See your North Carolina health insurance coverage options.

To qualify for health coverage through the North Carolina Marketplace, you must:⁶

• Live in North Carolina
• Be lawfully present in the United States
• Not be incarcerated
• Not be enrolled in Medicare

Eligibility for financial assistance (premium subsidies and cost-sharing reductions) depends on your income and how it compares with the cost of the second-lowest-cost Silver plan in your area – which depends on your age and location. In addition, to qualify for financial assistance with your Marketplace plan you must:

• Not have access to affordable health coverage through your employer. If your employer offers coverage but you feel it’s too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace. 
• Not be eligible for Medicaid or CHIP, or premium-free Medicare Part A.

In North Carolina, the open enrollment period for individual/family health coverage runs from November 1 to January 15.⁷ (For 2024 coverage, the deadline has been extended to January 16, 2024, due to the federal holiday on January 15.)⁸

Your coverage will start on January 1 if you enroll before December 15. But if you apply between December 16 and January 16, your coverage will begin on February 1.⁹ 

Outside of open enrollment, a qualifying event is generally necessary to enroll or make changes to your coverage, although there are some people who can qualify for a special enrollment period without a specific qualifying life event.

If you have questions about open enrollment, you can learn more in our comprehensive guide to open enrollment. We also have a comprehensive guide to special enrollment periods.

If you’re eligible for an ACA Marketplace plan, there are several ways you can enroll: 

• Online through HealthCare.gov
• By phone at (800) 318-2596
• With local help in your community from an agent/broker, Navigator, or certified application counselors (these individuals are available to help you over the phone, online, and sometimes in-person, depending on your preference)
• Through an approved enhanced direct enrollment entity.¹⁰

North Carolina uses the federally run exchange for individual market plans, so residents who buy their own health insurance enroll through HealthCare.gov.

More than nine out of ten eligible enrollees save money on premium payments amounting to an average savings of $583/month. After subsidies were applied, the average enrollee’s monthly cost was about $67/month.¹¹ 

The Affordable Care Act provides income-based advance premium tax credits (subsidies) that offset your premium payments to help keep your expenses down. People with household incomes up to 250% of the federal poverty level also qualify for cost-sharing reductions (CSR) that may reduce your deductibles and out-of-pocket expenses when you buy a Silver plan. In 2023, more than half of North Carolina Marketplace enrollees were receiving CSR benefits.¹² 

Between the premium subsidies and cost-sharing reductions, you may find that an ACA plan is the most affordable and robust health insurance option for you.

Source: CMS.gov ¹³

Nine insurers offer exchange plans in North Carolina, with coverage areas that vary from one insurer to another.¹⁴

The federal Marketplace insurer participation map shows North Carolina having one fewer Marketplace insurer in 2024 than they had in 2023.¹⁵ However, based on an analysis of the Marketplace landscape files, that’s because Friday Health Plans participated in the Marketplace in 2023 and will not in 2024.¹⁶

However, all Friday Health Plans policies in North Carolina terminated at the end of August 2023, so people no longer have coverage under those plans as we head into the open enrollment period for 2024 coverage. All of the other insurers are continuing to offer coverage in the North Carolina Marketplace for 2024.

There are nine insurers offering plans in North Carolina’s marketplace for 2024. The following average rate changes have been approved for 2024:

Source: North Carolina Department of Insurance¹⁷

The overall average approved rate change represents a 1.3% reduction in individual market premiums for 2024.¹⁸

For perspective, here’s a summary of how average unsubsidized premiums have changed each year in North Carolina’s individual/family market:

• 2015: Average increase of 12%.¹⁹
• 2016: Average increase of 28.1%.²⁰
• 2017: Average increase of 24.3%.²¹
• 2018: Average increase of 14.8%.²²
• 2019: Average decrease of 3.9%²³
• 2020: Average decrease of 5.6%.²⁴
• 2021: Average preliminary increase of 4%.²⁵
• 2022: Average increase of 3.2%.²⁶
• 2023: Average increase of 7.93%²⁷

In North Carolina, 800,850 people enrolled in private individual market plans through the exchange for 2023 coverage.²⁸ This was by far a record high, and dwarfed the previous year’s record of a little more than 670,000 enrollees. 

This increase in enrollment is thanks to the American Rescue Plan (ARP). Under the ARP, ACA’s premium subsidies are larger and more widely available. The ARP’s subsidy enhancements have been extended through 2025 by the Inflation Reduction Act.²⁹

Source: 2014,³⁰ 2015,³¹ 2016,³² 2017,³³ 2018,³⁴ 2019,³⁵ 2020,³⁶ 2021,³⁷ 2022,³⁸ 2023²⁸  2023²⁸

HealthCare.gov
800-318-2596

State Exchange Profile: North Carolina
The Henry J. Kaiser Family Foundation overview of North Carolina’s progress toward creating a state health insurance exchange.

North Carolina Institute of Medicine (NCIOM)

Health Insurance Smart NC
Assists people insured by private health plans, Medicaid, or other plans in resolving problems pertaining to their health coverage; assists uninsured residents with access to care.
Toll free: 1-877-885-0231

Managed Care Patient Assistance Program
Serves consumers who are members of managed health benefit plans.
(919) 733-6272 / Toll-Free: 1-866-867-6272 (in North Carolina only)
[email protected]

Community Care of North Carolina

Legal Aid of North Carolina (855-733-3711)