Have A Medical Condition?
If you have a minor medical condition when you apply for Individual Health Insurance coverage then by NC Law any company can either increase your quoted rates or rider/waiver the condition, which means that you will be covered for everything but that health condition.
If you have a major health condition like cancer, heart disease, diabetes, etc then unfortunatley you are considered to be too high of a risk for any company and you will be declined completely. Your only option is the
NC State High Risk Pool.
We highly suggest that you read each company's brochure or call us at 919-862-0636 or
888-404-9939 to help you understand how each company will treat you if you have a medical condition.
Riders/waivers are not the same as pre-existing conditions, although their definitions sound very similar. The big difference is that pre-existing conditions in a policy are temporary, no longer than 12 months long, and can be all together eliminated if you have had 12 months of prior health insurance coverage without a lapse of more than 63 days. A rider/waiver is permanent and will not be eliminated by having prior coverage. If you are ridered/waivered for a condition then the company will notify you in writing and it will become a part of your policy.
Wellpath and Blue Cross Blue Shield of NC are the only companies that will not rider/waiver your condition. That is why we recommend you look at those 2 companies first. The only way to find out the final rates is to apply. Fortunately neither BCBSNC nor Wellpath has an application fee. If you have a mild medical condition, such as allergies or reflux, the question you need to ask yourself is do you want to apply with a company that will give you the quoted rate, but will rider/waiver you for that condition. Or do you want to go with a company that will make you pay a little more, but you will have the condition covered. Most people we work with want all their health conditions covered and that is why we recommend Wellpath and BCBSNC first.
NC Law States that once you have indidividual insurance companies:
- Cannot single you out for annual rate increase
- Cannot single you out for cancellation
Once again, if you have a severe medical condition, such as diabetes or heart problems, then no company in NC will accept you and your only option is to apply with
NC State High Risk Pool. They are about twice the price of traditional companies, but you are guaranteed to be accepted. You first must be declined by a traditional company or have a major illness such as Cancer.