Quick answer
In 2026, the benchmark silver Marketplace plan in North Carolina averaged $638 a month for a 40-year-old before subsidies, slightly above the U.S. average of $625. Prices rise with age, from about $499 a month at 21 to $1,355 at 60. Most enrollees get a tax credit that lowers the cost. For 2027, insurers proposed an average increase of about 15%, and Cigna is leaving North Carolina’s Marketplace.
Key takeaways
- North Carolina’s 2026 benchmark premium for a 40-year-old was about $13 above the national average.
- About 761,000 North Carolinians picked a plan for 2026, down 22% from 2025, and 87% got a premium tax credit.
- Insurers proposed an average increase of about 14.9% for 2027, after an average 28.6% increase for 2026.
- Cigna is leaving North Carolina’s Marketplace for 2027.
- North Carolina expanded Medicaid in December 2023. Work requirements and six-month renewals start in 2027.
On this page
What a North Carolina Marketplace plan costs before subsidies
| Age | Benchmark silver plan, per month (2026 estimate) |
|---|---|
| 21 | $499 |
| 30 | $567 |
| 40 | $638 |
| 50 | $892 |
| 60 | $1,355 |
| 64 | $1,498 |
| Child under 15 | $382 |
A family of four with two 40-year-old parents and two young children would pay about $2,040 a month for benchmark plans before subsidies.
What you’d pay after a tax credit
If your household income is between 100% and 400% of the federal poverty level, a premium tax credit caps what you pay for the benchmark plan at a share of your income. A single 40-year-old in North Carolina earning $40,000 would pay about $287 a month for the benchmark plan in 2026, with a tax credit of about $351. For 2027, the same person’s share would be about $289 a month. Above 400% of the poverty level ($62,600 for one person for 2026 coverage, $63,840 for 2027), you’d pay full price.
Costs beyond the premium
What you pay when you get care depends on your plan’s deductible, copays and coinsurance, up to the out-of-pocket maximum of $10,600 for one person in 2026 ($12,000 in 2027). If your income is under 250% of the poverty level, a silver plan’s cost-sharing reductions lower those costs.
North Carolina Marketplace facts
- Marketplace: HealthCare.gov.
- Enrollment: 761,457 plan selections for 2026, down from 975,110 in 2025. Enrollees paid an average of $180 a month after tax credits.
- Insurers: Six in 2026: Ambetter, AmeriHealth Caritas, Blue Cross and Blue Shield of North Carolina, Cigna, Oscar and UnitedHealthcare. Cigna is leaving the state’s individual market for 2027. If you’re a Cigna member, see what to do if your insurance company leaves the Marketplace.
- 2027 prices: Insurers proposed increases averaging about 14.9%, including 17.7% for Blue Cross NC, 18.0% for Oscar and 8.5% for Ambetter. Final rates hadn’t been released as of late September 2026.
- Medicaid: North Carolina expanded Medicaid on December 1, 2023, covering adults with incomes up to 138% of the poverty level, and about 740,000 people are in the expansion group. Starting January 1, 2027, most expansion adults will have to earn at least $580 a month or spend 80 hours a month working, in school or volunteering, and renew every six months. State law would end the expansion if federal funding dropped below 90%. See Medicaid work requirements.
- State help: North Carolina doesn’t offer its own premium subsidy.
When to enroll
Open enrollment for 2027 coverage runs from November 1, 2026 to January 15, 2027. Sign up by December 15 for coverage that starts January 1. For ways to keep your bill down, see how to lower your Marketplace premium.
Other options in North Carolina
- Job-based coverage, usually the cheapest route if it’s offered.
- Medicaid for adults and children who qualify; see health insurance for low-income families.
- Medicare at 65.
Health insurance costs in other states: Arizona, California, Florida, Georgia, Illinois, Michigan, New Jersey, New York, Ohio, Pennsylvania, Texas, Virginia and Washington.
See 2027 plans and prices in your North Carolina county: compare quotes by ZIP code.
Frequently asked questions
What’s the average cost of health insurance in North Carolina?
Before subsidies, the 2026 benchmark silver plan for a 40-year-old averaged $638 a month. After tax credits, enrollees paid an average of $180 a month in 2026.
Is Cigna leaving North Carolina?
Yes. Cigna is discontinuing its individual health plans in North Carolina starting January 1, 2027. Members need to choose a new plan during open enrollment.
When is open enrollment for 2027 in North Carolina?
November 1, 2026 to January 15, 2027 on HealthCare.gov. Sign up by December 15 for coverage starting January 1.
Sources
This article is general information, not insurance or tax advice. Prices are averages and estimates; your actual premium depends on your county, age, income and plan. Last reviewed September 2026.