What Family Health Insurance or Children’s Health Insurance Options Do I Have in North Carolina?

If you are a North Carolina resident looking for health insurance for your child under the Affordable Care Act, know that there are both government-funded programs and private health insurance plans available.

What is the Children’s Health Insurance Program (CHIP)?

As part of the new healthcare plan, the Children’s Health Insurance Program provides low-cost health coverage to families in NC and across the US, available for both parents and pregnant women with moderate incomes. If you make too much money to qualify for Medicaid, you may still qualify for CHIP.

What Does CHIP Cover?

  • Much like the ”essential health benefits,” North Carolina must provide at least the following benefits under the Children’s Health Insurance Program:

    • Routine checkups
    • Immunizations
    • Doctor visits
    • Prescriptions
    • Dental and vision care
    • Inpatient and outpatient hospital care
    • Lab and X-ray services
    • Emergency services
  • The North Carolina Health Choice (NCHC) Health Insurance Program for Children (the NC version of CHIP), also offers:

    • Case management and care coordination services
    • Surgical services
    • Family planning services
    • Hearing care
    • Durable medical equipment and disposable medical supplies
    • Physical therapy, occupational therapy, and therapy for individuals with speech, hearing or language disorders
    • Hospice care
    • Home health care
    • Inpatient and outpatient mental health services
    • Inpatient and outpatient substance abuse treatment

How Much Does CHIP Cost?

The cost of CHIP varies by state; however, families cannot be asked to pay more than 5% of their total income for the year for this health insurance coverage. Under CHIP, all routine “well child” doctor and dental visits will be provided free of charge. Some copays may apply, as well as a monthly premium for coverage.

What are the CHIP Qualifications for North Carolina?

If your family is uninsured but makes too much money to qualify for Medicaid, you may qualify for North Carolina Health Choice (NCHC), depending on age of child(ren), insurance status, household income level, residency and other eligibility requirements.

Learn More About Low-Income Health Insurance Options

Need more information about the cost of health insurance for your children or family? Wondering if your family could qualify for NCHC? Give Independent Benefit Advisors a call today at (919) 303-9690.

Independent Benefit Advisors offers insurance assistance to customers in Apex, Raleigh, Durham, Cary, Charlotte, Fuquay-Varina, Greensboro, Rocky Mount, Sanford, Wake Forest, and other North Carolina locations.