Health insurance cost in North Carolina
If you're moving to North Carolina without job-based coverage, here's what a Marketplace plan costs before subsidies. North Carolina ranks #30 of 51 for the lowest benchmark premium.
Monthly premium by age
| Age | Benchmark silver | Cheapest bronze |
|---|---|---|
| 21 | $499 | $382 |
| 30 | $567 | $434 |
| 40 | $638 | $489 |
| 50 | $891 | $683 |
| 60 | $1,355 | $1,039 |
| 64 | $1,497 | $1,148 |
Scaled from the age-40 average with the federal default age curve, which lets insurers charge a 64-year-old up to 3× what a 21-year-old pays. Excludes tobacco surcharges.
The North Carolina benchmark rose 26% for 2026, in line with the 26% national increase, leaving it 2% above the U.S. average for a 40-year-old.
What is different in North Carolina
- Where to enroll
- HealthCare.gov
- Open enrollment for 2027
- Nov 1 – Jan 15
- Marketplace insurers, 2026
- 6
- Medicaid expansion
- Since Dec 2023
- Penalty if uninsured
- None
- Average paid after credits, 2026
- $180/mo
- Where and when. North Carolina uses HealthCare.gov, the federal marketplace. Open enrollment for 2027 coverage runs November 1, 2026 to January 15, 2027; pick a plan by December 15 for coverage that starts January 1.
- Choice of insurers. 6 insurers sell Marketplace plans in North Carolina for 2026, down from 8 in 2025. Not every insurer sells in every county, so your choices depend on where you live. 761,457 people picked a Marketplace plan here for 2026, down 22% from 2025, one of the five steepest drops in the country after the enhanced federal credits ran out.
- What enrollees paid. Enrollees here paid an average of $180 a month after tax credits for 2026, up 86% from the $97 they paid for 2025 (U.S. average: $178). Before credits, the plans they chose averaged $755.
- Medicaid. North Carolina expanded Medicaid in December 2023. Adults with income up to 138% of the federal poverty level can generally get Medicaid instead of a Marketplace plan. A state "trigger" law would end the expansion or force cost cuts if federal funding for it is reduced.
- Going uninsured. North Carolina doesn't charge a penalty for going without coverage, and the federal penalty ended after 2018. In 2024, 8.6% of residents had no health insurance (U.S.: 8.2%), and 6.9% bought their own coverage.
Subsidies in 2026
The enhanced premium tax credits of 2021–2025 expired, so 2026 follows the original ACA rules: credits are available for household incomes between 100% and 400% of the federal poverty level, and you're expected to pay between about 2.1% and 9.96% of income for the benchmark plan. Above 400% there's no federal credit. Check your price at HealthCare.gov.
Frequently asked questions
How much is health insurance in North Carolina in 2026?
The benchmark silver plan for a 40-year-old averages $638 a month before subsidies, and the cheapest bronze plan $489 (KFF analysis of CMS data). That's up 26% from 2025.
How much does health insurance cost for a 60-year-old in North Carolina?
About $1,355 a month for the benchmark silver plan before subsidies, using the federal default age curve.
Did North Carolina expand Medicaid?
North Carolina expanded Medicaid in December 2023. Adults with income up to 138% of the federal poverty level can generally get Medicaid instead of a Marketplace plan. A state "trigger" law would end the expansion or force cost cuts if federal funding for it is reduced.