ACA Health Insurance in North Carolina: Marketplace Plans & Subsidies
Residents of North Carolina can access affordable health insurance through HealthCare.gov. Thanks to the Affordable Care Act (ACA), most families qualify for subsidies that significantly lower monthly premiums.
📍 North Carolina Health Insurance Fast Facts
How Health Plans Work in North Carolina
When you shop on HealthCare.gov, you'll see plans organized by "Metal Levels" (Bronze, Silver, Gold). In North Carolina, specific options will vary by your zip code. For example, a Silver plan in Charlotte might be offered by Blue Cross Blue Shield of NC, while a similar plan in a rural county might be from a different provider.
Key takeaway for North Carolina residents: Don't just look at the premium. Check the provider network to ensure your preferred doctors and local hospitals are covered.
🏥NC Medicaid (Medicaid)
North Carolina expanded Medicaid in December 2023 after years of legislative debate. The expansion covers adults up to 138% of the Federal Poverty Level. NC Medicaid provides comprehensive coverage including medical, behavioral health, and some dental/vision services. The state uses managed care organizations (Prepaid Health Plans) to coordinate most Medicaid benefits.
✅Medicaid Expansion Update
IMPORTANT UPDATE: North Carolina expanded Medicaid in December 2023. If you previously didn't qualify for coverage, check your eligibility now. Adults with incomes up to 138% of the Federal Poverty Level may now qualify for free or low-cost Medicaid coverage. Visit epass.nc.gov to apply.
💡Insurance Shopping Tips for North Carolina
- •Blue Cross Blue Shield of NC has the most extensive statewide network and is available in all 100 counties
- •Ambetter (Centene) offers competitive pricing in many NC counties
- •Oscar Health has entered the Charlotte and Triangle markets with tech-forward plans
- •Check if your preferred providers are in-network—NC has significant network variation
- •With Medicaid expansion, check eligibility before purchasing marketplace coverage
🏛️Unique Healthcare Programs in North Carolina
NC Medicaid Expansion: New coverage for adults up to 138% FPL (began December 2023)
NC Health Choice for Children: CHIP program covering children up to 211% FPL
Carolina Pregnancy Care: Support for pregnant women enrolled in Medicaid
NC Breast and Cervical Cancer Control Program: Free screenings for qualifying women
Healthy Opportunities Pilots: Addressing social determinants of health through Medicaid
Important note
Marketplace (ACA) eligibility and premium tax credits depend on your household size, income, ages, ZIP code, and the plan you choose. Rules and plan pricing can change over time.
Use this page to understand the basics for North Carolina. For your exact eligibility and final monthly premium, confirm on the official marketplace.
Important Note for North Carolina
North Carolina uses federal marketplace. Recently expanded Medicaid. Blue Cross Blue Shield dominates the marketplace.
Frequently Asked Questions
How do ACA subsidies work in North Carolina?
Premium tax credits can reduce monthly premiums for Marketplace plans. Eligibility and amounts depend on household size, income, ages, ZIP code, and plan selection. Confirm specific results on the official marketplace.
Is "HealthCare.gov" the official site for North Carolina?
Yes, for North Carolina, you should use **HealthCare.gov** to apply for coverage and subsidies. Using third-party sites might result in extra fees or missing out on tax credits.
When is Open Enrollment?
In most states, Open Enrollment typically runs from Nov 1 to Jan 15. Some state marketplaces may have different deadlines.
What carriers offer plans in my area?
Major carriers in North Carolina often include Blue Cross Blue Shield of NC, Ambetter, Cigna. Availability varies by ZIP code, so residents in Charlotte might have different options than those in Raleigh.
Do ACA plans cover pre-existing conditions?
Yes. ACA-compliant plans cannot deny coverage or charge more due to pre-existing conditions like diabetes, cancer, or pregnancy.
Sources & Disclaimer
Last Updated: January 2026
Disclaimer: The information provided is for educational purposes only. Actual costs vary based on individual circumstances, location, age, plan selection, and other factors. Always verify current information with official sources or licensed professionals. This site does not sell insurance or provide medical advice and is not affiliated with any insurance company or healthcare provider.