Blue Cross and Blue Shield of NC Blue Advantage Health Insurance Online Quotes and Application

Jerry Ballard Toll Free: 888-765-5400
Phone: 252-726-5400
  
 
Blue Cross and Blue Shield of North Carolina® has announced that Jerry Ballard is again their top selling North Carolina agent in the individual health insurance business1. Jerry has lead the company in individual sales for the past 4 years, 2004, 2005, 2006, 2007, and qualified for President's Club Top Agency of the Year 2007. Ballard couples outstanding individual customer service with the technological sophistication that allows customers the best of both worlds--quick and accurate information via www.nchealthplans.com and ready access via his toll free number 888-765-5400 to a knowledgeable agent. You will be surprised how quickly and easily you can find and price the best North Carolina health plan for you and your family, and get all of your questions answered, without leaving your home or office, just by contacting Jerry Ballard and his trained, experienced staff.
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Company
Plan Name Plan A 100%2,3 Plan A 80%2,3 Plan B 70%2,3 Plan C 50%2,3
Our Newest Plan A Our Most Popular Plan Budget-Minded
Premiums 15%-35% Less		 Save Even More
Premiums 28%-40% Less
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Estimated Monthly Premium View Rates View Rates View Rates View Rates
Plan Type PPO PPO PPO PPO
Networks Search for Doctors and Hospitals Search for Doctors and Hospitals Search for Doctors and Hospitals Search for Doctors and Hospitals
Summary of Benefits Network Non-Network Network Non-Network Network Non-Network Network Non-Network
Office Visit/Copay
Primary doctors and specialists (including surgery, lab work, therapy and radiology performed by the same doctor on the same day in the office)		 100% after a $15 copay with no deductible for primary physicians4 or a $30 copay for specialists1 70% after calendar year deductible 100% after a $15 copay with no deductible for primary physicians or a $30 copay for specialists1 70% after calendar year deductible 100% after a $25 copay with no deductible for primary physicians or a $50 copay for specialists1 70% after calendar year deductible 100% after a $30 copay with no deductible for primary physicians or a $60 copay for specialists1 70% after calendar year deductible
Benefit period deductible Deductible options: $250, $500, $1,000 Same as In-Network Deductible options: $250, $500, $1,000, $2,500 Same as In-Network Deductible options: $500, $1,000, $2,500, $3,500, $5,000 Same as In-Network Deductible options: $1,000, $2,500, $3,500, $5,000 Same as In-Network
Coinsurance (% Paid by Company) Includes Home Health Care, Skilled Nursing, and Inpatient Hospital Care. 100% after calendar year deductible. You pay nothing after deductible of covered charges. 70% after calendar year deductible 80% after calendar year deductible 70% after calendar year deductible 70% after calendar year deductible 60% after calendar year deductible 50% after calendar year deductible 40% after calendar year deductible
Annual Out-of-Pocket Coinsurance Limit (% Paid by You) After calendar year deductible you pay nothing. You pay 20% after calendar year deductible until you have paid maximum $2000 per individual, $4000 per family You pay 30% after calendar year deductible until you have paid maximum $3000 per individual, $6000 per family You pay 50% after calendar year deductible until you have paid maximum $3000 per individual, $6000 per family
Lifetime Maximum unlimited unlimited $5 million $5 million
Prescription Drugs Unlimited coverage for generic drugs (max for brand drugs is $2000 benefit per person per calendar year) Includes family planning
100% after copayment with no deductible $10 copay for generic $35 or $50 copay for brand.6 Tier 4/25% coinsurance		 Unlimited coverage for generic drugs (max for brand drugs is $2000 benefit per person per calendar year) Includes family planning
100% after copayment with no deductible $10 copay for generic $35 or $50 copay for brand.6 Tier 4/25% coinsurance		 Unlimited coverage for generic drugs (max for brand drugs is $2000 benefit per person per calendar year) Includes family planning
100% after $200 annual deductible per member $10 copay for generic $35 or $50 for brand.6 Tier 4/25% coinsurance		 Unlimited coverage for generic drugs (max for brand drugs is $2000 benefit per person per calendar year) Includes family planning
100% after $500 annual deductible per member $10 copay for generic $35 or $50 for brand.6 Tier 4/25% coinsurance
Urgent Care Centers 100% after $30 copay with no deductible 100% after $30 copay with no deductible 100% after $30 copay with no deductible 100% after $30 copay with no deductible 100% after $50 copay with no deductible 100% after $50 copay with no deductible 100% after $60 copay with no deductible 100% after $60 copay with no deductible
Emergency Room 100% after $150 copay7 (copay waived if admitted) 100% after $150 copay7 (copay waived if admitted) 100% after $150 copay7 (copay waived if admitted) 100% after $150 copay7 (copay waived if admitted) 100% after $150 copay7 (copay waived if admitted) 100% after $150 copay7 (copay waived if admitted) 100% after $150 copay7 (copay waived if admitted) 100% after $150 copay7 (copay waived if admitted)
Preventive Care
Routine physical exam, including gynecological exam 100% after a $15 copay with no deductible for primary physicians4 or a $30 copay for specialists1 Not available 100% after a $15 copay with no deductible for primary physicians4 or a $30 copay for specialists1 Not available 100% after a $25 copay with no deductible for primary physicians4 or a $50 copay for specialists1 Not available 100% after a $30 copay with no deductible for primary physicians4 or a $60 copay for specialists1 Not available
Well-child and baby care (including periodic assessments and immunizations) 100% after a $15 copay with no deductible for primary physicians4 or a $30 copay for specialists1 Not available 100% after a $15 copay with no deductible for primary physicians4 or a $30 copay for specialists1 Not available 100% after a $25 copay with no deductible for primary physicians4 or a $50 copay for specialists1 Not available 100% after a $30 copay with no deductible for primary physicians4 or a $60 copay for specialists1 Not available
Immunizations 100% Not available 100% Not available 100% Not available 100% Not available
MRI PET & CT Scans Subject to the deductible and coinsurance regardless of where performed.
Physical Therapy $15/$30 copay maximum combined therapy 30 visits 70% after calendar year deductible $15/$30 copay maximum combined therapy 30 visits 70% after calendar year deductible $25/$50 copay maximum combined therapy 30 visits 60% after calendar year deductible $30/$60 copay maximum combined therapy 30 visits 40% after calendar year deductible
Vision Services 100% after $15 copay Not Available 100% after $15 copay Not Available Not Available Not Available Not Available Not Available
Mental Health $2,000 benefit max per person per calendar year; $10,000 lifetime max per person Inpatient facility, Inpatient professional. Outpatient professional
50% after calendar year deductible		 $2,000 benefit max per person per calendar year; $10,000 lifetime max per person Inpatient facility, Inpatient professional. Outpatient professional
50% after calendar year deductible		 $2,000 benefit max per person per calendar year; $10,000 lifetime max per person Inpatient facility, Inpatient professional. Outpatient professional
50% after calendar year deductible		 $2,000 benefit max per person per calendar year; $10,000 lifetime max per person Inpatient facility, Inpatient professional. Outpatient professional
50% after calendar year deductible
Maternity Benefits Optional -- please call for rates. Optional -- please call for rates. Optional -- please call for rates. Optional -- please call for rates.
Note

COVERAGE MAY BEGIN ON THE 1ST OR 15TH OF EACH MONTH BUT MUST BE AT LEAST 15 DAYS AND NO MORE THAN 60 DAYS FROM SIGNATURE DATE.

IF YOU NEED ASSISTANCE, PLEASE CALL 888-765-5400 OR 252-726-5400.
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1 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 your deductible and coinsurance. Please reference your provider directory for a complete list of these providers.
2 All services subject to the allowed amount.
3 NOTICE: Your actual expenses for covered services may exceed the stated coinsurance percentage or copayment amount because actual provider charges may not be used to determine the payment obligations for BCBSNC® and its members.
4 Primary physicians are in-network providers designated by BCBSNC® as a primary care provider (PCP). Please check with BCBSNC® to confirm your provider is in our network.
5 Only gynecological exams, cervical cancer screening, screening mammograms, colorectal screening and prostate specific antigen (PSA) tests are covered out-of-network subject to benefit period deductible and coinsurance.
6 Prescription drug benefits are divided into four drug-formulary tiers with varying copayment/coinsurance amounts based on the tier placement of a drug. Specific drug information can be found on the Prescription Drug Search tool at bcbsnc.com. Diabetic supplies are covered at 76% under the prescription drug benefit. In addition, benefits are provided for over-the-counter drugs when listed as covered in the formulary and a provider's prescription for that drug is presented at the pharmacy.
7 If admitted to the hospital from the emergency room, inpatient hospital benefits apply to all covered services provided. If held for observation, outpatient benefits apply to all covered services provided. If you are sent to the emergency room from an urgent care center, you may be responsible for both the emergency room copayment and the urgent care copayment.
8 Pre-existing conditions are those for which medical advice, diagnosis, care or treatment was received or recommended within 12 months of the date that your Blue Advantage® coverage begins. You may receive credit toward the 12 month waiting period if we receive your completed Blue Advantage® application within 63 days of the termination of your previous health coverage.
9 BCBSNC® Internal Enrollment figures as of 2006/2007.
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