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Overpaying for Health Insurance in North Carolina? Here's What You Can Do
If your premium went up again and your coverage didn't, you're not imagining it. Here's the checklist we walk clients through.
Are you getting a subsidy you qualify for?
A surprising number of self-employed North Carolinians buy full-price plans directly from a carrier and never apply through HealthCare.gov. If your income is under the 400% line, you're leaving money on the table.
Are you paying full price while healthy?
If you're above the subsidy line and in good health, you're paying a guaranteed-issue price for a risk you don't represent. Private shared-network PPOs on Cigna, Aetna and PHCS PPO price on health and are routinely hundreds less per month.
Is your network the one you use?
Many North Carolina marketplace plans are HMOs centered on one hospital system. If you drive past in-network hospitals to reach your doctor, or travel, you're paying for a network you can't use. A national PPO fixes that.
Is your deductible matched to your usage?
Healthy people on low-deductible plans overpay every month for a deductible they never reach. Moving to a mid-deductible plan plus an HSA is often the right trade.
North Carolina specifics
Medicaid expansion in late 2023 moved hundreds of thousands of lower-income North Carolinians onto Medicaid — which means the people still shopping are mostly above the subsidy range. North Carolina has no state individual mandate.
We do this review free, in 15 minutes, for anyone in North Carolina. Check your options.