The North Carolina State Health Plan provides health benefits not only for teachers and state employees, but also for retirees and others who are designated by the North Carolina General Statutes. In addition, the plan provides health insurance coverage for uninsured children in North Carolina. As of early 2011, more than 665,000 people were listed as insured by the state health plan.
PPO Basic Plan
The state of North Carolina offers its employees two preferred-provider organization (PPO) plans. These provide employees with the freedom to choose their doctors within the network, lower cost for out-of-pocket expenses and a focus on preventive health care. Employees who choose North Carolina's PPO Basic Plan pay higher co-pays,coinsurance and deductibles. However, the premiums are reduced when employees choose health coverage for their families, making this a good plan for healthy families.
PPO Standard Plan
North Carolina employees who choose the PPO Standard Plan receive a higher coverage level than those who choose PPO Basic. For employees seeking health coverage for themselves only or for families who have health care needs, this is the recommended plan. The North Carolina State Health Plan website provides links to the benefits booklets describing the details of these two plans. For both the Basic and Standard PPO plans, the website provides a link to My Member Services, where members can better manage their benefits by viewing their claims, updating policy information, ordering new ID cards or changing billing address information.
NC HealthSmart Wellness Programs
People who have the state health plan as their primary coverage are eligible to use the HealthSmart resources and benefits. Those who choose to take advantage of the program first take a confidential health assessment. Then, HealthSmart offers a variety of programs to help people maintain healthier lives, including programs for losing weight, stopping smoking, immunizations, healthy pregnancy, nutrition and support for chronic conditions. HealthSmart provides online tools and nurse-coaches who can be reached by phone or email for health advice and support.
NC Health Choice Program
For families whose income keeps them from qualifying for Medicaid, but who struggle to afford health insurance premiums, there is the North Carolina Health Choice for Children program. This program provides free or reduced-price health care for uninsured North Carolina children. Heath Choice for Children, which provides health benefits, including vision, hearing and dental care, is administered by the North Carolina Division of Medical Assistance.
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