Which of the following is a requirement for all individual health insurance plans in North Carolina?

Which of the following is a requirement for all individual health insurance plans in North Carolina?

• A. Coverage must include dental plans
• B. Plans must have annual and lifetime coverage limits
• C. Plans must provide essential benefits without limits
• D. Policies must include long-term care coverage

Answer: (C)

The correct answer is that all individual health insurance plans in North Carolina must provide essential benefits without limits. This requirement aligns with the broader mandates of the Affordable Care Act (ACA), which established that individual and small group health insurance plans must cover certain essential health benefits. These benefits generally include services such as emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, and preventive services, among others. By enforcing the requirement for essential benefits to be provided without limits, the legislation aims to ensure that individuals have access to comprehensive health care coverage, which can significantly reduce out-of-pocket expenses and enhance overall health outcomes. This means that insurers cannot impose restrictions on the number of visits or the amount of services covered under these categories, ensuring that individuals can receive necessary care when needed. The other options do not reflect the requirements set out for individual health insurance plans in North Carolina. There is no mandate for dental coverage to be included in health insurance plans, and while some policies may choose to have coverage limits, it is not a requirement for all plans. Long-term care coverage is not a standard inclusion in individual health insurance plans either; it typically requires a separate policy. Thus, the emphasis on providing essential benefits without limits underscores the

The correct answer is that all individual health insurance plans in North Carolina must provide essential benefits without limits. This requirement aligns with the broader mandates of the Affordable Care Act (ACA), which established that individual and small group health insurance plans must cover certain essential health benefits. These benefits generally include services such as emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, and preventive services, among others.

By enforcing the requirement for essential benefits to be provided without limits, the legislation aims to ensure that individuals have access to comprehensive health care coverage, which can significantly reduce out-of-pocket expenses and enhance overall health outcomes. This means that insurers cannot impose restrictions on the number of visits or the amount of services covered under these categories, ensuring that individuals can receive necessary care when needed.

The other options do not reflect the requirements set out for individual health insurance plans in North Carolina. There is no mandate for dental coverage to be included in health insurance plans, and while some policies may choose to have coverage limits, it is not a requirement for all plans. Long-term care coverage is not a standard inclusion in individual health insurance plans either; it typically requires a separate policy. Thus, the emphasis on providing essential benefits without limits underscores the