|---|
| Individual deductible (family=2x) | $1,400 | $2,800 | $6,000 |
| Individual out-of-pocket limit (family=2x) | $10,600 | $10,600 | $8,900 |
| Coseguro | 50% | 50% | 40% |
| Primary care provider (PCP) | 3 x $0 / $256 | 3 x $0 / $406 | $40 |
| Specialist / urgent care | $150 | $80 | $80 / $60 |
| Prescription drug deductible7 | $300 | Integrated8 | Integrated8 |
| Prescription drug benefit | $159 / $25 / $60 / $120 / 50% | $109 / 50% / 50% / 50% / 50% | $209 / $409 / $80 / $350 |
| Plans | Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | with Cone Health | Gold Standard A | with Cone Health |
|---|---|---|
| Individual deductible (family=2x) | $1,800 | $2,000 |
| Individual out-of-pocket limit (family=2x) | $10,600 | $8,200 |
| Coseguro | 30% | 25% |
| Primary care provider (PCP) | 3 x $0 / $156 | $30 |
| Specialist / urgent care | $40 | $60 / $45 |
| Prescription drug deductible7 | $400 | $0 |
| Prescription drug benefit | $109 / $25 / $35 / $75 / 50% | $159 / $309 / $609 / $2509 |
Blue Cross and Blue Shield of North Carolina no discrimina por motivos de raza, color, nacionalidad, sexo, edad o discapacidad en ninguno de sus programas y actividades de salud. Conozca más sobre nuestra política de no discriminación y los servicios gratuitos que tiene a su disposición.
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