Blue Local Silver 4000 (local network with Atrium Health) POS

Blue Cross and Blue Shield of NC
Silver
The Blue Local Silver 4000 (local network with Atrium Health) is a health plan issued by Blue Cross and Blue Shield of NC for the year 2021. The plan is offered by the U.S. federal government through Healthcare.gov under the Affordable Care Act.

Overview

Plan issuer
Blue Cross and Blue Shield of NC
Child-only offering
Allows Adult and Child-Only
Adult dental coverage
No
Child dental coverage
Yes
Plan type
POS

The Blue Local Silver 4000 (local network with Atrium Health) plan is a Point of Service (POS) plan. You pay less if you use doctors and hospitals within the plan's network. To see a specialist, you will need a referral from your primary care doctor.

Metal level
Silver

The metal type provides an estimate of how you and your insurance split the costs of healthcare. Silver plans have:

  • Moderate monthly premium
  • Moderate costs when you need care
  • Deductibles are usually lower than that those of Bronze plans

Silver plans are a good choice if you quality for 'extra savings' or if you want to pay a slightly higher premium than Bronze plans to have more of your care covered.

Contact

Customer service number
1-800-324-4973
Toll-free customer service number
1-800-324-4973

Coverage

Doctor coverage

Primary care physician visit cost
$10
Specialist visit cost
$50
Emergency visit cost
40% Coinsurance after deductible
Inpatient facility cost
40% Coinsurance after deductible
Inpatient physician cost
40% Coinsurance after deductible

Drug coverage

Generic drug cost
$10 Copay after deductible
Preferred brand drug cost
$40 Copay after deductible
Non-preferred brand drug cost
$80 Copay after deductible
Specialty drug cost
50% Coinsurance after deductible

Deductible

Individual
Medical deductible individual
$4,000
Drug deductible individual
$350
Medical maximum out of pocket individual
$8,550
Drug maximum out of pocket individual
Included in Medical
Family
Medical deductible family
$8,000
Drug deductible family
See Plan Brochure
Medical maximum out of pocket family
$17,100
Drug maximum out of pocket family
Included in Medical
Family per person
Medical deductible family per person
$4,000
Drug deductible family per person
$350
Medical maximum out of pocket family per person
$8,550
Drug maximum out of pocket family per person
Included in Medical

Premium payment

The premium is the amount you pay for health insurance each month. This does not include other healthcare costs such as your deductible, copayments, and coinsurance.

Your premium depends on who is covered by the insurance and their ages. Generally, premiums increase if there are more people covered or if people covered are older.

Premium rates

Coverage Monthly premium Annual premium
Child (age 0-14) $382.60 $4,591.20
Child (age 18) $456.62 $5,479.44
Adult individual (age 21) $500.13 $6,001.56
Adult individual (age 27) $524.14 $6,289.68
Adult individual (age 30) $567.65 $6,811.80
Adult individual (age 40) $639.17 $7,670.04
Adult individual (age 50) $893.23 $10,718.76
Adult individual (age 60) $1,357.35 $16,288.20
Couple (age 21) $1,000.26 $12,003.12
Couple (age 30) $1,135.30 $13,623.60
Couple (age 40) $1,278.34 $15,340.08
Couple (age 50) $1,786.46 $21,437.52
Couple (age 60) $2,714.70 $32,576.40
Couple (age 21) plus 1 child $1,382.86 $16,594.32
Couple (age 30) plus 1 child $1,517.90 $18,214.80
Couple (age 40) plus 1 child $1,660.94 $19,931.28
Couple (age 50) plus 1 child $2,169.06 $26,028.72
Couple (age 21) plus 2 children $1,765.46 $21,185.52
Couple (age 30) plus 2 children $1,900.50 $22,806.00
Couple (age 40) plus 2 children $2,043.54 $24,522.48
Couple (age 50) plus 2 children $2,551.66 $30,619.92
Couple (age 21) plus 3 or more children $2,148.06 $25,776.72
Couple (age 30) plus 3 or more children $2,283.10 $27,397.20
Couple (age 40) plus 3 or more children $2,426.14 $29,113.68
Couple (age 50) plus 3 or more children $2,934.26 $35,211.12
Single parent (age 21) plus 1 child $882.73 $10,592.76
Single parent (age 30) plus 1 child $950.25 $11,403.00
Single parent (age 40) plus 1 child $1,021.77 $12,261.24
Single parent (age 50) plus 1 child $1,275.83 $15,309.96
Single parent (age 21) plus 2 children $1,265.33 $15,183.96
Single parent (age 30) plus 2 children $1,332.85 $15,994.20
Single parent (age 40) plus 2 children $1,404.37 $16,852.44
Single parent (age 50) plus 2 children $1,658.43 $19,901.16
Single parent (age 21) plus 3 or more children $1,647.93 $19,775.16
Single parent (age 30) plus 3 or more children $1,715.45 $20,585.40
Single parent (age 40) plus 3 or more children $1,786.97 $21,443.64
Single parent (age 50) plus 3 or more children $2,041.03 $24,492.36

Source

Our data is directly sourced from Healthcare.gov, the U.S. federal government's Health Insurance Marketplace®, created under the Affordable Care Act.