Individual Health Coverage  
Individual Health Coverage
As most know, there is strength in numbers when buying insurance. Of course, when you are part of a group you can enjoy paying less on your premiums. But what do you do when you are no longer insured by your company’s health care provider, or you change jobs and the new one does not offer health insurance? Individual Health Coverage is insurance that is not connected to a business, it is insurance that you can purchase on yourself or for your whole family.

Blue Cross and Blue Shield of North Carolina’s® Blue Advantage® individual health coverage insurance program allows its members to see the best doctors, hospitals and specialists in North Carolina. The Blue Advantage® provider network is one of the largest in the state.

Many people that find themselves needing to purchase individual health coverage, simply overlook their situation and decide to not purchase any insurance at all. Many find that the prices for individual premiums are too high. Blue Cross and Blue Shield of North Carolina's® Blue Advantage® program has two different options for individual health coverage. Option A offers members lower co-payments, usually just 15 dollars, and lower costs for generic prescription drugs. Option B offers members lower monthly premiums for those on a budget, however these members share more in the cost of their health care and may have to pay a little more on their co-payments.

With Blue Advantage, members have access to many of the best doctors, hospitals and specialists in North Carolina. Our provider networks are large and member copayments and coinsurance are predictable.1 Members visit in-network providers, show their Blue Cross and Blue Shield of North Carolina (BCBSNC) ID card and pay their copayment. The doctor handles the administrative details and files the claims. There’s no messy paperwork. It’s that easy.

Blue Advantage members can also go directly to in-network specialists without a referral and have the freedom to go outside the network for most services.2 The only difference is the out-of-pocket cost.

Blue Advantage for individual coverage offers two plans, which allows applicants to choose the benefits and deductible that work best for them. Blue Advantage Plan A features a $15 copayment for doctor visits and just $10 for generic prescription drugs. For those on a budget, Blue Advantage Plan B offers lower monthly premiums. Members share more in the cost of their health care on Plan B through higher copayments.3

With Blue Advantage, members are covered across the nation and in more than 200 countries and territories worldwide.4 To find a nearby network provider, members can search the BlueCard® provider directory at or call 1-800-810-BLUE (2583).
Applicants may choose to purchase coverage for their children only. Children will receive full Blue Advantage benefits, including coverage for well-child and well-baby care and immunizations. Applicants can also select maternity coverage for an extra charge when they first purchase a policy, renew a policy (if the policy has been in effect for at least six months), or if they have a family status change like marriage.

As BCBSNC members, Blue Advantage members have access to a variety of resources and programs designed to maximize their health care experience. Resources include the Member Health Partnerships, programs that help members manage health conditions like asthma and diabetes, and the Blue Extras® free value-added programs, which provide members discounts on everything from vitamins to gym memberships.5

To be eligible for Blue Advantage, an applicant must be a resident of North Carolina, be under age 65 and not qualify for Medicare. Enrollment processing takes approximately 30 days. Applicants may need health insurance to cover this waiting period, or to cover the time between the termination date of their old plan and the effective date of their new plan.

® mark, SM marks of the Blue Cross and Blue Shield Association. SM1 mark of Blue Cross and Blue Shield of North Carolina. 1 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. 2 Referrals may be needed for certain mental health and substance abuse services. 3 Blue Advantage Plan B requires a $200 prescription drug deductible. 4 2004 BCBSNC Internal Data. 5 Blue Cross and Blue Shield of North Carolina reserves the right to discontinue or change this program at any time. All plans may not be eligible for these programs.
If you have any questions or would like more information, please contact us 828-256-3224, email us, or use our online request form.





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