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Affordable Health Insurance in NC- What We Can All Do

Friday, March 17th, 2017

The cost of health insurance and healthcare is growing and has been for a long time; but what can be done?  First, let’s understand that the health insurance industry is very complicated and unlikely to be accurately summarized in a short article.  The topic can be broken down into so many segments, each of which deserves its own time and attention.  Few segments are as important as the concept of affordability.  Without affordability, health insurance begins to lose its value and is capable of serving less people.

The concept of affordability is no simple matter.  Analyzing Medical Loss Ratios and actuarial values is a task performed by some of the best and brightest the insurance companies have to offer.  There’s no question these professionals have earned a seat at the table when discussing the cost of health insurance.

When looking beyond the highly publicized drivers of health insurance costs, there are a few much more simple concepts that can have significant impact on the affordability of health insurance in North Carolina and the entire country.  These are ways consumers can help in the fight to lower healthcare spending and health insurance premiums.

  1. Eat Healthy and Exercise Regularly: There is no shortage of available information about healthy diets and exercise. Positive Health Wellness is a great resource for ideas that can help us live healthier lifestyles and feel better as a result.  Large insurance companies like Blue Cross Blue Shield of North Carolina have been open about concerns regarding the health status of so many insured members.  This has initiated the insurance company to become more active in paving the way for their member to live healthier lifestyles.
  2. Take advantage of preventive care doctor visits: Most health insurance plans have coverage for services like routine physicals and screenings.  Typically, these visits are covered at 100%.  Utilizing these covered services may help identify potential illnesses before they become more severe.
  3. Use the Emergency Room for Emergencies: BCBSNC has found that a very large percentage of emergency room visits are for non-emergency situation that could have been handled in a Primary Care Doctors Office or an Urgent Care facility.  Emergency Rooms are often one of the most expensive places to seek care.  Emergency Rooms serve an important purpose and are recommended for certain situations.  However, it’s important to make sure this is the best place to be seen based on the circumstances.

Understanding that we all have some control of the cost of health insurance can change the conversation.  The recommendations listed don’t provide an immediate fix to the on-going problems but they can certainly contribute to a solution.

Short Term Health Insurance – Summertime Health Plans for Students

Thursday, June 2nd, 2016

Youth People Amity Summer Party Together ConceptSummertime is here and college students are heading home for a much needed break, but what about health insurance?  Although many colleges and universities offer student health insurance plans, most of those plans are only good for the school year, leaving students with a three month gap in coverage.  Because of the rules of the Affordable Care Act, these students cannot simply apply for another health plan outside of Open Enrollment, so what is available to them?  The answer is temporary health insurance.

A temporary health plan can fill gaps in coverage and also offers students the ability to enroll in health insurance when they need it.  In fact, these plans can be in effect as soon as the very next day and are typically very affordable. In addition, you can select temporary coverage anywhere from 1 to 11 months and you can choose to make one lump sum payment or pay monthly, whichever works best.  Short term plans ensure that students have the coverage they need over summer months when they are working part-time jobs that usually don’t provide health insurance and when students are more active than ever. (more…)

Temporary Health Insurance in AZ, FL, GA, IL, IN, MO, NC, OH, PA, TX

Thursday, May 12th, 2016

Family enjoying bike ride in parkAre you without a Qualifying Life Event that allows you to purchase health insurance outside of the Annual Enrollment Period?  A Temporary Health Insurance Plan can offer you the coverage you need to fill the gap between now and the next Open Enrollment and there are many benefits to a short term health plan.  For instance, most temporary insurance plans are less expensive than regular health insurance plans.  They are a low-cost solution that could protect your financial security should you be faced with an unexpected illness or injury.  You can also be approved for short term plans as soon as the very next day and coverage can be in place anywhere from 1 month to 11 months, whatever your circumstances require.

Although these plans won’t cover preexisting conditions and will not keep you from incurring a tax penalty (unless you are exempt), these plans can protect you in catastrophic circumstances and help give you the peace of mind that comes from knowing you will be covered in an emergency.  If you are still uninsured for 2016, consider a temporary health insurance plan.

For more information on North Carolina insurance coverage, please visit our website at or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.

Can I Purchase Health Insurance Now? – Understanding Special Enrollment

Tuesday, March 3rd, 2015



Open Enrollment 2018 has officially ended and the Special Enrollment Period has begun.  Contrary to what so many people believe, this does not mean that no Americans are able to purchase health insurance.  It simply means that those purchasing or making changes to existing health insurance plans are subject to a different set of rules that apply to the Special Enrollment Period.

The most distinguishing factor of Special Enrollment is that in order to purchase or change a health insurance plan you must have what is called a Qualifying Life Event.  This means you must have a special circumstance in your life that would qualify you to purchase or change insurance outside of Open Enrollment.  People often experience Qualifying Life Events without even realizing the opportunities presented as it relates to health insurance.


The following is a list of common Qualifying Life Events:

  • Loss of minimum coverage (through an employer, government plans, Medicaid, etc.)
  • Adding a dependent through birth, adoption or marriage
  • Gaining United States citizenship
  • Enrollment/non-enrollment errors by the federal Marketplace or the United States Department of Health and Human Services
  • Newly eligible for a subsidy or a change in the amount of subsidy for which you are eligible
  • Move to North Carolina or a new county within North Carolina
  • Other exceptional circumstances

Although this is a list of a few qualifying life events, this list is not exhaustive.  Ultimately, the only way to really determine if you are eligible to change or purchase health insurance during Special Enrollment is to complete an application.  Keep in mind that you can apply for health insurance without any obligation to purchase and the application itself will help you determine subsidy eligibility.

For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, please visit our website at or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the existing regulations of The Affordable Care Act, also known as Obama care.

All information contained herein is subject to change, from time to time, if the Federal Government or Blue Cross Blue Shield of North Carolina implement any new updates and/or changes that can impact information provided in this blog.



Save Money with BCBSNC Catastrophic Plans

Monday, November 17th, 2014

Young study groupBlue Cross Blue Shield of NC offers catastrophic plans to eligible customers as a lower cost, minimum coverage option. Qualified customers can save as much as 22% by selecting a catastrophic plan over BCBSNC’s least expensive bronze plan.

To be eligible for a catastrophic plan, you must meet one of the following criteria:

•Be under 30 years of age when the plan year begins

•Qualify for a hardship exemption through the federal government

BCBSNC Catastrophic plans cover preventive care at 100% and include $35 copayments for your first 3 visits to an in-network primary care provider. These plans have high deductibles that you must meet before BCBSNC pays for Essential Health Benefits. A catastrophic plan may be a good option if you don’t expect to have many medical expenses.


Catastrophic plans cover the Essential Health Benefits as well. These essential health benefits include:

  • Ambulatory services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance abuse services (including behavioral health)
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive/wellness services and chronic disease management
  • Pediatric services, including dental and vision

Keep in mind, if you choose a catastrophic plan, you cannot use an advance premium tax credit (federal subsidy). If you don’t qualify for or decide to forego a subsidy, you may save money with these plans.

Generate a quote today to learn more about catastrophic plans and other health insurance plans offered by Blue Cross Blue Shield of North Carolina.

For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, please visit our website at or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.  Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.


Keeping Healthcare Affordable

Sunday, February 1st, 2009

Most of us are shielded from the heavy burden of the full cost of medical procedures, treatments and drugs. That’s because employers spend, on average, five times more than employees do for healthcare.

From 2001 to 2002, premiums for employer-sponsored health insurance increased by an average of almost 13 percent nationwide. In this sluggish economy, businesses are struggling to pay for the steep increase in insurance premiums and some are asking employees to assume a greater responsibility.

Fortunately, there are simple things that we can all do to help keep healthcare affordable for everyone:

Discuss all treatment options with your doctors
Ask if a generic drug is available when you need prescription medicine
Carefully review your doctor and hospital bills and ask for explanations of charges that you don’t understand.

For more information on health insurance coverage in North Carolina, please visit our website at or call our toll free number 888-765-5400 and speak with one of our qualified agents.  Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC).  You may qualify for a 15% healthy lifestyle discount if you are in excellent health.  Call us for details.


Tuesday, November 11th, 2008


Just because health insurance is not on “Ophra’s List of Favorite Things” does not mean you should not consider it as an important item for the holidays or anytime for that matter. Lets think about the people that have beautiful homes, nice cars, cell phones, computer games, beautiful clothes, but they don’t have health insurance for their families. What happens when sickness or tragedy comes knocking on your door, how do you protect your family from the financial disaster that comes when you don’t have health insurance?