North Carolina Health Insurance

Health Care Has Changed, We’re Here To Help


There’s a lot to consider when selecting health insurance. Now with health care reform, there’s even more you need to know. By choosing First Pioneer Insurance Agency and Blue Cross and Blue Shield of North Carolina (BCBSNC), you’ll be with a company that’s earned the trust of more North Carolinians than any other health insurance company. With our depth of experience and range of plans, we can help you find coverage that’s right for you – and your budget.

With our plans you’ll enjoy:

  • Doctor and hospital accessibility
  • Local customer service
  • Simpler, more personalized health care

View the BCBSNC Health Plans for Individuals and Families brochure.

Health Insurance Plans That Offer Essential Benefits

All plans provide coverage for essential health benefits, which are now required by law. Maternity, newborn care and pediatric services, including dental and vision, are just some of the services covered.

No lifetime maximums: There are no lifetime dollar maximums on the plans.

No medical qualifications: No matter what condition(s) you have, including any pre-existing condition(s), health insurance plans are available to you with no “pre-existing condition(s)” waiting periods.

No referrals needed for specialists: Health insurance plans do not require a referral to go see a specialist. This makes getting the care you need easier, faster and more convenient.

Preventive care benefits: For individual plans, preventive services are covered at 100% when you go to an in-network provider. These covered services include annual exams, colonoscopies, mammograms and more.

Dental insurance: In addition to the pediatric dental coverage included in all medical plans, dental coverage is available through a separate plan that provides dental-only coverage at an additional cost to your health plan premium.

View the BCBSNC Dental Plan for Individuals and Families brochure.

Choose The Plan That’s Right For You

Everyone has different needs when it comes to health insurance. Our range of products let you weigh the balance between price, provider access and prescription coverage to find the plan that best meets your needs and your budget.

Health care reform established metallic levels to indicate the value of coverage in a plan. This helps you easily compare plans with different deductibles, copayments and coinsurance requirements to determine which plan works best for you.

  • Bronze: Good for people who want lower monthly premiums and don’t expect to need a lot of medical services
  • Silver: Good for people who want to keep monthly premiums and out-of-pocket medical costs more balanced
  • Gold: Good for people who receive medical services regularly and who are okay with a higher monthly premium to have more health care costs covered
  • Platinum: Good for people who receive medical services frequently and who are willing to pay more each month for the lowest ongoing health care costs

Metallic levels do not take into account all health plan features, such as provider network. Be sure to check if your doctor is in-network.

Health Care Reform – The Basics

While the Affordable Care Act (ACA) – also known as health care reform – went into effect in 2014, it’s still relatively new. Here is a brief overview of some of the more important changes you should be aware of when considering health insurance:

  • You must have health insurance coverage
    The federal government now requires that most individuals purchase health insurance or they may be subject to a tax penalty.
  • Financial help is available to those who qualify
    If you meet certain requirements, you can get subsidies – also known as advanced premium tax credits – from the federal government to help you pay for your health insurance. Our health agents can help estimate any subsidy you may qualify for. Your actual subsidy is determined by the federal government.
  • Annual open enrollment is between November 15 – January 31
    To have coverage, you need to enroll during the annual enrollment period. You can enroll outside this period if you have gone through a qualifying event such as marriage, the birth of a child or moving into North Carolina from a different state. Contact one of our health agents for assistance with a qualifying event.

Making Health Care More Affordable

To help make health insurance more affordable and effective, the federal government offers advanced premium tax credits, also called subsidies, to individuals and families who qualify based on their income and household size. These subsidies reduce the monthly cost of a health insurance plan for those who qualify.

In addition to premium subsidies there are also cost-sharing reductions (CSR), another type of subsidy that provides further help for those who qualify. CSRs lower the amount you have to pay for out-of-pocket costs like deductibles, coinsurance and copayments. Think of a CSR as an upgrade in your benefits. Based on your income level, the government will help to cover some of the costs of your medical services. That means you pay less money for those. Keep in mind, to get these benefits you must choose a Silver plan.

Overall, subsidies and CSRs can help lower your health insurance costs significantly if you qualify based on income. So be sure to talk with our health agents and learn if you qualify. The credits are paid directly to your health insurance company – you pay the difference between the full premium and the subsidy on your monthly bill.

Winning With An HSA

Health savings accounts (HSAs) are an easy way to win in today’s complex health care system and empower health savings. An HSA paired with an HSA-qualified health plan allows you to make tax-deductible contributions to an FDIC-insured savings account. Balances earn tax-free interest and can be used to pay for qualified medical expenses. HSA-qualified health plans typically cost less than traditional plans and the money saved can be deposited into your HSA.

Regardless of your personal medical situation, an HSA can empower you to maximize savings while building a reserve for the future. Contrary to what many may think, healthy individuals aren’t the only users who benefit from an HSA. As an HSA user, you save in several ways:

  • Lower monthly health insurance premiums
  • HSA contributions are not taxed
  • You earn tax-free interest on HSA balances
  • HSA funds used for qualified medical expenses are not taxed

With an HSA, you own the account and all contributions. Unlike flexible spending accounts (FSAs), your entire HSA balance rolls over and remains available for qualified expenses even if you change health plans, retire or change your line of work. Once you reach a determined account balance, you can invest your HSA funds for increased earning potential.

A Choice That Comes With Peace Of Mind

We know you have a variety of factors to consider when you are looking for a health insurance plan in North Carolina. You need one that will meet your specific needs, your budget and your unique life circumstances. At First Pioneer Insurance Agency, our agents will walk you through the steps of deciding which plan can give you the protection you need.