Blue Cross and Blue Shield of North Carolina BlueOptionsHSA Basics

If you already know how a BCBSNC high deductible health plan or HSA plan works then you can skip this part of the article.

The the idea here is that you would self-insure or cash pay for routine services in exchange for low maximum out-of-pocket exposure.

One of the problems that the BlueOptionsHSA solves is that most North Carolina health insurance co-pay plans do not credit office copayments nor prescription drug deductibles which can be $250-$500 a year per person and do not include copayments or coinsurance for prescription drugs towards the plan deductible..

Let’s look at a real world example so that we can understand exactly how the BlueOptionsHSA help’s us

For our example, we’ll look at a family of two in Charlotte considering a $5450 deductible HSA plan from Blue Cross Blue Shield.

Now with the HSA plan once the deductible is met, all covered services are paid for by Blue Cross Blue Shield for the rest of the year. and this is the family deductible not per person, that is an important feature to keep in mind when comparing individual health insurance plans in North Carolina.

So the monthly premium rate would be $306 for a married couple in Charlotte.

If you wanted a comparable out-of-pocket of around $5000 for a family or $2500 per person with co-pays for office visits and for medications you would be looking at a rate of about $631 a month for the Blue Advantage Plan A.

You would be paying an extra $3600 a year just so your office visits and medications are covered at a flat co-pay. Not to mention the fact that if you enroll in a high deductible health plan also referred to as a consumer driven health plan then you can open up a health savings account at your local bank.

The reason you may want to do this, is that you could write off your $5000 deductible on your taxes at the end of the year– this is only with an HSA eligible plans.


Now you may be asking yourself why should I pay $300 a month for an affordable health insurance plan that won’t pay anything until my deductibles is met?

Well the good news is that since this plan utilizes a PPO network, you are only going to be charged whatever Blue Cross’s contracted rate is for the medical service you are being provided.

And that is the amount you would pay out of your pocket and it’s credited towards your deductible for the year until you deductible is met.

As an example, if you want to the emergency room and needed to have an MRI and CAT scan done and your bill was $3000 without health insurance.

Let’s say Blue Cross’s negotiated or contracted rate for that service was $1200, you would only pay 1200-meaning you saved $1800, and that 1200 would be credited towards your deductible for the year. If you opened up the health savings account at your local bank to go along with your plan you could write off that $1200 on your taxes.

So as you can see in almost any situation regardless if you’re single, a couple or family with children the HSA plan from Blue Cross Blue Shield North Carolina will always make the most sense coming from a pure insurance perspective.

However we do recognize not many agents are recommending this kind of health insurance plan since many consumers are not aware that they are available or how they work.

We here at believe it’s worth the extra time on our part to educate our clients, so that they get the best product that meets their needs and budget and we have a happy and informed client!

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