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Health Insurance in North Carolina

North Carolina health insurance coverage is available to all U.S. residents under the Affordable Care Act (ACA), regardless of whether citizens hold a pre-existing medical condition such as diabetes or cancer. As such, customers can shop for an affordable health insurance plan under the federal health insurance marketplace, or they may enroll through an employer or a spouse’s place of employment. However, most patients who do not complete the health insurance enrollment process must pay a tax penalty when they file their federal income taxes. To avoid tax penalties during tax time, customers can get a health insurance quote here and enroll in a plan that best fits their lifestyle and budget. To learn more about medical insurance plans in NC, review the sections below.

North Carolina Health Insurance Requirements

Under the ACA, residents are mandated to enroll in a medical insurance plan before the final deadline to avoid tax penalties, unless they qualify for a low-income or hardship exemption. However, not all NC health insurance plans meet minimum essential coverage (MEC) requirements (or qualifying health coverage). Plans that do meet MEC requirements include those under the health insurance marketplace, job-based policies, Medicaid, Medicare, the Children’s Health Insurance Program (CHIP) and grandfathered plans purchased earlier than March 23, 2010. If patients enroll in health plans such as these, they will meet minimum ACA requirements and will be exempt from paying the penalty fee when they file their federal income taxes. The following medical insurance plans, however, do not meet MEC requirements:

  • Standalone dental or vision plans
  • Worker’s compensation
  • Medicare Part B
  • Certain limited coverage Medicaid policies
  • Plans providing coverage for specific diseases or conditions only

Before completing a health insurance application in NC, customers must verify that their plan meets MEC requirements. To get started, patients can find acceptable plans and compare health insurance quotes online here.

North Carolina Health Insurance Plan Penalties

If customers do not meet health insurance enrollment requirements, they may need to pay a penalty fee when they file their income taxes. The medical insurance penalty fee (or the individual shared responsibility payment) applies to all patients who can afford to pay for health care but choose not to. In most cases, the medical coverage penalty fee is either 2.5 percent of annual household income or $695 per adult and $347.50 per child under 18 years of age (for a maximum total of $2,085). However, the penalty fee only applies to each month for which customers do not have coverage. To avoid medical insurance enrollment penalty fees such as these, residents can get affordable health insurance quotes online here.

Furthermore, health insurance exemptions pertain to certain qualifying customers. These NC health insurance enrollment exemptions include hardship exclusions for homeless residents, patients facing foreclosure or eviction, and victims of domestic abuse. However, affordable health insurance options are also available through the health insurance marketplace, including catastrophic plans. These medical insurance plans are available to customers who qualify for a hardship exemption, or to certain qualifying patients under 30 years of age. As such, catastrophic medical plans offer high deductibles and low monthly premiums to help patients protect themselves in the event of a serious injury or illness. Customers who qualify for a medical insurance hardship exemption do not need to enroll in a catastrophic plan, but the option is available to them.

Benefits of North Carolina Medical Insurance Plans

Under the ACA, customers can search for health insurance quotes in NC through the federal medical insurance marketplace to find an affordable plan that meets their own specific needs while also staying within their budgetary limits. Benefits of marketplace health insurance plans include preventative care, inpatient and outpatient medical services, doctors’ visits, pregnancy and childbirth, prescription drug coverage, mental health treatments and emergency services. In some cases, marketplace medical insurance plans may include health care management programs or vision and dental coverage. To receive medical benefits such as these, customers can search for North Carolina health insurance quotes online here.

Additional benefits of health insurance enrollment include premium tax credits for households with lower annual incomes. If customers purchase a plan through the medical insurance marketplace, they may be able to save money on their monthly premium if their household’s annual income qualifies them for a tax credit. In most cases, NC health insurance tax credits and monthly premium amounts update whenever income or household information changes. For this reason, customers must report any income or household updates to the health insurance marketplace as soon as any changes occur.

North Carolina Health Insurance Enrollment

There are several medical insurance enrollment options available to North Carolina residents. As such, patients can find affordable health insurance plans through the federal health insurance marketplace, under government programs such as CHIP or Medicaid, under private insurance providers, or through an employer or a spouse’s place of employment. Before submitting a health insurance application in North Carolina or before enrolling in a plan, however, it is important to consider several important factors:

  • The cost of the plan (such as monthly premiums, co-payments and deductibles).
  • The plan type (such as a preferred provider organization or health maintenance organization).
  • The plan’s metal category (if purchasing a medical insurance plan through the marketplace).

If comparing NC medial insurance quotes through the marketplace, customers can choose a metal category that best fits their lifestyle and budget. These health insurance metal categories include bronze (low monthly premiums), silver (moderate monthly premiums), gold (high monthly premiums) and platinum (the highest monthly premium). However, health insurance plan categories do not impact the quality of care in which patients receive. To get started, customers, can compare health insurance quotes here.

After finding a medical insurance plan in North Carolina that best fits their budget, residents can begin the health insurance enrollment process. To enroll in a marketplace health insurance plan, customers may apply online through the website, by telephone, in person or by mail. To submit a health insurance application by mail, applicants must complete an Application for Health Coverage (OMB No. 0938-1213) and mail it to the Department of Health and Human Services in Kentucky. To apply for health insurance by telephone, applicants must contact the Marketplace Call Center to speak with a customer service representative. Alternately, customers can get an affordable health insurance quote online.