BlueCross BlueShield of North Carolina Medicare Plans Review
Learn about BlueCross BlueShield of North Carolina and the insurance plans they offer, including BlueCross BlueShield Medicare plans. Depending on where you live, you may have several Blue Cross NC plans available to choose from.
BlueCross BlueShield of North Carolina is one of the affiliate insurance companies that operate under the umbrella of the Blue Cross Blue Shield brand. In this review, we highlight Blue Cross NC Medicare plans as well as the other insurance products offered by Blue Cross NC to help you find the right plan for your needs.
Blue Cross NC has been selling health insurance since 1933 with a headquarters in Durham, NC and major operation centers in Fayetteville and Winston-Salem, NC. The company serves more than 3.8 million members and is the largest private insurer in the state of North Carolina.1
Blue Cross NC members enjoy access to 96% of doctors and 99% of all general acute-care hospitals in North Carolina. And outside the state, members still retain access to certain coverage with doctors and hospitals in all 50 states.
Blue Cross NC is well known for its Medicare plan offerings. The company sells all three types of private Medicare insurance which are detailed below.
Blue Cross NC Medicare Advantage
Medicare Advantage (Medicare Part C) plans provide all of the same benefits found in Original Medicare (Part A and Part B). Most Medicare Advantage plans may also cover a number of benefits not found in Original Medicare, such as coverage for dental care, vision care and eyeglasses, prescription drugs and other perks.
Blue Cross NC offers multiple different Medicare Advantage plans in the form of Health Maintenance Organization (HMO) plans and Preferred Provider Organization (PPO) plans. Many of these plans are available for a $0 monthly premium and include such benefits as:
- Hearing aids
- Prescription drugs
- Over-the-counter health products
- Silver&Fit membership
- Non-emergency medical transportation
Blue Cross NC also sells Dual-eligible Special Needs Plans (D-SNPs). These plans are specifically designed for beneficiaries of both Medicare and Medicaid and come with a $0 premium and $0 copayments for many services.
Blue Cross NC Medicare Part D
Medicare Part D prescription drug plans provide coverage for prescription medications, which are not covered by Original Medicare. Part D plans from Blue Cross NC may include benefits such as:
- $0 deductibles
- Enhanced coverage gap benefits
- Mail-order drug delivery
- Comprehensive lists of covered drugs
The Blue Medicare Rx Standard plan has no deductible for common generic drugs. The Blue Medicare Rx Enhanced plan, which is available for a higher premium, has no deductible for any drug. Both plans require minimal copayments and offer 30- or 90-day supplies of medications with mail order deliverability.
Plans may be used at Walmart, Walgreens, EPIC, AllianceRx and many other pharmacies big and small.
Blue Cross NC Medicare Supplement Insurance
Medicare Supplement Insurance, or Medigap, provides coverage for some of the out-of-pocket costs required by Original Medicare such as deductibles, copayments, coinsurance and other costs.
Blue Cross NC offers four Medigap plans including the highly popular Plan G. This plan provides coverage for:
- Medicare Part A coinsurance
- Medicare Part B coinsurance or copayments
- First three pints of blood
- Part A hospice care coinsurance or copayments
- Skilled nursing facility care coinsurance
- Part A deductible
- Part B excess charges
- Foreign travel emergency care
Blue Cross NC offers Plan G (along with the high-deductible version of Plan G), Plan K, Plan A and Plan N. The chart below shows the benefits covered by each type of Medigap plan.
|Medicare Supplement Benefits||A||B||C1||D||F1||G||K||L||M||N|
|Part A coinsurance and hospital costs||✓||✓||✓||✓||✓||✓||✓||✓||✓||✓|
|Part B coinsurance or copayment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|First 3 pints of blood||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Part A hospice care co-insurance or co-payment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Co-insurance for skilled nursing facility||✓||✓||✓||✓||50%||75%||✓||✓|
|Medicare Part A deductible||✓||✓||✓||✓||✓||50%||75%||50%||✓|
|Medicare Part B deductible||✓||✓|
|Medicare Part B excess charges||✓||✓|
|Foreign travel emergency||80%||80%||80%||80%||80%||80%|
|1. Plans C and F are not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
2. Plans F and G also offer a high deductible plan which has an annual deductible of $2,370 in 2021. Once the annual deductible is met, the plan pays 100% of covered services for the rest of the year. The high deductible Plan F is not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
3. Plan K has an out-of-pocket yearly limit of $6,220 in 2021. Plan L has an out-of-pocket yearly limit of $3,110 in 2021.
4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 for emergency room visits that don’t result in an inpatient admission.
View an image version of this table.
Blue Cross NC offers both individual and family health insurance plans for those not yet eligible for Medicare. Three levels of plans provide:
- 100% preventive care coverage
- No referrals needed for specialist appointments
- Large networks of participating providers
- 24/7 telehealth access
- Discounts on products related to fitness, personal care, healthy eating and more
- Government subsidies for qualifying individuals or households
Blue Cross NC also offers standalone vision plans and standalone dental plans in addition to supplemental coverage such as short-term care, disability, term-life, critical illness and hospital coverage.
Every year, Medicare evaluates plans based on a 5-star rating system. The Centers for Medicare & Medicaid Services (CMS) rates all Medicare Advantage and Medicare Part D plans on the 5-star scale according to quality.
In 2021, Blue Cross and Blue Shield of North Carolina earned an overall three star rating. A three-star rating is considered average.
One great way to enroll in a Medicare plan from Blue Cross NC is to work with a licensed insurance agent who can help you gather all of your available plan options, confirm your eligibility, answer any questions and guide you through the enrollment process.
It’s important to keep in mind that there may be several different insurance carriers selling Medicare plans in an area, so it’s wise to shop around for the best coverage and costs for your needs.