Wake Forest offers two comprehensive medical plans to meet the needs of the benefits eligible faculty and staff members and their eligible dependents.
These plans are the Core and Value medical plans. Both plans are Preferred Provider Organization (PPO) plans. The Core plan has higher paycheck premiums with a lower deductible and out-of-pocket maximum. The Value plan offers lower paycheck premiums with a larger deductible and out-of-pocket maximum.
Both plans offer Blue Cross Blue Shield of North Carolina (BCBSNC) medical coverage, Catalyst Rx prescription drug coverage and Carolina Behavioral Health (CBHA) mental health coverage. ID cards are issued for BCBS and Catalyst Rx. To receive care through CBHA, please contact them directly to set up an initial appointment with a provider.
Below is a brief overview of the two plans. Please refer to the Core Medical Plan Guidebook 
and Value Medical Plan Guidebook for a complete overview.
The plans run on a fiscal year (July 1- June 30) but the plan benefits, deductibles and out of pocket maximums are on a calendar year.
Plan Feature
Value Plan Core Plan
In-Network Out-of-Network In-Network Out-of-Network
Deductible
Individual $750 $1,500 $200 $500
Family* $1,875 $3,750 $500 $1,250
Coinsurance Coverage
(after deductible, plan pays)80%
60%
90%
70%
Out-of-Pocket Maximum (deductible + coinsurance)
Individual $2,500 $10,000 $1,000 $2,500
Family $6,250 $25,000 $2,500 $6,250
Routine Office Visit Co-pay $20 Subject to deductible & coinsurance $20 Subject to deductible & coinsurance
Specialist Office Visit Co-pay $40 Subject to deductible & coinsurance $40 Subject to deductible & coinsurance
The above information is intended as a benefit summary only. It does not include all of the benefit provisions, limitations and qualifications. If this information conflicts in any way with the contract, the contract will prevail. Any services rendered under the CBHA benefit do not apply towards the BCBS annual deductible or coinsurance.
BCBSNC Website
BCBSNC’s Website offers a wide variety of benefit and educational information ranging from detailed explanation of benefits to estimating cost of care to participating in one of their wellness programs.
BCBSNC Member Services
The BCBSNC Member Services website offers our participating Faculty and Staff a way to manage medical benefits in an organized and efficient way. This website is meant to help empower, educate and excite its members into taking charge of their health and using all the BCBSNC tools to achieve their goals. Below are some of the services that are available to members who register online. Signing up for BCBSNC Member Services will give members access to:
- View plan benefits to see how the plan will cover a particular service
- Review explanation of benefits to understand what the plan paid and what is the member’s responsibility
- Understand out of pocket expenditures and see how much has been applied towards the annual deductible and coinsurance in that plan year
- Request a new ID card
- Find in-network doctors
- Participate in BCBSNC’s Blue Points Rewards Program and earn points towards cash and merchandise rewards
- Join one of BCBSNC’s Member Health Partnership Programs including Asthma, Diabetes, Fibromyalgia, Heart Disease,
- Migraines, Weight Management, Pregnancy and Tobacco Cessation
- Enjoy the rewards and discounts that come along with the BCBSNC membership
- Take a personal health survey and get 1,000 points allocated to the Blue Points Program
- Estimate health care costs
- Partake in many online wellness programs including Getting Active, Healthy Thinking, Healthy Weight, Quitting Smoking, Sleeping Well and Dealing with Lower Back Pain
- Benefit from the Blue Extras Programs including Audio Blue, Chiropractic Services, Get Fit Blue, Health Line Blue, Optic Blue and Vita Blue
- Read information on the Blue Card program that can be used when traveling outside of North Carolina or the United States
- BCBSNC goes mobile
Id Cards
- You may request a new BCBS id card by calling 877-275-9787
Spanish Website:
The redesigned website is a place where Spanish-speaking customers can:
- Read about BCBSNC and the work we are doing in the community
- Access information about our plans and products
- Review information about the health care system in the United States
- Get tips to stay healthy
- Receive information about our value added services for members
In addition, subscribers can download visual job aids to help them navigate the member site at mybcbsnc.com. These guides can help Spanish-speaking members:
- Register to use the English member site
- Understand the ID card
- Find the health assessment
- Find a doctor
- Understand the appeal form
To join BCBS Member Services:
- Go to www.bcbsnc.com
- Under the Members section select Register Now
- Enter in the BCBSNC member ID number, this number can be found on the BCBSNC member ID card; then complete a few questions and set up a username and password
