Blue ValueSM
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Blue ValueSM
Blue ValueSM features a limited network of providers for savings on your monthly cost.
Blue Value offers:
- A limited statewide network that offers premium savings.
- A network that includes, but is not limited to the following providers: Atrium Health Wake Forest Baptist, CaroMont Health, Duke Health Lake Norman Regional Medical Center, Duke LifePoint Healthcare, Novant Health, and UNC Health Alliance.
- A network that does not include the following providers (these providers are out-of-network): Atrium Health (not including Atrium Health Wake Forest Baptist), Duke Health (not including Duke Health Lake Norman Regional Medical Center or Duke LifePoint Healthcare), and Wake Med.
- A plan where emergency services and urgent care outside of NC are covered at the in-network beneft level. All other non-emergency covered services are covered at the out-of-network benefit level.
Blue Value is only available in certain North Carolina counties, including:
- Alexander
- Brunswick
- Burke
- Caldwell
- Catawba
- Cleveland
- Colombus
- Duplin
- Gaston
- Iredell
- Lincoln
- New Hanover
- Onslow
- Pender
- Surry
Blue Value is a good fit for those who want savings and don’t have a strong provider preference, or whose provider is already in the limited network.
Blue ValueSM
1. Out-of-network (OON) deductible is fve times the in-network deductible. OON out-of-pocket limit has no maximum. 2. Member pays 30% more coinsurance when seeking services OON. 3. OON PCP and specialist visit is subject to the plan’s OON deductible and coinsurance. 4. Out-of-network urgent care and emergency services are covered at the same cost share level as in-network urgent care and emergency services. 5. Prescription drug deductible must be met before your plan begins to pay for prescriptions except when indicated otherwise. 6. PCP step down benefts: 3 x $0 copay for PCP ofce visits, followed by standard PCP copay (at the member level). 7. Prescription drug costs are subject to the medical deductible, coinsurance, and out-of-pocket limit. 8. Prescription drug costs are not subject to the deductible. 9. Members on a family HSA plan will have an individual deductible and a family total deductible. Any member of the family will only have to pay the individual amount to meet their deductible 10. 0 This plan is available of Marketplace only. ACAPOS-I, 5/25. U10160b, 9/25