North Carolina Health Insurance Coverage...
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If you are searching for ways to lower your health insurance costs and you live in the State of North Carolina...We, here at HealthInsureCoverage.com, work hard to supply you with the information you need to make an informed decision regarding your health insurance needs and requirements.

• What are your protections when buying individual health insurance in the State of North Carolina?
     If you do not have access to employer-sponsored group insurance, you may want to buy an individual health plan from a private health insurance company. However, in North Carolina – as in most other states – you have limited guaranteed access to individual health insurance. There are some alternatives to individual health insurance coverage – such as COBRA and conversion coverage.
• When do individual health insurers have to sell you coverage?
     In general, companies that sell individual health insurance in North Carolina, except for Blue Cross and Blue Shield, are free to turn you down because of your health status and other factors. When applying for individual coverage, you may be asked questions about health conditions you have now or had in the past. Depending on your health status, insurers might refuse to sell you coverage or offer to sell you a policy that has special limitations on what it covers.
• All residents are guaranteed access to individual health insurance through Blue Cross and Blue Shield of North Carolina, although rates may vary.
• If you are federally eligible, however, all private insurance companies that sell individual health insurance must offer you a choice of at least two plans, whose benefits must be similar to those sold to everyone else.
     Companies that do not designate two policies must offer you a choice of all their individual insurance policies. Policies sold to federally eligible individuals cannot impose pre-existing condition exclusion periods. However, there is no limit on what you can be charged for this coverage.
• To be federally eligible, you must meet certain criteria. Here's a list of some of the criteria:
  
     MIf you are federally eligible you are guaranteed the right to buy an individual health plan and are exempted from pre-existing condition exclusion periods. To be federally eligible, you must meet all of the following:
  
  * You must have had 18 months of continuous creditable coverage, at least the last day of which was under a group health plan.
  * You also must have used up any COBRA or state continuation coverage for which you were eligible.
  * You must not be eligible for Medicare, Medicaid or a group health plan.
  * You must not have health insurance. (Note, however, if you know your group coverage is about to end, you can apply for coverage for which you will be federally eligible.)
  * You must apply for health insurance for which you are federally eligible within 63 days of losing your prior coverage.
  Federal eligibility ends when you enroll in an individual plan, because the last day of your continuous health coverage must have been in a group plan. You can become federally eligible again by maintaining continuous coverage and rejoining a group health plan.
  
  
• All plans that provide benefits for any minor child must provide benefits from the moment of birth, as well as upon placement for foster and adopted children.
• Quit smoking.
  If you live in New York and have a one-pack-a-day habit you will immediately save $7.50 per day ($218 per month). The lifetime health care costs for smokers (who live shorter lives) vs. non-smokers (who tend to live longer lives) is one third higher on average. This, of course, drives up the cost of health care to everyone, not just lifetime smokers. One study puts the direct health-care costs associated with smoking as being in excess of $16 billion per year.
• What will your individual health plan cover?
     It depends on what you buy. North Carolina does not require health insurers in the individual market to sell standardized policies. Health plans can design different policies and you will have to read and compare them carefully. However, North Carolina does require all health plans to cover certain benefits – such as mammograms and pap smears. Check with the North Carolina Department of Insurance for more information about mandated benefits.
• What if you have a pre-existing condition?
     If you can buy an individual health plan, there are limits on pre-existing condition exclusion periods that can be imposed. Pre-existing condition exclusion periods cannot exceed 12 months. Individual health plans can look back 12 months to see if you actually received care or treatment for a condition. In North Carolina, pregnancy can be considered a pre-existing condition in individual health plans.
• You will get credit for prior continuous coverage that was not interrupted by a break of 63 or more days in a row.
     No pre-existing condition exclusion periods can be imposed on you if you are federally eligible.
• What can you be charged for individual health care coverage in North Carolina?
     If you have an expensive health condition, your individual health insurance premiums may be very high. The law does not prohibit North Carolina health insurers from charging you more because of your health status. Your premiums also will vary depending on your family size and the type of policy you want. In addition when you renew your individual coverage, your premiums can increase substantially as you age or if your health declines.
• Can your health insurance policy be cancelled?
     Your coverage cannot be canceled because you get sick. This is called guaranteed renewability. You have this protection provided that you pay the premiums, do not defraud the company, and, in the case of managed care plans, continue to live in the plan service area. Coverage may be canceled should the carrier exit the market after appropriate notice or membership ceases in certain kinds of association groups. Contact the North Carolina Department Insurance for more information about your protections in association health plans.
• Some insurance companies sell temporary health insurance policies.
     Temporary policies are not guaranteed renewable. They will only cover you for a limited time, such as six months. If you want to renew coverage under a temporary policy after it expires you will have to reapply and there is no guarantee that coverage will be re-issued at all or at the same price. Short Term Major Medical coverage does not constitute a break in coverage for the purpose of creditable coverage if the coverage does not last longer than twelve months.

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