BlueAdvantage^® BlueValue^SM

Morrow Insurance Agency, Inc.

WHY CHOOSE BLUE

There’s a lot to think about when it comes to choosing health insurance. As the only homegrown, local insurer in all 100 counties of the state¹, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is here for you. With over 85 years of experience in the market and our broad range of plans², you can find the coverage that’s right for you.

The benefits that are important for getting and staying healthy are at the core of all of our plans. Advantages of health care coverage with Blue Cross NC include:

No referrals needed to see a specialist
Coverage in- and out-of-network
24/7 Telehealth care options for behavioral and physical health, available in English and Spanish³
Convenience of 90-day prescription mail order option
No waiting periods for pre-existing conditions⁴
Annual wellness visits
Programs to help you control your type 2 diabetes⁵
Programs to help you quit smoking⁵
Access to Blue365®, which offers special member discounts on vitamins, healthy food delivery, fitness resources and more from national health and wellness retailers⁶
Affordable dental and vision plans available to complement your medical plan and support your whole health
Three Blue Cross NC Centers and six Authorized Agent Retail Stores located around the state, where you can get one-on-one assistance and take advantage of special classes offered at the Centers

With our plans you’ll enjoy:

Preventive care and essential health benefits – For all Blue Cross NC individual plans mentioned in this brochure, preventive services are covered at no charge when you go to an in-network provider.⁷ These covered services include annual exams, screenings for diabetes, mammograms and more. See BlueCrossNC.com/Preventive for a list of preventive care services. All Blue Cross NC plans mentioned in this brochure also provide coverage for essential health benefits including mental health, maternity and pediatric dental/vision. For a complete list, visit BlueCrossNC.com/Essential.
Online member tools – Blue Connect^SM is your gateway and guide to the tools and information you need to make the best decisions about your health care and plan. Through the Blue Connect^SM mobile app, you can access your digital member ID card, claim status, coverage details and much more.
Customer service to make using insurance easier – You can reach us by phone, send a secure inbox message or use our live chat feature. Our local customer service staff is ready to answer your questions quickly and accurately.
Coordinated care from high-quality doctors – With access to a network of high-quality providers, you can select and establish a relationship with a primary care provider (PCP) to serve as your medical “home” – or the quarterback of your entire health care team. From routine preventive care to occasional sick visits, having a primary doctor can help you take better control of your health and coordinate the care you need. Go to BlueCrossNC.com/ChooseMyPCP as soon as your plan is active to select your PCP on Blue Connect. If you have any dependents, do the same from their account(s) too.

YOUR CHECKLIST
for buying health insurance

How to sign up, step-by-step:

Enroll between November 1 and December 15, 2020 during the open enrollment period.
Find out if you may receive a subsidy to help pay for your health insurance.10 Contact your local authorized Blue Cross NC agent for help
Think about your health care needs. Visit BlueCrossNC.com/FindDoctors to verify which doctors and hospitals are in network for the selected plan.
Submit your application.
Pay for your plan. Your new health insurance plan will not become effective until Blue Cross NC receives and processes your first month’s premium.
Go to BlueCrossNC.com/ChooseMyPCP in the first month of your plan year to select your PCP on Blue Connect. If you have any dependents, do the same from their account(s) too.
Once open enrollment ends you may be able to buy health insurance if you qualify for a special enrollment period. If you get married, have a new baby, or lose your health coverage, you may qualify.⁹ Documentation will be required.

Two plan options:

Copayment plans offer a fixed copayment (or copay) for things like office visits and prescriptions. While you’ll know what you’re going to pay with copay plans, they come at a higher monthly premium cost. These plans are ideal for someone who wants predictable costs and doesn’t mind paying more in premiums.
Deductible and coinsurance plans have lower premiums than copayment plans. If you don’t expect a lot of medical expenses, this may be a good choice for you. With these plans, you pay the full cost of your medical expenses until you meet your deductible. After meeting your deductible, you will pay a coinsurance percentage for health care. This means you will share your health care costs with Blue Cross NC until you reach your out-of-pocket limit. Once you reach your out of pocket limit, Blue Cross NC pays all covered costs.

Limitations & Exclusions

Like most health care plans, Blue Advantage, Blue Home with Novant Health, Blue Home with UNC Health Alliance, Blue Local with Atrium Health, Blue Local with Wake Forest Baptist Health and Blue Value have some limitations and exclusions. Once you’re enrolled, a Member Guide will be made available to you. It will contain detailed information about your plan benefits, exclusions and limitations.
This is a partial list of benefits and services that are not covered:

Services for or related to assisted reproductive technology or for reversal of sterilization
Treatment of sexual dysfunction not related to organic disease
Services that are investigational in nature or obsolete, including any service, drug, procedure or treatment directly related to an investigational treatment, except as specifically covered by this health benefit plan
Side effects and complications of non-covered services, except for emergency services in the case of an emergency
Services that are not medically necessary
Dental services provided in a hospital, except as specifically covered by your health benefit plan
Services or expenses that are covered by any governmental unit except as required by federal law
Services received from an employer-sponsored dental or medical department
Services received or hospital stays before (or after) the effective dates of coverage
Custodial care, domiciliary care or rest cures
Eyeglasses or contact lenses or refractive eye surgery, except as specifically covered by your health benefit plan
Routine eye examinations for adults
Services for cosmetic purposes, except as specifically covered by your health benefit plan
Services for routine foot care that is palliative or cosmetic
Travel, except as covered by your health benefit plan
Inpatient admissions that are primarily for physical therapy, diagnostic studies or environmental change
Services that are rendered by or on the direction of those other than doctors, hospitals, facility and professional providers
For any condition suffered as a result of any act of war or while on active or reserve military duty
Services for which a charge is not normally made in the absence of insurance, or services provided by an immediate relative
Non-prescription drugs, except as specifically covered by your health benefit plan
Prescription drugs or refills which exceed the maximum supply
Personal hygiene, comfort and/or convenience items
Telephone consultations not provided through telehealth benefits, charges for failure to keep a scheduled visit, charges for completion of a claim form, charges for obtaining medical records and late payment charges
Services primarily for educational purposes
Services not specifically listed as covered services

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. The policy form number for Blue Home with Novant Health, Blue Home with UNC Health Alliance, Blue Local with Atrium Health, Blue Local with Wake Forest Baptist Health and Blue Value is ACAPOS-I, 5/20. The policy form number for Blue Advantage is NGFPPO-I, 5/20. This brochure contains a summary of the benefits only. It is not your insurance policy. Your policy and application are your contract. If there is any difference between this brochure and the policy, the provisions of the policy will control. Visit BlueCrossNC.com for more information.

Footnotes

Blue Cross NC internal data, 2020.
All information discussed in this brochure pertains to Blue Cross NC individual market, medical health insurance plans that are eligible for sale in 2021 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.
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.
Eligibility requirements apply. See benefit booklet for details.
Blue Cross NC provides tobacco cessation and diabetes reversal programs for your convenience. Blue Cross NC is not liable in any way for the goods or services received through the respective vendors. Blue Cross NC reserves the right to discontinue or change the program at any time without prior notification. Decisions regarding your care should be made with the advice of your doctor. 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 these offerings.
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 your Blue Cross NC plan. Any disputes regarding these products and services may be subject to the Blue Cross NC grievance process. The Blue Cross and Blue Shield Association (BCBSA) may receive payments from Blue365 vendors. BCBSA does not recommend, endorse, warrant or guarantee any specific Blue365 vendor or item.
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 examples of preventive care services.
The Dental Blue for Individuals core plan has a six-month waiting period for basic services and a 12-month waiting period for major services. There are no waiting periods on the Dental Blue for Individuals PPO preventive plan. Dental Blue for Individuals is not part of the covered health insurance benefits of any Blue Cross NC plan. Dental Blue for Individuals must be purchased separately. For costs and further details about Dental Blue for Individuals, including exclusions or limitations and terms under which the policy may be continued in force, contact Blue Cross NC or visit BlueCrossNC.com/DentalBlue.
Blue 20/20 for Individuals is not part of the covered health insurance benefits of any Blue Cross NC plan. Blue 20/20 for Individuals must be purchased separately. For costs and further details about Blue 20/20 for Individuals, including exclusions or limitations and terms under which the policy may be continued in force, contact Blue Cross NC or visit BlueCrossNC.com/Blue2020.
Subsidies only available for plans purchased through the federal health insurance Marketplace. Eligibility for and actual amount of any subsidy is determined by the federal Marketplace. Visit healthcare.gov for more information.
You must have a qualifying life event to enroll in a plan on or off Marketplace outside of the Open Enrollment Period. Documentation is required. The federal Marketplace will determine if you qualify for a Marketplace plan.
Blue Cross NC has collaborated with Novant Health to bring you Blue Home with Novant Health. Blue Home with Novant Health is a health insurance plan offered by Blue Cross NC that provides access to a limited network of providers. Novant Health is an independent company that is solely responsible for the physicians and medical facilities it owns and operates. Novant Health does not offer
Blue Cross or Blue Shield products or services.
Blue Cross NC has collaborated with UNC Health Care to bring you Blue Home with UNC Health Alliance. Blue Home with UNC Health Alliance is a health insurance plan offered by Blue Cross NC that provides access to a limited network of providers. UNC Health Care is an independent company that is solely responsible for the physicians and medical facilities it owns and operates. UNC Health Care does not offer Blue Cross or Blue Shield products or services.
Blue Cross NC has collaborated with Atrium Health to bring you Blue Local with Atrium Health. Blue Local with Atrium Health is a health insurance plan offered by Blue Cross NC that provides access to Atrium Health’s limited network of providers. Atrium Health is an independent company that is solely responsible for the physicians and medical facilities it owns/operates and does not offer Blue Cross or Blue Shield products or services.
Blue Cross NC has collaborated with Wake Forest Baptist Health to bring you Blue Local with Wake Forest Baptist Health. Blue Local with Wake Forest Baptist Health is a health insurance plan offered by Blue Cross NC that provides access to a limited network of providers. Wake Forest Baptist Health is an independent company that is solely responsible for the physicians and medical facilities it owns and operates. Wake Forest Baptist Health does not offer Blue Cross or Blue Shield products or services.
U.S. Department of Health & Human Services, aspe.hhs.gov/poverty-guidelines (Accessed May 2020). These 2020 FPL guidelines are for the 48 contiguous states and Washington, D.C.

Download the 2021 Health Plans for Individuals and Families Brochure (pdf)

Morrow Insurance Agency, Inc.
800 Beverly Hanks Centre
Hendersonville, NC 28792
828-694-5190
800-228-3132
fax: 828-693-5567

Rhonda Marshall is an independent authorized producer licensed to sell and promote products from Blue Cross and Blue Shield of North Carolina (Blue Cross NC). The content contained in this site is maintained by Morrow Insurance Agency, Inc. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association^®. Blue Cross and Blue Shield of North Carolina products can be only sold to those residing in North Carolina. ^® Registered mark of the Blue Cross and Blue Shield Association

Blue Cross NC Non-Discrimination Policy and Accessibility Services

Apply Now