When can I sign up for a 2027 North Carolina Marketplace plan?

Enroll by December 15 for coverage that starts January 1; the last day to sign up is January 15. Outside open enrollment you need a qualifying life event, such as losing other coverage, moving, marrying or having a baby.

Will I pay the full price shown?

Not necessarily. The prices on this page are before tax credits. Tax credits depend on your household size and income, and they can lower the monthly premium a lot. The plan finder estimates your price after tax credits.

Can I keep my doctor?

179 of North Carolina's 206 plans for 2026 are HMOs or EPOs, which only pay for in-network care except emergencies. Check that your doctors and hospital are in the plan's network before you enroll.

My plan is renewing. Do I need to do anything?

Compare before you let it renew. North Carolina insurers filed 2027 increases of about 8.5% to 27% before tax credits, and your plan or its network may change. Your new tax credit can change too.

Has North Carolina expanded Medicaid?

North Carolina expanded Medicaid on December 1, 2023 for adults 19 to 64 with income at or below 138% of the poverty level. Apply at medicaid.ncdhhs.gov or through ePass / your local DSS. From January 1, 2027 many expansion adults face work reporting and six-month renewals.

On HealthCare.gov, through an approved insurer or broker website, or with a licensed agent. The plans and prices are the same everywhere you enroll.

What if I have a Cigna plan now?

Your Cigna medical coverage ends December 31, 2026. Shop on HealthCare.gov starting November 1 and enroll by December 15 for January 1 coverage so you don't have a gap.

Which insurers cover rural counties?

Blue Cross NC sells in all 100 counties. Ambetter, Cigna (2026 only), AmeriHealth, UnitedHealthcare and Oscar cover fewer counties. Check your ZIP on HealthCare.gov.

What if my income changes during the year?

Update your HealthCare.gov application when income changes. Starting with 2026 tax returns, there is no cap on paying back extra tax credit.

North Carolina · Open enrollment Nov 1 – Jan 15

North Carolina Marketplace Health Insurance: How to Choose a 2027 Plan

Updated October 7, 2026

Open enrollment for 2027 runs November 1, 2026 to January 15, 2027 on HealthCare.gov.

North Carolina had 6 Marketplace insurers and 206 plans for 2026. How many you can choose from depends on your county.

Prices are going up for 2027. North Carolina insurers filed increases of about 8.5% to 27% before tax credits. Compare again even if you like your plan.

Find my North Carolina planFree. See your price after tax credits.

What's different in North Carolina for 2027

Cigna ends individual medical plans on December 31, 2026. Five insurers remain on HealthCare.gov for 2027: Blue Cross NC, Ambetter, Oscar, UnitedHealthcare and AmeriHealth Caritas Next.
Filed averages run from 8.5% at Ambetter to 27.4% at UnitedHealthcare, before tax credits. Your net change depends on your tax credit.
Blue Cross and Blue Shield of NC is the only 2026 Marketplace insurer in all 100 counties. Other carriers cover selected metros and regions.
From January 1, 2027 many expansion adults need 80 hours a month of work or similar activity, or $580 a month in household earnings. Renewals move to every six months.

Charlotte skyline at dusk with the Bank of America tower and city lights reflecting on the water

Which metal level fits how you use care?

Metal levels set how you and the plan share costs. The network, not the metal level, decides which doctors you can see.

Lowest monthly price, from $420 at age 40 before tax credits. You pay more when you get care: the typical deductible is $7,000. 9 Bronze plans work with a health savings account (HSA).
Only Silver plans get extra savings on deductibles and copays for lower incomes. If you qualify, Silver can cost less to use than Gold. From $540 at age 40; typical deductible $5,500 before those savings.
Higher monthly price, from $558 at age 40, but a much lower typical deductible of $2,000. Often the better deal with several visits, a planned procedure or ongoing prescriptions.

North Carolina 2026 plans. Monthly premium for one person before tax credits, in the lowest-priced area of the state. Deductibles are for one person, in network. Also available: 0 catastrophic plans for people under 30.
Metal	Plans	From, age 40	Typical deductible	Deductible range
Bronze	Plans83	From, age 40$420	Typical deductible$7,000	Deductible range$0–$10,600
Silver	Plans74	From, age 40$540	Typical deductible$5,500	Deductible range$400–$7,000
Gold	Plans49	From, age 40$558	Typical deductible$2,000	Deductible range$0–$2,000

Which insurers sell in North Carolina?

Not every insurer sells in every county. Your ZIP code decides your choices.

2026 plans. Lowest monthly premium before tax credits, any metal level except catastrophic. CMS rating is the Marketplace Quality Rating System overall score. 2027 change is each insurer's average as proposed. Final 2027 rates are published when open enrollment starts. Cigna leaves after 2026. NC DOI still shows Initial 2027 filings, so rate changes are labeled proposed. Blue Cross NC is the only insurer sold in all 100 counties.
Insurer	Counties (2026)	Plans (2026)	Plan types	From (age 40)	CMS rating (2026)	2027 change
Blue Cross NC	Counties (2026)100 of 100	Plans (2026)117	Plan typesEPO, HMO, POS, PPO	From (age 40)$446	CMS rating (2026)4 of 5	2027 change+17.7% proposed
Ambetter	Counties (2026)63 of 100	Plans (2026)29	Plan typesHMO	From (age 40)$420	CMS rating (2026)3 of 5	2027 change+8.5% proposed
Oscar	Counties (2026)23 of 100	Plans (2026)22	Plan typesHMO	From (age 40)$449	CMS rating (2026)Not yet rated	2027 change+16.5% proposed
Cigna	Counties (2026)87 of 100	Plans (2026)17	Plan typesHMO	From (age 40)$548	CMS rating (2026)3 of 5	2027 changeLeaving after 2026
UnitedHealthcare	Counties (2026)37 of 100	Plans (2026)13	Plan typesHMO	From (age 40)$511	CMS rating (2026)3 of 5	2027 change+27.4% proposed
AmeriHealth Next	Counties (2026)41 of 100	Plans (2026)8	Plan typesHMO	From (age 40)$450	CMS rating (2026)2 of 5	2027 change+9.3% proposed

What would you pay after tax credits?

Answer a few questions about your household and your care. See plans for your county, check your doctors and prescriptions, and get a recommendation.

Find my North Carolina plan

North Carolina Marketplace questions

Enroll by December 15 for coverage that starts January 1; the last day to sign up is January 15. Outside open enrollment you need a qualifying life event, such as losing other coverage, moving, marrying or having a baby.
Not necessarily. The prices on this page are before tax credits. Tax credits depend on your household size and income, and they can lower the monthly premium a lot. The plan finder estimates your price after tax credits.
179 of North Carolina's 206 plans for 2026 are HMOs or EPOs, which only pay for in-network care except emergencies. Check that your doctors and hospital are in the plan's network before you enroll.
Compare before you let it renew. North Carolina insurers filed 2027 increases of about 8.5% to 27% before tax credits, and your plan or its network may change. Your new tax credit can change too.
North Carolina expanded Medicaid on December 1, 2023 for adults 19 to 64 with income at or below 138% of the poverty level. Apply at medicaid.ncdhhs.gov or through ePass / your local DSS. From January 1, 2027 many expansion adults face work reporting and six-month renewals.
On HealthCare.gov, through an approved insurer or broker website, or with a licensed agent. The plans and prices are the same everywhere you enroll.
Your Cigna medical coverage ends December 31, 2026. Shop on HealthCare.gov starting November 1 and enroll by December 15 for January 1 coverage so you don't have a gap.
Blue Cross NC sells in all 100 counties. Ambetter, Cigna (2026 only), AmeriHealth, UnitedHealthcare and Oscar cover fewer counties. Check your ZIP on HealthCare.gov.
Update your HealthCare.gov application when income changes. Starting with 2026 tax returns, there is no cap on paying back extra tax credit.

Where these numbers come from

2026 plans, premiums, deductibles, copays and out-of-pocket maximums: CMS QHP Landscape and Benefits and Cost Sharing Public Use Files, plan year 2026. Checked October 4, 2026.
Proposed 2027 changes: each insurer's rate filing (ratereview.healthcare.gov or the state insurance department).

NC DOI, Rate Information for Public Disclosure (2027 Initial), July 28, 2026
CMS statement on City of Columbus v. Kennedy open enrollment, August 4, 2026
HealthCare.gov, dates and deadlines, accessed October 7, 2026
NC Medicaid, Work and Community Engagement Requirement, accessed October 7, 2026
KFF, Tracking Insurer Participation Changes in the ACA Marketplaces in 2027, October 7, 2026
CMS Nationwide QRS PUF PY2026, October 2025
CMS QHP Landscape PY2026 (county counts, our tally), October 2025

Reviewed by Jacob Guidi, licensed health insurance agent (NPN 19902041), Thrive Benefits Group.

Thrive Benefits Group is not HealthCare.gov or a government agency. Premiums shown are before tax credits, for one person age 40, and most people who qualify for tax credits pay less. Your price depends on your county, age, household and income. Plan details can change; the insurer's plan documents are final.