North Carolina Health Insurance
Starting in 2014, many North Carolinians can enjoy new options for accessing affordable health insurance. According to a February 2013 news release, Gov. Pat McCrory announced the state would not implement its own health insurance exchange.
Additionally, North Carolina is one of 19 states that decided not to expand Medicaid.
This simply means North Carolinians need to use the federal-marketplace website to shop for insurance plans, which can be found at HealthCare.gov. After registering and going through the application process, you can buy a private North Carolina health insurance plan.
You can also learn if you or your family members qualify for premium subsidies, Medicaid or the Children’s Health Insurance Program, called CHIP.
Do you qualify for a North Carolina health insurance subsidy?
The three main ways to get federal financial assistance are:
- Tax credits (subsidies) that subsidize private health insurance premiums
- Medicaid
- CHIP
According to a Kaiser Family Foundation profile of the uninsured in North Carolina, about 513,000 of the previously uninsured in the state qualify for tax credits. These credits can be used immediately to reduce the cost of qualified health insurance plans. Typically, people who already have access to employer-sponsored health insurance won’t qualify for assistance.
Here are North Carolina’s rules for health insurance financial assistance:
- Eligibility for subsidies will typically be based on 2013 poverty level limits, and Medicare and CHIP qualification will typically be based on 2014 limits.
- People with income between 100 and 400 percent of the poverty level may qualify for a subsidy. This would be between $23,550 and $94,200 for a family of four and $11,490 and $45,960 for an individual.
- Because North Carolina did not expand Medicaid, eligibility is limited to nondisabled parents of minors who earn less than 43 percent of the poverty level, and this is about $10,255 a year for a family of four.
- Children of North Carolina families who earn a yearly income of less than 216 percent of the poverty level — about $51,515 for a family of four — might qualify for CHIP.
Some North Carolinians might decide to purchase health insurance on the marketplace even if they earn too much to qualify for subsidies. Insurers cannot decline applicants because of pre-existing health conditions, and plans purchased through the marketplace must offer specific mandated benefits.
Alternatively, state residents are free to keep their current coverage as long as it follows new guidelines.
Marketplace health insurance companies in North Carolina
These companies offer qualified plans on the federal marketplace for North Carolina residents:
- Blue Cross and Blue Shield of North Carolina
- CoventryOne
North Carolina health and coverage statistics
North Carolina population (2013): 9,848,060
Population 65 and older (2012): 13.8 percent
Life expectancy (2010): 77.8 years
Number of Medicaid beneficiaries (2012): 1,523,900
Number of Medicare beneficiaries (2012): 1,390,800
Estimated number of uninsured residents (2012): 1,604,300
Overall state health ranking: 35
Sources: Kaiser Family Foundation, U.S. Census Bureau, America’s Health Rankings 2014 report.
North Carolina health insurance resources
Federal marketplace: https://www.healthcare.gov/
North Carolina Department of Health and Human Services: http://www.ncdhhs.gov/
North Carolina Department of Insurance: http://www.ncdoi.com/
North Carolina Medicaid: http://www.ncdhhs.gov/dma/medicaid/
North Carolina Division of Aging and Adult Services: http://www.ncdhhs.gov/aging/
Kaiser Family Foundation: http://kff.org/tag/north-carolina/
