Blue Advantage®

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Blue Advantage®

Blue Advantage® is a good option if you want a broad choice of doctors, specialists and hospitals along with flexibility in how much you pay for doctor visits and prescription drugs.

Blue Advantage® offers:

  • More than 95% of doctors and 98% of the hospitals in North Carolina are in-network1
  • More pharmacy options
  • Two ways to pay for medical expenses: a plan with predictable copayments or deductible and coinsurance

Blue Advantage is ideal for those who want choices: choices in which provider to see and choices for how much to pay for doctor visits and prescription drugs.


Benefit Choices

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.

Metallic Levels

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 $8,700.
Blue Advantage®
1. Blue Cross NC Provider Internal Data; Percentages indicated represent Blue Cross NC’s PPO Network as of May 11, 2018. Note: Not all plans are available in all areas. 2. HSA contribution amounts are limited to the amount established by the IRS for each year for single or family coverage. 3. The Center for Consumer Information and Insurance Oversight. Centers for Medicare and Medicaid Services. “Actuarial Value and Cost-Sharing Reductions Bulletin.” Accessed April 29, 2013. 4. These are approximate values with a +/- 2% variation. U9619, 10/13

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