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For a 40-year-old on a silver health plan in North Carolina, the average cost in 2022 is $463. The cheapest health insurance is as low as $178 even for major plans. (source) Irrespective of age, the average cost for a silver plan is $610 whereas the cheapest for the same plan in the state is $226. (source)
The wide variations in prices suggest there are affordable and pocket-friendly health plans in North Carolina.
In this article, we’ll delve into the availability of affordable health insurance in North Carolina, the current list of insurers, how to enroll for premium health coverage, and ways you could get free health insurance.
Health insurance companies in North Carolina.
There are 7 health insurance providers in the state but they are not all present in every county with the exclusion of the Blue Cross and Blue Shield which offer services in all parts of the state. Below is the list of current health insurance providers:
1. Ambetter of North Carolina: Ambetter health insurance plan is present in about 32 counties offering 3 Metal levels:
- Ambetter essential care(Bronze),
- Ambetter Balance care(Silver),
- Ambetter secure care(Gold).
2. Blue Cross Blue Shield of Michigan Mutual Insurance: It was founded and has been operating since 1933 with a commitment to ensure North Carolina residents get improved quality health coverage. You’ll find them in all the counties.
3. Bright Health Company of North Carolina: It’s present in over 30 counties and also offers dental, vision, and hearing coverage. Its prices could be cheap but with a trade-off.
4. Cigna: They offer coverage in the Bronze, Silver, and Gold metal levels in 68 counties.
5. Friday Health Plans: It has its headquarters in Denver. As one of the options available, it offers both group and individual plans but can only be found in just 3 counties.
6. Oscar Health Insurance of North Carolina: The company was started in 2012 and just like the others, aims to see to it you get affordable and high-quality healthcare coverage.
7. UnitedHealthcare of North Carolina: Has been around since 1977 and offers coverage for pregnant women and newborns, children, adults, plus people with disabilities, including dual coverage for those who are eligible for both Medicare and Medicaid.
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Best affordable health insurance in North Carolina.
One beautiful thing about health insurance coverage in North Carolina is that the carriers are prohibited from rejecting coverage on preexisting medical conditions as they do elsewhere and aren’t allowed to charge more for your care. (source)
The cost of health insurance differs among the counties and available health plans of choice.
By county.
The health insurance companies don’t have branches in all the counties except for Blue Cross Blue Shield. For this reason, the plans available in the counties differ and, by extension, are the cheapest or costliest plans in each county.
Here, we are concerned with the cheapest or most affordable plans in each of the counties. Each county has a specific plan or provider that’s the cheapest among all available options there. Among all the silver plans, the “Blue Advantage Silver 6000” is the cheapest in most of the counties like Bertie, Clay, and Gates whereas the “Blue Value Silver 6000” is the cheapest in New Hanover, Onslow, etc. (source)
You’ll find a complete detailed list of the cheapest silver plans in each of the North Carolina counties for singles, couples, and one dependent here.
Health choice.
This is a health insurance plan specifically meant for low-income children in situations where they are not eligible for Medicaid. When a child’s income is above the limit for Medicaid, but can’t afford private insurance coverage in addition to the lack of employer-sponsored coverage, then health choice may be the way out.
The North Carolina health choice program is for children between the ages of 6 to 19 years. Share on X It started on the first of October, 1998 (source) and has the following eligibility requirements:
- You must be a resident of North Carolina.
- You can be up to 18 years old but not older.
- You must be a US citizen.
- A legal resident or immigrant.
- Ineligible for Medicaid.
- Your annual household income before tax must be below a stipulated amount.
This should be $25,760 for an individual. This figure increases by $9,080 for each additional person in a household. So in a house of two people, you’ll get $(25,760+9,080) which equals $34,840. For a household of 3 people, it will be $(25,760+9,080+9,080) or $25,760 + 2($9,080). These sum up to $43,920.
The formula for calculating the maximum amount of household income to be eligible for North Carolina health choice is $25,760 + n-1($9,080). Where “n” represents the number of people in your household.
The process for approval involves first checking to find out if you are eligible for Medicaid before being considered for health choice.
The North Carolina Health Choice runs just like Medicaid where one pays either low or no premiums in some cases but enrollment is limited to available funds. This makes it imperative to register as soon as possible as you’ll be put on a waiting list once available funds can’t cater to more enrollees.
Medicaid.
According to the North Carolina Department of Health and Human Services, the state is among the few yet to expand Medicaid in line with the Affordable Care Act. So its requirement in the state can’t be like those that have. These requirements include having an annual household or personal income considered to be low or very low, plus any one of the following: (source)
- Pregnant lady,
- Aged,
- Being the provider and caregiver of an 18-year-old child or younger.
- Blind or disabled, etc.
Unlike most other health insurance options, any qualifying applicant can subscribe to Medicaid any time of the year without waiting for open enrollment periods. (source)
The maximum income limit to be eligible for the North Carolina Medicaid program varies according to family size. For an individual, the limit for eligibility is $17, 131. For a family size of two people, you add $6,038 to that for an individual($17,131) which gives $23,169. (source)
Generally, you can calculate the maximum annual income limit for Medicaid for any family size by adding $6,038 to $17,131 for each additional member of the family, aside from the main applicant, to be covered by the insurance. For instance, for a family of 3, the maximum income limit is $17,131 + 2($6,038) which gives $29,207.
This formula: $17,131 + n-1($6,038) can also be used to calculate the maximum income limit for Medicaid in North Carolina, where “n” represents the family size.
How to get affordable health insurance in North Carolina
The state gives options for health insurance coverage for all its full-time, permanent employees but for non-permanent employees, a plan is available through the state health plan (source).
Generally, North Carolina residents can buy health insurance coverage through private insurance or the Federal exchange during the open enrollment period. This exercise is done once every year.
However, there is an opportunity for people to enroll for health coverage during the year if they qualify for a special enrollment period (SEP) on the occurrence of qualifying life events like the birth of a new baby, adoption, marriage, divorce, loss of other insurance coverage like Medicaid or employer-sponsored insurance, etc.
How to get free health insurance in NC
Being a resident of the state grants you a double chance of getting free health insurance coverage either through the state-sponsored North Carolina Health Choice or Medicaid program. These are available in every county but you must meet the eligibility requirements for either program to stand a chance of benefiting from it.
The health choice program is state-sponsored and approval for the program depends on available funds. For this reason, it’s done on a first-come-first-served basis.
The state tries to discourage anyone with existing insurance coverage from applying for its health choice program and the reasons are apparently due to limited funding. Once the program is full any other applicant is placed on a waiting list.
You’ll first be assessed for eligibility into the Federal Medicaid plan before your application for health choice is processed.
I hope this article was helpful. You may also be interested in long-term health insurance plans,
an example of a health condition that would certainly need insurance coverage or a medical treatment procedure that calls for insurance coverage.
