North Carolina · Insurer
Ambetter Marketplace Plans in North Carolina
Ambetter of North Carolina is Centene's Marketplace HMO, with about 182,000 individual members and plans in 63 counties. It filed the lowest average 2027 increase among North Carolina's returning HealthCare.gov insurers.
- Proposed changes are as filed. Final 2027 rates are published when open enrollment starts.
Compare plans for my ZIP codeFree. See your price after tax credits.
63 of 100North Carolina counties (2026)
HMOPlan type
3 of 5CMS quality rating (2026)
+8.5%Proposed 2027 change
What makes Ambetter different
About 182,000 projected members and a filed 2027 average of 8.5%, the smallest request among NC's larger Marketplace filers.
Many Ambetter NC plans carry a with Atrium Health label. Atrium markets doctors, urgent care and hospitals as in-network for Ambetter members.
CMS rated Ambetter 3 of 5 overall for 2026, with 5 stars for member experience and plan administration.
Clear Silver with $0 Insulin Options covers preferred insulin and select mental health medications at $0 on the marketed design.
Is Ambetter a good fit?
A good fit if
- You live in one of Ambetter's 63 counties and want a Centene HMO with Atrium Health access
- You want the lowest filed average 2027 increase among North Carolina's large Marketplace insurers
- You manage diabetes and want to compare Clear Silver $0 insulin designs
Think twice if
- Ambetter is not sold statewide. Confirm your county on the coverage map before you shop on price.
- Closed-panel HMO: non-emergency out-of-network care is generally not covered.
- Medical Care scored 2 of 5 stars even while member experience and administration scored 5.
Good starting points
From its 29 2026 plans statewide, lowest price in any North Carolina rating area.Everyday Bronze with Atrium Health$420/monthLowest monthly premium
Elite Bronze with Atrium Health$477/monthLowest deductible, $0
Complete Gold with Atrium Health$584/month$15 primary care visits before the deductible
Clear Silver with $0 Insulin Options$596/monthDesigned for a specific health need
2027 plan-by-plan prices and copays appear here once HealthCare.gov publishes them on November 1.
See my price after tax creditsCompare every insurer in your county and check your doctors.
Ambetter plans and prices
All 2026 Ambetter plans in North Carolina
| Plan | Metal | Type | Premium (age 40) | Deductible | OOP max | Primary care | Specialist | Generic Rx | HSA | Counties |
|---|---|---|---|---|---|---|---|---|---|---|
| Everyday Bronze with Atrium Health | MetalBronze | TypeHMO | Premium (age 40)$420 | Deductible$8,450 | OOP max$10,150 | Primary care$40 | Specialist$90 | Generic Rx$3 | HSANo | Counties16 |
| Standard Expanded Bronze with Atrium Health | MetalBronze | TypeHMO | Premium (age 40)$422 | Deductible$7,500 | OOP max$10,000 | Primary care$50 | Specialist$100 | Generic Rx$25 | HSANo | Counties16 |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | MetalBronze | TypeHMO | Premium (age 40)$434 | Deductible$8,450 | OOP max$10,150 | Primary care$40 | Specialist$90 | Generic Rx$3 | HSANo | Counties16 |
| Standard Expanded Bronze with Atrium Health + Vision + Adult Dental | MetalBronze | TypeHMO | Premium (age 40)$436 | Deductible$7,500 | OOP max$10,000 | Primary care$50 | Specialist$100 | Generic Rx$25 | HSANo | Counties16 |
| Everyday Bronze | MetalBronze | TypeHMO | Premium (age 40)$463 | Deductible$8,450 | OOP max$10,150 | Primary care$40 | Specialist$90 | Generic Rx$3 | HSANo | Counties47 |
| Standard Expanded Bronze | MetalBronze | TypeHMO | Premium (age 40)$465 | Deductible$7,500 | OOP max$10,000 | Primary care$50 | Specialist$100 | Generic Rx$25 | HSANo | Counties47 |
| Elite Bronze with Atrium Health | MetalBronze | TypeHMO | Premium (age 40)$477 | Deductible$0 | OOP max$10,500 | Primary care$60 | Specialist$120 | Generic Rx$3 | HSANo | Counties16 |
| Everyday Bronze + Vision + Adult Dental | MetalBronze | TypeHMO | Premium (age 40)$479 | Deductible$8,450 | OOP max$10,150 | Primary care$40 | Specialist$90 | Generic Rx$3 | HSANo | Counties47 |
| Standard Expanded Bronze + Vision + Adult Dental | MetalBronze | TypeHMO | Premium (age 40)$481 | Deductible$7,500 | OOP max$10,000 | Primary care$50 | Specialist$100 | Generic Rx$25 | HSANo | Counties47 |
| Elite Bronze with Atrium Health + Vision + Adult Dental | MetalBronze | TypeHMO | Premium (age 40)$493 | Deductible$0 | OOP max$10,500 | Primary care$60 | Specialist$120 | Generic Rx$3 | HSANo | Counties16 |
| Elite Bronze | MetalBronze | TypeHMO | Premium (age 40)$527 | Deductible$0 | OOP max$10,500 | Primary care$60 | Specialist$120 | Generic Rx$3 | HSANo | Counties47 |
| Elite Bronze + Vision + Adult Dental | MetalBronze | TypeHMO | Premium (age 40)$544 | Deductible$0 | OOP max$10,500 | Primary care$60 | Specialist$120 | Generic Rx$3 | HSANo | Counties47 |
| Standard Silver with Atrium Health | MetalSilver | TypeHMO | Premium (age 40)$540 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties16 |
| Focused Silver with Atrium Health | MetalSilver | TypeHMO | Premium (age 40)$546 | Deductible$6,300 | OOP max$8,400 | Primary care$40 | Specialist$85 | Generic Rx$3 | HSANo | Counties16 |
| Standard Silver with Atrium Health + Vision + Adult Dental | MetalSilver | TypeHMO | Premium (age 40)$558 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties16 |
| Focused Silver with Atrium Health + Vision + Adult Dental | MetalSilver | TypeHMO | Premium (age 40)$564 | Deductible$6,300 | OOP max$8,400 | Primary care$40 | Specialist$85 | Generic Rx$3 | HSANo | Counties16 |
| Clear Silver with $0 Insulin Options | MetalSilver | TypeHMO | Premium (age 40)$596 | Deductible$7,000 | OOP max$7,000 | Primary care$50 | Specialist$100 | Generic Rx$0 after deductible | HSANo | Counties47 |
| Standard Silver | MetalSilver | TypeHMO | Premium (age 40)$596 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties47 |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options | MetalSilver | TypeHMO | Premium (age 40)$611 | Deductible$5,900 | OOP max$8,150 | Primary care$40 | Specialist$60 | Generic Rx$3 | HSANo | Counties47 |
| Standard Silver + Vision + Adult Dental | MetalSilver | TypeHMO | Premium (age 40)$616 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties47 |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental | MetalSilver | TypeHMO | Premium (age 40)$632 | Deductible$5,900 | OOP max$8,150 | Primary care$40 | Specialist$60 | Generic Rx$3 | HSANo | Counties47 |
| Standard Gold with Atrium Health | MetalGold | TypeHMO | Premium (age 40)$558 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties16 |
| Standard Gold with Atrium Health + Vision + Adult Dental | MetalGold | TypeHMO | Premium (age 40)$577 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties16 |
| Complete Gold with Atrium Health | MetalGold | TypeHMO | Premium (age 40)$584 | Deductible$1,450 | OOP max$7,500 | Primary care$15 | Specialist$35 | Generic Rx$3 | HSANo | Counties16 |
| Complete Gold with Atrium Health + Vision + Adult Dental | MetalGold | TypeHMO | Premium (age 40)$603 | Deductible$1,450 | OOP max$7,500 | Primary care$15 | Specialist$35 | Generic Rx$3 | HSANo | Counties16 |
| Standard Gold | MetalGold | TypeHMO | Premium (age 40)$616 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties47 |
| Standard Gold + Vision + Adult Dental | MetalGold | TypeHMO | Premium (age 40)$637 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties47 |
| Complete Gold | MetalGold | TypeHMO | Premium (age 40)$644 | Deductible$1,450 | OOP max$7,500 | Primary care$15 | Specialist$35 | Generic Rx$3 | HSANo | Counties47 |
| Complete Gold + Vision + Adult Dental | MetalGold | TypeHMO | Premium (age 40)$666 | Deductible$1,450 | OOP max$7,500 | Primary care$15 | Specialist$35 | Generic Rx$3 | HSANo | Counties47 |
Good to know
NC DOI's February 2025 market-conduct examination of Ambetter of North Carolina Inc. directed corrective action on utilization-management timing, credentialing documentation, denied-claims handling and grievance deadlines.
Other North Carolina Marketplace insurers
Sources
- NC DOI, 2027 Plan Year ACA Rate Filings (Initial), July 28, 2026
- Ambetter of North Carolina, coverage map, accessed October 7, 2026
- NC DOI, Report on Market Conduct Examination of Ambetter of North Carolina, Inc., February 28, 2025
- CMS Nationwide QRS PUF PY2026, October 2025
- CMS State-based Exchange Public Use Files, plan year 2026, checked October 4, 2026
← North Carolina Marketplace guide and all insurers
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.