Medical Insurance in North Carolina

North Carolina law requires their health insurance carriers to provide certain benefits to policyholders that aren’t mandated by other states. If an individual avails of a major medical health insurance from any insurer, the provider is obligated to provide them these benefits as stated under North Carolina law. If you’re buying medical insurance in North Carolina from a company like such as, make sure these key features are included in your policy.

Special Benefits of Medical Insurance in North Carolina

  1. Emergency Services – If an incident met the prudent layperson standard, which means an event was determined by a lay person to be an emergency medical condition, the insurance provider would have to cover the emergency services necessary to screen and stabilize their policyholder.
  2. Minimum Hospital Stay Following Childbirth – Insurance providers who sell medical insurance in North Carolina are required to cover both mother and child up to 48 hours after childbirth. This includes inpatient care after normal delivery for up to 48 hours, or inpatient care needed for caesarean section for up to 96 hours post delivery.
  3. Mammograms and Pap Smears – For the protection of women and prevention of further medical complications, insurance providers are required to cover the expenses for both pap smears and low-dose screening mammographies.
  4. Bone Mass Measurement – Certain qualified individuals can avail of coverage from here for accredited, proven, and certified bone mass measurement procedures for the diagnosis and treatment of osteoporosis or low bone mass. To be considered a qualified policyholder, the insured must meet one of the following criteria: a. estrogen deficient, b. with radiographic osteopenia anywhere in the skeleton, c. long term glucocorticoid therapy, d. primary hyperparathyroidism, e. under monitoring to identify the effectiveness of drug therapies for osteoporosis, f. history of low trauma fractures, g. with other conditions or medical therapies that are identified causes of osteoporosis.
  5. Diabetes Treatment and Services – Aside from medically appropriate and necessary diabetes treatment and services, insurance agencies are also required to cover outpatient self management training, educational services, equipment, supplies, medication, and laboratory expenses that are required for the treatment and management of diabetes.
  6. Mastectomy Length of Stay and Reconstructive Breast Surgery Following Mastectomy – The patient’s physician will be the one in charge of deciding how long a patient should stay in the hospital following a mastectomy procedure. Coverage for the reconstructive surgery following the procedure for the purpose of treating cancer or breast disease must also be provided by the insurance company.