Health Coverage for Pre-existing Conditions

The Inclusive Health Plan provides coverage for those who have pre existing medical conditions that renders them either uninsurable or can only obtain coverage from companies that penalizes the policyholder by adding endorsements to limit coverage for the pre-existing condition. This North Carolina plan provides coverage for illnesses such as Aids/HIV, Leukemia, Crohn's Disease and other pre-existing conditions that are usually excluded under traditional health insurance plans.

Additionally, residents may seek coverage through the Inclusive Health Plan if they wish to find a less expensive alternative to health insurance policies offered at an exorbitant rate due to their pre-existing condition.

Eligibility for Coverage under the Inclusive Health Plan

There are certain criteria that must be met in order to qualify for the plan as follows:

1. Must be a resident of North Carolina
2. Must not be eligible for Medicaid or Medicare
3. May not be eligible for a health plan through a spouse's job
4. Cannot be covered as a dependent on another health insurance plan

Applicants who meet the eligibility criteria must then take the time to review the available plans to select the one that best fits their insurance and budgetary needs.

Available Health Plans

Currently, Inclusive Health offers four different health care plans. Although the deductibles and coinsurance varies for each of the four plans, the maximum lifetime benefit for each plan is $1,000,000.

Applicants can choose from annual deductibles of $1,000, $2,500, $3,500 and $5,000. The coinsurance options for three of the plans of 80% for in network doctors/facilities and 50% for out of network doctors/facilities. The fourth plan ($5,000 deductible) pays 100% for doctors/facilities whether they are in or out of network.

Cost of North Carolina's Health Insurance Coverage

Rates for coverage under the plan are calculated based on gender, age and tobacco use. The rates are updated annually on the first of the year. To calculate the cost of coverage, the applicant can download the appropriate rate sheet (tobacco user vs. non tobacco user), scroll down the age column to find the appropriate age and then scroll across to locate the premium which is listed in columns according to gender and deductible amount.

For example, a non smoking 34 year old female opting for the $2,500 deductible plan will pay $473 per month.

How to Apply for Coverage

Applicants have several options when it comes to applying for coverage:

1. Call the Inclusive Health Plan directly (1-866-665-2117)
2. Contact a local North Carolina broker or agent
3. Apply online using the electronic application
4. Download, print, complete the 8 page application and mail it to Inclusive Health via snail mail.

The North Carolina Inclusive Health Plan may not be the answer for individuals who do not have pre-existing conditions or have never been denied health insurance coverage. However, it is a welcome alternative for people who are having a difficult time finding affordable health insurance that will provide coverage for pre-existing conditions.