Health Insurance from Blue Cross and Blue Shield of North Carolina

Lorrie Maxwell • Mark Thacker
Mike Bender

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Authorized Agents

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1-800-588-9025

Choosing the health plan that's right for you depends on
your specific needs, your budget and your unique life
circumstances. But putting all of that together isn't
always easy. That's why we’re here – to walk you
through the steps of deciding which health plan can
give you the protection you need.

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SELECT A PLAN BELOW

BlueAdvantage®/Blue Options HSA® Quote
Dental Blue Quote®

APPLICANT'S INFORMATION

First Name:

Last Name:

Date of Birth:

Male Female

Maternity: Yes No

Phone:

Email:

County of Residence:

Zip Code:

Blue Advantage is a PPO plan – a preferred provider organization plan – which means you pay convenient copayments or coinsurance for things like primary care visits, specialist office visits and prescription drugs.9

Blue Advantage Saver is a PPO plan that allows you to make certain decisions about what benefits you really need. If you want lower monthly premiums, you can choose a higher deductible. If there are some coverage benefits you may not need, such as brand-name prescriptions, you can choose a plan without that benefit and lower your premiums even more.

An HSA is a health savings account that allows you to save money to pay for future medical expenses on an income-tax-free basis. The HSA is connected to a high- deductible health plan that doesn’t have copayments. You pay out of pocket until your deductible is met for all services, excluding a predefined list of preventive services that are covered at 100% (no cost to you) each year.3

With Dental Blue for Individuals, you're covered for a broad range of dental services, including routine fillings and extractions, plus major services like crowns, bridges and dentures. Coverage includes preventive care twice per benefit period. And, there are no waiting periods for cleanings, routine oral exams and other diagnostic and preventive services.

Footnotes:

3. Preventative care is limited to in-network benefits and includes in-network annual routine physical exam, well-baby and wellchild care and certain immunizations. Screenings or other covered services may be subject to deductible and coinsurance. Members who receive covered services out-of-network may be required to pay the difference between the provider’s actual charge and the BCBSNC allowed amount, in addition to the coinsurance amount.
9. For Blue Advantage: Some services and supplies received by members in an office setting or in connection with an office visit are in fact outpatient hospital-based services provided by hospital-owned or operated practices. These services and supplies may be subject to deductible and coinsurance. Please see the BCBSNC provider listing at bcbsnc.com to identify these providers.

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Blue Cross and Blue Shield of North Carolina® (BCBSNC).