Individual health insurance is a type of insurance coverage purchased by an individual for himself and/or his beneficiaries/family. The ACA or Affordable Care Act has caused significant changes in the way that these health insurance policies are rated, as well as the different benefits that they provide. The provisions of North Carolina health insurance policies are regulated and overseen by the state, as an individual policy is administered by the state where it is purchased.
The dramatic changes in the policies due to the ACA make the counsel of insurance advisors even more critical when selecting health insurance in North Carolina. Individual policies should be purchased with the advice of an insurance adviser or a professional insurance provider. Because of the complexity of coverage offerings as well as structures of premium costs, professional advice is critical when acquiring this type of insurance.
The Jordan Insurance Agency is an industry leader that has been working with all the major insurance companies, including health insurance and life plan providers in North Carolina and neighboring states for the past decade. We have an experienced team of insurance advisors willing to lend you their expertise and help you find the best coverage to match your needs as well as your budget. Individual insurance is now a necessity, especially with the rising cost of healthcare. Work with us and we will give you your best options in North Carolina and beyond.
With individual health insurance, a person’s medical condition is no longer a factor for enrollment. However, you must enroll during the specified open enrollment period to acquire coverage for the year. Policies will cover all essential health benefits, although the richness of benefits under a specific plan is defined by a standard metal tier. Platinum plans are the most expensive, but also the most generous and are designed to cover as much as 90% of your medical expenses. Gold health insurance plans pay for 80% of medical expenses while silver and bronze plans pay for 70% and 60% of medical expenses, respectively.
One category of an individual plan is known as the catastrophic plan. In North Carolina, as with other states, a catastrophic plan meets the requirements of each metal tier, but its benefits are often very limited. This type of plan is often offered as an option for people under the age of 30 or those who have received a hardship exemption due to unaffordable health coverage.
Health Insurance plans will often offer the same set of essential health benefits, although some items and other benefits may also be added, depending on the type of plan that you acquire as well as the additional offerings by your policy provider. These essential benefits will often include ambulatory patient services, emergency services, maternity and newborn care, hospitalization, mental health and substance abuse disorder services, laboratory services, prescription drugs, pediatric services, preventive and wellness services, and rehabilitative and habilitative services and devices.