North Carolina: Health Insurance Coverage and Resources

Do you need health coverage in North Carolina? You have more choices than you think. Pivot Health is proud to offer short term health insurance plans that provide the flexibility you need at budget-friendly prices. Our temporary health insurance bridges the gap in coverage while you’re transitioning between major medical plans. You’ll be covered for doctor’s visits, urgent care, in-hospital care, prescription drugs, and more.

When you enroll in a Pivot short term health plan, you’ll get:

  • Up to 364 days of coverage with the ability to re-apply for up to three years.
  • A flexible coverage duration—choose the coverage period that meets your needs.
  • Flexible out-of-pocket costs such as your deductible and coinsurance along with rates that are up to 50% lower than individual major medical plans.
  • Freedom to choose your health care providers—no need to worry about “in-network” vs. “out of network” prices.

As a Pivot Health member, you’ll also enjoy several non-insurance benefits such as:

  • Unlimited access to discounted telehealth consultations. Telehealth doctors are on-call 24/7. You won’t have to book an appointment and drive to the office for an assessment.
  • Eye care and eyewear discounts. The cost of eye care can quickly add up. With a Pivot Health plan, you can save up to 40% on eye exams, glasses, and contacts.
  • Prescription drug coverage discounts. Avoid the sticker shock and save up to 75% on prescription drugs at thousands of pharmacies across the country.

Is short term health insurance right for you and your family? A Pivot Health plan may be the answer to your coverage needs if:

  • You’re transitioning between jobs and have an employer waiting period.
  • You retired early and need to wait to enroll in Medicare.
  • You lost your job, but COBRA coverage is unaffordable.
  • You’re turning 26 and will no longer be covered by your parents’ plan.
  • You’re unable to afford an individual plan through the federal exchange.

If you’re ready to apply for short term health insurance, Pivot Health’s online portal makes it quick and easy. You’ll know within minutes if you’ve been approved for coverage. Once you’re approved, your effective date is up to you. It can be as early as 24 hours after you apply or at a later date.

North Carolina Health Insurance Exchange Challenges

Thanks to the Affordable Care Act, the uninsured rate in North Carolina fell by 31.2% between 2013 and 2016. In 2017, roughly 451,000 residents bought health plans through the federal exchange. Of those enrolled, 93% were eligible for premium tax credits and 67% were eligible for reductions in cost-sharing responsibilities.

Although most North Carolinians receive financial assistance, stabilizing the costs of individual health plans remains a major challenge for health insurers. Monthly premiums rose by an average of 40% in the Charlotte market from 2016 to 2017, increasing prices from $409 to $572. 

From 2017 to 2018, the American Academy of Actuaries predicted that premiums would rise by an average of 5% to 8%. This was due to a growth in health care costs and regulatory uncertainty. (The total cost of healthcare nationwide is projected to increase by 5.6% each year through 2025.)

A Report on North Carolina’s Wellbeing

A 2017 Gallup-Sharecare Well-Being Index examined how people’s well-being varies by states. North Carolina ranked 19th out of 50 based on survey responses to questions about different categories of well-being.

North Carolinians reported an overall wellness score of 61.8, slightly higher than the national average of 61.5.

Residents ranked highly in 3 out of 5 categories. These include:

  • 6th for Social, defined as having a supportive relationship and love in your life.
  • 7th for Purpose, defined as liking what you do every day and being motivated to achieve your goals.
  • 19th for Community, defined as liking where you live, feeling safe and having pride in your community.

However, North Carolinians ranked 35th for both of the following categories:

  • Financial, defined as managing your economic life to reduce stress and increase security.
  • Physical, defined as having good health and enough energy to get things done daily.  

Children’s Wellbeing in North Carolina

North Carolina ranks 33rd in children’s overall well-being, according to a Kids Count Profile by the Anne E. Casey Foundation. The state has made gains in areas such as economic well-being and health care.

The report found that as of 2017:

  • 21% of children live in poverty, down from 25% in 2010.
  • 28% of children have parents who lack secure employment, down from 35% in 2010.
  • 27% percent of children live in households with a high cost of living burden, down from 38% in 2010.
  • 5% of children lack health insurance, down from 8% in 2010.
  • Teen births fell to 21 per 1,000 residents, down from 38 per 1,000 in 2010.

The State of Health in North Carolina

According to a 2019 County Health Rankings report, North Carolina’s overall health outcomes are slightly worse than the national average.

The report found:

  • 18% of adults have fair or poor health, compared to 16% nationwide.
  •  30% of adults are obese, compared to 29% nationwide.
  •  23% of adults age 20 or older report no leisure-time physical activity, compared to 22% percent nationwide.
  • 18% of adults are current smokers, compared to 17% percent nationwide.
  • 12% of the population under 65 is uninsured, compared to 10% nationwide.
  • Adults report an average of 3.9 poor mental health days per 30 days, compared to 3.8 nationwide.

Health outcomes in North Carolina also vary significantly by race and ethnicity. For example:

  • 33% of Hispanics and Native Americans reported fair or poor health, compared to 20% of African Americans, 14% of Whites, and 12% of Asians.  
  • 14% of African American babies had a low birth weight, compared to 11% of Native Americans, 9% of Asians, and 7% of Hispanics and Whites.
  • 10,300 Native Americans die prematurely every year, compared to 10,100 African Americans, 7,300 Whites, 3,700 Hispanics, and 3,100 Asians.

Diabetes in North Carolina

North Carolina ranks among the states for the highest prevalence of diabetes (40th out of 50). According to a 2017 State of American Well-Being report, 12.7% of North Carolinians have the disease, up from 12.1% in 2009. The state-wide diabetes rate has grown 0.1% slower than the national rate (10.8% to 11.5% during the same period).

2019 Health Insurance Plans in North Carolina

Three health insurance companies offer coverage through the federal exchange in North Carolina. These are:

  • Cigna
  • Ambetter
  • Blue Cross Blue Shield of North Carolina

In 2019, the average monthly cost for a Silver Plan in North Carolina was $646 for an individual and $1,293 for an adult couple. For a family of three (two adults, one child), plans cost an average of $1,680. For a family of four (two adults, two children), plans cost an average of $2,066.

Overall premiums for BCBS of North Carolina plans fell 4.1% due in part to lower projected health costs. Federal tax cuts and federal income tax savings from the 2017 Tax Cuts and Jobs Act contributed to rate cut as well. 

BCBS is the only carrier that offers exchange plans in all 100 counties, but it faced more competition in 2019. Cigna started offering plans in Chatham, Orange, Wake, Johnston, and Nash counties. And the St. Louis-based Ambetter entered the North Carolina marketplace for the first time.  

Medicaid Enrollment in North Carolina

North Carolina is one of 14 states that have chosen not to expand Medicaid under the Affordable Care Act. Yet a new study by the Cone Health Foundation determined that Medicaid Expansion would provide coverage to 634,000 residents by 2022.

As of 2019, the state has almost 1 million uninsured residents, and has the 10th highest uninsured rate in the country. By expanding Medicaid, people whose income is up to 138% of the federal poverty line would become eligible to enroll in the program.

Your Health Care Coverage Choices

Forgoing health insurance can spell financial disaster. A short term health plan from Pivot Health can give you the peace of mind you need, without going over your budget. If you’re uninsured in North Carolina, consider taking a look at what Pivot Health has to offer.

Pivot Health: offering you choices and flexibility that pivot with your insurance needs over time.


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