Individual Health Insurance in Raleigh, North Carolina FAQs
1. Can I purchase an individual health insurance plan in North Carolina with an agent at any time throughout the year?
For most North Carolina residents, the Open Enrollment period for buying health insurance closes on December 15 each year, depending on the state. However, if you have a qualifying life event, you are eligible for a “Special Enrollment Period” (SEP). During this 60-day period, you may purchase individual health insurance coverage, even if it is outside of Open Enrollment.
2. What qualifies as a SEP (Special Enrollment Period)?
The following are examples of situations that would qualify you for a Special Enrollment Period:
- Termination of job-based, employer-sponsored, or COBRA coverage
- Loss of individual health insurance coverage for a plan you bought yourself
- Expired insurance coverage through a family member
- End of eligibility for Medicaid, Children’s Health Insurance Program (CHIP), or Medicare Advantage Plans
- Changes in household size due to marriage, birth, divorce, or death
- Moving to a new home in NC, in a new zip code or county
- Other circumstances outlined at Healthcare.gov
Contact Carolina Insurance Professionals today for more details. Because we’re an independent insurance agency, our assistance is available at no extra cost to you, whether you are trying to get a quote from insurance providers as a self-employed individual, or you want to be sure you have the best individual insurance, group health insurance or other insurance policies from the best insurance providers in North Carolina.
3. I do qualify for a SEP. What is the Marketplace and why should I purchase health insurance there?
The health insurance Marketplace is a health insurance exchange – an online collective where individual families and small businesses in North Carolina can purchase group or personal health insurance. Plans on the exchange are offered in three different coverage levels: gold, silver, and bronze. Each insurance plan is required to cover 10 essential health benefits. If you purchase your plan through the Marketplace, you may be eligible to receive a government subsidy to assist in paying for your health insurance premiums.
Plus, Carolina Insurance Professionals is a local North Carolina health insurance broker. We can help you navigate the Health Insurance Marketplace at no additional cost to you. Contact us today for more information and details about our no-cost assistance.
4. Will I qualify for a subsidy to help with my individual health insurance premiums?
Consult with one of our licensed health insurance agents to see if you qualify for financial assistance to lower your monthly premiums. We’re the insurance broker that specializes in finding quality health insurance at affordable prices across a wide array of insurance companies, like Blue Cross And Blue Shield.
5. If I won’t qualify for a subsidy, do I still need to purchase my plan from the Marketplace?
If you know your income is too high to qualify for a subsidy, you can purchase your medical plan directly from the insurer with help from one of our agents. Keep in mind you will still need a Special Enrollment Period to be able to enroll in any health plans among your available individual or family health insurance options.
6. What are the “Essential Health Benefits?”
Essential health benefits are specific services that, according to the Affordable Care Act, must be included in any health plan sold to individuals or businesses in North Carolina to be considered compliant. These benefits include coverage for events like maternity, newborn care, hospitalization, ambulatory care, and prescription drugs.
7. Do I need to carry health insurance?
As of 2019, there is no longer a federal tax penalty if you do not have individual health insurance. However, some tax penalties may be enforced on the state level beginning in 2020, which individuals will see on their 2021 taxes. Do keep in mind that even if your state does not enforce tax penalties, you still run the risk of exorbitant hospital bills should you have a major medical incident. We highly recommend speaking with a licensed health insurance agent at Carolina Insurance Professionals. More options are becoming available and we can help you find the right plan for the right price.
8. How can a health insurance broker in North Carolina help me?
Although the Marketplace has navigators to help customers apply for government subsidies, a health insurance broker can do this as well and make the health insurance enrollment process even easier at no additional cost to you. Health insurance brokers can recommend a health insurance plan based on your budget, help you understand your benefits, and support you even after enrollment. Health insurance agents with Carolina Insurance Professionals hold a state license, undergo criminal background checks, and use their insurance expertise to find you the best coverage.
Ready to get started?
We have years of experience meeting the health insurance needs of individuals, families, and small businesses in North Carolina. It can be scary being uninsured. Our North Carolina health insurance agents can guide you through the SEP and Open Enrollment processes to get you covered. When you work with us, rest assured that you will have the health care coverage you need and that we will always be here to answer your questions all year long. Contact us today to learn more about your health insurance options.
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