Can I Receive Health Insurance Coverage in North Carolina If I Have a Pre-Existing Condition?

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The short answer is yes — under the new healthcare reform, no health insurance plan in the Marketplace (including Medicaid and CHIP) can refuse to cover you just because you have a pre-existing health condition.

Open enrollment for pre-existing condition health insurance begins October 1, 2013, and ends on March 31, 2014. Outside of open enrollment, you cannot enroll in Marketplace coverage without a qualifying life event. (This may include, but is not limited to, moving to a new state, certain income changes, changes in family size, and more.)

If I Have a Grandfathered Individual Health Insurance Plan, Do They Have to Cover Pre-Existing Conditions?

If you purchased an individual health insurance plan in North Carolina prior to March 23, 2010 (not through an employer), your insurance provider is not required to offer pre-existing condition insurance coverage. However, if you have a grandfathered insurance plan and decide to switch to a Marketplace plan during open enrollment, you will immediately receive coverage for your pre-existing conditions.

If you were previously enrolled in the Pre-Existing Condition Insurance Plan in NC, please visit our our FAQ page on PCIP coverage ending.

Learn More About Pre-Existing Condition Health Insurance Coverage in NC

Under the new healthcare reform, an insurance company can’t turn you down because you are sick or refuse to provide you treatment for any pre-existing conditions you may have — even if you have been turned down in the past.

For more information on individual health insurance for pre-existing conditions in NC, please call Independent Benefit Advisors today at (919) 303-9690. We would be happy to assist you.

Independent Benefit Advisors is proud to serve individuals and businesses in ApexRaleighDurhamCaryCharlotteFuquay-VarinaGreensboroRocky MountSanfordWake Forest, and other North Carolina locations.

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