Can I afford a personal healthcare plan like Carolina Direct?

Do you offer a supplemental accident product in conjunction with these plans?

I'm 65 or older - is Carolina Direct right for me? Would you be able to provide it?

Can I still get Carolina Direct coverage if I have a pre-existing condition?

If I currently have Carolina Direct, can I change the type of healthcare plan in which I am enrolled?

I am already a Carolina Direct member, can I add benefits?

I only need coverage for a couple of months - can you help?

Does my doctor accept Carolina Direct?

Is Carolina Direct available in other states?

Who is considered a dependent?

Can I get a policy for my child only?

What if the parents are divorced, the mother has custody, but the father wants to buy medical insurance for the child?

What if a dependent is pregnant when the application is submitted?

What is a deductible?

Does Carolina Direct include other benefits, like vision, or prescription drug?

How accurate is the Estimated Premium?

Once I have a premium estimate, what is the next step?

How does a customer change his/her billing method?

I need help! Who can I contact?

How much may be contributed to a Health Savings Account?

What are the catch-up contribution provisions?

Who will administer my Health Savings Account?

How can contributions be made to a Health Savings Account?

How can Health Savings Accounts be invested?

What are qualified medical expenses?

What happens to the account at year-end?

How can the Health Savings Account be accessed?

Who may contribute to a Health Savings Account?

If one or both spouses have family coverage, how is the contribution limit computed?

What is the tax treatment of an eligible individual's HEALTH SAVINGS ACCOUNT contributions?

When may Health Savings Account contributions be made? Is there a deadline for contributions to a Health Savings Account for a taxable year?

Are health insurance premiums qualified medical expenses?

Can I use the Health Savings Account to pay the monthly health insurance premiums?

Can I afford a personal healthcare plan like Carolina Direct?

Absolutely. Many people think personal healthcare plans are too expensive and beyond their means. But Carolina Direct allows you to choose a plan to suit your personal healthcare needs and your budget.

Do you offer a supplemental accident product in conjunction with these plans?

No. Carolina Direct does offer benefits for emergency services. Emergency services are subject to the deductible and any applicable coinsurance.

I'm 65 or older - is Carolina Direct right for me? Would you be able to provide it?

Carolina Direct Personal Health Plan is available for individuals up to age 64.

Can I still get Carolina Direct coverage if I have a pre-existing condition?

The Carolina Direct health plans have a pre-existing condition clause. If a pre-existing condition existed at any time during the twelve-month period immediately preceding an applicant's effective date, then Carolina Care Plan will not provide benefits for covered services relating to the pre-existing condition until the subscriber has been enrolled in a Carolina Direct for 12 months.

A pre-existing condition is a condition for which an ordinarily prudent person would seek medical advice, diagnosis, care or treatment; or for which the applicant/dependent incurred medical expenses, received medical treatment, used a prescription drug or was advised by a physician or other medical professional to receive treatment.

However, if you are accepted, pre-existing conditions is waived for any conditions disclosed on your application.

If I currently have Carolina Direct, can I change the type of healthcare plan in which I am enrolled?

Yes, you may choose to change benefits but only at renewal. Benefit upgrades are subject to medical underwriting approval.

To change from a Carolina Direct plan to a Carolina Direct HDHP compatible plan, please contact your Carolina Direct broker.

I am already a Carolina Direct member, can I add benefits?

If you are currently a member and would like to add to or change your current benefits, please contact your Carolina Care Plan Representative.

I only need coverage for a couple of months - can you help?

Yes. You can purchase Carolina Direct for any period of time.

Does my doctor accept Carolina Direct?

Carolina Direct is only available to those who are residents of South Carolina at least six months out of the year.

To search for a provider:

In South Carolina

To search for a provider when traveling outside of South Carolina:

In Georgia:

In Ohio:

All Other States:

To search for a provider of these services, please select the appropriate link.

Express Scripts Pharmacy Locator:

Find a SuperMed Vision Provider:

Is Carolina Direct available in other states?

Carolina Direct is only available in South Carolina. However, through Medical Mutual and Consumers Life Insurance Company, we offer Personal Health Plans in states outside South Carolina. The list of states where Personal Health Plans is available is constantly growing. For more information please call 877/271-4095.

Who is considered a dependent?

Carolina Direct eligible dependents include the contract or policy holder's spouse and unmarried children up to the age limit (the end of the month of their 23rd birthday), subject to the following:

• Natural children of the contract holder
• Children placed in the contract holder's home for the purpose of adoption
• Children for whom the contract holder or spouse is either the legal guardian or has been ordered by a court to provide health coverage
• Stepchildren, if the natural parent is also listed as a dependent of the policyholder
• Disabled dependents*, if they are:
  • Unmarried and under the limiting age
  • Primarily dependent on the contract holder for support
  • Dependents as defined by IRS income tax code
  • Covered by the contract holder's current/prior carrier

*Incapacity must have begun before reaching the age limit and must be medically certified by a physician.

Can I get a policy for my child only?

Carolina Direct will accept medical coverage applications for minor dependent children. All such applications should be submitted with the child's name as the applicant and the signature of a custodial parent or legal guardian who has knowledge of the health of the minor dependents and has the authority to legally contract on the minor's behalf.

What if the parents are divorced, the mother has custody, but the father wants to buy medical insurance for the child?

The father should complete and sign the application on behalf of his child. If there is more than one child who needs coverage, then the father must complete and sign separate applications for each child.

What if a dependent is pregnant when the application is submitted?

Eligible dependents include not pregnant dependent children under the age of 19. Coverage for the pregnant dependent is not available until her six-week post-delivery exam has been completed. In the case of a Caesarian-Section delivery the dependent will not be eligible until six months after the surgery.

What is a deductible?

A deductible is an amount, usually stated in dollars, for which you are responsible each Benefit Period before Carolina Care Plan will start to provide benefits.

Does Carolina Direct include other benefits, like vision, or prescription drug?

Incorporated into each Carolina Direct medical plan is a prescription drug benefit and a routine vision exam. Also, you may select one or more of the following ancillary riders in conjunction with a permanent health plan:

Adult Carolina Direct:

• Maternity Services Rider
• Prescription Drug Rider

For Carolina Direct HDHP compatible plans, you may select the following ancillary rider in conjunction with a QHDHP:

• Maternity Services Rider

How accurate is the Estimated Premium?

The rates quoted are estimates only, and are subject to change based on your medical history, the underwriting practices of the health plan, the optional benefits you selected, if any, and other relevant factors. Carolina Care Plan reserves the right to change the terms of the policy under proper notifications.

Once I have a premium estimate, what is the next step?

Once you have found the Plan and Options that are right for you, download and print the Carolina Direct Application Form. Complete the application and follow the procedures listed in the "Apply for Coverage" section within this Web site. Or call your insurance agent or broker, or dial 877/271-4095. One of our friendly representatives will guide you through the application process.

How does a customer change his/ her billing method?

To change billing methods, the subscriber should complete page four of the application, include his/her group number or subscriber number, and fax or mail it to Carolina Care Plan at:

Carolina Care Plan
201 Executive Center Drive
Columbia, SC 29210-8406
Fax: 803/214-3949

I need help! Who can I contact?

If you need assistance at any time during your plan selection process,
call your broker, or dial 877/271-4095.

How much may be contributed to a Health Savings Account?

The maximum annual contribution to a Health Savings Account is the sum of the limits determined separately for each month, based on status, eligibility and health plan coverage as of the first day of the month. For calendar year 2009, the maximum monthly contributions are:

• For individual coverage, the maximum monthly contribution is one-twelfth of either:
  • The annual deductible under the Qualified High Deductible Health Plan (QHDHP) (minimum of $1,150) OR
  • $3,000 (indexed for inflation after 2007)
• For family coverage, the maximum monthly contribution is one-twelfth of either:
  • The annual deductible under the QHDHP (minimum of $2,300) OR
  • $5,950 (indexed for inflation after 2007)

In addition to the maximum contribution amount, catch-up contributions may be made by or on behalf of individuals between the ages of 55 and 65.

What are the catch-up contribution provisions?

As of 2009, persons age 55 and older have a catch-up provision of an additional $1000 allowed per year.

Who will administer my Health Savings Account?

Because the Health Savings Account is set up separate from your qualified high-deductible health plan, a qualified, IRS-approved institution must be used to administer your Health Savings Account.

Carolina Care Plan has contracted with several companies to administer the Carolina Direct Health Saving Accounts. Please contact your Carolina Care Plan representative for more information.

How can contributions be made to a Health Savings Account?

Contributions to a Health Savings Account must be made in cash and may not be made in the form of stock or other property. In any given year, contributions may be made until April 15 of the following year.

How can Health Savings Accounts be invested?

Health Savings Accounts may be invested like a 401K or IRA - in an interest bearing account, a mutual fund, stocks or bonds. For easy access to pay for qualified medical expenses, it is recommended that the majority of the Health Savings Account be invested in a bank account.

What are qualified medical expenses?

Health Savings Accounts may be used to pay for various medical expenses including some that are included in health insurance plans. Following is a partial list of qualified medical expenses based on IRS Section 213 and listed in Publication 502:

• Health insurance plan deductibles, copayments and coinsurance
• Prescription Drug and over the counter drugs
• Dental services including braces, bridges and crowns
• Vision care including glasses and lasik eye surgery
• Psychiatric and certain psychological treatments
• Long-term care services
• Medically related transportation and lodging
• Certain health premiums including COBRA

What happens to the account at year-end?

The account balance may be carried over into future years with no limits. The account is owned by the individual and maintained in trust.

How can the Health Savings Account be accessed?

Checks and a debit card will be provided to each individual account holder. Account holders may use the checks/debit cards for expenses as they choose.

Who may contribute to a Health Savings Account?

An eligible individual may contribute to a Health Savings Account. Family members may also make contribution to a Health Savings Account on behalf of another family member as long as that other family member is an eligible individual.

If one or both spouses have family coverage, how is the contribution limit computed?

In the case of individuals who are married to each other, if either spouse has family coverage, both are treated as having family coverage. If each spouse has family coverage under a separate health plan, both spouses are treated as covered under the plan with the lowest deductible.

The contribution limit for the spouses is the lowest deductible amount, divided equally between the spouses unless they agree on a different division. The family coverage limit is reduced further by any contribution to an existing MSA during the same calendar year.

However, both spouses may make the catch-up contributions for individuals age 55 or over without exceeding the family coverage limit.

What is the tax treatment of an eligible individual's HEALTH SAVINGS ACCOUNT contributions?

Contributions made by an eligible individual to a Health Savings Account can be deducted from adjusted gross income. The contributions are deductible whether or not the eligible individual itemizes deductions. However, he or she cannot also deduct the contributions as medical expense deductions under section 213.

When may Health Savings Account contributions be made? Is there a deadline for contributions to a Health Savings Account for a taxable year?

Contributions for the taxable year can be made in one or more payments, at the convenience of the individual, at any time prior to the time prescribed by law (without extensions) for filing the eligible individual's federal income tax return for that year, but not before the beginning of that year.

For calendar year taxpayers, the deadline for contributions to a Health Savings Account is generally April 15 following the year for which the contributions are made.

Note: Although the annual contribution is determined monthly, the maximum contribution may be made on the first day of the year.

Are health insurance premiums qualified medical expenses?

In most cases, no. However, the following are exceptions:

• Premiums for qualified long-term care insurance
• Premiums for COBRA health care continuation coverage
• Premiums for health coverage while an individual is receiving unemployment compensation
• For individuals over age 65, premiums for Medicare Part A or B, a Medicare HMO and the employee share of premiums for employer-sponsored health insurance, including premiums for employer-sponsored retiree health insurance.

Premiums for Medigap policies are not qualified medical expenses.

Can I use the Health Savings Account to pay the monthly health insurance premiums?

No, not unless you are unemployed and are getting Federal unemployment insurance.