North Carolina
Cheapest ACA plans in North Carolina for 2026
Cheapest Bronze plan in North Carolina, before subsidies: Ambetter of North Carolina Everyday Bronze with Atrium Health in Davidson County at $420/month for a 40-year-old; Ambetter of North Carolina Everyday Bronze with Atrium Health in Davidson County at $1,343/month for a family of four (two 40-year-olds and two kids under 14). North Carolina participates in Healthcare.gov, expanded Medicaid in December 2023 via HB 76 (one of the most recent expansion states), and relies on federal APTC with no state premium subsidy.
Cheapest plans by metal tier
Lowest 2026 monthly premium for a single 40-year-old, on-exchange, before any subsidy. Per-age figures derived from the CMS QHP Landscape file using the HHS standardized age-rating curve (45 CFR 147.102).
| Tier | Cheapest age 40 monthly | Plans statewide |
|---|---|---|
| Expanded Bronze | $420 | 1,899 |
| Bronze | $450 | 78 |
| Silver | $540 | 1,748 |
| Gold | $558 | 1,134 |
The actual cheapest plan in major counties
Same data the search returns: carrier, plan name, monthly premium, individual deductible, individual MOOP. Computed for a single 40-year-old, before any subsidy. Catastrophic plans excluded because adults 30+ typically need a hardship-exemption certificate to enroll.
Mecklenburg County
$447/moBlue Cross and Blue Shield of NC · Blue Home Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | with Novant Health
Wake County
$446/moBlue Cross and Blue Shield of NC · Blue Home Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | with UNC Health Alliance
Guilford County
$422/moAmbetter of North Carolina · Everyday Bronze with Atrium Health
Forsyth County
$420/moAmbetter of North Carolina · Everyday Bronze with Atrium Health
Cumberland County
$505/moAmbetter of North Carolina · Everyday Bronze
Durham County
$460/moBlue Cross and Blue Shield of NC · Blue Home Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | with UNC Health Alliance
The actual cheapest plan for a family of four
Two 40-year-old adults and two kids in the 0-14 age band, before any subsidy. Carrier, plan name, premium, deductible, and MOOP exactly as the search would return them.
Mecklenburg County
$1,429/moBlue Cross and Blue Shield of NC · Blue Home Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | with Novant Health
Wake County
$1,425/moBlue Cross and Blue Shield of NC · Blue Home Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | with UNC Health Alliance
Guilford County
$1,349/moAmbetter of North Carolina · Everyday Bronze with Atrium Health
Forsyth County
$1,343/moAmbetter of North Carolina · Everyday Bronze with Atrium Health
Cumberland County
$1,614/moAmbetter of North Carolina · Everyday Bronze
Durham County
$1,470/moBlue Cross and Blue Shield of NC · Blue Home Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | with UNC Health Alliance
Subsidies: federal APTC only (no state premium subsidy)
North Carolina does not fund a supplemental state premium subsidy or §1332 reinsurance waiver. Marketplace financial help is federal only:
- Federal Advance Premium Tax Credit (APTC). Households 100-400% FPL on the PY2026 standard ACA contribution curve, applied through Healthcare.gov. The ARPA / IRA enhanced subsidies expired 2025-12-31 and are not in effect for 2026, so the hard 400% FPL cliff is back and subsidized net premiums are meaningfully higher than PY2025 for most enrollees.
- Federal cost-sharing reductions (CSRs). Households 100-250% FPL enrolled in a Silver plan receive reduced deductibles, copays, and out-of-pocket maximums automatically.
North Carolina expanded Medicaid effective December 1, 2023, under House Bill 76, a bipartisan deal tied to certificate-of-need reform signed by Gov. Roy Cooper. Adults 19-64 up to 138% FPL qualify regardless of parental status or disability. Roughly 600,000 residents have been added to Medicaid through the expansion rollout.
Catastrophic plans in North Carolina follow federal rules
North Carolina follows the federal ACA default: Catastrophic plans are available to enrollees under age 30, or at any age with a hardship / affordability exemption. The PY2026 federal auto-expansion applies: adults 30+ automatically qualify when the lowest-cost Bronze plan exceeds the affordability threshold. APTC does not apply to Catastrophic plans.
Tobacco surcharges follow the federal 1.5x default in North Carolina
North Carolina applies the federal ACA default (45 CFR 147.102): carriers may charge tobacco users up to 50% more than non-users (a 1.5-to-1 rate ratio). The NC Department of Insurance reviews rate filings under NC Gen. Stat. Chapter 58. No NC-specific cap below the federal 1.5x ceiling has been identified. Federal APTC does not offset the tobacco portion.
Carriers selling 2026 plans in North Carolina
6 carriers sell 2026 plans on Healthcare.gov. 7,052 plans across 100 counties. BlueCross BlueShield of North Carolina carries the statewide individual market across all 100 counties and is often the only on-exchange carrier in rural counties. Cigna Healthcare (91 counties), Ambetter (Celtic, 73 counties), UnitedHealthcare (61 counties), Oscar (46 counties), and AmeriHealth Caritas Next (45 counties) compete primarily in the Charlotte, Raleigh-Durham, Greensboro, and Winston-Salem metros. North Carolina is the largest Healthcare.gov state by Marketplace enrollment, with roughly one million or more enrollees.
| Carrier | On-exchange plans | Counties |
|---|---|---|
| BlueCross BlueShield of North Carolina | 2,034 | 100 |
| Ambetter | 929 | 63 |
| Cigna | 831 | 91 |
| UnitedHealthcare | 481 | 61 |
| AmeriHealth Caritas Next | 328 | 41 |
| Oscar | 256 | 23 |
Enrollment
Open Enrollment for 2026 coverage runs November 1, 2025 through January 15, 2026. Enroll by December 15 for a January 1 effective date; December 16 through January 15 takes effect February 1. Special Enrollment is available year-round for qualifying life events.
Direct enrollment: healthcare.gov.
Frequently asked questions
What is the cheapest ACA plan in North Carolina for 2026?
The cheapest Bronze-tier plan a 40-year-old can enroll in without paperwork is Ambetter of North Carolina Everyday Bronze with Atrium Health in Davidson County at $420 per month before subsidies. Data refreshed 2026-04-19T08:08:55.462Z.
Does North Carolina use Healthcare.gov?
Yes. North Carolina participates in the federally-facilitated Marketplace (FFM) and is in fact the largest Healthcare.gov state by Marketplace enrollment, with roughly one million or more enrollees. Enrollment and subsidy applications run through healthcare.gov.
Has North Carolina expanded Medicaid?
Yes, effective December 1, 2023. House Bill 76 was a bipartisan deal signed by Gov. Roy Cooper earlier in 2023 that tied expansion to certificate-of-need reforms. Adults 19-64 up to 138% FPL qualify; roughly 600,000 residents have been added to Medicaid rolls since implementation.
What was North Carolina House Bill 76?
HB 76 was the 2023 bipartisan legislation that authorized Medicaid expansion in North Carolina as part of a broader deal that included reforms to the state's certificate-of-need hospital regulations. Implementation began December 1, 2023, making NC one of the most recent expansion states.
Why are so many NC counties only offering Blue Cross plans?
Blue Cross Blue Shield of North Carolina has historically held a dominant share of the NC individual market, and in many rural counties BCBSNC is the only on-exchange carrier. Ambetter, Cigna, UnitedHealthcare, and Oscar compete in the major metros (Charlotte, Raleigh-Durham, Greensboro, Winston-Salem).
Does North Carolina have a state premium subsidy or reinsurance program?
No. North Carolina does not fund a state premium subsidy or §1332 reinsurance waiver. Marketplace help is federal APTC and CSRs only, and the ARPA/IRA enhanced credits expired at the end of 2025.
Compare North Carolina with other states
- Virginia (shares a border)
- South Carolina (shares a border)
- Georgia (shares a border)
- See all 51 jurisdictions side by side
Browse county pages in North Carolina
County-level pricing pages with the cheapest plan in each county.
Browse city pages in North Carolina
City-level pricing pages for major North Carolina cities.
Carriers in North Carolina
Per-carrier 2026 pricing pages with the cheapest plan from each carrier.
Sources
- HealthCare.gov for enrollment, OEP dates, and federal APTC / CSR application.
- North Carolina Department of Insurance for rate review, carrier filings, and consumer guidance.
- NC Department of Health and Human Services: Medicaid Expansion for NC Medicaid expansion eligibility and enrollment.
- KFF: North Carolina State Health Facts for Medicaid expansion, enrollment, and benchmark premium context.
- CMS 2026 OEP National Snapshot for federal Marketplace enrollment context.
- CMS QHP Landscape Individual Medical 2026 for plan availability, premiums, and metal tiers.
Plan year 2026, last refreshed 2026-04-19T08:08:55.462Z. Full pricing pipeline + regulatory references at methodology; ACA terminology in the glossary.