North Carolina Health Insurance

North Carolina has fewer health insurance regulations than most states. Still, it's important to familiarize yourself with them, so you're more confident and wise in your purchase.

This guide:

  • Describes North Carolina health insurance policy regulations.

  • Lists rules North Carolina health insurance companies follow.

Health insurance policies are regulated by each state's own health insurance laws. North Carolina health insurance companies and policyholders alike must abide by established insurance laws.

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North Carolina health insurance policy provisions

Some of the most important North Carolina health insurance laws are the ones that influence the health insurance policy specifically.

One of the more universal policy provision is the guaranteed renewability provision. In North Carolina this clause, stating that a policyholder has the right to renew an existing health insurance policy as long as no part of the contract was violated, is a required element in all health insurance policy.

A second important provision of North Carolina health insurance policies that is allowed to be included is a pre-existing exclusion period clause. Exclusion periods can last for up to 12 months.

Medical conditions are considered to be pre-existing if you received medical treatment for or were diagnosed with them in the 6 months before the beginning of your health insurance plan.

In situations of switching your North Carolina health insurance make sure you have continuous coverage, because state laws allow your old coverage to be used to credit the pre-existing condition period of your new North Carolina health insurance plan. This means if, under your old policy, your condition was excluded from coverage for 5 months, the maximum exclusion period under your new plan, would be 7 months, not 12.

Finally, under North Carolina health insurance laws, newborns and adopted children are covered by their parent's insurance policy if the policy already provides coverage for dependents. The coverage ends after 31 days and the policy needs to be amended to include these dependents.

Regulating North Carolina health insurance companies

The other area of importance in regards to health insurance laws is the degree of influence your health insurance company has over your policy and its price.

The general rule is that any North Carolina health insurance company, except Blue Cross Blue Shield, is free to refuse you coverage. You can be denied health insurance or can be charged high premiums for health insurance on the basis of your health.

Also, you North Carolina health insurance premiums can increase due to age and and health.

However, since North Carolina health insurance company can't refuse to renew your existing health insurance policy not even on the grounds of illness, it is advisable to buy health insurance while you are young and healthy to guarantee a comprehensive health insurance policy.

Temporary North Carolina health insurance

If you are seeking temporary North Carolina health insurance, conversion policies are a good choice. They are available to individuals who have recently left a fully insured group policy.

Although the price may be higher and the coverage less than your old North Carolina health insurance policy, conversion policies offer adequate insurance in times when you have breaks in between your coverage.

In North Carolina, you must be given at least two different policies to choose from when buying a conversion policy. These policies will not require a new pre-existing condition exclusion period and will never be canceled because you fall ill.

Temporary insurance, for those that do not qualify for a conversion policy, can also be obtained in North Carolina.

More NC health insurance help

If you want more help getting the a good health insurance policy, read our guide to health insurance.

Also see the guide to North Carolina small business health insurance.

To find out more about NC health insurance laws and regulations, visit the official website of the North Carolina Department of Insurance.