Insurance

Dermatology & Laser Center of Chapel Hill (DLC) participates with:

  • Blue Cross and Blue Shield of North Carolina (BCBS) plans *see list below
  • Cigna Healthcare
    • We do not accept Cigna Connect Individual and Family Plan (IFP)
  • Medicare (read 10 Things to Know About Your New Medicare Card)
    • Medicare Humana may require a referral if an HMO plan
    • Medicare Advantage may require a referral
  • United Healthcare
    • United Healthcare may require a referral

Here is a detailed list of the BCBS plans that we do and do not participate with.

We do accept:

  • Blue Advantage
  • Blue Care
  • Blue Options
  • Blue Select
  • Classic Blue
  • The North Carolina State Health Plan

We do not accept:

  • Blue Value
  • Blue Home

If you have other insurance that we do not accept, please make sure to get a receipt so that you may file a claim. Please note that insurance plans will most likely not cover cosmetic treatments.

DLC schedules routine general dermatology referrals according to our scheduling protocols. If you require the appointment date and/or visit summary, we will communicate this to the referring provider provider. 

HMO vs PPO

With an HMO plan, you pick one primary care physician. All your health care services go through that doctor. That mean that you need a referral before you can see any other health care professional, except in an emergency. Visits to health care professionals outside of your network typically aren’y covered by your insurance.

For example, if you get a skin rash, you wouldn’t go straight to a dermatologist. You would first go to your primary care physician, who’d examine you. If you r primary care physician can’t help you, he or she will give you a referral to a trusted dermatologist in your network that will.

Coordinating all your health care through your primary care physician means less paperwork and lower health care costs for everyone.

PPO Plans

PPO plans give you flexibility. You don’t need a primary care physician. You can go to any health care professional you want without a referral – inside or outside of your network.

Staying inside your network means smaller copays and full coverage. If you choose to go outside your network, you’ll have higher out-of-pocket costs, ad not all services may be covered. 

How do deductibles, coinsurance and copays work?

Deductible
A deductible is the amount you pay out of pocket for health care services before your health insurance begins to pay.

How it works: If your plan’s deductible is $1,500, you’ll pay 100 percent of eligible health care expenses until the bills total $1,500. This is “meeting your deductible.” After your deductible is met, you share the cost with your plan by paying coinsurance.

Coinsurance
Coinsurance is your share of the costs of a health care service. It’s usually figured as a percentage of the amount the insurance company allows to be charged for services. You start paying coinsurance after you’ve paid your plan’s deductible.

How it works: You’ve paid $1,500 in health care expenses and met your deductible. When you go to the physician’s office, instead of paying all costs, you and your plan share the cost. For example, your plan pays 70 percent. The 30 percent you pay is your coinsurance.

Copay
A copay is a fixed amount you pay for a health care service, collected when services are rendered.  The amount can vary by the type of service.

How it works: Your insurance plan determines what your copay is for different types of services. You may have a copay before you’ve finished paying toward your deductible. You may also have a copay after you pay your deductible, and when you owe coinsurance.

Please contact your Insurance carrier directly for individual health care plan coverage benefits, limitations and questions.

Questions?

If you have any questions about insurance or your bill, please contact DLC:

Phone: 919-942-2922

Email: contact@dlcofchapelhill.com