Individual

Individual health insurance in North Carolina for 2020

by Keely S.

Open enrollment is approaching quickly, and that means it's decision time for nearly 520,000 people in North Carolina who enrolled for individual health coverage in 2019.

Good news for you: the three insurers that offer 2019 coverage in the North Carolina exchange – Cigna, Ambetter (Centene) and Blue Cross Blue Shield of North Carolina – have all proposed average rate decreases for 2020. In addition, Bright Health is entering the North Carolina marketplace, and plans to offer coverage in Charlotte and Winston-Salem.

Here's how 2020 is shaping up in comparison to last year

When to enroll: Open enrollment in North Carolina runs from November 1, 2019 to December 15, 2019.

  • Short term plans are also a new option, as of last year. 

    These short term, limited duration plans (STLDs) come with more restrictions, such as limits on preexisting conditions, and offer less coverage (i.e., good bye well-visits and maternity coverage), but their lower price point can be attractive to those that are relatively healthy and looking for more affordability. 

With new regulatory rules in place, employers have more flexibility to reimburse employees with cash-for coverage, meaning they can reimburse their teams for individual marketplace health plans. This is great news! Here are the details on the two latest HRAs.

  • ICHRA- individual coverage HRAs are going to be a game-changer. They are a flexible, customizible, tax-free option. Employees choose any plan they want from the individual marketplace to qualify for participation.
  • EBHRA- excepted benefits HRAs allow for higher levels of employer contributions than flexible spending arrangements (FSAs) and the unused funds can rollover year to year. These can be used to cover the cost of copays, deductibles, or other costs not covered by the plan. 
  • QSEHRA- no longer the new kid on the block, this HRA has steadily grown in popularity. 

Some things haven't changed: 

Doctor networks continue to stay small: An ongoing trend since the start of Obamacare, many plans will cover an increasingly smaller percentage of doctors in a given area. That leaves the consumer with fewer choices and a greater chance of having to go out of network to get the care they need. This is a strategy used by carriers to keep costs down, but it leaves consumers financially vulnerable for shouldering those scary and sky-high out-of-network costs. It's always smart to check every year if your doctor will remain on your network. 

Premiums are still really expensive: While premiums decreased by 4% across the board, according to CMS, they are still too expensive for those who don't qualify for premium tax credits to off-set the costs. We see markets stabilizing and more and more options designed to help individuals afford health insurance. Here are a few things to keep in mind that are new to 2020 or in the past year.

 


Know your alternatives: individual insurance available in North Carolina in 2020

Go to Ambetter homepage

Ambetter

Expect an average decrease of 8.73%. Ambetter was new to North Carolina in 2019, with plans available in Durham and Wake counties.

bluecross-grey

BlueCross Blue Shield of North Carolina

Expect an average decrease of 5.18%. BCBSNC has the majority of the ACA-compliant individual market in North Carolina, with about 489,000 enrollees in 2019. Blue Cross Blue Shield of North Carolina decreased their premiums by about 4% for 2019, so the 2020 rate proposal represents two straight years of declining rates.

Image result for bright health

Bright Health Plan

New to North Carolina for 2020, so no applicable rate change. Bright plans to offer coverage in the Charlotte area and the Winston-Salem area.

Cigna-Logo-2

Cigna

Expect an average decrease of 4.7% Cigna has 5,806 enrollees in 2019. The proposed premium decrease for 2020 comes on the heels of a very slight average increase for 2019. Cigna’s plans are available in the Raleigh area, in Chatham, Johnston, Nash, Orange, and Wake counties.

Affordable Alternatives You Should Know About

An increasing number of our customers are opting for alternatives to traditional insurance. Here’s a couple of our top picks. They might not be for everyone, but they are worth checking out and comparing to major medical plans on our platform.

Pivot short term plans: Pivot provides short term medical insurance solutions until a qualified major medical health plan is chosen, helping reduce your financial risk. Pivot plans are renewable 90 day plans which in most states can be automatically renewed 4 times without additional medical screening to provide up to 12 months of continuous coverage.

Faith-based: Faith-based Medi-Share has a state-wide PPO network available in 2019 managed by PHCS (Private Healthcare Systems, now owned by Multiplan). It’s smaller than some of the PPO networks in the past, but it does provide flexibility to see your doctors and will cover out-of-network expenses as long as it meets Medi-Share’s faith-based guidelines. Medi-Share won’t be for everyone, but is a worthy option to consider if it fits your personal convictions and lifestyle. Make sure to check out our Medi-Share review and compare it to other major medical plans on our website before you enroll.

United Health One: This option offers a lot of flexibility to those looking for a short term solution. First consumers choose the term length- from 30 day minimum up to the state maximum. Then they choose a deductible and coinsurance amount that fits the budget. Enrollees have access to United Health Care’s large network of doctors and hospitals. With United Health One plans you must use a network doctor or hospital in order for insurance to pay for eligible expenses, only emergencies are allowed out of network.

Next steps: What's my best option? 

 While more choices are a welcome change, hunting down and comparing all of these options can feel overwhelming. However, at TakeCommandHealth.com we help you compare all of your options side-by-side including off-exchange plans, marketplace plans, and faith-based options. You can use our award-winning tools to check your prescriptions, and even simulate conditions and health needs to make sure you get the most of for your money. 

With growing demand, we've also put together a bigger support team ready to help you tackle any issue. You can get started by chatting with us on our website or emailing us at support@takecommandhealth.com. 

Once open enrollment begins, you can visit our website and we'll walk you through your options. Our goal is to help you get the most out of your money and find the plan that really works for you and your family. Remember you have until Dec 15th to select a plan that starts Jan 1st, 2020. 

Extra perks with Take Command Health

We've negotiated some pretty awesome deals for our members. Call a doctor 24/7 for $0, enjoy medical bill negotiation support, a personal health advocate, dental, vision, and pharmacy discounts, etc. These really help save money with some of the higher deductible plans.  

Picture of Keely S.

Hi, I'm Keely S.! A wife to one and mother to four, Keely does all of the things. She’s also dabbled in personal finance blogging and social media management, contributed to MetroFamily magazine, and is passionate about good food, treasure hunting and upcycling. With a B.S. in Psychology from the University of Oklahoma and a knack for a witty punchline, it’s no surprise that Keely’s social posts are as clever as they get. In her (very little) free time, you’ll find Keely with her nose in a book or trying out a local restaurant with her family.