Comparing Plans Made Easier
With the implemented Health Care Reform, comparing health insurance plans has never been easier! Separated by different metallic levels (Bronze, Silver, and Gold) with various options of coverage, deductibles, co-payments and coinsurance requirements, you’ll be able to choose which plan is best for you. Annual open enrollment is between November 1st and December 15th. This is the only time you can buy health insurance unless you qualify for a special enrollment period. Special enrollment periods include: a change in your family (marriage, divorce or new baby), losing your qualified health coverage, change in residential area (new county or state) for which documentation will be required.
Health Care Has Changed. We’re Here to Help
For over 20 years, the Mair Agency has helped thousands of North Carolina residents choose the health insurance plan for themselves and their families. We chose to work exclusively with Blue Cross Blue Shield of North Carolina because of their commitment to quality coverage and excellent customer service.
With Blue Cross NC Plans You’ll Enjoy:
- Customer service to make using insurance easier. Local customer service professionals are ready to answer your questions quickly and accurately.
- Online member tools: Blue Connect is your gateway for all tools and what you need to know about your health plan, and you can use it on any mobile phone, tablet, or laptop.
- Doctor and hospital choices: Blue Cross NC offers a range of network choices to meet your needs.
- Your health plan goes where you go: with the BlueCard program, your coverage extends worldwide.
Key Benefits of Plans
- No waiting period for pre-existing conditions
Preventive Care Benefits:
These covered services include annual exams, screenings for diabetes, mammograms, and more.
Essential Health Benefits include:
- Preventive Care
- Professional Services
- Hospital Services
- Outpatient Services
- Urgent and Emergency Services
- Maternity Services
- Mental Health / Chemical Dependency Services
- Pediatric Dental and Pediatric Vision Care
Health Insurance Subsidies: Do You Qualify?
- The federal government offers financial assistance, also called subsidies, to individuals and families who qualify based on their income and household size.To qualify for a subsidy under health care reform, you must:
- Be between 100% and 400% of the Federal Poverty Level (FPL)
- Not be eligible for public coverage, such as Medicaid, the Children’s Health Insurance Program (CHIP), Medicare, or coverage through the armed services.
- Not have access to insurance through an employer. An exception can be made if the employer’s plan doesn’t provide required minimum essential coverage, or if the plan is considered unaffordable (if an individual’s self-only premium is more than 9.56% of the employee’s household income).
What Are Federal Poverty Levels Used For?
Federal Poverty Levels (which are also called Federal Poverty Guidelines, Federal Poverty Line, or simply FPL) are used to see if you qualify for cost assistance when buying insurance through the State or Federal Health Insurance Marketplace.
| 2023 Federal Poverty Guidelines | |||
|---|---|---|---|
| Persons in family / household | 48 contiguous states and DC | Alaska | Hawaii |
| 1 | $14,580 | $18,210 | $16,770 |
| 2 | $19,720 | $24,640 | $22,680 |
| 3 | $24,860 | $31,070 | $28,590 |
| 4 | $30,000 | $37,500 | $34,500 |
| 5 | $35,140 | $43,930 | $40,410 |
| 6 | $40,280 | $50,360 | $46,320 |
| 7 | $45,420 | $56,790 | $52,230 |
| 8 | $50,560 | $63,220 | $58,140 |
| 9 | If more than 8 in household / family, add $5,140 per additional family member | If more than 8 in household / family, add $6,430 per additional family member | If more than 8 in household / family, add $5,910 per additional family member |
*Chart is for 48 contiguous states and the District of Columbia; for Hawaii and Alaska, please visit the HHS ASPE website: https://aspe.hhs.gov/poverty-guidelines.
*If your household is larger than 8 people, add $4,320 for each additional person.
Federal Poverty Levels are also used to help determine Medicaid and CHIP eligibility and to help determine eligibility for a number of other non-health care related assistance programs (see full list and more details on the guidelines below).
- If you make between 100% – 400% of the Federal Poverty Level you may qualify for premium tax credits on the Health Insurance Marketplace.
- If you make less than 138% of the Federal Poverty Level and your state expanded Medicaid, you may qualify for Medicaid or CHIP.
- If you make between 100% – 250% of the Federal Poverty Level you may qualify for out-of-pocket cost assistance on Silver plans sold through the Marketplace.
- Other assistance programs have unique eligibility guidelines.
- Cost assistance for the Affordable Care Act is based on household income (family income). Household or family income for the purposes of the ACA is MAGI (modified adjusted gross income) of the head of household (and spouse if filing jointly) plus the AGI of anyone claimed as a dependent. If you are filing as single, count MAGI only.