Blue Cross Blue Shield of North Carolina

Blue Cross Blue Shield of North Carolina – Overview

Blue Cross Blue Shield of North Carolina (Blue Cross NC) has been providing health insurance services to North Carolina’s residents since its establishment. Blue Cross NC is a not-for-profit health insurance provider in North Carolina, with significant operations in locations including Durham.

The company employs over 5,000 people who serve more than 4.3 million members. This number includes 1.2 million members served on behalf of other Blue Plans. Blue Cross NC is an Independent Blue Cross and Blue Shield Association Licensee.

According to statistics from Blue Cross and Blue Shield Association statistics, three main factors are causing the rise in healthcare costs. These include spending on prescription drugs, treating chronic conditions, and poor lifestyle choices. However, with the help of health insurance, getting medical and healthcare becomes easier and significantly affordable.

The Blue Cross NC PPO Network of healthcare professionals includes 92% of all medical doctors and 100% of all general acute-care hospitals in the state. Members can also receive prompt and affordable medical care outside the state through BlueCard coverage in all 50 states.

Besides this, BlueCard members also have access to medical care in more than 200 counties and territories globally.

Blue Cross Blue Shield of North Carolina Individual and Family Health Insurance

Blue Cross NC offers extensive coverage to individuals and families through its various health insurance plans. You get complete coverage for preventive care services, including annual wellness tests. You can access Telehealth services that allow you to talk to a primary care physician or specialist using your mobile or laptop.

Blue Cross Blue Shield of North Carolina

Blue Cross Blue Shield of North Carolina – Individual and Family Health Insurance

Members don’t need referrals from their primary care provider to visit a specialist. Every member, irrespective of the plan they buy, gets 3 no-cost primary care provider visits and 3 no-cost mental health visits each year. Besides this, every Blue Cross NC member also gets comprehensive maternity, newborn, and pediatric coverage.

According to insurance experts, choosing an individual or family health insurance plan is recommended according to how often you need medical care, how much you are willing to pay monthly, and the extent of services you need to have covered in your insurance plan.

Check the out-of-pocket expenses associated with every plan, such as copayments, coinsurance, and deductibles. Blue Cross NC offers its ACA health plans in three levels – Gold, Silver, and Bronze. The ACA creates these levels so consumers can understand the value of coverage for each plan.

The amount of coverage usually varies depending on your regular medical expenses. This makes it easier to compare different individual and health insurance plans from Blue Cross NC.

Bronze Plan – The Blue Cross NC Bronze Plan for individuals and families offers to pay 60% of your overall eligible medical costs while you need to cover the remaining 40% from your pocket.

According to insurance experts, the Bronze Plan is recommended for those who do not need medical services often but want extensive coverage in a serious medical situations, such as chronic ailments and severe injuries. Though the Bronze Plan has a lower monthly premium, you should be ready to pay for most of the routine healthcare expenses independently.

Silver Plan – The Blue Cross NC Silver Plan covers up to 70% of eligible medical and healthcare expenses, while you must pay the remaining 30% on your own. The Silver Plan is advisable if you are willing to pay a higher monthly premium in exchange for affordable and easy access to extensive medical and healthcare services.

Gold Plan – The Blue Cross NC Gold Plan covers up to 80% of your overall medical expenses, while you only need to cover the remaining 20% on your own. The Gold Plan is highly recommended for those who frequently need medical and healthcare services and are willing to pay a higher monthly premium but get the most comprehensive coverage in terms of services.

To learn more about the Blue Cross NC Individual and Family health insurance plans, you can check out the official website here

Blue Cross Blue Shield of North Carolina Medicare Health Insurance

The Blue Cross Blue Shield of North Carolina is also a popular provider of Medicare health insurance plans. For those who are unaware, Medicare is a federal health insurance program aimed mostly at people over the age of 65 years.

However, there are provisions to provide insurance coverage to younger people in certain situations, such as people with specific disabilities and those suffering from end-stage kidney disease.

Medicare offers comprehensive health insurance coverage through four different parts. Medicare Part A is also called Hospital Insurance. This insurance plan covers expenses related to inpatient care in a hospital, hospice care, services of a skilled nursing care facility, and home health care service expenses.

Medicare Part B is also called Medical Insurance, covers the cost of physician services, ambulance services, mental healthcare, durable medical equipment, and some preventive care services. Medicare Part A and Medicare Part B are often combined and called Original Medicare.

Medicare Part C is also called Medicare Advantage. It combines the coverage provided under Medicare Part A and B but comes with lower out-of-pocket expenses when you visit doctors who are part of the Blue Cross NC PPO network.

Medicare Part D is also called Prescription Drug Plan. This plan provides coverage to buy prescription drugs. However, there are still some gaps left between these plans, and this is where the Medicare Supplement plan comes in handy. The Medicare Supplement Plan covers the gaps in your overall insurance coverage.

Medicare provides nationwide coverage and is usable at any Medicare-accepting healthcare provider. It allows you to travel anywhere in the country and see a doctor or visit a hospital of your choice. Medicare generally does not cover health care while you are outside the United States, except in limited situations; supplemental insurance like Medigap may offer coverage for travel abroad.

To learn more about Blue Cross NC Medicare health insurance plans, you can check out the official website here


The Blue Cross Blue Shield of North Carolina has provided extensive health insurance coverage to individuals, families, groups, and employers since 1933. Blue Cross NC offers a wide range of health insurance products, including plans available through the Health Insurance Marketplace and outside it, with thousands of in-network providers spread across the expanse to ensure members have easy access to quality health and medical care.

See Also

Best Nursing Schools in North Carolina

Blue Cross Blue Shield of California

Blue Cross Blue Shield of Minnesota

Blue Cross Blue Shield Kansas

Blue Cross Blue Shield of Louisiana

Blue Cross Blue Shield of Oklahoma

Current Version
April 3, 2024
Updated By
Andrea Morales G.
April 1, 2023
Written By
Shubham Grover

Follow us