Health Insurance

North Carolina Health Insurance
More Health Information by city: 
Greensboro, Raleigh, Winston-Salem, Burlington, High-Point, Charlotte, Asheville and Fayetteville.

Health Insurance
               Medical insurance helps individuals pay for cost associated with sickness or injury.  The benefits associated with a health insurance policy can vary from policy to policy.  Policies have deductibles, coinsurance amounts, co-payments, and out-of-pockets expenses that may be different according to the plan purchased by the individual.  Different types of plans are widely available such as Traditional Co-pay Plans, High Deductible Savings Plans (H S A), and Short Term Insurance Plans.  By asking questions and speaking with a health insurance agent, individuals can find affordable health insurance in Greensboro, the Triad, and the entire state of North Carolina.

Under 65 Health Insurance
               There are numerous companies that offer individual health insurance in North Carolina to those under 65.  Blue Cross Blue Shield of North Carolina, Humana, WellPath Coventry, Cigna, and Assurant Health are companies that provide medical insurance in Greensboro, the Raleigh-Durham area and other parts of North Carolina.  Each of these companies offers traditional co-pay plans as well as high deductible health plans.  When speaking with an agent, they should be able to assist you in deciding which type of plan is best for your specific circumstances.

Over 65 Health Insurance (Medicare)
               All citizens are entitled to Medicare coverage when they turn 65.  Individuals must sign up for their coverage three months preceding their 65th birthday or three months after their 65th birthday unless they are already receiving social security.  In this case, they will be automatically enrolled in Part A and Part B.  Medicare coverage has 2 parts:  Part A and Part B.  Part A is mandatory for all American citizens.  This is coverage for “inpatient hospital care, hospice care, home health care and treatment in a skilled nursing facility”. 
               Part B covers routine care such as screenings, doctor’s visits and forms of home care.  This premium is paid by the individual and can be deducted from their social security payment each month. 
               Medicare Parts C and D are offered by approved, private companies.  Part C is also called Medicare Advantage (like an HMO or PPO).  If an individual chooses to join a Medicare Advantage Plan, it will provide for their Part A and Part B coverage.  Part C has a monthly premium that must be paid by the individual.  In most situations, the individual can choose whether to have this premium deducted from their social security payment or to receive a bill.  When an individual over 65 chooses to purchase a Part D plan, they have a similar choice.  Individual’s desiring a Plan D policy must obtain one when they are first eligible or they may be charged a late enrollment penalty.  Part D helps to cover the expense of prescription drugs.  A monthly premium must be paid for Part D.  For additional information on Medicare go to:
               In the state of North Carolina, health insurance coverage is offered thru Medicaid to individuals who are disabled or uninsured due to their income level.

Health Insurance Terminology

Coinsurance:  A predetermined percentage that the insured will pay for a provider’s charge for service or for the purchase of a prescription drugs after the deductible is met.  Once the out-of-pocket maximum is met, the insured will no longer be required to pay out-of-pocket for covered medical expenses.  (The actual coinsurance amount to be paid out by the insured is usually a pre-set amount which is disclosed in the policy.)

Co-pay:  A predetermined, specified amount that the insured pays the day service is rendered at a physician’s office or at the time a prescription is purchased.  The co-pay amounts usually appear on the health insurance card.  The insurance company covers the remaining portion (as long as it is a covered expense).

Deductible:  The deductible is the amount of money the insured must pay out-of-pocket before most of the benefits of the policy are enjoyed by the insured.  These benefits vary according to differing plans.  Some plans allow for doctor’s visits, prescription drug purchases, and emergency room visits before the deductible is met.  All plans now allow for coverage of preventative care before the deductible is met.  Be aware that some plans have individual deductibles and some have family deductibles. 

Out-of –pocket Maximum:  This is an amount of money the insured will pay per year for their covered medical expenses.  Individuals must pay for some of their medical care.  Once the out-of-pocket maximum has been satisfied, the insurance company will pay 100% of the allowed amount of covered medical expenses.

Provider:  One who gives medical service; A clinic, hospital, doctor, laboratory, health care practitioner, pharmacy, etc.

Insured The individual that owns a health insurance policy or is covered by a health insurance policy.