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Additional wellness incentives are available in the 80/20 Plan that lower your out-of-pocket costs for various health care services you receive throughout the year.

The Blue Options Designated Providers program is available to members on the 80/20 Plan. Blue Options Designated specialists and facilities refer to hospitals and providers who meet certain levels of criteria which include delivering quality health outcomes, cost effectiveness and accessibility by members. The criteria is set forth by Blue Cross and Blue Shield of North Carolina (Blue Cross NC).

The specialties in which you may find a Blue Options Designated Provider include the following:

  • General Surgery
  • OB-GYN
  • Orthopedics
  • Cardiology
  • Neurology
  • Endocrinology
  • Gastroenterology

​Additional Wellness Activities

​Visit the Primary Care Provider (PCP) listed on your ID card or another provider in the same practice ​$10 copay
​Visit a Blue Options Designated Specialist* ​$45 copay
​Get inpatient care in a Blue Options Designated Hospital* $0; copay not applied
​* You can identify Blue Options Designated providers within the "Find a Doctor" tool by looking for this designation by their name: "Designated for Cost and Quality." For help in finding a Blue Options Designated Provider, call 888-234-2416. ​

Mental Health Benefits

The PPO Plans cover the following types of mental health treatments:

  • Office visits, such as visits to psychologists, psychiatrists and other mental health therapists. Certification is not required for office visits.

  • Inpatient care and outpatient treatment when provided in a mental health or substance abuse treatment facility. Inpatient and outpatient care requires certification in advance.

  • Medications prescribed by your doctor.

To learn more details about what types of treatment are covered, consult your Benefits Booklet.

To obtain certification for inpatient and outpatient care, contact the mental health case manager by calling 800-367-6143.

To locate a mental health provider near you, use the Blue Cross and Blue Shield of North Carolina online Provider Search​.

In addition to providing coverage for mental health treatment, the State Health Plan also provides resources for plan members who need help facing life's challenges — available through NC HealthSmart and the Plan’s mental health case manager. 

Visit NC HealthSmart and theAchieve Solutions​​  where you will find a variety of resources to assist you with stress and other issues. Also, most state agencies and universities provide Employee Assistance Program (EAP) services for employees and family members. Please contact your Human Resource Office to find out if EAP services are available to you. 

Although the State Health Plan does not administer the NCFlex, we support it in different ways. For specific information on NCFlex, click the link below. 

The Office of State Human Resources (OSHR) administers the NCFlex Program​ for state employees. This website is a convenient way to access your NCFlex benefits information. Teachers may access their flex benefits through their school's benefits administrator.