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:

  • Local customer service to make using insurance easier
  • Online member tools with BlueConnectSM
  • Doctor and hospital choices
  • Your health plan goes where you go

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 waiting period for pre-existing conditions: 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.

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.

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

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 lower out-of-pocket 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. Those who don’t may be subject to a tax penalty.
  • Financial help is available if you meet certain requirements
    Financial assistance (also known as a subsidy) from the federal government may help you pay for your health insurance. Our health agents can help you estimate your subsidy. Remember, your actual subsidy is decided by the federal government.
  • Annual open enrollment is between November 1 and January 31
    Annual enrollment is the only time you know for certain you can buy health insurance. Apply by December 15 to get coverage that starts January 1.
  • Once open enrollment ends
    You may still be able to buy health insurance if you have what is called a qualifying life event. If you get married, have a new baby, or lose your health coverage, you may qualify and documentation may be required.

Making Health Care More Affordable

To help make health insurance more affordable and effective, the federal government offers financial assistance, 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 (CSRs), 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. 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. Be sure to learn more about them to see 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.

Save With An HSA-Eligible Plan

A Health Savings Account (HSA) plan pairs a High Deductible Health Plan (HDHP) with an HSA. An HSA is a special tax-advantaged savings account that allows you to pay for current covered health care expenses and save for future qualified medical and retiree health care expenses on a tax-favored basis. As an HSA user, you save in several ways:

  • Save money with lower monthly health insurance premiums
  • Use your HSA account to hold funds for medical expenses
  • HSA contributions are tax-deductible
  • Account growth and withdrawals for medical expenses are tax-free

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.