North Carolina ACA Marketplace at a glance
| North Carolina | |
|---|---|
| Marketplace | HealthCare.gov (federal Marketplace) |
| Open enrollment (2027 coverage) | November 1, 2026 to January 15, 2027 — source |
| Medicaid expansion | Yes — details |
| Enhanced federal tax credits | The enhanced federal premium tax credits expired at the end of 2025 and have not been extended. (KFF, October 2026) |
Facts verified from the sources linked above as of October 2026. Dates and rules can change; confirm on the official Marketplace site before you act.
Help with the cost of coverage in North Carolina
Premium tax credits lower your monthly Marketplace premium based on your household income and the cost of local plans. The enhanced federal credits that applied through 2025 have expired, so many households pay more than before. To know your number, run it with your real income. Our subsidy guide explains what happens if your income changes during the year.
Medicaid in North Carolina
North Carolina has expanded Medicaid for adults age 19 to 64. NC Medicaid’s 2025 limit was $1,800 a month for a single adult, and limits are updated each year. North Carolina has said most expansion adults will need to meet work requirements starting January 1, 2027, with exemptions. Whether you qualify depends on your household and income, so we check Medicaid and Marketplace eligibility together before you pick a plan.
Plan choices and networks in North Carolina
Marketplace plans come in bronze, silver, gold and platinum levels, and networks differ by insurer and by where you live. Compare the metal tiers, check that your doctors and hospitals are in network, and look at the deductible and out-of-pocket maximum, not just the premium.
Business owners and self-employed in North Carolina
If you run a business, you may have better options than the individual Marketplace. See ICHRA (an employer allowance for employees’ individual plans), group health and SHOP, and self-employed health insurance.
ACA help by county in North Carolina
Marketplace plans and prices are set by area, so they can differ across North Carolina. Here are the 10 largest counties. See all of them in our North Carolina directory.
- Wake County
- Mecklenburg County
- Guilford County
- Forsyth County
- Buncombe County
- Brunswick County
- Durham County
- New Hanover County
- Cumberland County
- Gaston County
Official North Carolina resources
- HealthCare.gov: the official North Carolina Marketplace for 2027 coverage.
- HealthCare.gov: federal Marketplace information.
- North Carolina Medicaid: eligibility and how to apply.
- North Carolina Department of Insurance: North Carolina’s insurance regulator, including agent license lookup.
Helpful guides
- ACA open enrollment deadline: can I sign up late?
- Can I keep my ACA subsidy if my income changes?
- Bronze vs. silver vs. gold ACA plans
- HMO vs. PPO vs. EPO
- Deductible vs. out-of-pocket maximum
- How much does health insurance cost without a job?
Let’s check your North Carolina options together
We run your income through the subsidy rules and compare plans for your doctors. No cost, no pressure.
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