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Shop Plans Blue Value Plan

Blue Value offers a limited statewide network within North Carolina. It might be good fit if you are flexible about which providers you see.

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Plan highlights

With our Blue Value plan options from Blue Cross and Blue Shield of North Carolina (Blue Cross NC), you get:

  • A limited network of hospital systems and doctors
  • Lower monthly premiums compared to other plans
Availability and coverage info

Available in these NC counties

Blue Value plans are only available in certain North Carolina counties:

  • Alexander
  • Brunswick
  • Burke
  • Caldwell
  • Catawba
  • Cleveland
  • Columbus
  • Duplin
  • Gaston
  • Iredell
  • Lincoln
  • New Hanover
  • Onslow
  • Pender
  • Surry

Blue Value plan network

The Blue Value network includes, but is not limited to, the following providers:

  • Atrium Health Wake Forest Baptist
  • CaroMont Health
  • Duke LifePoint Healthcare
  • Novant Health
  • UNC Health Alliance

The following providers are considered out-of-network for Blue Value:

  • Atrium Health (not including Atrium Health Wake Forest Baptist)
  • Duke Health (not including Duke LifePoint Healthcare)
  • WakeMed

Outside of NC, emergency services and urgent care will be covered at the in-network benefit level. All other non-emergency covered services will be covered at the out-of-network benefit level.

 

Limitations and Exclusions
Understanding metallic plan levels

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 level

Bronze plans typically pay 60% of covered medical costs on average, and you pay 40%.

Silver level

Silver plans usually pay 70% of covered medical costs on average, and you pay 30%.

Gold level

Gold plans generally pay 80% of covered medical costs on average, and you pay 20%.

In-network Blue Value bronze plan options
PlansBronze Basic | 3 Free PCP | $20 Tier 1 Rx | Integrated | Limited Statewide DoctorsBronze Standard | Limited Statewide DoctorsBronze Complete | $60 PCP | $20 Tier 1 Rx | Limited Statewide DoctorsBronze HSA Eligible1 |
Integrated | Limited Statewide Doctors2, 3
Individual deductible
(family = 2x)4
$7,000$7,500$4,000$8,300
Individual out-of pocket limit
(family = 2x)4
$9,200$9,200$9,200$8,300
Coinsurance550%50%50%0%
Primary care provider
(PCP6
3 x $0 / $1007$50$60Ded / 0%
Specialists6and
urgent care
$150$100 / $75$120Ded / 0%
Prescription drug
deductible8
Integrated9Integrated9$1,000Integrated9
Prescription
drug benefit
$2010 / 50% / 50% / 50% / 50%$2510 / $50 / $100 / $500$2010/ $25 / $75 / $150 / 50%0% after deductible
In-network Blue Value silver plan options
PlansSilver Access | 3 Free PCP | $15 Tier 1 Rx | Limited Statewide Doctors3Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide DoctorsSilver Standard | Nationwide DoctorsSilver Choice | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors
Individual deductible (family = 2x)4$1,400$1,575$5,000$3,000
Individual out-of-pocket limit (family = 2x)4$9,200$9,200$8,000$9,200
Coinsurance5 50%50%40%50%
Primary care provider (PCP)6 3 x $0 / $2573 x $0 / $557 $403 x $0 / $457
Specialists6 and urgent care$150$110$80 / $60$90
Prescription drug deductible8 $300Integrated9 Integrated9 $250
Prescription drug benefit$159 / $25 / $60 / $120 / 50%$1010 / 50% / 50% / 50% / 50%$2010 / $4010 / $80 / $350$1510 / $30 / $40 / $80 / 50%
In-network Blue Value gold plan options
PlansGold Premier | 3 Free PCP | $10 Tier 1 Rx | Limited Statewide DoctorsGold Standard | Limited Statewide Doctors
Individual deductible (family = 2x)4
$1,800

$1,500
Individual out-of-pocket limit (family = 2x)4$9,100$7,800
Coinsurance5
30%25%
Primary care provider (PCP)63 x $0 / $107$30
Specialists6 and urgent care$40$60 / $45
Prescription drug deductible8 $400$0
Prescription drug benefit$1010 / $25 / $40 / $80 / 50%$1510 / $3010 / $6010 / $25010