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Health Insurance Alternatives: Wilmington & Cape Fear FAQ

Straight answers to the questions Cape Fear households ask most.

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Answer 6 quick questions to see what Direct Primary Care plus health sharing could cost your household.

Frequently asked questions

Is health care sharing the same as health insurance?

No. Health care sharing is a group of members who agree to share each other's eligible medical bills under written guidelines. Nobody is required to pay, so sharing isn't guaranteed. It isn't regulated as insurance, and it isn't Minimum Essential Coverage under the ACA.

Is it legal in North Carolina?

Yes. N.C. Gen. Stat. § 58-49-12 says a qualifying health care sharing organization isn't under the insurance commissioner's jurisdiction, which also means insurance consumer protections don't apply. N.C. Gen. Stat. § 58-3-8 says direct primary care agreements aren't insurance. There's no state penalty for going without insurance.

What is an Initial Unshareable Amount (IUA)?

It's the part of each medical Need you pay yourself before other members can share the rest. It works per Need, not per year, so it isn't a deductible. With the program we most often recommend, you choose the amount when you join (our price table shows $500 to $2,500), and no more than three IUAs apply in a membership year.

What isn't shared?

Routine and preventive care (except some screenings), most ongoing prescriptions after the first 120 days, routine dental, glasses and contacts, alternative medicine, and counseling above $750 a year. That's why we pair sharing with primary care and a dental plan.

What about pre-existing conditions?

Conditions with symptoms, treatment or medication in the 36 months before joining are phased in: not shareable in year one, up to $25,000 in year two, up to $50,000 in year three, and fully shareable after that.

Can I use any doctor or hospital?

For health sharing, yes: Novant Health, Dosher Memorial or any other licensed hospital, in North Carolina or out of state. There's no provider network, so you pay as a self-pay patient and submit eligible bills. The virtual primary care membership is a specific practice that you reach by video and phone.

How do I pay a big bill?

You pay the provider up to your IUA, open a Needs case and upload itemized bills within six months. The program negotiates bills over $1,000, and shared money is paid to you so you can pay the provider.

Is there an age limit?

New members must be 18 to 64. At 65, members need Medicare Parts A and B to stay.

What if I need care while I'm traveling?

Health sharing has no network, so you can use any licensed hospital wherever you are, in North Carolina or out of state, and your virtual primary care team is a phone or video call away. For an emergency, notify the sharing program within 48 hours.

My Cigna Marketplace plan is ending for 2027. What now?

Cigna is leaving North Carolina's individual market for 2027. Choose a new plan on HealthCare.gov during open enrollment (Nov 1, 2026 to Jan 15, 2027; by Dec 15 for a Jan 1 start). If you want to compare the alternatives too, we'll show you prices and limits. We don't sell insurance.

I'm on NC Medicaid. What changes in 2027?

From January 1, 2027, most expansion adults ages 19 to 64 must show 80 hours a month of work, school, training or community service, unless exempt, and renew every six months. If you lose Medicaid, check HealthCare.gov right away: losing coverage usually opens a special enrollment period.

Can I keep my HSA?

Generally no. Health sharing isn't a high-deductible health plan, so you usually can't add new money to an HSA while you rely on it. Money already in an HSA stays yours. Ask your tax preparer about your situation.

Do you charge for help?

No. There's no cost to talk with us. We may be paid by some programs we recommend; our Referral Marketing Disclosure explains how.

Written and reviewed by Graham Kerswell. Last updated November 5, 2026. Facts and prices are checked against the sources named on this page.

Sources

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Health care sharing
Health care sharing ministries are not insurance and are not regulated as insurance. Sharing of medical expenses is voluntary and not guaranteed. Review each organization's guidelines for details, limitations, and state-specific notices.

North Carolina notice (N.C. Gen. Stat. § 58-49-12)
North Carolina law asks health care sharing organizations to give members this notice: “NOTICE: The organization facilitating the sharing of medical expenses is not an insurance company and neither its guidelines nor its plan of operation is an insurance policy. Whether anyone chooses to assist you with your medical bills will be voluntary. No other participant will be compelled by law to contribute toward your medical bills. As such, participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive any payment for medical expenses or whether this organization continues to operate, you are always personally liable for the payment of your own medical bills.” Health care sharing is not Minimum Essential Coverage.

Direct primary care
Direct primary care is a membership with a primary care practice. Under N.C. Gen. Stat. § 58-3-8, a medical direct primary care agreement is not insurance and is not subject to North Carolina's insurance laws; the agreement must be in writing and must state prominently that it is not health insurance. A DPC membership does not pay for specialists, hospital care or emergencies, and it is not Minimum Essential Coverage.

Discount plans
THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. A discount plan provides discounts at participating providers and does not make payments to providers; the member pays the discounted fee. Discount plan organization: Careington International Corporation, 7400 Gaylord Parkway, Frisco, TX 75034. Discount plans are not ACA Qualified Health Plans.

How we're paid
We may receive compensation from some organizations we recommend. This does not change our evaluation of how they work. See our Referral Marketing Disclosure.

Not advice
This page is general information, not medical, legal, tax or financial advice. Prices are examples, not quotes; they depend on your household and can change. Affordable Healthcare Wilmington is not an insurance agency and does not sell insurance. We help individuals and families explore alternatives to insurance, including direct primary care, health care sharing and discount plans.