Blue Connect℠ is your go-to source for tools and information about your health plan, including claims and what’s left to pay before your payment plan kicks in.
Register for Blue Connect today for quick access to plan info and in-network providers.
Understanding the details of your health care plans means you can better manage your overall health. By taking advantage of built-in benefits, like preventive care or nutrition counseling, you gain control of your health care and save money.
Get the most from your coverage by understanding how it works and what your care options are. Learn how to take advantage of all the no-cost and low-cost benefits you get, from telehealth to discount programs. You can even use a cost estimator, so you know what you’re paying before you go to the doctor.
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Blue Connect℠ is your go-to source for tools and information about your health plan, including claims and what’s left to pay before your payment plan kicks in.
Register for Blue Connect today for quick access to plan info and in-network providers.
Download the Blue Connect Mobile℠ app to access your digital ID card.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) negotiates special lower rates with doctors and medical facilities that meet our quality standards. Then we build plan networks that get you the best savings.
It's important to have a doctor you see regularly. When your primary care provider (PCP) is in your network, your out-of-pocket costs are lower. And if you need to see a specialist, the network matters even more, since costs can be higher.
See if a provider is in your plan’s network with our Find a Doctor tool on Blue Connect℠ or Blue Connect Mobile℠. It’s a simple way to search for doctors, specialists and facilities that accept your Blue Cross NC health plan. If you’re traveling, the tool will find out-of-state providers that accept your plan, too.
Find a health care provider or location in your network with our Find a Doctor tool.
HOW-TO: Click the button above and log in to Blue Connect. Select “Find a Doctor.” Browse by specialty, like Urgent Care or Behavioral/Mental Health. Or enter the specialty, procedure or provider you're looking for in the search bar.
If you have a plan that covers prescription drugs, your network includes pharmacies as well as drug "tiers," which determine the cost of your medications and what's covered by your plan.
Go to the Prescriptions section of Blue Connect to access Prime Therapeutics with your plan information pre-loaded. There you can:
Use our tools to save money. Get your prescriptions filled at in-network pharmacies and know your Rx costs up front.
NOTE: If you do not have Blue Cross NC prescription drug coverage, you will not have access to the Blue Connect Prescriptions page. Check your Benefit Booklet for more information on your coverage.
When you know your plan, you know how to make the most of it. Explore below to boost your knowledge of health care coverage so you can use yours well.
Time for a refresher? These are some of the top terms that can help you use your plan better.
An “allowed amount” is the amount in-network doctors and health care facilities have agreed to accept as full payment on covered services for Blue Cross NC members. It’s usually lower than their normal charge.
Your coinsurance is your % share of medical costs after you’ve met your deductible for your benefit period (plan year). (Usually 10-30% based on plan and provider type). Not all plans have coinsurance.
Your copayment (copay) is how much you pay for medical services when you receive them. The fixed cost you pay when you check out at the doctor’s office is your copay (usually around $20 or so – cost varies by plan). Not all plans have a copay.
Your deductible is the set amount you pay toward medical services before Blue Cross NC starts paying toward those services during your benefit period (plan year).
This is the limit on the amount of money you can pay during a plan year. If you meet the out of pocket limit, we pay 100% of covered medical services and procedures.
Wondering what a pre-existing condition is? Don’t worry, we cover them. What’s an excluded service? Still confused about deductibles?
Learn more about how your plan works in the "Beginner's Guide to Understanding Health Insurance" on our blog.
All your plan information is detailed in the Benefit Booklet you receive at the beginning of your plan year. You can also find these terms on your member ID card, the Explanation of Benefits (EOB) mailed to you after claims are processed, and on the Blue Connect Benefits page and Claims page.
At your appointment, ask your doctor:
Will any additional tests or treatments I get during my appointment not be considered preventive care?
Will talking about other topics that are not considered preventive care during my appointment lead to out-of-pocket costs?
Can any routine lab work be sent to a Blue Cross NC in-network lab to lower any out-of-pocket costs?
When you schedule your appointment, also check that both your doctor and the location are in your network.
Ask the scheduler or check the Find a Doctor tool.
Open Enrollment Period (OEP) is the one time a year when you can make changes for the next plan year.* Your employer will tell you when your OEP is and give you information to help you make coverage decisions. If you have questions, your HR department is there to help.
Help – I need a plan change and it’s not OEP! You can make changes during the year if you have what’s called a qualifying life event, like a change in the size of your household (getting married, having a baby, etc.). Here’s a list of the most common qualifying life events. Check this list and talk to HR to determine if you can make changes to your plan outside of OEP.**
Other, less common life events, such as natural disasters and enrollment in government programs, may also make you eligible. Please see HR if you feel your situation warrants a plan change.
You involuntarily lose your main health coverage
Your household size changes
(more or fewer dependents, etc.)
Your address (where you live) changes
You’re eligible for coverage when you weren’t before
You used to have help paying for coverage and you no longer do
There is an error in your plan, or there was an error when you enrolled in your plan
*You can make changes outside of OEP if you have a “qualifying life event.”
**Having a situation on this list is not a guarantee that you can make changes. Please talk to your HR representative.
The secure and private Inbox on your Blue Connect homepage is a great way to connect with Customer Service to ask questions about your account.
For questions about your plan, bills or claims, call the Customer Service number on the back of your Blue Cross NC member ID card.
Log in to Blue Connect to get the right phone number for your plan or to contact us via email.
Preventive care is routine health care that includes screenings, services and counseling to help prevent illness, disease or other health problems. It also includes well-baby visits and immunizations that can keep your family healthy.
Many preventive care services from in-network doctors are covered at 100% with no out-of-pocket costs to you as part of your health plan.1
Below are examples of common services your doctor may do that are not identified as preventive care by the ACA, so are not 100% covered.* These services may cost you money at your doctor's office or lab:
No-cost preventive care services are listed in detail in your benefit booklet. Check what’s covered and educate yourself before you go to the doctor, so you can avoid any costs you weren't expecting.
Download our preventive care flyer with a more in-depth list of some of the most common covered services for men, women and children. It includes questions to ask your doctor to avoid a surprise bill later.
Go to our preventive care site to find covered services for men, women and children – like cancer screenings, flu shots and childhood immunizations – and when you should get them.
Focus on small steps to better health. Little things – done day-by-day – build healthy habits that can last a lifetime. The wellness resources and education on Blue Connect can help. Keep an eye out for our emails and letters, too. It’s often an invitation to join a special program or take a specific action to improve your health!
Blue Cross NC is committed to helping you make the most of your health care, and that includes finding ways to save you money. Blue365® is a member discount program that helps you get exclusive deals on health and fitness products.2
Choose weekly discounts from health and wellness categories including:
Joining Blue365 is easy – and taking advantage of the discounts is even easier.
Your wellbeing is about more than just your physical health. It's important to remember to take care of both mind and body – the total health package. That's why we're working with both PCPs (primary care providers) and behavioral health (mental health + substance use) providers to help you get the care you need at the right time. We have programs, partnerships and tools in place to connect your health care team and identify behavioral health concerns early, so you can live your best life.
Access our Blue Connect℠ member site to find an in-network provider.
Search for keywords like: Psychologist, Psychiatrist, Social Worker, Therapist, Substance Abuse Facility, or Counselor.
Talk to your primary care provider. He or she can address your concerns in the office or refer you to a behavioral health provider.
We will help connect you to a high-quality behavioral health provider or program.
800-359-2422
QuitlineNC offers Blue Cross NC members counseling and nicotine replacement therapy at no extra cost to you.
Call 1-844-8NCQUIT to quit for keeps.
Personalized nutrition counseling is covered by most Blue Cross NC plans as preventive care. Check your Benefit Booklet for details. Go to Blue Connect to learn more or find a nutrition counselor in your network with our Find a Doctor tool.
You can get the most value from your plan if you stay in your network, understand your care options (including cost differences in locations) and take advantage of medication savings.
What you pay for medical services can vary based on where you go. The same doctor can cost you more at a different location because of a facility charge at that location, no matter what coverage you have.
Our cost estimator tool lets you compare costs for a range of medical services and procedures covered by your plan and check providers at different locations. By knowing how much a doctor or facility may charge, you can save money and avoid surprises.
HOW-TO: Click the button above and log in to Blue Connect. Select “Find Medical Costs.” Then, click the Browse Categories drop-down and choose Medical Procedures to find a specific service – or enter the procedure in the search bar.
If you have prescription drug coverage with Blue Cross NC, you have access to a Prescriptions section in Blue Connect℠. There you can learn more about using in-network pharmacies and other great ways to cut down on medication costs.
Manage your prescriptions
NOTE: If you do not have Blue Cross NC prescription drug coverage, you will not have access to the Blue Connect Prescriptions page.
Check your Benefit Booklet for more information on your coverage.
Our Know Where to Go flyer can help you get the right care at the right place at the right time. When should you go to urgent care vs. the emergency room? How long is the average wait at a drug store (retail) clinic? Go to our KnowMyOptions page to see all the care options your plan offers and create a personalized Quick Reference Guide to print out with your doctor's information.
If your doctor uses a lab that is not in your Blue Cross NC network for your covered lab tests, it may end up costing you more. Your doctor may not know what labs are in your network, so find out before your appointment to save money. Get a list of in-network labs by city or use the Find a Doctor tool on Blue Connect.
We work out special rates with providers to create networks for our members. Using health care providers in your Blue Cross NC network reduces your out-of-pocket costs. Find a health care provider or location in your network with our Find a Doctor tool.
Disclosures:
Preventive care is covered at 100% when 1) it is provided by an in-network doctor, 2) the claim is filed as a preventive visit and 3) services are identified as preventive care under the Affordable Care Act (ACA). Most plans are covered at 100%, but not all (e.g., grandfathered plans). Check the full list of services and any limitations on our website at BlueCrossNC.com/Preventive or in your Benefit Booklet.
Blue365 offers access to savings on items that Members may purchase directly from independent vendors, which are different from items that are covered under the policies with Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Any disputes regarding these products and services may be subject to the Blue Cross NC grievance process. Blue Cross and Blue Shield Association (BCBSA) may receive payments from Blue365 vendors. Neither Blue Cross NC nor BCBSA recommends, endorses, warrants or guarantees any specific Blue365 vendor or item. This program may be modified or discontinued at any time without prior notice.
Learn more and get help on the National Suicide Prevention Lifeline website: www.suicidepreventionlifeline.org. The National Suicide Prevention Lifeline is a 24-hour, toll-free, confidential suicide prevention hotline available to anyone in suicidal crisis or emotional distress. The Lifeline is offered by the Suicide Prevention Resource Center. Neither Blue Cross NC nor the Blue Cross and Blue Shield Association (BCBSA) recommends, endorses, warrants or guarantees any specific result or service provided by another organization.
EAP is a confidential voluntary, work-based program that offers free counseling for work related and/or personal problems. Ask your employer if there's an EAP program where you work.
Telehealth offers virtual consults with doctors, counselors, psychiatrists or other health professionals via video, phone or mobile app. Ask your employer if this program is available through your plan. Telehealth services are subject to the terms and conditions of the member’s health plan, including benefits, limitations and exclusions. Telehealth services are not a substitute for emergency care. Decisions regarding your care should be made with the advice of your doctor.
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Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
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