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North Carolina Health Insurance

According to the Center for Disease Control, an average of 16.1% of North Carolina residents went uninsured for North Carolina health insurance each year between 2001 and 2003.

North Carolina Health Insurance Regulations

Any individual offered health insurance through an employer cannot be denied or limited coverage under that plan. Most North Carolina health insurance companies in can turn down applicants for individual medical insurance based on health, age or other factors. All residents, however, are guaranteed access to health insurance through Blue Cross and Blue Shield. HIPAA eligible residents also have access to plans under most North Carolina health insurance companies.


All North Carolina health insurance plans are guaranteed renewable which means that an individual is guaranteed the right to renew an existing plan as long as he or she has not provided any false information and has paid all premiums on time.

Pre-Existing Conditions

Individual North Carolina health insurance policies can carry elimination riders and pre-existing condition exclusion periods. Elimination riders can permanently exclude coverage for a medical condition or body part for the duration of the policy. If an individual was treated, diagnosed, or advised for a medical condition during the 12 months prior to the beginning of the health insurance policy, the North Carolina medical insurance company can exclude coverage for that condition for up to 12 months. Continuous coverage for medical insurance prior to the beginning of the new policy can credit towards the pre-existing condition exclusion period.

Insurers can also determine a condition is pre-existing if the individual files a claim for a condition and the insurance company decides the condition existed prior to application for the policy. The company can then decide not to cover the condition or treatment.


Although pregnancy is considered a pre-existing condition, if the parent has dependent coverage under an individual North Carolina health insurance plan, a newborn or adopted child will be automatically protected for the first 30 after birth or adoption. Disabled children can remain under the policy even past the age at which children cease to be “dependents”.


North Carolina health insurance rates can vary based on age, health, family size and other factors. Rates can also change when policies are renewed. Temporary North Carolina health insurance can be purchased when an individual is between jobs or policies.

Alternative North Carolina Health Insurance Options

For individuals who cannot afford North Carolina Health Insurance or who need assistance, there are state programs that may help:

  • North Carolina Medicaid is available to persons who meet eligibility and qualifying criteria.
  • NC Health Choice for Children is North Carolina’s State Health Insurance Program that is designed to provide health insurance to children under 19 whose families do not qualify for Medicaid and who might not be able to afford North Carolina health insurance.

North Carolina Department of Insurance

North Carolina Department of Insurance
1201 Mail Service Center
Raleigh, NC 27699-1201

800-JIM LONG (800-546-5664) - in North Carolina Only
919-733-2032 - outside North Carolina

For other North Carolina Insurance Resources, See:

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