North Carolina Health Insurance

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Types of Health Insurance in North Carolina

North Carolina residents have two main types of health insurance available to individuals and families that do not purchase coverage through an employer.  

  • Affordable Care Act “ACA” compliant plans. All ACA-complaint plans must cover the same set of essential health benefits and meet regulations set forth by under the Affordable Care Act laws.  Blue Cross Blue Shield of North Carolina offers the vast majority of these plans across the state while several other companies offer plans in a select few counties.
  • Short Term Health Insurance. Despite the name, Short Term plans can have extended policy periods.  Short Term plans do not cover pre-existing conditions and are not Affordable Care Act compliant.  This allows individuals and families to enroll outside the Open Enrollment Periods without a Qualifying Event in plans that are often less expensive than ACA compliant plans.

The Affordable Care Act or “Obamacare” in North Carolina

The Affordable Care Act (ACA), often referred to as Obamacare in North Carolina, has significantly influenced the types of health insurance plans available and how shoppers enroll in medical coverage.  The ACA legislation was originally signed into law in 2010, with full implementation beginning in 2014.  Rather than establishing its own state-based exchange, North Carolina elected to participate in the federally facilitated exchange.  North Carolina health plan benefits, networks, and rates have adapted to the new market, with plans providing required coverages and no exclusions for preexisting conditions.  Insurance premiums have also responded to these new coverages and the claims history under the regulations.  Provider networks have adapted, with particular areas of North Carolina experiencing greater network changes than others.  Federal subsidies, which are determined by household income, have also directly influenced the consumer’s cost of health insurance in NC.

North Carolina Health Insurance Companies

Since 2014, various insurance companies have entered and exited the North Carolina individual health insurance market and continue to do so.  In 2014, the two largest insurance companies offering both On and Off Marketplace/Exchange health plans in NC were Blue Cross and Blue Shield of North Carolina and Coventry, which is now owned by Aetna.  In 2015, United Healthcare began offering plans.  In 2017, however, Aetna/Coventry and United Healthcare announced they will no longer offer On Exchange plans in North Carolina.  Their exit from the market leaves Blue Cross Blue Shield of North Carolina as the only carrier offering On and Off Exchange plans in all 100 counties of NC.  Cigna has indicated they will offer On Exchange plans in a few select counties.  Below is an outline of the involvement of the largest insurers offering On Exchange plans prior to 2017.

Blue Cross and Blue Shield of North Carolina Entered 2014-Current On Exchange Plans
Aetna/Coventry Entered 2014-Exited 2016 On Exchange Plans
United Healthcare Entered 2015-Exited 2016 On Exchange Plans

North Carolina and Medicaid/CHIP

North Carolina is one of 19 states that chose not to expand Medicaid under the provision allowed by the Affordable Care Act.  North Carolina Health Choice for Children is also available to families who make too much money to qualify for Medicaid, but not enough money to qualify for federal aid.  Health Choice offers free or reduced-price health care for children.

At NC Health Plans/Jerry Ballard & Associates Inc, we are unwavering in our commitment to North Carolina and the individual health insurance market that serves so many of our fellow North Carolinians.  We have weathered the changes and hurdles of the last few years and have remained committed to serving as advisors to NC consumers who seek affordable health insurance in North Carolina.  Our website allows you to generate quotes, shop for plans, and apply online at your convenience.  If we can assist you in selecting a health insurance plan, please call us at 888-765-5400.  We are North Carolinians serving North Carolinians!