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How Much Is Health Insurance A Month In North Carolina

In North Carolina, health insurance rates vary widely, depending on where you stay.

The average cost of health insurance in North Carolina for rates for individuals differs significantly across the state and is among the highest in the nation. The state’s top insurance costs have been blamed on a grab bag of causes, as well as entrenched market dominance by Blue Cross, the state’s decision last year not to expand Medicaid, and a decades-long race among hospital companies to build one of the United States’s best health care networks.

Restrictions on Some Plans in North Carolina

At the county level, North Carolina’s price disparities can be noticeable. Insuring a family with three children could differ by more than $200 a month for the same health insurance plan, depending on where the family lives.

The costliest counties are in the northwestern corner of the state, the Charlotte area, and along much of the state’s eastern coast, depending on the underwriter and health plan. There are significant variations within individual insurance carriers; the area with the costly Blue Cross “silver” plans, the Fayetteville rating area, has the state’s cheapest “silver” plans.

North Carolina’s health insurance costs are higher than in many other states. Of the 34 states that are not running their health insurance exchanges, only four – Alaska, Maine, New Jersey, and Wyoming – have equal or higher monthly 2015 premiums among typical lowest-priced “silver” plans.

The analysis by Kaiser Health News, an independent news organization, shows that North Carolina’s average monthly premium is $315 among the lowest-cost “silver” plans provided throughout the state. Actual premiums for a single, 40-year-old nonsmoker will range from $267 to $351 a month across North Carolina’s 16 rating areas next year.

On average, that’s 8.5 percent more expensive than North Carolina’s Affordable Care Acts rates this year.

Better Facilities, Higher Costs

North Carolina’s high insurance costs result from multiple causes.

Supporters of the Affordable Care Act have long said that uninsured populations drive up health care costs because low-income people depend on hospital emergency rooms for preventable treatments. The hospitals pass along those losses through their charges to health insurance carriers.

When Republican leaders decided in 2013 not to expand Medicaid here, that left as many as 500,000 individuals without coverage. About 200,000 of those who would have qualified for Medicaid eligible for heavily subsidized private insurance. This group is most likely to be in poor health and needs expensive medical treatment, which increases insurance rates.

It is not clear how many signed up for coverage this year, but 91 percent of the Affordable Care Act enrollees in North Carolina are eligible for subsidies, one of the country’s highest rates.

The rise in insurance costs here can be traced to the 1970s when the state started emerging as a modern Southern economic powerhouse.

As part of that transformation, North Carolina rapidly started building a world-class healthcare system, on par with those in large metro areas. This development is still underway, with intensive capital projects adding new hospitals and facilities throughout the regions, said Thomas Ricketts, professor of social medicine and health policy at UNC-Chapel Hill.

“You are paying for quality, and you are paying for quantity,” Ricketts said. “Very complex care, very high-cost procedures, and services.”

North Carolina’s 16 rating areas were set in 2013, based on metropolitan statistical regions. The federal Center for Consumer Information and Insurance Oversight rejected a proposal from N.C. Department of Insurance and insurance carriers to create 100 rating regions, one for every county.

According to October 2012, minutes of a Department of Insurance workshop on rating regions, insurance industry officials contended that creating 100 rating areas would expose the true cost of healthcare inequalities – pressuring local physicians, hospitals, and health officials to do something about runaway health care costs.

Resources and References:

• North Carolina Rating Areas
• The Affordable Care Act