Review Your Benefit Options
Medical
Medical Benefits
Overview
CAGC offers four medical plan options administered by Blue Cross and Blue Shield of North Carolina (Blue Cross NC). All plans use the same network of providers who have agreed to charge discounted rates to plan members. The amount you pay for health care will vary depending on whether or not you use in-network providers and facilities. You always have the choice to go to any provider, but you’ll pay less if you stay within the Blue Cross NC Blue Options℠ network.
Plan Highlights
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Platinum | Gold | Silver | HDHP H.S.A | |
---|---|---|---|---|
In-Network | In-Network | In-Network | In-Network | |
Deductible | ||||
Individual | $1,000 | $3,500 | $5,000 | $5,000 |
Family | $2,000 | $7,000 | $10,000 | $10,000 |
Coinsurance | 80% | 80% | 80% | 70% |
Out-of-Pocket Max. | ||||
Individual | $3,000 | $7,000 | $9,450 | $8,050 |
Family | $6,000 | $14,000 | $18,900 | $16,100 |
Inpatient Services | ||||
Inpatient Facility | 20% Coinsurance | 20% Coinsurance | 20% Coinsurance | 30% Coinsurance |
Emergency Room | Covered at 100% after $300 copay | Covered at 100% after $300 copay | Covered at 100% after $500 copay | 30% Coinsurance |
Physician Office Visits | ||||
Preventive Care | 100% Covered | 100% Covered | 100% Covered | 100% Covered |
Primary Care | $15 Copay | $25 Copay | $35 Copay | 30% Coinsurance |
Specialist Office | $30 Copay | $50 Copay | $70 Copay | 30% Coinsurance |
Outpatient Services | ||||
Outpatient Surgical | 20% Coinsurance | 20% Coinsurance | 20% Coinsurance | 30% Coinsurance |
Diagnostic X-Ray Lab | 20% Coinsurance | 20% Coinsurance | 20% Coinsurance | 30% Coinsurance |
Mental Health / Substance Abuse | 20% Coinsurance | 20% Coinsurance | 20% Coinsurance | 30% Coinsurance |
Prescription Drug | ||||
Tier 1 | $4 Copay | $4 Copay | $15 Copay | 30% Coinsurance |
Tier 2 | $25 Copay | $25 Copay | $45 Copay | 30% Coinsurance |
Tier 3 | $35 Copay | $35 Copay | $85 Copay | 30% Coinsurance |
Tier 4 | $75 Copay | $75 Copay | $105 Copay | 30% Coinsurance |
Tier 5 | 25% Coinsurance | 25% Coinsurance | 25% Coinsurance | 30% Coinsurance |
Total Monthly Premium
Platinum | Gold | Silver | HDHP H.S.A | |
---|---|---|---|---|
Single | $817.45 | $695.49 | $610.87 | $451.65 |
Employee + Spouse | $1,801.35 | $1,533.07 | $1,346.91 | $996.63 |
Employee + Child | $1,559.12 | $1,327.42 | $1,166.63 | $864.14 |
Family | $2,543.04 | $2,164.99 | $1,902.68 | $1,409.13 |
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