Blue Cross Blue Shield of South Carolina

With more than 2 million people covered, Blue Cross Blue Shield of South Carolina is the number one health insurance carrier in South Carolina.

Palmetto State residents like it because of its combination of comprehensive coverage, price competitiveness, and extensive network of physicians and other providers across the state. 

Advantages of Blue Cross Blue Shield of South Carolina

 With over 10,000 in-network providers, and access to every hospital in South Carolina,Blue Cross Blue Shield of South Carolina members have access to the broadest range of medical professionals and facilities in the state.

This huge provider network can help reduce out-of-pocket expenses for care compared to going out-of-network. 

Additionally, BCBS SC offers affordable ACA-qualified plans across multiple tiers including bronze, silver, gold & platinum levels. So there are options available at different price points depending on your needs.

A.M. Best rates Blue Cross Blue Shield of South Carolina as A+ (superior), indicating that  BCBS SC is financially stable and has the resources to pay claims when due.

Blue Essentials

 Blue Essentials plans are classified as Health Maintenance Organization (HMO) plans.

These plans typically have lower monthly premiums compared to Blue Exclusive plans. But they may have higher out-of-pocket costs, such as deductibles and copayments.

As HMOs, Blue Essentials plans usually require members to choose a primary care physician (PCP) who coordinates their healthcare and provides referrals to specialists.

You also must use in-network providers and facilities.

Members may have to obtain pre-authorization for certain services or treatments.

Blue Exclusive

Blue Exclusive plans are available only in Greenville, Laurens, Oconee, and Pickens counties, and are generally lower-priced than Blue Essentials.

These plans offer access to a network of healthcare providers and facilities, but members are not required to select a primary care physician or obtain referrals for specialist care.

In-network coverage is available, and out-of-network coverage is typically limited to emergencies only.

Blue Exclusive plans generally have higher monthly premiums compared to Blue Essentials plans. But in the event of an injury or illness requiring medical treatment, Blue Exclusive plans may have lower out-of-pocket costs. 

These plans are better suited for those who may need to see a doctor more often, or who generally expect to consume more health care. 

There are two distinct versions of Blue Essentials plans in South Carolina, Reedy and Cooper plans.

Reedy plan members must visit any hospital and doctor in the Prisma Health Upstate network.Only Prisma Health Upstate providers are in the Reedy network.

Similarly, Cooper plan Members must visit any hospital and doctor in the MUSC Health Alliance network. Only MUSC Health Alliance providers are in the Cooper Lowcountry network.

Note that Prisma and MUSC Health Alliance are separate networks from historical and broader BlueCross BlueShield of South Carolina Individual Health Exchange Network.

The Reedy and Cooper Blue Exclusive plans do not cover costs from care providers from outside their respective networks.

Catastrophic Plans

BCBS South Carolina also offers a low-premium, high-deductible catastrophic plan to people under age 30.

This plan may be suitable for those in very good health who don’t expect to consume much healthcare, and just need coverage for a major medical incident. Everything else would come out-of-pocket, up to a deductible of $9,100 per year ($18,200 per year for families).

These plans do not qualify for an Affordable Care Act subsidy (see below). 

Blue Cross South Carolina and Obamacare subsidies

Rates are based on age, zip code, and smoking status.

Most Blue Cross Blue Shield plans available in South Carolina are ACA-qualified. That means you may qualify for a subsidy to help you pay your health insurance premiums, depending on your income and size of your household.

Those who qualify for subsidies can often find much more affordable rates, and sometimes even zero-premium plans.

Only silver-tier plans and higher qualify for a subsidy. Bronze-level plans do not qualify for a subsidy.

There are some “off-exchange” plans that do not qualify for an Affordable Care Act subsidy. 

Plan Features

 All Blue Cross Blue Shield South Carolina plans include the following services at no additional cost: 

• Immunizations
• Mammograms
• Prostate screenings and lab work (IAW American Cancer Society Guidelines
• Contraceptive devices 
• Flu shots
• Wellness exams

Blue Care on Demand

Blue Cross Blue Shield’s Blue Care on Demand is a telehealth service that allows members to access healthcare remotely through their mobile devices or computers.

It’s based on a free, easy-to-use mobile app that you can download right to your phone.

This money-saving program provides a convenient and cost-effective way for Blue Cross Blue Shield SC plan members to connect with healthcare professionals for non-emergency medical consultations. 

Why people like Blue Care on Demand: 

• Virtual Consultations. Members can have virtual consultations with healthcare providers, including doctors, nurse practitioners, and physician assistants, using live video or secure messaging.
• 24/7 Availability. Blue Care on Demand is available 24 hours a day, 7 days a week, allowing members to seek medical advice and treatment at any time, including evenings, weekends, and holidays.
• Wide Range of Services. Members can use Blue Care on Demand for various non-emergency healthcare needs, such as minor illnesses, common health concerns, prescription refills, and general medical advice.
• Convenience and Accessibility. By using Blue Care on Demand, members can access healthcare from the comfort of their own homes or while traveling, eliminating the need for in-person visits to healthcare facilities.
• Cost Savings. Blue Care on Demand can often be more cost-effective than in-person visits, as it may involve lower copayments or no additional costs beyond regular plan benefits.
• Quality Care. The healthcare providers available through Blue Care on Demand are experienced professionals who can provide appropriate medical advice, diagnoses, and treatment recommendations.

Summary of BCBS South Carolina

Blue Cross Blue Shield of South Carolina is an excellent choice for anyone looking for comprehensive health insurance coverage in South Carolina. 

With a broad range of plans, extensive provider networks, and excellent financial stability, BCBS SC has everything you need to stay healthy and secure. Whether you’re an individual looking for coverage or an employer seeking solutions for your workforce, get in touch with us today to learn more about how we can help meet your healthcare needs!