Inclusive Health - NC Health Insurance Risk Pool

Inclusive Health, also referred to as the NC Health Insurance Risk Pool, provides affordable health insurance coverage for individual residents of North Carolina that do not have access to an employer sponsored health plan and whom have been denied individual coverage, had benefits excluded and/or have higher premiums due to pre-existing medical conditions.

Are You Eligible?

If you can answer YES to AT LEAST ONE of the below questions you are eligible for coverage with Inclusive Health:

1. You are "uninsurable" due to a medical condition. 
2. An insurer has offered you coverage but has placed a conditional rider that significantly limits the coverage.  Example:  An insurer offered you coverage but excluded anything to do with Carpal Tunnel Syndrome you have on your right wrist.
3. An Insurer has offered you coverage, however the rate they gave you was higher than Inclusive Health's rate.  Example:  You were offered coverage with Cigna for $455/mo but a similar plan with Inclusive Health was $395/mo.
4. You have been diagnosed with one of Inclusive Health's presumptive conditions which allows automatic enrollment.
5. You are currently on or eligible COBRA or state continuation coverage but your premium rate for this COBRA is higher than Inclusive Health's premium.  You also must be able to answer "Yes" to at least one of numbers 1-4 above.
6. You have exhausted COBRA coverage and have had 18 months of continuous coverage without a lapse of more than 63 days.
7. You are eligible for the Health Coverage Tax Credit (HCTC) for trade displaced workers under the TAA, ATAA or PBGC programs.

2. You are eligible if you can answer YES to ALL of the following questions:

• You aren't eligible for Medicare.
• You aren't eligible for Medicaid.
• You are a resident of the United States.
• You are a resident of North Carolina.
• You or your spouse is not eligible for insurance at work.
• You aren't covered as a dependent

Will My Pre-existing Condition be Covered?

If you have had continuous medical coverage for the previous 12 months without a lapse in coverage of more than 63 days then your pre-existing conditions will be covered from Day 1 the plan goes into effect.  Upon enrolling you will need to provide proof of continuous coverage, known as a Certificate of Creditable Coverage, to have the pre-existing condition clause waived.

If you have been without coverage for the previous 63 days of coverage then Inclusive Health coverage shall exclude charges or expenses incurred during the first 6 months following the effective date of coverage for any condition for which medical advice, care or treatment was recommended or received for conditions during the 12- month period immediately preceding the effective date of coverage.  If this is your situation then the Inclusive Health Federal Health Insurance Risk Pool may be your best option.

What Types of Plans Are Available?

Currently, the NC Health Insurance Risk Pool offers four different plan options.  Here is a general summary of the plan options:

What's my Next Step?

If you think you are eligible for the Inclusive Health - North Carolina Health Insurance Risk Pool we recommend that you contact us at 704-560-8972 to assist you with the process.  You can do it yourself but it is a PIA and why not use a professional to assist you and make your life easier.  You can also fill out the form below with general inforamtion and we will get back to you: