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Differences in Eligibility
State Plan
An individual has to be a resident of NC, be a US legal resident, is not eligible for any other group health insurance coverage and is not eligible for any other government program AND at least one of the following:
- Has been rejected or refused coverage by a carrier (need denial letter)
- Has been given coverage but with a limiting rider (need a letter or policy showing limitation)
- Have been refused coverage or have a policy at a rate higher than the IH rate
- Have a presumptive medical condition which allows automatic enrollment
- You are eligible for or are enrolled in COBRA or state continuation and have an individual rate that is higher than the Inclusive Health rate and answer "yes" to at least one of numbers 1-4 above.
- Is exhausting 18 months of COBRA coverage
- Is eligible for HCTC (Have HCTC Certificate)
Federal Plan
An individual that has not had creditable health insurance coverage for at least six (6) months that is a resident of NC, a legal US resident and is not eligible for any other government program AND at least one of the following:
- Has been rejected or refused coverage by a carrier (need denial letter)
- Has been given coverage but with a limiting rider (need a letter or policy showing limitation)
- Have a presumptive medical condition which allows automatic enrollment
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