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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.
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With Blue
Advantage, you can have access to many of the best doctors,
hospitals and
specialists in North Carolina. Blue Cross and Blue Shield of North
Carolina’s
(BCBSNC) networks are large and member co-payments and coinsurance
are predictable.(1)
Just visit an in-network provider, show your BCBSNC ID card and pay
the co-payment.
The doctor handles all the administrative details and files the
claims. You can go directly
to in-network specialists without a referral, and you can go outside
the network for most
services.(2, 3) The only difference is the out-of-pocket cost.
Blue Advantage offers three plans that allow you to choose the
benefits and deductible
that work best for you, with costs as low as $15 for co-payments and
$10 for generic
prescription drugs.(4)
Blue Advantage has you covered across the nation and in more than
200 countries and
territories worldwide through the BlueCard® network.5 To find a
nearby network
provider, call 1-800-810-BLUE (1-800-810-2583) or search the
provider directory at
bcbsnc.com.
You can also purchase coverage for children. With Blue Advantage,
children receive full
benefits, including coverage for well-child and well-baby care and
immunizations.
Maternity coverage is available for an extra charge when you first
purchase a policy,
renew a policy (if the policy has been in effect for at least six
months) or if you have a
family status change, like marriage.(6)
Blue Advantage provides you with access to a variety of online
resources and programs
designed to maximize your health care experience. Resources include
Member Health Partnerships, our confidential health management
program for adults and children –
offered at no additional cost – that can help you better manage
health conditions like
asthma and diabetes. And, our value-added Rewards and Discounts
offer you member
discounts on everything from vitamins to gym memberships.(7, 8)
To be eligible for Blue Advantage, you must be a North Carolina
resident, under age 65,
medically eligible, and not eligible for Medicare. Enrollment takes
approximately 15-30
days.
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. Please see the BCBSNC provider
listing to identify these providers.
2 Referrals may be needed for certain mental health and substance
abuse services.
3 Preventive care is limited to in-network benefits.
4 Refers to Plan A, Preferred Tier, policy form number M58, 7/07
5 Blue Cross and Blue Shield Association Internal Data, 2007:
www.bcbs.com/news/press/facts/bluecard.html. (09/08)
6 Maternity coverage is offered through Blue Advantage at an
additional rate.
7 BCBSNC provides the Member Health Partnerships (MHP) program for
your convenience and is not liable in any way for the services
received. BCBSNC reserves the right to discontinue or change the
program at any time. Benefits available through MHP are subject to
your current benefit plan and preexisting
waiting periods.
8 Blue ExtrasSM programs may not apply to all health plans.
Discounts on certain goods and services may not be provided directly
by BCBSNC, but may instead be arranged by BCBSNC for member
convenience. Any discounts are outside your health plan benefits.
BCBSNC is not liable for problems resulting from goods and services
it does not provide directly, such as goods and services not being
provided or being provided negligently. BCBSNC may change or
discontinue these programs at any time.
Blue Cross and Blue Shield of North Carolina is an independent
licensee of the Blue Cross and Blue Shield Association. ®, SM Marks
of the Blue Cross and Blue Shield Association. SM1 Mark of Blue
Cross and Blue Shield of North Carolina. |
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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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