These are the insurance companies that offer plans compliant with the Affordable Care Act in NC:

BlueCross BlueShield of North Carolina, a.k.a BCBSNC

BCBSNC is the only insurance company that offers plans that are compliant with the Affordable Care Act (a.k.a. ACA) in all NC counties. They have 5 medical provider networks which are Blue Advantage, Blue Value, Blue Local and Blue Home. The Blue Advantage network is the largest and includes 97% of doctors and 99% of hospital in NC.

This network is available in all counties except these:
Alamance, Anson, Cabarrus, Caswell, Chatham, Caswell, Cleveland, Durham, Franklin, Gaston, Johnston, Lee, Lincoln, Mecklenburg, Orange, Person, Rowan, Stanley, Union and Wake.

If you live in any of the above counties it is important for you to ask your agent to check their website to make sure your medical providers and preferred hospitals are in network with the plan you choose. You can also check yourself at their website www.bcbsnc.com.
BCBSNC does not require a referral to see a specialist.

Telehealth care options are available for behavioral and physical health 24/7.

 

Ambetter Health Insurance

Ambetter Health Insurance offers HMO (Health Maintenance Organization) plans in Alamance, Caswell, Chatham, Durham, Franklin, Granville, Guilford, Lee, Orange, Person, Rockingham, Vance, Wake and Warren Counties. This means if you go to an out of network provider the insurance company will not pay for your medical services unless they are coded as an emergency. Ambetter does not require you have a referral from your PCP (Primary Care Physician) before you visit a specialist. Duke and Wake Med hospitals are in-network with Ambetter. To determine if your medical providers and preferred hospitals are in their provider network speak with your agent or go to their website www.ambetterofnorthcarolina.com.

Their plans include:
Myhealthpays Rewards, which allows policyholders to earn up to $500 for health activities like getting a flu shot, having a wellness exam and completing an Ambetter Wellness survey. The rewards are given in the form of a prepaid Visa card and can be used to pay premiums, co-pays or buy food at Walmart.
Telehealth, which is a 24-hour phone or video access to in-network providers for non-emergency health issues.

Cigna

Cigna offers HMO plans in NC in five counties, which are: Chatham, Johnston, Nash, Orange and Wake. The UNC Hospitals (which includes Rex Hospital) are in-network with Cigna.
Their HMO plans require the policy holder to have a PCP (Primary Care Physician). Cigna’s policies will not pay for specialist visits without a referral from the policy holder’s PCP.
For more information about the Cigna plans you can call Cigna Direct to Consumer at 1-844-224-9633, visit www.cigna.com .

Bright Health Insurance

Bright Health offers HMO policies in 10 counties, which are Cabarrus, Davie, Davidson, Forsythe, Gaston, Mecklenburg, Rowan, Stokes Union and Yadkin. Referrals are not required to visit a specialist. Policy holders can earn cash rewards for healthy activities like having a flu shot or getting their annual preventative exam. After a hospital stay a policy holder can get free meals delivered to their house for several days.

In network hospitals include Novant and Caromont. To determine if your medical providers or preferred hospital are in their network speak with your agent or go to their website www.brighthealthplans.com.