North Carolina Individual Health Insurance
Medical insurance not just an option, it is an inevitable precaution for every family. Suitable health coverage can prepare you and your family from potential health risks and the costs associated with the treatment of the same. If you are without group health insurance coverage, purchasing a North Carolina individual health insurance plan is a great option. As a North Carolina resident, you should educate yourself on the state laws and regulations that affect these individual health plans.
Eligibility: How Am I Evaluated?
Individual health insurance applicants in North Carolina are generally reviewed based on individual factors, such as age, health, and lifestyle choices. Private insurers in North Carolina are free to turn down any applicant for any reason and there are no regulations is North Carolina's insurance law that mandate who should and should not receive individual health insurance from private insurers.
In order to comply with HIPPA Group-to-Individual Portability Coverage regulations, North Carolina, guarantees issuance of health insurance via the Inclusive Health or North Carolina Health Insurance Risk Pool (NCHIRP), which manages the state's; high-risk health insurance pool, to HIPPA eligible consumers who have been unable to obtain a policy from a private health insurance provider.
North Carolina Guaranteed Benefits & Pre-Existing Conditions
For the most part, your North Carolina individual health insurance policy will cover benefits depending on what type of plan you choose. Insurers in North Carolina are not required to carry any standardized policies and can decide which plans and benefits to offer to residents. However, there are a few benefits that must be offered to all residents who purchase health insurance, including Care for some medical clinical trials, screening for breast, colorectal, cervical, prostate, and ovarian cancer, care for pregnant women, newborn baby health screening and contraceptives if a health plan covers prescription drugs. North Carolina health insurance companies must also follow mental health parity, where mental health conditions are covered equally to physical health conditions.
In North Carolina, an insurer can impose an exclusionary period on suspected pre-existing conditions. They can look back into your medical history up to 12 months prior to your application date to find any pre-existing conditions. This exclusionary period can last up to 12 months. HIPPA-eligible consumers cannot have exclusionary periods imposed against them. The insurer can impose an elimination rider on any condition that it feels is pre-existing. This rider will exclude the condition(s) from your policy permanently. Lastly, if you file a claim regarding a specific condition within the first two years of your policy, your insurer can look back in your medical history up to 12 months prior to your application date to see if it is something that should have been listed as a pre-existing condition. If so, then your claim can be denied. The insurer no longer reserves this right after 2 years.
North Carolina Individual Health Insurance Premiums
To conclude, your North Carolina individual health insurance premiums will be determined by the insurer, according to their rules and regulations, and there are no state laws that limit what you can be charged for a policy. Your health insurance is guaranteed renewable and cannot be cancelled due to health status. On the other hand, the insurer can raise your premiums in order to protect themselves from these higher costs.
Health insurance is valuable and it is your equally important to be fully aware of the coverage provided by your health plan and the costs associated with it. Get in touch with a North Carolina licensed agent/broker to choose from a variety of health plans for you and your family.
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