The Consumer-Directed Health Plan is a high deductible health plan that is accompanied by a Health Reimbursement Account (HRA), which is set up by the State Health Plan. This plan includes the ability to lower your monthly premium by completing wellness activities.
Affordable Care Act (ACA) Preventive Services performed by an in-network provider are covered at 100% in this plan, which means there is no charge to you.
CDHP Important Documents
CDHP Rate Sheets (2017)
Members indicated as 50% or 100% contributory notes the percentage of the premium for which they are responsible.
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 and Blue Shield website*.
* 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.
Certain services require prior review and certification before they can be covered by your health insurance plan. Click here for more information.
If 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.