What Health Insurance Benefits Will I Receive Under My Private Health Insurance Plan in North Carolina?

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Under the new healthcare legislation, all private health insurance plans in North Carolina and across the US will now offer the same essential health benefits. For a plan to be certified and offered in the Health Insurance Marketplace, it must include at least the following benefits:

What are the 10 Essential Health Benefits in NC?

  1. Ambulatory Patient Services
    Includes any outpatient care received without hospital admittance
  2. Emergency Services
    Includes any outpatient care received at in-network or out-of-network hospitals, such as trips to the emergency room
  3. Hospitalization
    Includes any treatment received in the hospital for inpatient care, such as surgery
  4. Maternity, Prenatal & Postnatal Care
    Includes care for mother or baby, before, during and after the baby is born
  5. Mental Health & Substance Use Disorder Services
    Includes behavioral health treatment, counseling, and psychotherapy
  6. Prescription Drugs
  7. Rehabilitative & Habilitative Services & Devices
    Includes services and devices designed to help people with injuries, disabilities, or chronic conditions gain or recover their mental and physical skills, such as physical therapy, occupational therapy, speech language pathology, psychiatric rehabilitation, and more
  8. Laboratory Services
  9. Preventive & Wellness Services
    Includes chronic disease management, as well as alcohol misuse screening and counseling, aspirin use, blood pressure screening, cholesterol screening, colorectal cancer screening, depression screening, Type 2 diabetes screening, diet counseling, HIV screening, immunization vaccines, obesity screening and counseling, STI prevention counseling, syphilis screening, tobacco use screening, and more
  10. Pediatric Services
    Includes oral and vision care

Let Us Help You Navigate the New Health Insurance Marketplace

Customers should note that coverage under the previously listed benefits will vary by state — to learn more about the health benefits NC residents will receive, please contact Independent Benefit Advisors today at (919) 303-9690.

Independent Benefit Advisors is happy to discuss any health insurance coverage questions with individuals and businesses in ApexRaleighDurhamCaryCharlotteFuquay-VarinaGreensboroRocky MountSanfordWake Forest, and other North Carolina locations.

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