2016 Obamacare in NC Enrollment

As you may or may not be aware with the changes from the Affordable Care Act you can only purchase health insurance and/or change your coverage during the Annual Enrollment Period (AEP), unless you have a qualifying life event that triggers a Special Enrollment Period.


Well  2016 AEP for Obamacare in NC is almost here so if you need to enroll in coverage or change your current plan for 2016 it needs to be completed between Nov 1, 2015 – Jan 31,2016. Below is a chart that shows the date the new plan goes into effect based on when the coverage changes are made:


Change Date Policy Effective Date
11/1/15 – 12/15/15 1/1/16
12/16/15 – 1/15/16 2/1/16
1/16/16 – 1/31/16 3/1/16

Just to recap, to be eligible for health insurance with subsidies through the Marketplace you must meet the following eligibility requirements:

  1. Cannot have access to employer coverage…this includes through your employment and spouses employment.
  2. Must have Modified Annual Gross Income (MAGI) between 100 – 400% Federal Poverty Level.  See this page for the chart to see if you fall in the income range

We have helped thousands of North Carolinians successfully enroll in Obamacare in North Carolina and we can help you too.  Here is how we help you:

  1. Help you get qualified for your maximum subsidy amount allowed in the Marketplace.
  2. Consult with you on information needed to retain your subsidy
  3. Licensed by all the insurance carriers that provide coverage on the Marketplace so we explain to you the pros and cons of the different plans.
  4. Help you enroll in the plan that YOU choose making sure that you understand and receive maximum benefits offered.
  5. All this from never having to leave your home.  We handle everything for you via phone and internet…you don’t have to get dress up for us!
  6. Absolutely NO COST to you.  We are compensated by the insurance companies and by using us the plans DO NOT cost any more.

So if you are reading this and would like our assistance and you meet the 2 minimum guidelines listed above, please complete the contact form to the right of this page and we will contact you directly.



New Options for NC Obamacare in 2015

The annual enrollment period for 2015 coverage for NC Obamacare will be here before we know it…enrollment starts on November 15 and goes through February 15. In 2014 there were only two health insurance carriers that participated on the marketplace for subsidized premiums in North Carolina. In 2015, United HealthCare (UHC) will also offer a range of plan options to compete with these other two options. Since plans and rates for these three carriers have yet to be released to the public we don’t know a whole lot of information. We do know that the current two carriers plans will be very similar to what they were in 2014. We have heard that the plan options with UHC will be Health Maintenance Organization (HMO) based and will have plan options ranging from Bronze to Platinum. If you have used us in the past you will know that we strongly encourage a Preferred Provider Organization (PPO) based network over an HMO based network. A lot of times when people are looking over plans without a professionals assistance this may be overlooked because they are only looking at price. Some of the pitfalls of an HMO based product is as follows:

  • Primary care physician (PCP) coordinates all care
  • Referrals needed from PCP to see specialists
  • No out of network coverage….must remain within the HMO.  This is a high risk
  • Limited choice of doctors in network

This is just a few of the issues that we have with the HMO product.  You really have to evaluate your risk vs reward in choosing these plans and this is where we can assist you the most.  We give you an unbiased opinion on the plan options and ensure that you fully understand you benefits.  Best of all there is absolutely zero cost to you for our services!

Enrolling in Obamacare in NC outside of Enrollment Period

We are still getting a lot of inquiries for people looking for coverage. Times have changed with the Affordable Care Act (aka “Obamacare”) in that you now can’t just buy coverage whenever you want. The initial Enrollment Period for coverage starting in 2014 was from October 1, 2013 – March 31, 2014.

If you missed this enrollment period you will have to qualify under a “life event” that will trigger a Special Enrollment Period (SEP). In order to obtain coverage during the SEP you must meet at least one of the following criteria:

• Losing health insurance provided by your employer
• Recently moved
• Aging off of a parent’s plan (at age 26)
• Expiration of COBRA
• Losing a job
• Leaving incarceration
• Divorce
• Birth or adoption of child
• Gaining citizenship
• Losing eligibility for Medicaid
• Getting married
• Complex Situations (will be covered in later post)

Please note that you have a 60 day window to enroll during the SEP. We recommend that you contact us well before the event occurs, if possible, so that we can plan your enrollment process to make it a much smoother experience for you.
If you feel that you meet the criteria for an SEP please complete the form to the right of this article.

When does Obamacare in NC start?

Open enrollment for plans offered through the NC health insurance exchange starts on October 1, 2013 with coverage starting on January 1, 2014.  This initial open enrollment period will run through March 31, 2014.  After this date enrollment periods for health coverage will coincide with Medicare’s open enrollment period each year which is October 15 – December 7.

Enrollment periods are an important part of the Affordable Care Act (Obamacare).  This will help prevent people (typically the healthy and fearless) from opting not to purchase coverage and only pick it up once they become sick or have an accident. This type of thinking wont help you to much since most likely your injuries or illness will already be cured once you are able to get coverage in place….or even worse once you are able to get coverage in place you are already bankrupt from the prior years medical bills.

Enrollment is crucial for everyone and there will be a lot of moving parts.  This is why it is beneficial to work with a qualified professional to help guide you through the nuances of the plans and enrollment process.