Blue Select® is a tiered benefit plan that features a large network of providers at a lower cost than Blue Advantage®.
- Two tiers of in-network providers to choose from2
- Copayments for predictable costs
- Limited pharmacy network to save you money
- More preauthorization requirements for prescription drug benefits
- Preventive care covered at 100%3
Blue Select is a good fit for those who want savings but also want the flexibility of access to our largest network of providers. Blue Select offers two tiers of in-network benefits in addition to out-of-network coverage. You are always free to choose providers from either tier or out-of-network, but you’ll receive a richer benefit and more savings by choosing a Tier 1 provider.
The blue shaded area on the map represents the network coverage for the Blue Select network. Dark blue represents Tier 1 providers and light blue represents Tier 2 providers.
How Do Tiers Work?
We’ve taken the large network you know today and tiered its hospitals and specially selected physicians in neurology, OB/GYN, general surgery, cardiology, orthopedics and gastroenterology. This tiered approach means there is a smaller number of providers available in Tier 1 for the specialties listed above.
Tier 1 provides a richer benefit and represents the hospitals and selected specialists that received Blue Cross NC’s top ratings for clinical quality outcomes, cost-efficiency and accessibility. Also included in Tier 1 are providers outside of the specialist categories listed above as well as providers located outside the state through the BlueCard® network. Tier 2 provides a less rich benefit and represents the remaining in-network hospitals and specialists that meet Blue Cross NC’s standards for clinical quality outcomes, cost-efficiency and/or accessibility.2 Doctors and hospitals that are not Tier 1 or Tier 2 will be covered as out-of-network.
Blue Select plans are copayment plans. They offer predictable copayments so you’ll know what to expect when paying your medical expenses.
Blue Select plans are available in 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. Silver plans pay 70% and gold plans pay 80% of medical costs on average.4, 5
All plans have a maximum out-of-pocket (OOP) limit of $7,350 or less.
2. Blue Select offers two tiers of benefits in addition to out-of network coverage. Tier 2 providers may not have met one or more of the standards necessary for inclusion in Tier 1.
3. Certain preventive care services are covered at 100% before deductible when received in an in-network office or out-patient setting. Other covered services may be subject to deductible and coinsurance. When you receive preventive care out-of-network, you may pay more. Visit bcbsnc.com/preventive for a full list of preventive services.
4. The Center for Consumer Information and Insurance Oversight. Centers for Medicare and Medicaid Services. “Actuarial Value and Cost-Sharing Reductions Bulletin.” http://cciio.cms.gov/resources/files/Files2/02242012/Av-csr-bulletin.pdf. Accessed April 29, 2013.
5. These are approximate values with a +/- 2% variation.