BESTOne Advantage Gold – PPO
Network type: PPO
Coverage tier: High
Basic Dental: 10% after deductible
Major dental care: 50% after deductible
Orthodontics: Not covered
Exams: No charge
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BESTOne Base Silver – PPO
Network type: PPO
Coverage tier: High
Basic Dental: 50% after deductible
Major dental care: 100%
Orthodontics: Not covered
Exams: No charge -
BESTOne Basic Silver – PPO
Network type: PPO
Coverage tier: High
Basic Dental: 30% after deductible
Major dental care: 60% after deductible
Orthodontics: Not covered
Exams: No charge -
BESTOne Gold Plus – PPO
Network type: PPO
Coverage tier: High
Basic Dental: 30% after deductible
Major dental care: 60% after deductible
Orthodontics: Not covered
Exams: No charge -
Blue Local Bronze | $60 PCP | $20 Tier 1 Rx | with Atrium Health – EPO
Network type: EPO
Coverage tier: Expanded Bronze
Primary care visit: $60 copay
Specialist visit: $120 copay
Urgent care visit: $120 copay -
Blue Local Bronze | 3 Free PCP | $20 Tier 1 Rx | Integrated | with Atrium Health – EPO
Network type: EPO
Coverage tier: Expanded Bronze
Primary care visit: $100 copay
Specialist visit: $150 copay
Urgent care visit: $150 copay -
Blue Local Bronze | HSA Eligible | Integrated | with Atrium Health – EPO
Network type: EPO
Coverage tier: Expanded Bronze
Primary care visit: No charge after deductible
Specialist visit: No charge after deductible
Urgent care visit: No charge after deductible -
Blue Local Bronze Standard | with Atrium Health – EPO
Network type: EPO
Coverage tier: Expanded Bronze
Primary care visit: $50 copay
Specialist visit: $100 copay
Urgent care visit: $75 copay -
Blue Local Gold | 3 Free PCP | $10 Tier 1 Rx | with Atrium Health – EPO
Network type: EPO
Coverage tier: Gold
Primary care visit: $10 copay
Specialist visit: $40 copay
Urgent care visit: $40 copay -
Blue Local Gold Standard | with Atrium Health – EPO
Network type: EPO
Coverage tier: Gold
Primary care visit: $30 copay
Specialist visit: $60 copay
Urgent care visit: $45 copay -
Blue Local Silver Choice | 3 Free PCP | $15 Tier 1 Rx | with Atrium Health – EPO
Network type: EPO
Coverage tier: Silver
Primary care visit: $50 copay
Specialist visit: $100 copay
Urgent care visit: $100 copay -
Blue Local Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | with Atrium Health – EPO
Network type: EPO
Coverage tier: Silver
Primary care visit: $55 copay
Specialist visit: $110 copay
Urgent care visit: $110 copay -
Blue Local Silver Secure | $15 PCP | $15 Tier 1 Rx | with Atrium Health – EPO
Network type: EPO
Coverage tier: Silver
Primary care visit: $15 copay
Specialist visit: $150 copay
Urgent care visit: $150 copay -
Blue Local Silver Standard | with Atrium Health – EPO
Network type: EPO
Coverage tier: Silver
Primary care visit: $40 copay
Specialist visit: $80 copay
Urgent care visit: $60 copay -
Blue Value Bronze | $60 PCP | $20 Tier 1 Rx | Statewide Doctors – POS
Network type: POS
Coverage tier: Expanded Bronze
Primary care visit: $60 copay
Specialist visit: $120 copay
Urgent care visit: $120 copay -
Blue Value Bronze | 3 Free PCP | $20 Tier 1 Rx | Integrated | Statewide Doctors – POS
Network type: POS
Coverage tier: Expanded Bronze
Primary care visit: $100 copay
Specialist visit: $150 copay
Urgent care visit: $150 copay