North Carolina Health Insurance

Health Insurance Overview

North Carolina residents have many options for health care coverage. There are numerous North Carolina insurance providers to choose from, along with a variety of North Carolina medical insurance plans designed to meet the specific needs of individuals, families and groups.

Whether you need independent self-employed health coverage, or your employer simply doesn’t offer group North Carolina health insurance benefits. Whether you are looking to cover your spouse and children under the same low rate, or you are a small business that wants to provide your employees with affordable coverage. Whatever your situation, we are your one stop resource for all your health care needs – including reliable North Carolina medical insurance from the best North Carolina insurance providers around.

Each state is unique in its laws and regulations, as well as the types of coverage it offers. Here you will find an array of resources and useful information to help you better understand North Carolina health insurance and the range of options available to you. This includes current facts and statistics about residents, important state legislation, financial assistance and public North Carolina health insurance programs, and even details on some of the top North Carolina insurance providers.

To compare specific North Carolina medical insurance plans offered by the various North Carolina insurance providers, and get a personalized quote for the options that are right for you, contact us now for free. We’ll connect you with a highly qualified insurance agent near you who will be happy to help you with all of your North Carolina health insurance needs.

At Healthcare Solutions Team, we’re committed to making affordable health care accessible to everyone. Our group of elite North Carolina health insurance advisors is dedicated to helping match the right coverage to fit the unique needs of all families, individuals and groups. Not a resident of North Carolina? Find your state here.

North Carolina Health Insurance Facts & Statistics

Total North Carolina Residents – 9,229,900

Total Health Insurance Coverage In North Carolina:
Employer – 47%
Individual – 4%
Medicaid – 16%
Medicare – 13%
Other Public – 2%
Uninsured – 18%

Average Individual Monthly Premiums – $207

Average Annual Single Employee Contribution for Employer-Based Health Insurance Plan – 19%

Average Annual Single Employee Premium for Employer-Based Health Insurance Plan – $926

Average adjusted hospital cost per inpatient day – $1,641

Source data according to the Kaiser Family Foundation (http://www.kff.org/) (2009-2012 data) and http://www.statehealthfacts.org/

North Carolina Medical Insurance Laws, Regulations & Policies

There are several North Carolina health insurance laws and regulations that are put in place to protect policyholders living in the state. North Carolina health insurance law requires all health plans to cover certain medical care services. They include:

  • Care for some medical clinical trials
  • Screening for breast, colorectal, cervical, prostate, and ovarian cancer
  • Care for pregnant women
  • Newborn baby health screening
  • Contraceptives if a health plan covers prescription drugs

North Carolina insurance providers must also follow mental health parity, which means that mental health conditions are covered equally to physical health conditions. Most North Carolina insurance providers may accept applications and set premiums based on health status, but Blue Cross and Blue Shield is required by state law to accept all applicants.

Additionally, some individuals with pre-existing health conditions who recently left a group health plan with an employer may be HIPAA-eligible. Under this federal law, North Carolina insurance providers are not allowed to impose restrictions on coverage or deny applications.

North Carolina Health Insurance Resources

Helping Families

North Carolina Department of Health and Human Services. Visit the website.

North Carolina County Health Departments

A listing of local health departments. Visit the website.

North Carolina Health Insurance High Risk Pool

The Patient Protection and Affordable Care Act established temporary national high risk pools to provide health insurance to those with pre-existing conditions. Residents in North Carolina with pre-existing conditions are able to get health insurance from the Inclusive Health – Federal Option in North Carolina. This works similar to regular North Carolina health insurance plans and requires enrollees to pay affordable premiums and out-of-pocket costs.

Enrollees in the North Carolina program pay around the same amount that people without medical conditions pay for health insurance. The estimated premiums for North Carolina residents range from $183 to $729 per month. The deductible ranges from $1,000 to $4,500 and allows individuals to invest in a Health Savings Account with the highest deductible. There is also an out-of-pocket limit set at $5,950 a year for in-network services. Residents who are eligible for the plan will get access to health insurance coverage for doctor and hospital visits, prescription drugs, emergency services and more.

Individuals may apply for the North Carolina PCIP program if they are a United States’ citizen, have an existing medical condition, and have been without health insurance for six months. For more information on the North Carolina health insurance high risk pools visit http://www.inclusivehealth.org/.

To stay up-to-date on the latest health care reform news, visit: http://healthreform.kff.org/

North Carolina Medical Insurance and Health Care Programs

The state of North Carolina offers residents quite a few public health insurance programs to assist low-income residents in getting access to affordable health care and insurance coverage. These programs include:

  • Medicaid
    North Carolina Medicaid is designed for some low-income and disabled residents. To learn more about the state’s Medicaid program, visit online.
  • North Carolina Health Choice for Children
    This program is designed for children of families who do not qualify for Medicaid, but who cannot afford the rising costs of health insurance premiums. Health Choice offers free or reduced price comprehensive health care for children. Learn more about this North Carolina health insurance program for children online.
  • North Carolina Medicare
    Seniors can find North Carolina health insurance through Medicare Advantage, Medicare Supplement and Original Medicare.
  • North Carolina Breast and Cervical Cancer Control Program
    Low-earning women living in North Carolina can receive free screening for breast and cervical cancer under this program. To find more information about this North Carolina medical insurance for women, visit their website.

Early retirees and trade workers in North Carolina might also be eligible for the Federal Health Coverage Tax Credit. To learn more visit the programs’s website.

North Carolina Insurance Providers

Aetna Health Insurance

Aetna is one of the largest health insurance providers in America with more than 30 million members. Its network includes more than 787,000 health care professionals.

Assurant Health Insurance

Assurant Health, headquartered in Milwaukee, has been offering quality insurance products and coverage to more than 1 million members since 1982. Assurant is committed to providing health insurance plans that have broad coverage while providing valuable protection.

Celtic Health Insurance

Celtic concentrates on individual health insurance, offering a wide variety of plans for both individuals and families.

Cigna Health Insurance

CIGNA is one of the oldest insurance companies in America, providing health insurance and other coverage solutions to millions of consumers around the country.

Golden Rule Health Insurance

Golden Rule Insurance Company provides affordable and customized health insurance plans for millions of individuals and families.

Great American Health Insurance

Great American Insurance Company, part of Great American Financial Resources Inc., is a leading provider of health insurance and other coverage solutions.

Humana Health Insurance

Through affordable health insurance options, Humana helps its members better manage their health care and make informed health decisions.

John Alden Health Insurance

John Alden Life Insurance has been selling health coverage throughout America since 1961. Today, it is part of Assurant. John Alden plans include individual health and small group coverage. It also sells Health Savings Account plans.

Standard Security Life Health Insurance

The Independence Holding Company (IHC) provides management services to large companies that deliver insurance solutions to groups and individuals. As divisions of IHC, the Standard Security Life Insurance Company of New York and the Independence American Insurance Company offer various lines of life, health and disability insurance.

Time Insurance Health Insurance

Today, Time Insurance is known as Assurant Health with insurance coverage for individuals, students, families, seniors, and businesses.

Time Short Term Health Insurance

Today, Time Short Term health insurance is offered through the Assurant name. Time short-term health plans provide comprehensive coverage for a temporary period of time at affordable rates.

UnitedHealthOne Health Insurance

Golden Rule, a United Healthcare company, has been offering affordable health insurance solutions for over 60 years.

WellPath Select, Inc. Health Insurance

WellPath is a Coventry Health Care Plan and subsidiary of Coventry Health Care, Inc., one of the country’s largest health insurance companies. WellPath provides coverage to 160,000 members in South and North Carolina and strives to be the premier regional plan in its area.

WorldIns ExpressMed Health Insurance

World Insurance offers several types of individual health insurance ranging from dental coverage to comprehensive major medical plans.

Important Contacts and Links

North Carolina Department of Insurance and Department of Health and Human Services

Find the contact information for the North Carolina health insurance and health and human services departments at:

North Carolina Department of Insurance
Dobbs Building
430 N. Salisbury St.
Raleigh, NC 27603-5926
Phone: (800) 546-5664
http://www.ncdoi.com/

North Carolina Department of Health and Human Services
101 Blair Drive
Raleigh, NC 27699
Phone: (919) 733-4534
http://www.ncdhhs.gov/