Blue Cross Blue Shield of North Carolina (BCBSNC) always promotes a healthy lifestyle.  You could reduce your monthly rate as much as 15%  if you qualify for this discount.  This rating tier is referred to as “Preferred Plus” – if you do not smoke, you do not have any pre-existing health conditions, lead a healthy lifestyle, if you are not taking any medications and if your height and weight ratio is within Blue Cross Blue Shield of North Carolina’s preferred guidelines, you may qualify for this discount. 

 

It does not cost anything to apply for our Blue Advantage or Blue Options HSA plans to determine if you qualify for this discount.  After you apply, your application is submitted to underwriting for final approval.  Once approved, you view your final rates, you have the ability to change to any plan available and enroll in your policy.  If you determine you do not want to proceed with acquiring the coverage, you have the option of deleting your application.  You are not under any obligation to purchase the plan once you have received final rates and approval.  Also, compare our Blue Advantage plans to our Blue Options HSA for even more costs savings. (more…)

CAN YOU PURCHASE A “CHILD ONLY” POLICY?

 

  As an agency, we receive many calls each day from parents who are looking to purchase private health insurance for their child and/or children.  Circumstances could vary from removing a dependent off an employee group health insurance policy to saving money in premium, a child reaching maturity, a new birth, marriage and an array of different circumstances.  The answer is YES… Blue Cross Blue Shield of North Carolina (BCBSNC) provides health insurance beginning at birth.  To apply for private insurance for your child click here and complete the form with all information and we will immediately send you an email with the quote and on-line application for Blue Advantage.    The good news, child only policies are affordable and provide excellent insurance coverage. You can select from a variety of coverage that works in your budget, 100%, 80% or 70% plans.  With Blue Advantage, Plan A, you pay just a $15.00 co-payment to visit your primary care physician and only $30.00 to see a specialist, neither are subject to the deductible or co-insurance.   Prescription drug benefits are available under these Blue Advantage plans with only a $10.00 co-payment for generic drugs, $35.00 for preferred and $50.00 for non-preferred and 25% co-insurance for specialty drugs.  Plan B and C require a deductible before prescription co-payments begin, Plan A does not. (more…)

Effective October 1, 2009, Blue Cross and Blue Shield of North Carolina is revising our upfront member collection policy for members who have Blue Options HSA, Blue Options HRA and any Blue Options non-copayment plans.

Beginning October 1, 2009, for Blue Options HSA and Blue Options HRASM, as well as any Blue Options non-copayment plans, providers are no longer limited to collecting up to $50 for an office visit or up to $500 for services received at a facility. Providers may now collect the member liability based on the benefits of the member’s specific plan and the provider’s current fee schedules for elective or scheduled care.

Why are we making this change?
Collecting the patient’s share of the bill has become increasingly important in recent years as more cost has shifted to members. For the products designated above, many patients have higher deductibles than in the past and also pay a percentage of the remaining bill. This change to our collection policy allows us to leverage our technology and partner with our providers to reduce the administrative expenses that can add to the total cost of health care.

What’s required of the providers?
If a provider office maintains a policy to collect the estimated patient financial responsibility at the time of service, they are required to:
• Collect only according to negotiated network fee schedules in place at the time of service.
• Collect only an amount determined to be accurate with reasonable certainty through validation using BCBSNC provider tools.
• Refund any overpayment owed to the member as soon as identified, but no more than 45 days after they receive our payment for the service in question.
What does this mean for copayment plans?
Blue Care®, Blue Options, Blue Advantage®, and State Health Plan members should expect to pay their applicable copayment for office services as usual. When deductible and/or coinsurance apply, providers can use the above guidelines to request member liability prior to treatment.

Does this apply to emergency and urgent care?
For emergency services, providers cannot require any upfront payment from the member until the provider receives the BCBSNC Explanation of Payment (EOP).

For urgent care services, providers can use the above guidelines to require payment of member liability at time of service or after treatment.

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Blue Advantage health insurance through Blue Cross Blue Shield of North Carolina is our most popular individual health plan in NC.  This is a traditional PPO plan with doctor office co-payments as low as $15 for your primary care physician and as low as $30 for a specialist.  BCBSNC allows you to build your own plan, selecting deductibles ranging from $250.00 up to $5000.00 with co-insurance starting at 50% up to 100%.  Blue Advantage Plans also allow an add on option of Dental Blue and/or maternity coverage as well.   (more…)

“When you go to the doctor, make sure you talk about your prescription options and how they affect your wallet.  Generic drugs are safe, affordable options should be at the top of your list when you and your doctor discuss a new prescription.

All you have to do is ask… Before your doctor writes you a prescription or prescribes a medication for you electronically, you can say, “I’m interested in generic medications if they’re available.”

If your doctor says generic is not available, ask, “Is there a generic drug in the same therapeutic class that could work for me?”

Other ways to manage prescription costs….. The BCBSNC Web site can help you find out how much a brand-name prescription drug will cost and let you know if there are less expensive alternatives.  Go online to the BCBSNC website and click on “Find a Drug” then click on “Prescription drug search”.  In the search box, type in the name of the drug you’re looking up and click “Find drug”.  The tool will then show you which tier the drug falls under so that you know your cost up front.  It will also tell you whether there is a generic alternative and will list other treatment options.”

The information above is brought to you from BCBSNC, A Guide to a Healthier You, 2009.

For more information on health insurance coverage in North Carolina and how to utilize My Member Services, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our qualified agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

 

A traditional PPO, BCBSNC’s Blue Advantage offers great coverage, a range of premium and deductible options to meet your budget.  You can provide coverage for your child/children or for your entire family.  Often times, if covered under a group sponsored plan, an employee will move their children to a private plan to save in premium.

•   Blue Cross Blue Shield of North Carolina has a broad range of premium and deductible options for you to pick from.  With predictable co-payments and the largest provider network in the State of North Carolina, this local company has been serving the State of North Carolina for more than 70 years offering North Carolinians the most popular individual health insurance plan in the state. (more…)

Approximately 50 percent of people who suffer from chronic health conditions do not take their medications as directed. 1 Studies show that failure to take medications as prescribed results in the loss of approximately 125,000 lives a year from cardiovascular disease alone. 2
Medication DedicationSM, a new program from Blue Cross and Blue Shield of North Carolina (BCBSNC), is designed to help members with specific chronic conditions avoid the risks involved with not taking their medications as prescribed by removing cost barriers often associated with prescription medications.

Q: What is Medication Dedication?
It’s a new medication adherence program from Blue Cross and Blue Shield of North Carolina (BCBSNC) designed to help members with specific chronic conditions take their medications as prescribed by their health care provider. Since cost can be a significant barrier to taking medications as directed, BCBSNC is waiving the copayment for generic medications that treat the following conditions: congestive heart failure, high blood pressure, high cholesterol and diabetes. BCBSNC is also moving certain brand-name drugs that treat those same conditions to a lower drug level tier to make them more affordable.
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THE INVINCIBLES

They’re young. They’re just starting out. They’re often paid lower wages. And, in some cases, they can’t imagine themselves as sick or helpless. They’re used to being covered on their parents’ plans, but they’ve reached the age when they’re no longer eligible for dependent coverage.  Whatever the reason, those from 18 to 34 comprise the group that’s most likely not to have health insurance coverage.* As a result, preventive care is neglected, routine checkups are delayed, and needless financial and physical suffering is experienced (more…)

ABOUT NORTH CAROLINA HEALTH INSURANCE:

Residents of North Carolina have a variety of health insurance plans they can research and qualify for.  The most important question is, what is the best and most affordable plan for you and your family?  Our agency has written for some of the top companies in North Carolina throughout our career.  We have recently become exclusive agents for Blue Cross Blue Shield of North Carolina, a company providing healthcare coverage for residents of North Carolina.  You may ask, why exclusive for BCBSNC?  It really revolves around customer service and products offered for health insurance coverage in North Carolina.  As an agency doing business for 34 years in North Carolina, we take tremendous pride in offering the best health insurance plans on the market with a company that we have 100% confidence in how they treat our clients as well as the products they offer.  There are so many health insurance plans in North Carolina that are being offered today, it is our job to determine what will work best for our clients and provide the best NC health coverage and affordability that is offered on the market today.   So, lets talk about North Carolina health insurance plans and highlight what we think is the best product on the market and provide the best health coverage for you and your family. (more…)

AFFORDABLE HEALTH CARE

Just because health insurance is not on “Ophra’s List of Favorite Things” does not mean you should not consider it as an important item for the holidays or anytime for that matter. Lets think about the people that have beautiful homes, nice cars, cell phones, computer games, beautiful clothes, but they don’t have health insurance for their families. What happens when sickness or tragedy comes knocking on your door, how do you protect your family from the financial disaster that comes when you don’t have health insurance?

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Many people often ask us how the process for applying for health coverage begins and ends…

 

Requesting a Quote:

Applying for insurance with BCBSNC is a very simple process.  It does not cost anything to apply and you will have the opportunity to review your final rate before accepting a plan and making payment.  To apply for Blue Advantage, Blue Options HSA and Dental Blue, you must first request and receive a personalized quote.  Simply click here to request your personal quote and apply today.  Next, your request will be submitted and received by Jerry Ballard & Associates.  We will process your request and send your personalized quote to you via email. The quote will be emailed from ratequote@bcbsnc.com.  Once you receive the email, you will want to be sure and turn off pop-up blockers and make sure the email did not go to any spam files. 

 

Receiving Your Quote:

 

In the body of the email, you will see a link that says, View Your Rate Quote Here.  Simply click on the link and your personalized quote will populate with all the Blue Cross Blue Shield of North Carolina plans and premiums you requested.  A yellow apply button will appear to the right of each plan/premium.  Click the yellow apply button to begin your online application process.  Call our office (888-765-5400) so we can go over the plans with you and answer any questions about the benefits associated with these plans.

 

The Application:

 

The application itself takes 10-15 minutes to complete.  You will create a user id and password that you will need to write down for future access into the application.  You and other applicants will answer health questions pertaining to your health.  In addition, you will enter any prior insurance coverage.  Once submitted, the application will either be auto approved or submitted for further underwriting with BCBSNC.

 

Auto-Approved:

 

This simply means that your application received a final rate automatically.  You will see this final rate at the end of the application.  If you are in exceptionally good health and fall within the Preferred Plus guidelines set out by BCBSNC,  you may qualify for a 15% healthy discount in your monthly premium.  Many people will receive the preferred quoted rate.  Some based on their individual health, could receive a rate increase. 

 

Underwriting Review:

 

Blue Cross Blue Shield may require further information from you such as a telephone interview, a paramedical exam, or medical records.  Our customer service representative and BCBSNC will contact you if this is required.  All of these are processed with no cost to you.  A telephone interview involves a phone conversation between the underwriting interviewer and the applicant confirming information on the application.  The paramedical exam is a small physical exam that is performed by a nurse at your convenience at your home or work.  An analysis of height, weight, blood pressure, blood work and urinalysis could be a part of the paramedical exam.  Medical records may be requested from one of your health care providers.  We recommend that you call that provider and let them know to be expecting this request so that they can process it in a timely manner.

 

Final Approval after Underwriting:

 

Once your final rate is approved, BCBSNC and our office will contact you to resume your application (with the user id and password you created), view your quote, accept and make payment.  Once you open up the application, you will view the final rate for the plan that you applied for with BCBSNC.  Before accepting this plan, you have the options to change to any plan that BCBSNC offers to you.  For example, if you applied for Plan A 80% coinsurance with $2500 deductible, you can click on “Lower Cost Options” or “All Available Plans” and switch to any of those plans.  This allows for more decision making based on the final rate and gives the applicant more choices.

 

Making payment:

 

There are 2 payment options for Blue Advantage and Blue Options HSA.  Bank Draft or Direct Bill.  We encourage Bank Draft because it is convenient and you never have to worry about a lost bill in the mail.  On-going Bank Drafts occur on the 2nd of each month for 1st of the month effective dates and the 12th of the month of 15th of the month effective dates.  Initial Bank Draft payments for any effective date will occur on the 2nd of the month that the policy becomes effective.  Direct Bill, requires an initial payment to be made by credit card online.  The credit card will be processed for payment on the day it is entered.  You will receive subsequent bills by mail each month with a due date of the 1st (for effective dates on the 1st) or the 15th (for effective dates on the 15th).

 Benefits Booklets and ID Cards: 

These are mailed to the address you provided on your application within 10 business days.  On the 2nd page of the booklet, you will find your id cards. 

 For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our qualified agents.  Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC).  You may qualify for a 15% healthy lifestyle discount if you are in excellent health.  Call us for details.

 

 

Group health insurance plans, such as Blue Options PPO, differ from individual/family health insurance plans, such as the Blue Advantage plan, in several ways. First of all, they are most often sponsored by an employer, who in NC, must contribute at least 50% of the cost of the employee portion of the premium. Groups must also have at least 75% of their eligible employees (full time working 30 hours or more per week) participating on the plan, less anyone who is on another group plan. Blue Advantage can be applied for by any resident of North Carolina who is under 65 and who is not on Medicare or Medicaid – there are no participation requirements.

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