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Enrollment Checklist
Download the Checklist
If you are coming to the Enrollment Event and want to enroll with Inclusive Health, you will need to bring:
1. A voided check with banking information for an EFT (Electronic Funds Transfer)
2. One form of identification to show state residency:
- a current North Carolina driver's license or state ID
- current rent or mortgage payment receipt
- voter 's registration card
- state income tax return
- car registration
- property tax receipt
- utility bill
3. Proof of US Citizenship or Lawful Permanent Resident Alien:
If you are NOT a citizen of the United States, you are required to provide:
- a current North Carolina driver's license or state ID (can use for both NC and US Residency)
- naturalization/ citizenship certificate
- Visa
- green card
- I-94 card
- Employment Authorization Document (EAD) and Advance Parole (Temporary travel document)
4. Proof of Eligibility:
- a letter from an individual health insurer that includes one of the following:
- i. denial or rejection due to a medical condition from the health insurer
- ii. a conditional rider that would exclude coverage for a medical condition
5. Other documentation (if applicable):
- a disability award letter
- a letter from a physician confirming the diagnosis of one of the Presumptive Medical Conditions.
- Healthcare Savings Account Banking set-up form, if using HSA Banking option through the Inclusive Health Plan
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