Catastrophic plans provide minimum coverage at a lower price.
- High deductible plans
- Essential Health Benefits covered after deductible is met
- Preventive care covered at 100%1
- Primary care in-network office visits covered with a $35 copayment for the first 3 visits
- These plans have high deductibles that you must meet before BCBSNC pays for Essential Health Benefits. They may be a good option if you don’t expect to have many medical expenses.
Essential Health Benefits
Essential Health Benefits that are covered include:
- Ambulatory services
- Emergency services
- Maternity and newborn care
- Mental health and substance abuse services (including behavioral health)
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive/wellness services and chronic disease management
- Pediatric services, including dental and vision
You must meet one of the following criteria to be eligible for a catastrophic plan.
- Be under 30 years of age when the plan year begins
- Qualify for a hardship exemption through the federal government
If you choose a catastrophic plan, you cannot use an advance premium tax credit (federal subsidy). If you don’t qualify for or decide to forego a subsidy, you may save money with these plans.
Catastrophic plans are not required to meet the metallic levels that other plans must meet. However, because Blue Cross NC is committed to quality coverage, Blue Cross NC’s catastrophic plans do meet bronze level requirements.
1. 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.