Attention: This website is operated by Blue Cross Blue Shield North Carolina and is not the Health Insurance Marketplace® website at HealthCare.gov. This website does not display all Qualified Health Plans (QHPs) available through HealthCare.gov. To see all available QHP options, go to the Health Insurance Marketplace® website at HealthCare.gov.
Also, you should visit the Health Insurance Marketplace® website at HealthCare.gov if:
- You want to enroll members of your household in dental coverage. [The plans offered here do not offer pediatric dental coverage and you want to choose a QHP offered by a different issuer that covers pediatric dental services or a separate dental plan with pediatric coverage.]
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) provides free aids to service people with disabilities as well as free language services for people whose primary language is not English. Please contact 888-206-4697 (TTY: 711) for assistance.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) proporciona asistencia gratuita a las personas con discapacidades, así como servicios lingüísticos gratuitos para las personas cuyo idioma principal no es el inglés. Llame al 888-206-4697 (TTY: 711) para obtener ayuda.
All Blue Cross NC individual ACA plans may be purchased through the Health Insurance Marketplace as a Qualified Health Plan (QHP) or through other sources, such as directly from Blue Cross NC. Advanced Premium Tax Credits (APTC) and Cost Sharing Reductions are only available when plans are purchased through the Health Insurance Marketplace. If you apply through Blue Cross NC, you'll be able to go to the Health Insurance Marketplace to get any APTC or Cost Sharing Reductions you're eligible for. The Health Insurance Marketplace displays all QHPs available for sale in a given state by all issuers and may contain more QHPs than displayed on this site. The Health Insurance Marketplace allows individuals to apply via its website, in-person or by phone. This website is operated by Blue Cross NC and is not the Health Insurance Marketplace website. This website does not display all QHPs available through the Health Insurance Marketplace website. To see all available QHP options, go to the Health Insurance Marketplace website at HealthCare.gov. All information discussed on this page pertains to Blue Cross NC individual-market, medical health insurance plans that are eligible for sale in 2023 and meet Affordable Care Act guidelines. The information contained does not apply to plans that are transitional, group, dental-only or other plan types. All details regarding plan benefits and design contained herein are for informational purposes only. Please see the product benefit booklet for all terms and conditions that apply.
If you use a broker or agent to help facilitate your enrollment, their compensation is based on a flat rate per member per month. In addition, your broker/agent may receive a bonus if certain sales thresholds are met. This is paid by Blue Cross and Blue Shield of North Carolina. Your monthly premium will be the same whether you choose to use a broker/agent or not.
Your actual rate is based on the deductible and plan you choose, your age, the number of family members covered and your county of residence. Deductibles, coinsurance, limitations and exclusions apply to this coverage. Pre-existing condition waiting periods may also apply. Further details of coverage, limitations and exclusions and terms under which the policy can be continued in force will be included in your free information packet.
Your coverage will automatically renew. Your coverage may be canceled by Blue Cross NC for fraud or intentional misrepresentation of material fact on your application or for nonpayment of premiums. Coverage for dependent children ends at the end of the month they become age 26. Members will be notified 30 days in advance of any change in coverage. To be eligible for a catastrophic health plan, you must be under 30 years of age when the plan begins or qualify for a hardship exemption through the federal government.
Telehealth benefits are available on all plans either from Blue Cross NC or through the provider network. Blue Cross NC provides the telehealth program for your convenience and is not liable in any way for the goods or services received. Blue Cross NC reserves the right to discontinue or change the program at any time without prior notice. Decisions regarding your care should be made with the advice of a doctor. Depending on your plan, selected programs may not be available to you at this time. Check with Blue Cross NC Customer Service to determine your eligibility. Blue Cross NC has contracted with a third-party vendor independent from Blue Cross NC to bring you telehealth benefits.
Preventive care services as defined by recent federal regulations are covered at no charge to you in-network. Federal and state-mandated preventive services are available out-of-network, for which members will pay deductible and coinsurance, plus charges over the allowed amount. Visit bluecrossnc.com/preventive for more details.
Pay as little as $0 per month – based on internal Blue Cross NC data, 2023. Includes any applicable subsidy from the federal government that determines eligibility and subsidy amount for plans purchased on the federally facilitated Marketplace.
Better claims payment - compared to the national average, Pollitz, K., Lo, J., Wallace, R., Mengistu, S. (2023, February 9). Claims Denials and Appeals in ACA Marketplace Plans in 2021. Kaiser Family Foundation (KFF). www.kff.org/private-insurance/issue-brief/claims-denials-and-appeals-in-aca-marketplace-plans/ (Accessed September 2023).
Three free in-network primary care provider (PCP) visits available on specific plans.
$0 to $3 Rx Drugs – for many prescriptions.
98% of hospitals and 95% of providers in our network - Blue Cross NC Provider Internal Data; percentages indicated represent Blue Cross NC’s PPO Network as of July 28, 2022.
Highly Ranked Hospital Networks - Source: U.S. News and World Report, https://health.usnews.com/best-hospitals/area/raleigh-durham-nc (Accessed October 2023), Source: U.S. News and World Report, https://health.usnews.com/best-hospitals/area/charlotte-nc (Accessed October 2023)
HealthSherpa is an independent company providing health plan enrollment services on behalf of Blue Cross NC. HealthSherpa does not offer Blue Cross or Blue Shield products or services.
The federal government determines eligibility and subsidy amount for health insurance plans purchased on the federally facilitated Marketplace. Details can be found at HealthCare.gov
© 2023 Blue Cross and Blue Shield of North Carolina. ®, SM are marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. All other marks and names are property of their respective owners. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. NGFPPO-I, 5/23; NGFEPO-I, 5/23; ACAPOS-I, 5/23. U43722, 10/23.
