North Carolina State health plan

If you live in North Carolina you should count yourself lucky that you live in a state that offers such a great government-sponsored health care program called Inclusive Health.

This a government subsidize quality health insurance plan administered by Blue Cross Blue Shield of North Carolina for folks that cannot qualify for an individual health insurance plan due to health history.

Trying to find a quality health plan with pre-existing conditions can be very difficult if you have never tried to shop for a private policy before on your own.

Every carrier in the state has different but similar underwriting guidelines, so before you try to apply for the inclusive health plan you should make sure no other plan will cover you.

This is a pretty good plan that covers basically the same services you would expect any major medical health insurance policy such as wellness visits, outpatient care, emergency room visits and your medications are covered as well of course.

What are the eligibility requirements for the NC state health plan?

Eligibility Requirements for State Option Coverage

You are eligible of Inclusive Health Coverage if you have a pre-existing condition and…

You can answer YES to AT LEAST ONE of the following questions:

  • You were rejected or refused coverage for health reasons by an insurance company
  • You have been offered coverage by an insurer with a conditional rider limiting coverage
  • Your current individual health insurance coverage is at a premium rate exceeding the Inclusive Health premium
  • You were refused individual coverage by an insurance company except at a premium rate that is higher than the Inclusive Health rate
  • You are eligible for or are enrolled in COBRA or state continuation and have an individual premium rate that is higher than Inclusive Health and answer “Yes” to at least one of numbers 1-3 or 6
  • You have been diagnosed with a presumptive qualifying medical condition listed below
  • You have had 18 months of continuous coverage and have exhausted COBRA coverage
  • You are eligible for the Health Coverage Tax Credit (HCTC) for trade displaced workers under the TAA, ATAA or PBGC programs

.

You are eligible if you can answer YES to ALL of the following questions:

  • You are not Medicare eligible
  • You are not Medicaid eligible
  • You are a legal U.S. resident
  • You are a North Carolina resident
  • You or your spouse are not eligible for insurance at work
  • You are not covered as a dependent

 

How much are the rates for the Inclusive Health state plan?

As an example the rate for a 30 year old male non smoker, who has had insurance in the last 63 days would be:

State Option
For people who have existing coverage, have not had a lapse in coverage of more than 63 days who have a pre-existing condition, are on COBRA or are HIPAA eligible or HCTC eligible.
Plan Option Monthly Premium Deductible/Co-Insurance
PPO 1000 $110 $1000/80%-50%
PPO 2500 $72 $2500/80%-50%
PPO 3500 $59 $3500/80%-50%
HDHP 5000 $43 $5000/100%

 

If you would like help with the Inclusive Health application please click here!

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