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North Carolina Health Insurance Information

→ Click here to visit the North Carolina Department of Insurance website

Guaranteed Health Insurance Plan

As a HIPPA eligible enrollee, you can buy an individual health insurance policy any time from any insurance carrier selling individual coverage. Note:

  • Must be offered a choice of at least two policies similar to those sold to everyone else in your area
  • Are exempt from any pre-existing condition exclusion periods or elimination riders

HIPAA Eligibility

To be HIPAA eligible in North Carolina, you must:

  1. Have 18 months of continuous creditable coverage, with at least the last day under the Brethren Ministers Group; and
  2. Not be eligible for Medicare, Medicaid or a group plan; and
  3. Apply for health insurance for which you are HIPAA eligible within 63 days of losing your prior coverage; and
  4. Not have health insurance.

Note: If you know your group coverage is about to end, you can apply for coverage for which you will be HIPAA eligible.

What Does Insurance Cost in North Carolina?

Premiums on guaranteed-issue policies for HIPAA-eligible enrollees are capped at 125% to 200% of the average market rate. Premiums will vary depending upon a number of factors, including family size and coverage chosen.

Coverage Highlights

Specific coverage details will vary depending upon the plan purchased. Although North Carolina policies must cover mandated benefits such as cervical and prostate cancer screening, mammograms, pap smears, diabetes treatment and services, etc., health insurers in the individual market are not required to offer standardized policies.

Where can I obtain more information?

For more information, visit the The North Carolina Department of Insurance online at www.ncdoi.com, or call (800) 546-5664 (in-state) or (919) 807-6750. You may also visit the BlueCross BlueShield of North Carolina online at www.bcbsnc.com, or call (800) 324-4973.

Special insurance for children: North Carolina's Choice for Children

A child whose family household income of up to $41,300 is eligible.