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Insurance for Individuals with Medical Conditions

     In August, 2007, the Governor signed into law House Bill 265, Establish Health Insurance Risk Pool.     H265 established a state subsidized private non-profit health insurance program to help North Carolinians who have pre-existing conditions that make it extremely expensive for them to purchase individual health insurance.    

Michael Keough, the Executive Director of the program - called Inclusive Health, recently sent the following announcement. Please share this information with others who might be interested.

Inclusive Health: North Carolina’s High Risk Pool Begins Coverage January 1, 2009

On January 1, 2009, for the first time North Carolina will begin to offer a high risk health insurance pool.  This represents a major development in the health insurance landscape of North Carolina as thousands of North Carolinians will now have access to more affordable coverage.

The North Carolina Health Insurance Risk Pool, Inc. is offering three plans under the brand name of Inclusive Health.  Enrollment began October 20^th and the first effective coverage date is January 1, 2009. 

The Pool was established by the 2007 North Carolina General Assembly. It is designed primarily for individuals with medical conditions that cause them to face higher health insurance premiums in the individual market.  Eligible individuals will pay premiums that are set at 175% of an average of the individual insurance market rate.  For many individuals who have been deemed high risk, this rate level will be considerably less than they would face from commercial plans.  This is because the Legislature has placed a ceiling on premiums, with the state subsidizing the difference between what you would expect to pay under a commercial plan and what Inclusive Health will charge you.  To quickly determine your Inclusive Health premium rate, visit www.inclusivehealth.org and follow the “Applicants” link to the “Premium Rate Calculator.”

There are multiple ways individuals can qualify, with many people qualifying due to a pre-existing medical condition.  The second group of potential Inclusive Health enrollees are federally qualified HIPAA eligibles who have continuous coverage under other plans.  The third group is those individuals eligible for the Health Coverage Tax Credit, which includes individuals who qualify under the Trade Adjustment Assistance Reform Act who have lost their job because they have been shipped overseas.  People with access to group employer coverage or who have Medicare or Medicaid do not qualify for Inclusive Health.  To quickly determine if you may be eligible, visit www.inclusivehealth.org and follow the “Applicants” link to the eligibility worksheet.

Inclusive Health offers three different benefit plans with annual deductibles of $1,000, $2,500 and $5,000 respectively.   Their rates and benefit plans have been reviewed and approved by the North Carolina Department of Insurance.  Benefits details can be found at www.inclusivehealth.org under the “About Us” link. 

If you or someone you know may be eligible, the Legislature created an incentive to enroll by June 30, 2009.  Anyone who enrolls by then will have any pre-existing condition exclusion waiting period they face reduced from a maximum of 12 months to no more than 6 months.  If you have any questions or would like additional information you may also contact Inclusive Health directly during business hours at (866)665-2117

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