New condition-specific plan designed to help eligible members manage congestive heart failure with reduced out-of-pocket costs and personalized support
RALEIGH, N.C., Nov. 13, 2026 /PRNewswire/ — Ambetter of North Carolina Inc. announced today that it will introduce a new Enhanced Congestive Heart Failure Care Premier plan for 2027, expanding access to coverage designed specifically for individuals managing heart failure. The offering reflects Ambetter Health’s continued focus on designing coverage around the conditions members live with every day.
The new plan offers eligible members $0 copays for certain heart failure medications, $0 select mental health medications, $0 nicotine replacement therapy and $0 cardiologist visits (up to four per year). The plan also includes coverage for cholesterol labs, EKGs, cardiac education and nutritional counseling visits.
“Managing heart failure can require ongoing care, medication management and regular access to specialists,” said Chris E. Paterson, Plan President and CEO. “This new coverage option is designed to help make that care more accessible while supporting members throughout their health journey.”
The North Carolina launch builds on Ambetter Health’s broader strategy of offering condition-specific coverage through its Premier product. Nationwide data from Ambetter Health’s existing condition-specific plans show high member satisfaction and higher primary care engagement than traditional plans. These findings reflect national results, not North Carolina-specific outcomes.
Ambetter of North Carolina Inc. already offers an Enhanced Asthma and COPD Care plan, with $0 copays for preferred Asthma/COPD medications, including controller and rescue inhalers and mental health medications, $0 pulmonologist visits, $0 allergy testing and $0 pulmonary rehabilitation services.
Ambetter of North Carolina Inc. also offers Clear Silver with $0 insulin options, a plan designed to support members managing diabetes. The plan includes $0 preferred insulins, $0 covered mental health medications, and a free glucometer.
Open Enrollment for 2027 Marketplace coverage began Nov. 1, 2026. Consumers can explore coverage options, compare plans, and learn more about available benefits by visiting AmbetterHealth.com.
About Ambetter Health
Ambetter Health is a health insurance offering that is available on the Health Insurance Marketplace, or exchange, established by the Affordable Care Act. It is one of the healthcare programs provided by Centene Corporation, a leading healthcare enterprise committed to helping people live healthier lives. Ambetter Health is made available through local health plans and covers a wide variety of healthcare services, including preventive and wellness services, maternity and newborn care, pediatric services, mental health and substance misuse services, prescription drug coverage and more.
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SOURCE Ambetter of North Carolina Inc.
