North Carolina Health Insurance (Cary, NC Area)
Family or Individual
HMO, PPO, POS or Major Medical Coverage
Individual or family health insurance can provide the important protection
needed in the event of illness and for regular preventive care. Using the
strength and experience of our health insurance markets, Ed Moore &
Associates can offer affordable HMO, PPO, POS, and Major Medical
Health Insurance policy coverages throughout central North Carolina,
with a focus on the Cary, NC area.

Health insurance plans that allow you the most choices in doctors and
hospitals also tend to cost more than plans that limit choices. Individual
and family health insurance plans that help to manage the care you
receive, such as PPO and POS plans, usually cost you less, but you
must give up some freedom of choice.
Learn more about HMO, PPO, and POS managed health care insurance policies we offer throughout
the Cary, NC area by clicking on a link below or click on the link for information on North Carolina Major
Medical health insurance.
Click on the link below to fill out a secure quote request form for a Cary, North Carolina area health
insurance policy that provides excellent health insurance coverage and services at an affordable cost.
Or you can speak with our North Carolina Health Insurance agent specialist at (919) 467-6339 to
discuss the insurance policy features in more detail.
* Preventive care emphasis
* Primary care physician (PCP) coordinates your total care
* Must get a referral from your PCP to visit a specialist
* Fixed monthly fee
HMO Health Insurance Policy Overview - North Carolina
Subscribers to an HMO receive medical services from participating physicians, clinics and hospitals.
You choose a primary care physician (PCP) from a list of participating doctors from where you live in
North Carolina. That doctor is used for typical circumstances such as annual exams and usual
health issues. If you need to see a specialist, be hospitalized, or have lab or X-ray work, your doctor
will refer you to a provider or facility within the HMO system. Your doctor must give authorization for
those services to be covered by your HMO. In other words, you must see HMO approved physicians
and use HMO approved facilities or pay the entire cost of the visit yourself.

Similar to Point-of Service (POS) and PPO's, HMO's have made arrangements for lower fees with a
network of health care providers and give their policyholders a financial incentive to stay within that
network.
You may have to pay some portion of the cost (co-payment) for each office or hospital visit, such as
$20 - $30 per doctor visit, regardless of what the services cost. Also, some services such as
emergency room, mental health and chemical dependency services, may carry additional costs in a
North Carolina HMO health maintenance plan.
Click on the link below to fill out a secure quote request form for a Cary, North Carolina area HMO
health insurance policy that provides excellent health insurance coverage and services at an
affordable cost. Or you can speak with our North Carolina Health Insurance agent specialist at
(919) 467-6339 to discuss the features.
Learn more about the other types of North Carolina Individual or Family Health Insurance polices we
offer by clicking on a link below!
Managed Health Care Plans:
Fee-for-Service Health Plan:
* Convenient access to quality health care
* Large and diverse network available of primary care physicians,
specialists, hospitals & clinics.
* Pay for services as they are provided
PPO Health Insurance Policy Overview - North Carolina
You can see any health care professional in the network any time you choose to make an
appointment. You don't need referrals for specialists or other services as you do in an HMO. You
can see doctors or specialists outside your PPO network, however, your portion of the costs will
be higher.
You may have to pay some portion of the cost (co-payment) for each office or hospital visit, such
as $20 - $30 per doctor visit, regardless of what the services cost. Also, some services such as
emergency room, mental health and chemical dependency services, may carry additional costs in
a North Carolina PPO health insurance plan.
Click on the link below to fill out a secure quote request form for a Cary, North Carolina area family
or individual PPO health insurance policy that provides excellent health insurance coverage and
services at an affordable cost. Or you can speak with our North Carolina Health Insurance agent
specialist at (919) 467-6339 to discuss the policy features in more detail.
Learn more about the other types of North Carolina Individual or Family Health Insurance polices we
offer by clicking on a link below!
Managed Health Care Plans:
Fee-for-Service Health Plan:
* Preventive care emphasis
* Pays benefits for out-of-network care, but at a lower level
POS Health Insurance Policy Overview - North Carolina
Less restrictive than an HMO or PPO, a (POS) or Point of Service plan lets you see any licensed
health care professional for anything covered by the insurance. Care you receive from out-of-plan
health care professionals is reimbursed, but you must pay an often times much higher co
payment or deductible amount. While you may choose to see a physician outside the network, if
you don't receive permission from your (PCP) primary care physician, you're likely to end up
submitting the bills yourself and receiving only a small reimbursement...if any.

Costs that exceed your deductible are covered by a co-insurance plan in which you and the
insurance company share the cost for services covered by the policy.
Also, some services such as emergency room, mental health and chemical dependency
services, may carry additional costs in a North Carolina POS health insurance plan.
Click on the link below to fill out a secure quote request form for a Cary, North Carolina area family
or individual POS health insurance policy that provides excellent health insurance coverage and
services at an affordable cost. Or you can speak with our North Carolina Health Insurance agent
specialist at (919) 467-6339 to discuss the insurance policy features in more detail.
Learn more about the other types of North Carolina Individual or Family Health Insurance polices we
offer by clicking on a link below!
Managed Health Care Plans:
Fee-for-Service Health Plan:
Major medical health insurance provides benefits up to a high limit for most types of medical
expenses incurred, subject to a deductible. Once you meet the deductible, our North Carolina
Major Medical Insurance plans pay a percentage of what is considered the "Usual and Customary"
charge for covered services. The insurance company generally pays 80% of the Usual and
Customary costs and you pay the other 20%, which is known as co-insurance. If the insurance
company charges more than the Usual and Customary rates, you will need to pay both the co
insurance and the difference.
With North Carolina Major Medical Insurance plans you can choose your doctor and any hospital
for your medical services. You or your doctor send the bill to the insurance company, which pays
part of it. Usually, you have a deductible such as $500 or more to pay each year before the insurer
starts paying. The plan will pay for charges such as medical tests and prescriptions as well as
from doctors and hospitals.
Major medical insurance coverages offer more choice of doctors (including specialists, such as
cardiologists and surgeons), hospitals, and other health care providers than managed care plans,
such as HMO, PPO, and POS. North Carolina Major Medical Insurance may not pay for some
preventive care, such as check-ups, and is usually a more expensive health insurance coverage
than utilizing a North Carolina HMO, PPO, or POS plan.
Click on the link below to fill out a secure quote request form for a North Carolina family or
individual Fee-for-Service / Major Medical health insurance policy that provides excellent health
insurance coverage and services at an affordable cost. Or you can speak with our North Carolina
Health Insurance agent specialist at (919) 467-6339 to discuss the policy features in more detail.
Learn more about the other types of North Carolina Individual or Family Health Insurance polices
we offer by clicking on a link below!
Managed Health Care Plans:
Ed Moore & Associates, Inc.
103-B Kilmayne Drive
Cary, North Carolina 27511
Wake County, NC
Office: (919) 467-6339
Fax: (919) 467-6434

ED MOORE
& Associates, Inc.
Always here when you need us. Protecting
hundreds of North Carolina families and businesses.
PERSONAL INSURANCE
BUSINESS INSURANCE
Health
Experience - Dedication - Insurance Options
As an independent insurance agency we work for you.
We find the best, affordable health insurance products
from our wide range of insurance carrier options.
Professionalism - Small Business Specialists
Whether you are searching for better commercial insurance
options or just starting your small business, we can help.
Ed Moore & Associates, Inc.
Copyright 2011-2017, All rights reserved
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**The information, pictures, and other content in this website about particular insurance services is only
provided for informational purposes. Any decisions regarding your insurance needs should be discussed
with a licensed insurance agent.

Please be advised that insurance coverage cannot be bound, changed or confirmed via voicemail, email,
fax or online at the agency's website. You must speak directly with a licensed insurance agent.
We are a Cary, North Carolina insurance agency offering affordable health insurance policy
premiums to residents of the following towns, cities and counties in central North Carolina:
Raleigh, Morrisville, Apex, Garner, Green Level, New Hope, Neuse, Bayleaf, Falls, Wake Forest,
Forestville, Bethesda, Carpenter, Lowes Grove, Auburn, Holly Springs, Chapel Hill, Durham,
Knightdale, Macedonia, New Hill, Brentwood, McCullers, Farrington, Leesville, Durham County,
Orange County, Chatham County, and Wake County, NC.
The Bronze Plan has the lowest premium, but you'll pay a higher share of costs when you get care.
On the other end of the cost spectrum, the Platinum Plan will have the highest monthly premiums
and the lowest out-of-pocket costs when care is needed.
Bronze Plan
Silver Plan
Gold Plan
Platinum Plan
You can choose the plan that is right for your budget and needs. All
plans offer the 10 essential health services mentioned above. The cost
of each plan will be different whether your state has set up its own
Health Marketplace or uses the National Health Marketplace. Speak with
your health insurance agent for specific costs and enrollment
information.
Health Marketplace Insuranace Plans
1. hospitalization
2. maternity and newborn care
3. ambulatory patient services
4. emergency services
5. mental health and substance use disorder services, including
behavioral health treatment
6. prescription drugs
7. rehabilitative and habilitative services and devices
8. laboratory services
9. preventive and wellness services and chronic disease management
10.pediatric services, including oral and vision care
The Affordable Care Act passed in 2010 required individual health
insurance plans beginning on January 1, 2014 to offer essential
health benefits services. Below is the list of minimum services
required under all health insurance plans.
Essential Health Benefits
Enrollment began October 1, 2013 and coverage began
January 1, 2014.
New National Healthcare Overview
The Marketplace will also tell you if you qualify for free or low-cost coverage available through
Medicaid or the Children's Health Insurance Program (CHIP).
The only exception is for grandfathered individual health insurance plans--the kind you buy yourself,
not through an employer. If you have one of these plans you can switch to a Marketplace plan during
open enrollment and get coverage for your pre-existing condition.
An insurance company can't turn you down or charge you more because of your health condition.
It can't refuse to cover treatment for pre-existing conditions.
Pre-existing Conditions
Marketplace Health Plans Pricing
All insurance plans available through the Marketplace will be offered by private insurance companies.
Marketplace pricing will show any cost savings you may be eligible for based on your income.