The data is clear – health insurance makes a difference in whether and when people get necessary medical care. Those without coverage are more likely to skip necessary care, and more likely to have negative health consequences. Those without insurance are less likely to receive preventive services, such as blood pressure and cholesterol checks and cancer screenings, which can lead to later stage diagnoses and more serious complications.

This is why getting and staying covered is so important – even if you are well today, insurance coverage helps you stay that way.

Most North Carolinians get their health insurance through one of four ways.

Group coverage through an employer: If you receive health benefits through your workplace, your employer will select the timeframe for you to change or renew your plan. Ask your HR department for more information.

Individual coverage through Healthcare.gov: Individuals and families in North Carolina can purchase health plans directly from insurance carriers through the federal marketplace, Healthcare.gov. This enrollment period runs from Nov. 1-Dec. 15 for coverage to start Jan. 1. The last day to enroll in or change health plans for the year is Jan. 15. After this date, you can enroll in or change plans only if you qualify for special enrollment.

After this period ends, you cannot sign up for or change your coverage unless you experience a “qualifying event,” such as having a new baby or moving. 

Medicare: Medicare recipients have to choose their plans between Oct. 15 and Dec. 7. You can review and sign up for plans through Medicare.gov.

Medicaid: Some North Carolinians can get healthcare coverage through Medicaid. You are eligible if you are 19-64 years old and your income is up to 138% of the Federal Poverty Level. And if you were eligible before, you still are. Nothing changes for you. Apply for Medicaid online at epass.nc.gov or through the HealthCare.gov. You can also submit a paper application at your local Department of Social Services.

Health insurance plans come with different premium costs, deductibles, co-pays, and out-of-pocket maximums. When comparing health plans, you might be considering choosing one with a low premium. This is the amount you pay every month for coverage, so it is an important cost to review. But low premium plans generally cover less, which can lead to higher out-of-pocket costs. 

Typically, if you choose a plan with a lower premium, you will pay more to use it. This can become expensive for patients with chronic conditions who expect to visit the doctor frequently or take regular medications. These patients may need to choose a plan that covers more. Consider how you plan to use your coverage and be sure to consider both premium costs and cost-sharing when choosing a health plan.

A provider network is the group of doctors, hospitals and other healthcare providers who have contracted with your insurance plan. You will typically pay less to visit in-network providers, and some plans do not cover out-of-network providers at all. If you have a preferred doctor, specialist, or medical facility, it's crucial to check if they are included in the network of the plan you're considering.

There is no one-size-fits-all approach to health insurance. It's important to assess your health needs and budget prior to selecting your plan.  Consider your age, medical history, family situation, and overall health. For instance, a young, single individual without any chronic health conditions may require different coverage than a family with children or an older individual with existing health issues. If you rely on prescription medications, it's important to examine a plan's formulary to ensure your medications are covered and at a reasonable cost.