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North Carolina Health Insurance Information

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Updated August 12, 2008

North Carolina Department of Insurance

The North Carolina Department of Insurance is responsible for regulating all types of insurance sold in the state of North Carolina -- including health insurance policies.

If you are looking for health insurance coverage, the Department of Insurance can help you find an insurance agent or insurance company that is licensed to do business in North Carolina. You can also get information about the license status of a particular insurance company online.

If you are having trouble resolving a claims dispute with your insurer, you can file a complaint with the Department of Insurance. Find out more about the consumer complaint process online or go directly to the complaint form.

North Carolina Department of Insurance
430 N. Salisbury St.
Raleigh, NC 27603-5926
Phone:800-546-5664 or 919-807-6750 (outside North Carolina)

U.S. Department of Labor

If you get your insurance through your job, your plan is also regulated by the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). They make and enforce the rules that your employer must follow when offering health insurance coverage to employees -- for example, your employer cannot single out an individual employee to exclude her from the plan because she (or one of her dependents) has a costly illness. Also, if there are 20 or more employees at your job, you should be offered COBRA continuation coverage when you leave your job. The EBSA works to make sure that all of this happens and your rights are protected.

If you have concerns about your employer's practices in administering your job-based health coverage -- for example, if you think you should have been offered COBRA continuation coverage, but were not, or if you feel that you were wrongly terminated from your health plan -- contact your regional EBSA office.

U.S. Department of Labor Employee Benefits Security Administration
Atlanta Regional Office
61 Forsyth Street, SW, Suite 7B54
Atlanta, GA 30303
Rebecca Marshall - Director
Phone: 404-302-3900
Fax: 404-302-3975

Buying Individual Policies in North Carolina

All insurers in North Carolina, except for Blue Cross Blue Shield, are allowed to reject your application for coverage based on your health status. Blue Cross Blue Shield offers a special "guaranteed issue" plan to residents with pre-existing medical conditions.

You may also qualify for coverage as a "HIPAA-eligible" individual if you:

  • had at least 18 months of continuous creditable coverage, the last day of which was under a group plan AND
  • you have exhausted all COBRA continuation coverage which was available to you.

If you are not sure whether you are a HIPAA-eligible individual, your insurance agent or the North Carolina Department of Insurance can help you find out.

Health Choice for Children - the State Children's Health Insurance Program

Health Choice for Children provides health insurance coverage for children whose family income meets certain income guidelines.

North Carolina Health Choice for Children
North Carolina Division of Medical Assistance
Phone: 800-367-2229

Seniors' Health Insurance Information Program (SHIIP)

SHIIP provides free one-on-one counseling for Medicare beneficiaries with questions about any aspect of Medicare, including the Medicare Part D prescription drug benefit, or Medigap coverage.

North Carolina SHIIP
Phone: 800-443-9354 or 919-807-6900

North Carolina Medicaid

Medicaid is a government program designed to help the poor and indigent obtain health care services. Pregnant women and children under age 19 who meet certain income requirements may be eligible for Medicaid coverage, along with aged, blind, and disabled individuals. For more information about North Carolina's Medicaid program, contact your local Division of Social Services Office.

North Carolina Medicaid
Phone: 800-662-7030 or 919-855-4400

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