Shopping for Health Insurance

The North Carolina Department of Insurance understands that choosing an insurance policy can be confusing. There are many things to think about when you are looking for health insurance because everyone’s needs are different. Here are a few things to consider.

How much will it cost? It is important to look at your total out-of-pocket costs including premiums, deductibles, co-pays and coinsurance. Generally, the lower your premium, the more you’ll pay in out-of-pocket costs.
Can I see my doctor? It is important to check with your hospital, doctors and other health care providers to see if they participate in the plan.
How does the plan work? You may need to meet a deductible before the plan begins paying claims. Most plans have a network of hospitals, doctors and other health care providers. Some plans may require a referral before you see a specialist.
When shopping for health insurance you may begin to receive email and telemarketer calls offering assistance. You can print this checklist to help you know what questions to ask or use these tips.

Who to Contact for Help Locating a Plan

Agent/Broker

An insurance agent or broker is a person or business who can help you apply for help paying for coverage and enroll in a Qualified Health Plan (QHP) through the Marketplace. They can make specific recommendations about which plan you should enroll. Agents are licensed and regulated by states and typically get payments, or commissions, from health insurers for enrolling a consumer into an issuer's plans. Contact the state Department of Insurance to verify the license status of any agent you choose to work with.

Navigator/Assister

A Navigator/Assister is an individual or organization that's trained and able to help consumers, small businesses, and their employees as they look for health coverage options through the Federal Marketplace, including completing eligibility and enrollment forms. These individuals and organizations are required to be unbiased and their services are free to consumers.

Legal Aid of North Carolina leads the NC Navigators Consortium. They can be contacted at https://ncnavigator.net/ or 1-855-733-3711 for a referral to a Navigator in your local area.

Health Insurance Marketplace

For more information about the Marketplace, call 800-318-2596 or visit www.healthcare.gov.