According to the NC  State Health Plan rate sheet, the child only rates are:

• Basic Plan (70/30) – $150.66
• Standard Plan (80/20) $200.36
• Plus Plan (90/10) $269.78

If you have one or two children and would like to compare rates, fill out a child quote request form and we’ll email you a free, no obligation quote.  You can compare the rates and benefits and decide if you would like to learn more.

The latest example of this was seen in Arizona when LifeWise decided no longer offer health insurance in Arizona.  Fortunately, Blue Cross Blue Shield (BCBS) of Arizona agreed to accept their customers with “no further medical underwriting”.

As the old adage says sometimes “you get what you pay for”.

If you are shopping for health insurance for your child, remember that for extra dollars you can buy health insurance that you can depend on.  Contact us today for a health insurance quote.

Finding affordable health insurance for your children can feel like an uphill struggle as health-care costs rise and family finances tighten.

If you’re finding it hard to make ends meet and your children are healthy, but you and your spouse have medical problems, electing employer-sponsored coverage for yourselves and purchasing separate policies for your children might reduce the hit on your paycheck. Employers subsidize employee-only coverage at higher rates than other coverage options, such as family coverage, according to a survey by the Kaiser Family Foundation and the Health Research & Educational Trust.

In the private market, premiums for children’s policies are typically the lowest. In most states, your age and health status are the main factors insurers look at when determining who gets coverage and at what rates. Click here to request a free quote on a child health insurance policy. 

Employees at smaller firms are more likely to find it cheaper to get children covered by private policies. Smaller employers tend to subsidize employee-only more generously, and family coverage less generously, than larger firms.

Covering healthy children separately can also be a money-saving strategy if you lose your health benefits along with your job and you need to keep the health plan you had at work for medical reasons. Under the federal Consolidated Omnibus Budget Reconciliation Act, or Cobra, you can purchase coverage for up to 18 months if you’ve been laid off (if your company has 20 or more employees). You have to pay the full premium plus a 2% administration fee. For an employer plan this year, the average annual family premium was $12,680, and $4,704 for single coverage, according to data from Kaiser/HRET.

There are caveats. Private policies can turn out to be more costly overall because they cover fewer medical services and out-of-pocket costs beyond the premium, such as co-payments, tend to be higher. Typically, the cheapest policies are plans with the highest deductibles, expenses consumers must pay before coverage kicks in.

Such policies don’t provide the same legal protections as group policies do. Under federal law, in an employer-sponsored health plan you can’t be denied coverage on medical grounds. By contrast, in the majority of states, private policies can permanently exclude pre-existing conditions, such as allergies, or deny you coverage for chronic illnesses, such as diabetes. So don’t drop job-based insurance for your kids unless you’re sure they’ll be approved at reasonable rates. Premiums can also vary widely by state.  

Don’t just go for the lowest premium; think about the coverage you need and whether your doctor is in the network. Call your state insurance department to check that the insurer is licensed in the state where you live and get information about any complaints. And if your income is modest, don’t forget to check out government-sponsored programs for uninsured children.

Children are generally dropped from their parents’ health insurance when they turn 18 or 19 or graduate from college. But 16 states now require insurers to cover dependent children on their parents’ policies until the children are in their mid-twenties — and sometimes up to age 30.

The new rules can help cover adult children who don’t have health insurance through their jobs or don’t have jobs. To qualify, grown children must be unmarried and live in the same state as their parents. But they don’t need to live with their parents or even be considered dependents for tax purposes.

This can be an attractive option for adult children who have health problems and could have trouble qualifying for affordable insurance on their own. But other young adults might be better off declining the deal. In many states, healthy people in their twenties can purchase insurance on their own for less than $100 per month.  That could be less than the cost of keeping a child on your family policy.

In most states (other than New Jersey), insurers don’t charge extra specifically to keep older children on your policy. But your rate might drop if you remove your child, especially if you’re insuring only one child and can switch from family coverage to rates for a single person or a couple. You’d have to compare the price with what it would cost for your child to purchase individual insurance.

If you still have other children on your policy, you may be able to insure older ones at no extra charge (as long as your insurer doesn’t base premiums on the number of children). That would be the best deal.

For a list of each state’s age requirements for dependent coverage, see the National Conference of State Legislatures’ Web site. Note that these laws don’t apply to employers who self-insure.

Washington Post

Get a Quote on Health Insurance for Child in NC

1. COBRA. While this may be the most expensive option, it’s a good one
   for someone with a pre-existing medical condition. For people recently
   laid off, the first, immediate option to review is COBRA coverage. COBRA
   is required of businesses with 20 or more employees. It provides
   continuation of group health coverage that otherwise might be terminated.
   One common myth about COBRA coverage is that it is only good for 18
   months, but quite often this is not the case as it can be continued
   indefinitely through state COBRA programs. First steps include checking
   with the employer’s human resources department to receive complete
   information on how to qualify for COBRA, the costs and how to apply. If
   COBRA is an option, it should be carefully reviewed before being refused
   as once it’s dismissed, it can’t be recalled.
2. High Deductible Plans. For healthy individuals, another cost effective
   option while unemployed may be to purchase lower-cost high deductible
   individual coverage. until new employment is found. With the exception
   for New York, Massachusetts and Vermont, a person can obtain this
   coverage for anywhere from $50 to $150 per month providing basic
   catastrophic coverage with a high deductible until he or she becomes
   eligible for the new employer’s plan. You can visit www.nahu.org for
   a national listing of insurance brokers near you.
3. Going from a double- to a single-income family. For the family in a
   two-income home where one parent has been laid off, checking into
   programs like Healthy Families is an important step. In many states, a
   family of 4 can make up to $60,000 (California, Connecticut, Hawaii,
   Illinois, Indiana, Maryland, Massachusetts, Missouri, New Hampshire, New
   Jersey, Pennsylvania, Tennessee, Vermont, Washington, D.C.) and in other
   states up to $50,000 a year (Alabama, Georgia, Louisiana, New Mexico, New
   York, Washington) and still qualify the children for comprehensive
   coverage. These programs may provide low-cost health coverage for
   children and teens up to age 19 including comprehensive health, dental
   and vision coverage. Moving the family’s young dependents from
   private insurance to government sponsored plans can reduce monthly
   premiums and perhaps make a family’s adult private premium coverage
   affordable.
4. Coverage for Pre-existing Conditions. For people who have been laid off
   and must purchase individual health insurance but are unable to obtain
   coverage due to a pre-existing condition, many states have government
   sponsored medical risk insurance pools (such as California’s Major
   Risk Medical Insurance Program). State residents who qualify for these
   programs participate in the cost of their continued coverage by paying
   premiums that are supplemented by the state. Go to your state’s
   government website to find out what type of medical pool coverage may be
   offered.
5. Help for Single Pregnant Women. For a single woman who is pregnant and
   doesn’t make more than $25,900 in a year, there are maternity
   programs state by state which will pay for the coverage of the baby
   before, during and after the birth of the child into the first year. With
   names like Access for Infants and Mothers, this often comprehensive
   coverage provides low-cost or free health coverage for pregnant women
   before, during and following the delivery of the baby and health coverage
   for their newborn through the baby’s first year of life.

Credit: The Foundation for Health Coverage Education

The Foundation for Health Coverage Education is a non-profit organization based in San Jose, California. For more information, please visit the website at www.coverageforall.org.

1. Talk to a professional to decide on the best plan that will fit your needs. It is important to find the best plan for your health insurance needs. Finding a plan that fits your needs is not just about coverage, but also about budget. You want to make sure you are getting the best coverage for your money.  An experienced broker can help you buy reccomending a plan that provides you with the coverage you need at a price that fits your budget.
2. Find out if your doctors are in-network before purchasing a plan. Finding out if your chid’s doctor is in-network is an important and easy step. This information can be found by looking on the insurance carrier’s website or by asking your doctors office if they accept your particular insurance carrier and plan.  Some “low cost” plans may not be accepted by your child’s doctor or hospital or they may require you to file the claims directly with your health insurance company. 
3. If your child is taking any prescription medications be sure to find out how they will be covered on your new plan. Whether you are choosing a plan that has prescription coverage by paying a copay or being applied to your deductible the cost of the prescription is something you should know.
4. Make sure you understand any waiting periods. Waiting periods can apply to your new plan if you have not had continuous coverage, a lapse in coverage of more than 63 days. Be aware of any waiting periods and how to avoid a waiting period in the future.
5. Know how your plan will renew and what is to be expected at the time of renewal. Different carriers have different procedures for renewal. Most plans renew annually and some plans require action at renewal. If you want to make changes to your plan, renewal is a good time for changes.

Buying health insurance for your child in North Carolina can be quick and easy.  Get a  free quote on Health Insurance for Children in NC

Why do I need health care insurance and what are its limitations?

Health insurance helps protect you against high medical costs that could arise if you get sick or experience an accident. Though you may not be sick now, paying for health insurance protects you later if you or a member of your family get sick. There is no way to completely predict who will get sick, when they will need care, and how much that care will cost. Health insurance works by pooling large numbers of people together and then spreading the risk for high costs among everyone. That way, if you pay some money now, you can get benefits later if you need them.

Of course, health insurance can have major limitations. Most policies cover a defined range of treatments, tests, and doctors’ visits. If you need a treatment or drug that is not covered, you could pay for it yourself. Most insurance also charges you more than just the premium. For example, you are likely to be required to pay copayments (fixed per-visit or per-prescription costs), deductibles (dollar thresholds you must pay before coverage kicks in), or other payments.

Policies may also limit the amount of covered care you can receive, the number of times you can go to a doctor in a year, or the total dollar amount for care. They may require you to pay a large portion of costs even after you’ve paid your premiums.

What is a health maintenance organization (HMO)?

An HMO is the type of insurance that often has the lowest out-of-pocket costs to you, the patient. You may pay a small deductible along with copays for visiting the doctor or filling a prescription. HMOs keep costs lower by limiting the network of health providers you can see. Generally you must stick to the primary care physicians and specialists in the closed network. That means if a particular doctor is not in the HMO’s network, you may have to pay extra to see him or her, or not be allowed to use their services at all.

What is a preferred provider organization (PPO)?

A preferred provider organization has a network like an HMO, but you are allowed to go outside the network if you pay higher fees. Out-of-pocket costs of the insurance are usually greater because of this expanded choice. PPOs offer a lot of choice of doctors and hospitals, but they usually cost you more.

What is a point-of-service plan (POS)?

A point-of-service plan combines an HMO-like network with the freedom to see any doctor outside the network. If you stay inside the network, you pay regular HMO copays and co-insurance (Paying a certain percentage of costs up to a capped level). If you go outside the network, you likely won’t have any co-insurance, but you will have a higher deductible. For instance, you could be required to pay the first $1,000 for any care you receive, in addition to your premiums.

What is an indemnity plan?

An indemnity plan has no provider network. Instead it pays for care regardless of which hospital or doctor you go to. There is a lot of freedom with an indemnity plan, but because there are no closed networks, it is harder for the insurance company to negotiate to control costs. That means that premiums and deductibles may be very high, to help the plan cover high health care costs if you get sick.

What is a health savings account?

Health savings accounts are accounts that allow you to save a certain amount of money tax-free as long as you spend it on health costs. Current law limits yearly HSA contributions to $2,650 for individuals and $5,250 for families. HSAs are used in conjunction with low-premium, high-deductible plans that cost less up-front but require you to spend more of your own money if you need care. Employers may also contribute to these accounts.

What is a flexible spending account?

A flexible spending account may be set up by your employer to help cover medical expenses. The account allows an employee to deduct a set amount of money from their paycheck, tax-free, that can be set aside to pay for medical costs such as out-of-pocket costs or uncovered care. Employers may also contribute to these accounts.

Companies may place a limit on how much money can be set aside in such an account. In addition, the employee will lose the money if they don’t spend it by the end of the year.

How can I protect my private medical information?

Most doctors, nurses, clinics, hospitals, health plans, and insurers are required to follow the rules of the Health Insurance Portability and Accountability Act. That law gives you the right to:
o Ask to see your health records
o Have corrections added to your records
o Receive notice that tells you how your health information can be used or shared
o Decide if you want to give your permission BEFORE your health information is used or shared for certain purposes like marketing.
o Get a report on when and why your health information was shared
o File a complaint with your health insurer, health provider, or the federal government if you feel your privacy rights were violated

What is the difference between group and individual insurance?

Group insurance is typically offered through an employer. It insures a group of people, i.e., the company’s employees, all together. Individual insurance is what you buy if you are self-employed or if you choose not to take insurance through your job. Individual insurance is almost always more expensive because you don’t have the advantage of collective buying or negotiating with the insurance company. But one advantage of individual insurance is that you may deduct your premiums from your taxes.

What is a pre-existing condition? How does it affect my current insurance?

A pre-existing condition is a medical condition, such as diabetes, that you already have when applying for new insurance. Insurance plans may try to exclude coverage of your pre-existing condition before insuring you. But generally they may not exclude illnesses that occur after insurance starts. Usually you take a physical at the start of a new policy so that the plan can determine if you have any pre-existing conditions.
How does it affect getting a new insurance policy?

As stated above, insurance plans may try to exclude coverage for pre-existing conditions before insuring you. They may offer insurance only at a higher cost in the form of deductibles, copayments, and coinsurance, or they may choose not to offer you coverage at all.

What is the Health Insurance Portability and Accountability Act (HIPAA) and its impact on my having insurance?

Passed in 1996, HIPAA is designed to protect health insurance coverage for workers and their families when they change or lose their jobs. HIPAA prevents group health insurance plans from singling any one person out for higher premiums based on age, sex, health status, or other factors. HIPAA also limits how plans can exclude covering you for pre-existing conditions. In effect, HIPAA lets you “carry over” coverage of a pre-existing condition to a new insurance policy if you had roughly equal coverage before.

Why should I worry about a “coverage gap,” not having insurance for 63 days or more?

The “carry over” of coverage mentioned above only applies if your previous coverage ended less than 63 days before your new coverage begins. That means that for your new plan to cover a pre-existing condition, or limit exclusions for a pre-existing condition based on previous coverage, that coverage must have ended no more than 63 days ago. That’s why you may hear 63 days quoted as a HIPAA definition of “continuous coverage.”

By Todd Zwillich
Researched by Michele Foust
WebMD Special Report Reviewed by Louise Chang, MD

NEW YORK (CNNMoney.com) — If your kid is heading off to college this Fall, make sure they have enough insurance coverage. Here’s what you need to know.

It’s a good idea to check into your child’s health coverage as they go off to college. Full-time students between the ages of 18-23 are usually covered under their parents’ health plan.

But keep in mind that some plans have younger age cutoffs. If your health plan has a network, you’ll want to scout out a doctor near where your child is going to be living. Then you’ll need a referral from your local physician.

And if your child is no longer on your plan, most colleges offer limited health insurance plans for students. And don’t forget that many colleges offer emergency health-care or infirmary hours on campus too.

Basically insurance companies reward you if you don’t drive.

Case in point: your son or daughter can get a discount on their insurance if they leave their car at home while attending school. And the school has to be at least 100 miles away.

You’ll also want to notify your insurance company that the car will be garaged in a different location. Your premium could go down depending on where the college is located.

And if you must bring your car to campus – don’t let other people drive your car. No matter who’s driving, your kid is still responsible for what happens.

If you have a kid that’ll be living on campus, chances are, your homeowners’ policy will cover most of their possessions.

In most cases, your homeowners insurance will cover about 10% of property that’s outside the home. That means if you have $75,000 worth of contents coverage at home, it will cover about $7500 worth of stuff that’s in a dorm room.

Of course, you’ll want to get in touch with your insurance company since not all insurers have this same limit. And if your kid is going to be living off-campus at an apartment, your homeowners’ policy won’t be helpful. In this case, you’ll want to look into renters insurance.

Rates run about $250 a year for contents of about $15,000 according to the Independent Insurance Agents & Brokers Association.

Get a Quote on Health Insurance for Student

By TOM MURPHY – Jul 13, 2008
Associated Press

Low health insurance caps leave patients stranded

By TOM MURPHY – Jul 13, 2008

Mary Wusterbarth thought her toddler was struggling with an ear infection when she seemed sluggish. Instead, a virus had attacked the little girl’s heart, damaging it beyond repair. Brea needed a transplant.

Within three weeks of a 2007 doctor visit, the 20-month-old had exhausted the $1 million lifetime maximum on her health insurance. Her parents have scrambled ever since for ways to cover thousands of dollars in monthly medical costs.

“We have no idea what kind of financial future we have,” said Wusterbarth, of Wake Forest, N.C. “The medical bills come almost daily. There’s never an end.”

Insurers set lifetime limits to keep rates low on some policies, but holders are learning that individual caps that seemed large quickly max out as health care costs soar. Several patient advocacy groups are prodding insurers to raise the caps, which generally don’t adjust for inflation. Congress also is considering two bills that would do that.

Only 1 percent of employer-offered group plans — the largest health insurance segment — had caps as low as $1 million last year, according to a survey by The Henry J. Kaiser Family Foundation. But 22 percent had caps of less than $2 million, and some want to see all these relatively low maximums eliminated.

Insurers, however, say most health coverage already offers either a comfortable maximum of several million dollars or unlimited coverage. They note that more government regulation could lead to higher coverage costs, and low lifetime caps help them offer a greater variety of coverages.

“I think the discussion needs to move into why do some health care services cost hundreds of thousands of dollars and what can we do to address those issues,” said Robert Zirkelbach of America’s Health Insurance Plans, a trade association representing nearly 1,300 insurers.

Kelly and Tom Treinen used to think the $1 million individual cap that came with the insurance they had for seven years offered plenty of protection. In fact, they chose that plan, which Kelly received through her job as an elementary school principal, over a higher-priced option through Tom’s business. That one offered a $5 million cap.

Then doctors diagnosed their teenage son, Michael, with an aggressive form of leukemia in May 2007. His treatment called for 10 doses of a chemotherapy drug that cost $10,000 per dose. A 56-day stay in an intensive care unit cost about $400,000.

Michael reached his $1 million lifetime maximum in less than a year. The Noblesville, Ind., family had to issue a public plea for help after a hospital told them it needed either $600,000 in certified insurance or a $500,000 deposit to continue preparing for a critical bone marrow transplant.

The Treinens raised $865,000 in six days. Money came from all over the United States and as far away as Germany. But Michael’s cancer had stopped responding to chemotherapy, and he died May 25 before he could receive the transplant.

The family had no idea how fast costs were piling up. Some initial bills didn’t arrive until months after treatment started. Then they would receive multiple mailings for each treatment, each listing a different amount — the hospital cost, the insurance discount, the amount they owed.

“When you’re dealing with constant care of your child, you’re not going home with a calculator and adding up to see where you’re at,” Kelly Treinen said.

Insurance can shield patients from the true cost of health care, said Jerry Flanagan, health care policy director for California-based Consumer Watchdog. He noted that most people have no idea how quickly $1 million “can evaporate,” unless they’ve been seriously ill before.

“You can eat through a million-dollar lifetime cap in two or three surgeries,” he said.

Low lifetime maximums are found more often in small-employer group plans, Flanagan said, noting that those businesses generally have less insurance buying power. He said employers often give their workers a choice on plans or premiums but not on lifetime maximums.

The Kaiser Family Foundation study says a greater percentage of employer-offered group plans are providing lifetime caps of at least $2 million, and the percentage that offers caps below $2 million has declined slightly.

But medical costs for employer-sponsored health plans should increase 9.9 and 9.6 percent this year and next, according to PricewaterhouseCoopers Health Research Institute.

“The nature of caps is that over time it becomes easier and easier to hit (them) because the cost of health care services keeps going up,” said Mike Thompson, a health care and employee benefits expert with the firm.

A coverage cap of $1 million in the 1970s would have had to grow to more than $10 million today to keep pace with rising costs, said Glenn Mones of the National Hemophilia Foundation.

The foundation’s vice president for public policy says he’s seen more patients approach their lifetime caps in recent years. People with hemophilia can spend more than $200,000 a year just on drugs that prevent internal bleeding.

His foundation renewed a lobbying push in Congress this year for higher lifetime caps because it sees a better political climate for one.

U.S. Rep. Anna Eshoo, D-Calif., unsuccessfully pitched a bill on lifetime caps in 1996. She will try again this summer because she sees better odds with a Democrat majority in the House of Representatives. Sen. Byron Dorgan, D-N.D., introduced a similar bill in March in the Senate.

Mary Wusterbarth, a stay-at-home mother with two other children, thinks legislation on minimum lifetime caps is an excellent idea. Her daughter, Brea, is 3 now and doing well. But family finances aren’t as healthy.

The Wusterbarths spent more than $20,000 to adopt Brea from China in 2006. Then her heart began to fail, just months after she arrived at their Louisiana home.

She qualified for Medicaid while hospitalized for the transplant, but that coverage ended once she was released. The family has since moved to North Carolina, where Brea’s father, Danny, works as an operations manager for a distribution center.

They drained their savings and spent more than $60,000 out of pocket on medical bills in the past year. Church donations have helped, and they negotiated some discounts to wind up with $50,000 in insurance coverage for Brea they hope will last the next six months.

But Danny Wusterbarth makes too much money for Brea to receive Medicaid coverage. Insurers won’t cover Brea because of the medical history, a common problem with people who reach caps.

Brea’s anti-rejection drugs run about $3,000 a month. The biopsies she needs every few months to check for rejection can cost $40,000. She’ll also need another transplant in about 10 years. Her mother isn’t sure where all the money will come from.

“We were actually told that if we would get a divorce or if he would quit his job, then she could get all the help she needed,” Wusterbarth said. “But that’s not the way we do things, so we just take it day by day.”

Applying for  health insurance does not mean you have committed to buy.  It is important to apply for coverage and find out your rate before making a final decision.  This is how you ensure you are making the right decision about what is best for your child.  We are here to guide you through this process and provide you with the information you need in order to make this important decision.

Get a Quote on Health Insurance for your Child