Choosing a North Carolina health insurance plan may seem simple at first. That’s because in most areas of the state, the only available carrier offering ACA-compliant health plans is Blue Cross Blue Shield of North Carolina. It is only in five counties (Chatham, Johnston, Nash, Orange, and Wake) which offer another choice with Cigna.
To find the plans that are available in your area, you only need to use our search bar here at HealthQuoteInfo. You can then get the opportunity to delve into the details of each available plan so you can decide if your options are suitable for your circumstances.
Work-Sponsored Insurance & Small Business Health Insurance North Carolina
One of the simpler ways of obtaining more affordable insurance is to enroll in the health plan offered by your North Carolina employer. The employer can pay for a considerable percentage of the premium, which can make the plan much more affordable. Your pre-existing conditions cannot be denied coverage unless you didn’t have prior health care. If you lacked healthcare before, the carrier can look over your medical history for the last six months, and any pre-existing medical condition may be excluded from coverage for the first 12 months of the policy.
If you’re transferring from one employer-sponsored insurance (ESI) to another, you should check if you can use the COBRA program to extend the coverage of your previous health plan. You can then continue to pay for the premiums of your current plan and then wait for a new employer-sponsored insurance plan to take into effect without a lapse of coverage.
Medicaid & Low Income Health Insurance North Carolina
As private insurance can be too exorbitant for many families in North Carolina, the state offers Medicaid support for people with lower incomes or with special needs. The benefits include the essential services that you may find in ACA-compliant health plans, but the costs are either free or low. However, there is one important caveat: if you’re an adult who does not have a child or a disability (or a pregnancy), you may not be eligible for Medicaid in North Carolina regardless of how much you earn.
The program offers services for the aged, the blind, and the disabled. If you’re categorized in this group, you can qualify if your income as an individual is no more than $1,012 a month while your countable resources (cash, bank accounts, stocks, retirement accounts) cannot total more than $2,000. For couples, the income limit is $1,372 a month while the resource limit is $3,000.
Medicaid for infants and children have income limits depending on the age of the child. A child up to the age of 5 can qualify if their family income does not exceed 210% of the federal poverty level. The children from ages six to 18 can qualify if their family income total does not go past 133% of the FPL.
Parents and caretakers (along with the children ages 20 and 21) can also qualify if their income is 44% FPL.
Medicaid for Pregnant Women
Pregnant Women can be eligible if their income level is within 196% of the FPL. As the FPL considers household size, the unborn child or children count as part of the household. The services include prenatal care, the delivery of the baby, and post-partum care. Medicaid will also cover the necessary services to treat medical conditions that may complicate the pregnancy. Childbirth classes and family planning services are also covered under the plan.
However, the Medicaid for Pregnant Women program only covers the services related to the pregnancy.
Medicaid for Children under 21
This program offers a comprehensive range of services meant to prevent, diagnose, and treat medical conditions for low-income families. This is also known as the EPSDT benefit, which stands for Early and Periodic Screening, Diagnostic and Treatment.
This program helps make sure that children get access to the medical services they need to remain healthy. The main goal is to prevent serious medical conditions from appearing or progressing, and this is why it does not contain some of the restrictions found in other Medicaid programs.
The wellness checks include physical exams, routine preventive care, testing for vision or hearing issues, and screenings for developmental and mental health. Vaccines will also be administered.
For this program, there are no charges or copays required. A health care provider may also recommend a treatment product or service that’s not expressly covered by this program, but this service may be requested and a medical necessity review will be conducted. If the request is denied, the decision can still be appealed.
North Carolina Open Enrollment 2019 & North Carolina Obamacare Insurance
The North Carolina Open Enrollment period for health insurance in 2019 will run from November 1st, 2018 to December 15th, 2019.
For all your other questions regarding health insurance in North Carolina, please do not hesitate to give us a call at 1-855-614-5057. We stand ready to guide you so that you can get the health & medical insurance coverage you need and deserve.