Atrium Health program aims to lower 2027 costs for NC State Health Plan members
CHARLOTTE, NC (WWAY) — Atrium Health says it will launch a new program in January aimed at lowering out-of-pocket costs for North Carolina State Health Plan members who receive care through its hospitals and providers.
The Atrium Health Affordability Protection Program is scheduled to take effect Jan. 1, 2027. Atrium says the program will reduce copays and other cost-sharing for enrolled State Health Plan members receiving primary, specialty, outpatient and inpatient care.
The move follows changes to the State Health Plan’s provider network for 2027. Atrium Health was not initially included in the plan’s Access or Preferred tiers.
A later agreement preserved lower-cost access to several services, including primary care, behavioral health, emergency services, children’s hospitals and rural hospitals. However, some specialty services and other care would still carry higher costs under the new tier structure.
Atrium says its new program is designed to reduce that remaining difference.
In one example provided by Atrium, a member in the Standard Plan receiving outpatient surgery at a non-preferred facility could otherwise face a $1,000 copay, a deductible of up to $5,000 and 30% coinsurance. Under Atrium’s program, the company says that member would instead pay a $400 copay.
For inpatient care at one of Atrium’s urban hospitals, the company says a Standard Plan member could otherwise face a $1,500 copay, a deductible of up to $5,000 and 30% coinsurance. Atrium says its program would reduce that to a $500 copay.
Atrium Health says additional information about eligibility, enrollment and administration of the program will be available through its State Health Plan Member Education Center.
