Blue Advantage offers a variety of benefit choices to give you options for how much you pay for medical expenses: copayments, and deductible and coinsurance plans.
Copayment plans are what most people think of as traditional plans. They offer a fixed copayment for things like primary care office visits and prescriptions. While you’ll know what you’re going to pay with copayment plans, they come at a higher premium. These plans are ideal for someone who wants predictable costs and doesn’t mind paying more in premiums.
Deductible and coinsurance plans have lower premiums than copayment plans. If you don’t expect a lot of medical expenses and want to save money on premiums, these may be the plans for you. For these plans, you pay the full cost of your medical expenses until you meet your medical deductible. Then you pay a coinsurance percentage, sharing the cost with Blue Cross and Blue Shield of North Carolina (Blue Cross NC) until you reach your out-of-pocket limit. After that, Blue Cross NC pays all covered costs.
For more options for your budget and your needs, some plans offer a combination of copayments, and deductible and coinsurance.
Health Savings Account (HSA)
Certain plans are also eligible for an HSA.
- The money you contribute to your HSA is tax-deductible.2
- When you need to pay for eligible medical services, you can pay for them with your HSA funds.
- Your HSA rolls over from year to year. That means you keep what you put into it. It’s your HSA – it’s your money.
Blue Advantage plans are available in bronze, silver and gold. The levels differ by how much of your medical costs a plan will pay on average. They are based on approximate values for standard medical expenses.3,4
- Bronze plans pay 60% of medical costs on average
- Silver plans pay 70% of medical costs on average
- Gold plans pay 80% of medical costs on average
- All plans have a maximum out-of-pocket (OOP) limit of $7,350.