Ambetter of North Carolina Inc. Expands Health Insurance Offering to 63 Counties Statewide, Offering More Residents Affordable, Accessible Coverage

Rhea-AI Summary

Ambetter of North Carolina Inc., a Centene (NYSE: CNC) product, is expanding its health insurance offering to 63 counties in North Carolina for plan year 2025. The open enrollment period runs from Nov. 1, 2024, through Jan. 15, 2025. Key features of Ambetter's 2025 plans include:

• Virtual 24/7 Care
• Comprehensive coverage for essential health benefits
• Convenient online enrollment
• My Health Pays® rewards program
• Specific plan design changes for members with diabetes
• Premier Network (formerly Bronze|Silver|Gold network)

Ambetter also announced an expanded partnership with the YMCA, offering gym memberships and YMCA360 online classes for members starting October 2024. The expansion aims to provide more North Carolina residents with affordable, accessible health coverage.

Positive

• Expansion of health insurance offering to 63 counties in North Carolina
• Introduction of Virtual 24/7 Care for convenient access to healthcare
• Expanded partnership with YMCA offering gym memberships and online classes
• Implementation of My Health Pays® rewards program for healthy lifestyle incentives
• Specific plan design changes for members with diabetes, potentially lowering out-of-pocket costs

Negative

• None.

Insights

Healthcare Policy Analyst

Ambetter of North Carolina Inc.'s expansion to 63 counties for the 2025 plan year is a significant development in the state's health insurance landscape. This move aligns with the broader trend of increasing access to affordable healthcare coverage through the Affordable Care Act's Health Insurance Marketplace.

Key points to consider:

• The expansion covers 63 out of 100 counties in North Carolina, potentially reaching a substantial portion of the state's population.
• The offering includes essential health benefits and some plans with dental and vision coverage, addressing comprehensive healthcare needs.
• The introduction of diabetes-specific plan designs with potential cost savings on medications and supplies could be particularly impactful in a state where diabetes prevalence is significant.
• The partnership with YMCA for gym memberships and online classes indicates a focus on preventive health and wellness, which could lead to long-term cost savings for both members and the insurer.

While this expansion is positive for consumer choice and access, it's important to monitor how it affects market competition and overall premium rates in the state. The impact on Centene's market share and financial performance in North Carolina will be worth watching in the coming years.

North Carolina residents will have access to a variety of affordable plans from Ambetter of North Carolina during open enrollment beginning Nov. 1, 2024

RALEIGH, N.C., Oct. 2, 2024 /PRNewswire/ -- Ambetter of North Carolina Inc., a product offered by a Centene Corporation (NYSE: CNC) company, which provides insurance to under-insured and uninsured populations through the federal Health Insurance Marketplace®, will offer a variety of affordable health insurance plans to North Carolinians in 63 counties for plan year 2025. Open enrollment for the Health Insurance Marketplace for North Carolina runs from Nov. 1, 2024, through Jan. 15, 2025. Enroll by Dec. 15 for coverage starting Jan. 1, 2025.  

"Ambetter is excited to continue to expand in North Carolina where we now offer our high-quality, affordable plans in 63 counties," said Ambetter of North Carolina Inc. Plan President, Catherine Campbell. "Our health plans provide members with access to a large network of local doctors and hospitals. We are also pleased to announce an expanded partnership with the YMCA, offering gym memberships and YMCA360 online classes for members beginning October 2024."

Ambetter of North Carolina offers its members access to quality care, convenient services and valuable rewards. The 2025 benefits and extra offerings include:

• Virtual 24/7 Care
  Virtual 24/7 Care offers members an Ambetter-designated licensed provider via telehealth for Members to access care for illnesses such as flu, skin conditions, ear infections, fever and respiratory infections – all from the comfort of their home.
   
• Affordable and Reliable Coverage
  Ambetter of North Carolina Inc. provides coverage for all essential health benefits, including preventive and wellness services, maternity and newborn care, pediatric services, mental health services, hospitalizations and prescription drug coverage. Some plans also include dental and vision coverage.
   
• Convenient Online Enrollment
  Through the Ambetter of North Carolina Inc. website, people can browse and compare coverage options, determine their eligibility for financial subsidies and directly enroll in coverage – all in one place. The platform is accessible through mobile devices, so people can enroll using smartphones. If a person is unable to complete enrollment all at once, the system will save progress and provide reminders to finish enrollment.
   
• My Health Pays
  Members have access to the My Health Pays® program, where they can earn points for practicing healthy eating habits, staying active and leading a healthy lifestyle. Through the program, members can complete health-related activities and challenges, earning rewards that can be used for health-related expenses such as premiums, copays and deductibles (pharmacy copays are excluded). My Health Pays also allows members to set and reach health goals at their own pace by providing seasonal suggestions for activities and guidance to help stay on track.
   
• Specific Plan Design Changes for Members with Diabetes
  Starting in 2025, some Ambetter Health Premier plans provide members managing diabetes with additional healthcare options and savings. Members on these plans may have lower out of pocket costs for certain medications, supplies, and clinical support. Members of these plans may also have access to $0 copays for preferred insulins as well as $0 copays for select mental health medications.
   
• Premier Network
  Beginning Jan. 1, 2025, the Ambetter Health Bronze|Silver|Gold network will become known as the Premier Network. Members can continue to rely on the same provider network with the doctors and hospitals they know and trust.

Below is the full list of counties in which Ambetter of North Carolina Inc. will be offered:

• Alexander
• Alleghany
• Anson
• Avery
• Bladen
• Brunswick
• Buncombe
• Burke
• Cabarrus
• Caldwell
• Caswell
• Catawba
• Clay
• Cleveland
• Columbus
• Cumberland
• Davidson
• Davie
• Durham
• Forsyth
• Franklin
• Gaston
• Graham
• Granville
• Guilford
• Harnett
• Haywood
• Hoke
• Iredell
• Jackson
• Johnston
• Lee
• Lincoln
• Macon
• Madison
• McDowell
• Mecklenburg
• Mitchell
• Montgomery
• Moore
• New Hanover
• Orange
• Pender
• Person
• Polk
• Randolph
• Richmond
• Robeson
• Rowan
• Rutherford
• Sampson
• Scotland
• Stanly
• Stokes
• Swain
• Transylvania
• Union
• Vance
• Wake
• Warren
• Wilkes
• Yadkin
• Yancey

North Carolina residents interested in learning more about Ambetter of North Carolina Inc. or enrolling in a health plan during the open enrollment period may visit ambetterhealth.com/en/nc/.

About Ambetter of North Carolina Inc.
Ambetter of North Carolina Inc. serves under-insured and uninsured populations through the federal Health Insurance Marketplace. Ambetter of North Carolina Inc. is underwritten by Ambetter of North Carolina Inc., which is a Qualified Health Plan issuer in North Carolina. For more information visit ambetterhealth.com/en/nc. This is a solicitation for insurance. For information on your right to receive an Ambetter of North Carolina Inc. plan free of discrimination, or your right to receive language, auditory and/or visual assistance services, please visit ambetterhealth.com/en/ and scroll to the bottom of the page. 

View original content:https://www.prnewswire.com/news-releases/ambetter-of-north-carolina-inc-expands-health-insurance-offering-to-63-counties-statewide-offering-more-residents-affordable-accessible-coverage-302264680.html

SOURCE Ambetter of North Carolina Inc.

FAQ

When is the open enrollment period for Ambetter of North Carolina Inc. for plan year 2025?

The open enrollment period for Ambetter of North Carolina Inc. for plan year 2025 runs from November 1, 2024, through January 15, 2025. To have coverage starting January 1, 2025, you must enroll by December 15, 2024.

How many counties will Ambetter of North Carolina Inc. (CNC) cover in 2025?

Ambetter of North Carolina Inc. will offer health insurance plans in 63 counties across North Carolina for plan year 2025.

What new features are included in Ambetter of North Carolina's 2025 health plans?

Ambetter of North Carolina's 2025 health plans include Virtual 24/7 Care, comprehensive coverage for essential health benefits, convenient online enrollment, the My Health Pays® rewards program, specific plan design changes for members with diabetes, and access to the Premier Network.

What is the new partnership announced by Ambetter of North Carolina Inc. (CNC) for 2025?

Ambetter of North Carolina Inc. announced an expanded partnership with the YMCA, offering gym memberships and YMCA360 online classes for members beginning October 2024.