Jeffrey Wade
If you are a resident of North Carolina and are looking to get state medical insurance, you may be eligible for NC Medicaid. NC Medicaid provides health care coverage for people with lower incomes and has recently expanded its coverage to more people, including those aged 19-64. To be eligible, you must be a US citizen or have an eligible immigration status, live in North Carolina, and have a Social Security number. You can apply for your child even if you are not eligible for coverage, and applying will not affect your immigration status or chances of becoming a permanent resident or citizen.
| Characteristics | Values |
|---|---|
| Name of State Medical Insurance | NC Medicaid |
| Who is eligible | People with lower incomes, including those aged 19-64 |
| Requirements | Must be a U.S. citizen or have eligible immigration status, live in North Carolina, and have a Social Security number |
| Application Process | Apply online, in person, by mail, or more |
| Additional Information | Families that include non-U.S. citizens can apply; applying will not affect immigration status or chances of becoming a permanent resident or citizen |
| Help with Application | NC Navigator Consortium gives free advice about health insurance and helps with applications; can make a free appointment online or call 1-855-733-3711 |
| Insurance Licensing Requirements | Must complete prelicensing before taking the state licensing exam; must choose a line of authority (health insurance, life insurance, property and casualty insurance, or a combination) |
| Time Commitment | Prelicensing courses range from 10 hours to 20 hours |
| Exam Details | Must score 70% or higher to pass; exam will cover general insurance product knowledge and state-specific insurance laws, rules, regulations, and practices |
| Exam Proctoring | A disinterested third party (someone with no conflict of interest) must be present for online certification exams |
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$20.75
What You'll Learn
NC Medicaid: eligibility and how to apply
NC Medicaid is a state program that provides healthcare coverage for people with lower incomes. NC Medicaid has expanded in recent years and now covers more people, including those aged 19–64.
To be eligible for NC Medicaid, you must:
- Be a U.S. citizen or have an eligible immigration status.
- Live in North Carolina.
- Have a Social Security number or show that you have applied for one if you are eligible.
Families that include non-U.S. citizens can apply, and you can apply for your child even if you are not eligible for coverage. Applying will not affect your immigration status or chances of becoming a permanent resident or citizen.
To find out if you are eligible, you must apply. You can apply online, in person, by mail, or by other means. A caseworker will review your application to see what is available to you and if certain deductions might help you qualify.
You can also connect with a health insurance expert from the NC Navigator Consortium, who can give you free advice about health insurance and help you apply.
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NC State Health Plan: understanding medical plan options
The North Carolina State Health Plan provides health care coverage for people with lower incomes. NC Medicaid has expanded to cover more people, including those aged 19-64. To be eligible, you must be a US citizen or have eligible immigration status, live in North Carolina, and have a Social Security number.
If you are unsure whether you are eligible, you can apply to find out. You can apply online, in person, or by mail. If you are not eligible for NC Medicaid, there are other options available. For instance, if you are an employer with between 1 and 50 full-time equivalent employees, you can offer insurance through SHOP (Small Business Health Options Program). You can choose to share the cost of these premiums with your employees. If you have fewer than 25 employees making less than an average of $50,000 per year, you may qualify for a tax credit worth up to 50% of your contribution to employees' premiums.
If you are a retired member turning 65 in the next 2 years, or are over 65 and working, you can refer to the "Understanding Your Medical Plan Options When You Become Medicare-Eligible" resource to understand your options.
The NC Medicaid Ombudsman helps beneficiaries when they are unable to solve problems with their provider or health plan. The NC Navigator Consortium also provides free advice about health insurance and can help you apply.
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Prelicensing requirements for insurance licenses
To obtain an insurance license in North Carolina, applicants must complete prelicensing requirements before taking the state licensing exam. These prelicensing requirements include both educational components and administrative tasks.
Prelicensing Education
North Carolina requires applicants seeking an insurance license to complete prelicensing education before taking the state licensing exam. This education can be obtained through approved prelicensing providers, and it includes courses specific to the line of insurance being pursued. For example, Medicare Supplement/Long-Term Care insurance requires 10 hours of prelicensing, and applicants must already be licensed for Accident and Health or Sickness.
Some individuals may be exempt from prelicensing education requirements. This includes those with a degree in insurance (associate or bachelor's) and those holding certain insurance designations or certifications who pass the exam on their first attempt. If an exempted individual fails the exam, they must complete the prelicensing education before retaking the exam.
Online Study Requirements
For online prelicensing courses, North Carolina mandates time tracking, with a maximum of 8 hours of instruction per day. The course must be completed sequentially, with each page finished before proceeding to the next. Additionally, bi-data/security questions must be answered correctly to confirm the identity of the user.
Certification Exam
The prelicensing course must adhere to specific rules for the applicant to receive prelicensing credit. The final course examination must be monitored and administered by a disinterested third party, meaning someone with no financial or personal conflict of interest. Examples include a librarian or test center employee, while an immediate family member or prospective employer would not qualify.
Administrative Tasks
Before taking the state licensing exam, applicants must obtain an Insurance Licensing Examination Candidate Guide, which is free of charge and accessible through Pearson Vue. The Candidate Guide includes information on prelicensing and examination requirements, as well as a list of approved prelicensing providers for scheduling courses.
After completing the prelicensing course, applicants will receive an admission ticket that must be taken to the examination site. The state licensing exam is administered by Pearson Vue and covers both general insurance product knowledge and specific insurance laws, rules, and regulations unique to North Carolina. It is a multiple-choice exam taken on a computer, with a passing score of 70% or higher.
Once the exam is passed, applicants must complete an electronic application at www.nipr.com and submit fingerprint impressions. An NPN (National Producer Number) will be assigned to track individuals and business entities, replacing the producer license number in some states.
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NC Medicaid Managed Care: beneficiaries' protections
North Carolina has expanded its health care coverage to include more people. The state's Medicaid program now covers people aged 19-64, and families that include non-US citizens can apply.
The NC Medicaid Ombudsman helps beneficiaries understand NC Medicaid Managed Care and their rights and responsibilities. The Ombudsman offers free, confidential support and education, and can help beneficiaries when they are unable to solve problems with their provider or health plan.
The NC Medicaid Enrollment Broker helps beneficiaries learn about their healthcare options, how to find a primary care provider, and how to enroll in a health plan. Beneficiaries can also learn about Medicaid recertification and non-emergency medical transportation.
If a beneficiary disagrees with a denial, reduction, suspension, or termination of health services under NC Medicaid, they can request a hearing.
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NC Medicaid Managed Care: how to get help
NC Medicaid provides health care coverage for people with lower incomes. NC Medicaid Managed Care is a new way to get the same Medicaid services, allowing you to get the most out of your Medicaid benefits. Instead of one Medicaid program, there are several health plans to choose from. All health plans are required to have the same Medicaid services, such as office visits, blood tests, and X-rays. Health plans may also offer additional services such as programs to help you quit smoking, eat healthier, and have a healthy pregnancy.
To get help with NC Medicaid Managed Care, you can follow the steps outlined below:
Check Your Eligibility
Before applying, it is important to check if you meet the basic eligibility criteria for NC Medicaid. You must be a U.S. citizen or have an eligible immigration status, live in North Carolina, and have a Social Security number or have applied for one. Families that include non-U.S. citizens can apply, and you can also apply for your child even if you are not eligible for coverage yourself.
Understand the Application Process
You can apply for NC Medicaid online, in person, by mail, or through other available methods. The NC Medicaid website provides information on the application process, eligibility requirements, and health care options. You can also learn about the new NC Medicaid health plan and determine if you are newly eligible for coverage.
Connect with a Health Insurance Expert
If you need assistance with the application process or have general questions about health insurance, you can connect with the NC Navigator Consortium. They offer free advice and can help you apply for coverage. You can make a free appointment online or call them at 1-855-733-3711.
Choose a Health Plan
Once you are enrolled in NC Medicaid Managed Care, you will need to choose a health plan that meets your specific needs. You can use the Health Care Option Guide to compare different health plans and understand the services they offer. All health plans are required to provide the same core Medicaid services, but they may differ in additional benefits and their network of qualified doctors and healthcare professionals.
Contact the NC Medicaid Ombudsman
If you have questions or concerns about your health plan or provider that you are unable to resolve, you can contact the NC Medicaid Ombudsman. They are available to help beneficiaries understand NC Medicaid Managed Care and can provide assistance when dealing with issues related to your health plan or provider. You can reach them by calling 1-877-201-3750.
Stay Informed and Utilize Available Resources
Stay up to date with any changes or updates to NC Medicaid by visiting the official website and enrolling in NC Medicaid Managed Care. You can also utilize the NC Medicaid Managed Care mobile app to find and view primary care providers (PCPs) and health plans. Additionally, make sure that your DSS Caseworker has your most updated contact information, including your address, phone number, and email address.
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Frequently asked questions
NC Medicaid is the state medical insurance in North Carolina.
To be eligible for NC Medicaid, you must be a US citizen or have eligible immigration status, live in North Carolina, and have a Social Security number. NC Medicaid provides health care coverage for people with lower incomes, including those aged 19-64.
You can apply for NC Medicaid online, in person, by mail, or by other means. You can also connect with a health insurance expert from the NC Navigator Consortium, who can provide free advice and help with the application process.
To get a state insurance license in North Carolina, you must complete a prelicensing course and pass the state licensing exam. The prelicensing course requirement can be waived if you hold a degree in insurance or have certain designations or certifications and pass the exam on your first attempt. The exam covers insurance product knowledge, specific insurance laws, rules, regulations, and practices unique to North Carolina.
Yes, North Carolina has specific requirements for the prelicensing process. The state mandates a maximum of 8 hours of online study time per day and requires the use of bi-data questions to confirm your identity. Additionally, a disinterested third-party proctor, such as a librarian or test center employee, must be present for the online certification exam.
