North Carolina · Insurer
UnitedHealthcare Marketplace Plans in North Carolina
UnitedHealthcare sells non-gated Marketplace HMOs in 37 North Carolina counties, with about 23,000 individual members. Every plan name says No Referrals, and many include $0 virtual urgent care and $0 insulin. It filed the highest average 2027 increase among returning NC Marketplace 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.
What makes UnitedHealthcare different
All 13 UnitedHealthcare NC Marketplace HMOs say No Referrals. UHC's admin guide confirms specialists do not need a primary care referral for coverage.
2026 agent maps name Atrium, UNC Health, Cone, Cape Fear Valley and Novant New Hanover across Charlotte, Triad, Triangle, Fayetteville and Wilmington corridors.
Plan names lean on $0 Virtual Urgent Care, $0 Insulin, Copay Focus, Value and Advantage tiers, plus optional Dental + Vision variants.
UnitedHealthcare of NC filed a 27.4% Initial average, the largest among returning Marketplace carriers on the NC DOI table.
Is UnitedHealthcare a good fit?
A good fit if
- You live in one of UHC's 37 counties and want an HMO that does not require specialist referrals
- You already use Atrium, UNC Health, Cone, Cape Fear Valley or Novant New Hanover and want to confirm Exchange participation
- You want $0 virtual urgent care and $0 insulin designs in the plan name
Think twice if
- The filed 2027 average is about 27.4% before tax credits. Compare after-subsidy prices carefully.
- HMO: routine out-of-network care is not covered. Confirm the Individual Exchange network, not commercial UHC.
- Medical Care scored 2 of 5 stars for 2025 and 2026; member experience was not rated.
Good starting points
From its 13 2026 plans statewide, lowest price in any North Carolina rating area.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.
UnitedHealthcare plans and prices
All 2026 UnitedHealthcare plans in North Carolina
| Plan | Metal | Type | Premium (age 40) | Deductible | OOP max | Primary care | Specialist | Generic Rx | HSA | Counties |
|---|---|---|---|---|---|---|---|---|---|---|
| UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals | MetalBronze | TypeHMO | Premium (age 40)$511 | Deductible$10,600 | OOP max$10,600 | Primary care$0 after deductible | Specialist$0 after deductible | Generic Rx$0 after deductible | HSANo | Counties37 |
| UHC Bronze Standard (No Referrals) | MetalBronze | TypeHMO | Premium (age 40)$540 | Deductible$7,500 | OOP max$10,000 | Primary care$50 | Specialist$100 | Generic Rx$25 | HSANo | Counties37 |
| UHC Bronze Standard+ Dental + Vision (No Referrals) | MetalBronze | TypeHMO | Premium (age 40)$560 | Deductible$7,500 | OOP max$10,000 | Primary care$50 | Specialist$100 | Generic Rx$25 | HSANo | Counties37 |
| UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) | MetalBronze | TypeHMO | Premium (age 40)$561 | Deductible$0 | OOP max$10,600 | Primary care$55 | Specialist$115 | Generic Rx$20 | HSANo | Counties37 |
| UHC Silver Value ($0 Virtual Urgent Care, No Referrals) | MetalSilver | TypeHMO | Premium (age 40)$745 | Deductible$3,550 | OOP max$10,000 | Primary care$40 | Specialist$100 | Generic Rx$5 | HSANo | Counties37 |
| UHC Silver Standard (No Referrals) | MetalSilver | TypeHMO | Premium (age 40)$746 | Deductible$6,000 | OOP max$8,900 | Primary care$40 | Specialist$80 | Generic Rx$20 | HSANo | Counties37 |
| UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) | MetalSilver | TypeHMO | Premium (age 40)$755 | Deductible$2,500 | OOP max$10,150 | Primary care$30 | Specialist$100 | Generic Rx$3 | HSANo | Counties37 |
| UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) | MetalSilver | TypeHMO | Premium (age 40)$765 | Deductible$3,550 | OOP max$10,000 | Primary care$40 | Specialist$100 | Generic Rx$5 | HSANo | Counties37 |
| UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) | MetalSilver | TypeHMO | Premium (age 40)$775 | Deductible$2,500 | OOP max$10,150 | Primary care$30 | Specialist$100 | Generic Rx$3 | HSANo | Counties37 |
| UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) | MetalGold | TypeHMO | Premium (age 40)$826 | Deductible$0 | OOP max$10,600 | Primary care$20 | Specialist$60 | Generic Rx$5 | HSANo | Counties37 |
| UHC Gold Standard (No Referrals) | MetalGold | TypeHMO | Premium (age 40)$830 | Deductible$2,000 | OOP max$8,200 | Primary care$30 | Specialist$60 | Generic Rx$15 | HSANo | Counties37 |
| UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) | MetalGold | TypeHMO | Premium (age 40)$850 | Deductible$750 | OOP max$9,200 | Primary care$15 | Specialist$50 | Generic Rx$1 | HSANo | Counties37 |
| UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) | MetalGold | TypeHMO | Premium (age 40)$870 | Deductible$750 | OOP max$9,200 | Primary care$15 | Specialist$50 | Generic Rx$1 | HSANo | Counties37 |
Good to know
In February 2025, NC DOI fined UnitedHealthcare of North Carolina, Inc. and UnitedHealthcare Insurance Company a combined $3.4 million after a market-conduct exam on claims handling and balance-billing practices.
Other North Carolina Marketplace insurers
Sources
- NC DOI, 2027 Plan Year ACA Rate Filings (Initial), July 28, 2026
- NC DOI, Market Conduct Examination / UnitedHealthcare companies 2025, January 24, 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.