Overview of PPO Plans
Listed below are links to plan summaries and benefits booklets for each of the plans.
Summaries of Coverage
Listed below are links to Summary of Coverage documents for each plan:
Although your Benefits Booklet provides a good overview of what services and products are available to you under the PPO plans, the medical policies provide detailed information around the circumstances under which certain services and products are and are not covered. Medical policies can be found here on the Blue Cross Blue Shield website*.
In addition, you can find a list of upcoming medical policy changes by clicking here.
Certain services require prior review and certification before they can be covered by your health insurance plan. Click here for more information.
AppealsIf you disagree with the way a claim has been handled, you can request an appeal or grievance review. For the complete appeals process, please click here.
Health Plan Frequently Asked Questions (FAQs)
Archived DocumentsArchived rate sheets, Benefits Booklets and other materials can be found by clicking here.
* If any of the State Health Plan medical policies conflict with the Blue Cross and Blue Shield of North Carolina medical policies, the State Health Plan medical policies will prevail.
Explore My Medical Benefits