North Carolina Individual and Family Health Insurance

Survey different North Carolina individual health insurance plans throughout the state, including the metropolitan areas of Charlotte, West Raleigh, Raleigh, Greensboro, Durham, Winston-Salem, Fayetteville, Cary, High Point, and Wilmington.

The State of Affairs of North Carolina’s Health Insurance

North Carolina, in 2004, spent a total of $44.2 billion in healthcare expenditures, with the largest costs associated towards hospital, professional, and physician fees.  North Carolinians experience health care expenses that increase 9% annually, and subsequently, it is critical for residents to access affordable health insurance.

The Land of the Sky is called home by 8.9 million residents.  26% of the population has Medicaid and/or Medicare coverage.  Approximately 50% or 4.5 million have North Carolina small business health insurance coverage through their workplace, paying average premium of $725 for individual health insurance plans and $2,847 for family health insurance plans. 

A significant part of North Carolina’s population does not have health insurance coverage, and entrepreneurs consistently need self employed health insurance.  However, various health insurance providers are now offering affordable North Carolina health insurance plans. To locate the health insurance coverage that best suits you, explore InsureMonkey, who is proud to be your health insurance agent.

North Carolina Health Insurance Providers

North Carolina’s High Risk Pool

Unfortunately, in North Carolina, there is no high-risk pool program that helps residents with pre-existing medical conditions obtain healthcare coverage. These residents may need to look into various publicly funded North Carolina health insurance plans, but many of them may not qualify due to income eligibility requirements.

However, this sorry state of affairs in North Carolina may change when state governments are pushed to expand their healthcare programs. The expansion may include the state’s high-risk population.

To get the latest on health insurance coverage in North Carolina, call the Department of Health and Human Services at 1-800-662-7030.

North Carolina’s Uninsured

Based upon the 2006-2007 survey commissioned by the Urban Institute and the Kaiser Commission, the total uninsured population in North Carolina is more than 1.5 million. About 20% of this population, or 310,000, are uninsured children.

Two out of eight children are uninsured in North Carolina. This number of uninsured is expected to continue rising in the face of higher unemployment rates and a softening economy. Clearly, this underlines the need for affordable North Carolina healthcare coverage.

Finding an affordable North Carolina health insurance plan can be confusing.  This is why InsureMonkey was formed – to remove the confusion and help you access a health plan that meets your needs.  InsureMonkey will allow the good people of North Carolina to find an affordable health plan with excellent coverage benefits.

North Carolina SCHIP

The NCHC or North Carolina Health Choice is the state’s SCHIP-funded health insurance plan for children whose families have income brackets that are not eligible for Medicaid. Some children may qualify for Health Choice without having to shoulder any co-pay.

Eligibility for CHIP coverage must meet income requirements. The parents of the children must have a total household income that is 200% of the Federal Poverty Level (FPL) as of January 2009. This translates to an annual income of $35,200.

If the Health Choice applicant has a monthly income of 150% below FPL, there is no enrollment fee. But if the monthly income is above 150% of the poverty level, the enrollment fee is $50 per child.

For more information about eligibility, please contact the Division of Medical Assistance at 1-800-662-7030 or visit the website at http://www.dhhs.state.nc.us/dma/healthchoice/index.htm. To apply, call or visit the nearest office of the Department of Social Services. A list of required documents will be provided to those who wanted to be covered by NCHC.

Medicaid in North Carolina

In North Carolina, the Division of Medical Assistance of the Department of Health and Human Services is tasked to manage the state’s Medicaid Program. Medicaid is provided to residents who are unable to afford the costs of their North Carolina healthcare services, including doctor and hospital bills, prescriptions, nursing home care, dental and vision care, and personal care services.

If a resident in North Carolina is already receiving SSI or Supplemental Security Income, he or she is automatically eligible for Medicaid coverage. Those who receive special assistance to the blind, Work First Family assistance, and special assistance for the aged or disabled are also automatically eligible. For low-income families, seniors, people with disabilities, and children younger than 21, eligibility is determined by these income requirements:

•    Children
      o    Infants Ages 0-1:  $35,200 or 200% of the Federal Poverty Level as of January 2009
      o    Children Ages 1-5:  $35,200 or 200% of the Federal Poverty Level as of January 2009
      o    Children Ages 6-19:  $17,600 or 100% of the Federal Poverty Level as of January 2009
•    Parents
      o    Non-Working:  $6,528 or 37% of the Federal Poverty Level as of January 2009
      o    Working:  $9,000 or 51% of the Federal Poverty Level as of January 2009
•    Women
      o    Pregnant women: $32,560 or 185% of the Federal Poverty Level as of January 2009

To apply for Medicaid coverage in North Carolina, a resident may visit in person the nearest county office of the Department of Social Services. Required documents, such as those that prove citizenship or alien status and those that show income sources, should be brought. An application form need not be brought, but it would facilitate the application process. An electronic version of the application form can be obtained at the website of the Department of Health and Human Services at http://www.dhhs.state.nc.us/dma/medicaid/applications.htm. Application forms can also be obtained from hospitals and health centers.

For more information about the Medicaid Program in North Carolina, call the Social Security Office at 1-800-772-1213 or visit the website of the Division of Medical Assistance at http://www.dhhs.state.nc.us/dma/medicaid/index.htm.

(Facts throughout this page provided by the Kaiser Family Foundation at www.statehealthfacts.org and by The New Health Insurance Solution at www.tnhis.com.  Commentary provided by InsureMonkey.)

State Resources

Department of Health and Human Services
Website: http://www.dhhs.state.nc.us/
Phone: 1-800-662-7030

North Carolina State Health Plan
Website: http://www.shpnc.org/
Phone: 1-888-234-2416

Department of Insurance
Website: http://www.ncdoi.com/
Phone: 800-546-5664