North Carolina ACA Health Insurance
100 counties, 6 issuers, 206 plans
ACA marketplace coverage in North Carolina averages $609/mo for a 27-year-old across 100 counties and 6 issuers, before subsidies. Where you live matters most: Cabarrus is the cheapest county at $565/mo Silver, while Edgecombe is the priciest at $766/mo.
Premium Range
Premiums in North Carolina range from $345/mo to $1,103/mo (age 27 base rate).
Reading the North Carolina Marketplace
The ACA marketplace in North Carolina lists 206 plans from 6 issuers spread across 100 counties. The statewide average premium is $609/mo for a 27-year-old, $743/mo at age 40, and $1,577/mo at age 60, reflecting the ACA's 3-to-1 age rating band. Individual plan premiums run from $345 at the low end to $1,103 at the high end, before subsidies.
Geography drives most of the within-state variation: Edgecombe posts the highest Silver average at $766/mo, while Cabarrus sits at $565/mo, a gap shaped by local issuer competition, hospital pricing, and risk-pool composition rather than benefit differences, since every marketplace plan must cover the same 10 essential health benefits. The statewide average annual deductible is $4,840, the amount most enrollees must pay before non-preventive coverage begins.
Premium tax credits (APTCs) further reduce what most enrollees pay out of pocket, with the size of the subsidy keyed to each county's benchmark (second-lowest Silver) premium. This page is informational only and is not insurance, medical, or tax advice, confirm your exact plan options, network providers, and subsidy eligibility at HealthCare.gov before enrolling. Source: CMS Marketplace Public Use Files.
Top 5 most-expensive counties - North Carolina (Silver avg)
Source: CMS Health Insurance Marketplace Public Use Files (Plan Year 2026) North Carolina ACA marketplace premiums by county and metal tier (Plan Year 2026) · 2026 CMS publishes the Marketplace Public Use Files annually, covering the federal exchange and participating state-based exchanges. Premiums shown are pre-subsidy and reflect age-27 Silver averages.
Most Expensive Counties
| # | County | Silver Avg | Plans | Issuers |
|---|---|---|---|---|
| 1 | Edgecombe | $766/mo | 28 | 2 |
| 2 | Greene | $766/mo | 28 | 2 |
| 3 | Pitt | $766/mo | 28 | 2 |
| 4 | Wayne | $766/mo | 28 | 2 |
| 5 | Wilson | $766/mo | 28 | 2 |
Most Affordable Counties
| # | County | Silver Avg | Plans | Issuers |
|---|---|---|---|---|
| 1 | Cabarrus | $565/mo | 68 | 4 |
| 2 | Union | $565/mo | 68 | 4 |
| 3 | Anson | $572/mo | 62 | 4 |
| 4 | Stanly | $574/mo | 52 | 3 |
| 5 | Franklin | $586/mo | 44 | 4 |
All Counties in North Carolina
| County | Silver Avg | Bronze Avg | Gold Avg | Plans | Issuers | YoY |
|---|---|---|---|---|---|---|
| Alamance | $629 | $461 | $694 | 45 | 5 | +25.9% |
| Alexander | $624 | $447 | $663 | 63 | 4 | +25.9% |
| Alleghany | $629 | $457 | $652 | 41 | 3 | +21.6% |
| Anson | $572 | N/A | $634 | 62 | 4 | +25.9% |
| Ashe | $663 | $457 | $689 | 26 | 2 | +18.6% |
| Avery | $696 | $452 | $731 | 51 | 4 | +26.4% |
| Beaufort | $731 | N/A | $797 | 28 | 2 | +22.5% |
| Bertie | $703 | N/A | $768 | 28 | 2 | +17.4% |
| Bladen | $657 | $435 | $705 | 56 | 4 | +37.0% |
| Brunswick | $687 | $487 | $736 | 65 | 4 | +31.7% |
| Buncombe | $697 | $452 | $733 | 59 | 5 | +27.2% |
| Burke | $624 | $447 | $663 | 63 | 4 | +22.6% |
| Cabarrus | $565 | N/A | $617 | 68 | 4 | +25.6% |
| Caldwell | $624 | $447 | $663 | 63 | 4 | +25.9% |
| Camden | $703 | N/A | $768 | 28 | 2 | +17.4% |
| Carteret | $731 | N/A | $797 | 28 | 2 | +22.5% |
| Caswell | $600 | $452 | $610 | 39 | 4 | +17.4% |
| Catawba | $624 | $447 | $663 | 63 | 4 | +22.6% |
| Chatham | $659 | N/A | $675 | 16 | 2 | +19.3% |
| Cherokee | $736 | $452 | $787 | 36 | 3 | +27.7% |
| Chowan | $703 | N/A | $768 | 28 | 2 | +17.4% |
| Clay | $696 | $452 | $731 | 51 | 4 | +26.4% |
| Cleveland | $604 | N/A | $649 | 64 | 3 | +25.3% |
| Columbus | $687 | $487 | $736 | 65 | 4 | +31.7% |
| Craven | $731 | N/A | $797 | 28 | 2 | +22.5% |
| Cumberland | $657 | $435 | $705 | 56 | 4 | +37.0% |
| Currituck | $703 | N/A | $768 | 28 | 2 | +17.4% |
| Dare | $731 | N/A | $797 | 28 | 2 | +22.5% |
| Davidson | $587 | $444 | $638 | 89 | 6 | +28.1% |
| Davie | $589 | $444 | $644 | 83 | 6 | +28.0% |
| Duplin | $717 | $487 | $780 | 50 | 3 | +30.2% |
| Durham | $600 | N/A | $606 | 31 | 3 | +13.2% |
| Edgecombe | $766 | N/A | $831 | 28 | 2 | +29.3% |
| Forsyth | $587 | $444 | $638 | 89 | 6 | +28.1% |
| Franklin | $586 | $419 | $624 | 44 | 4 | +23.4% |
| Gaston | $629 | N/A | $662 | 60 | 3 | +27.0% |
| Gates | $703 | N/A | $768 | 28 | 2 | +17.4% |
| Graham | $696 | $452 | $731 | 51 | 4 | +26.4% |
| Granville | $668 | $452 | $685 | 48 | 4 | +24.9% |
| Greene | $766 | N/A | $831 | 28 | 2 | +29.3% |
| Guilford | $588 | $452 | $636 | 83 | 6 | +27.9% |
| Halifax | $703 | N/A | $768 | 28 | 2 | +17.4% |
| Harnett | $657 | $435 | $705 | 56 | 4 | +37.0% |
| Haywood | $702 | $471 | $750 | 64 | 5 | +29.1% |
| Henderson | $728 | $471 | $791 | 57 | 5 | +29.6% |
| Hertford | $703 | N/A | $768 | 28 | 2 | +17.4% |
| Hoke | $657 | $435 | $705 | 56 | 4 | +37.0% |
| Hyde | $731 | N/A | $797 | 28 | 2 | +19.0% |
| Iredell | $624 | $447 | $663 | 63 | 4 | +25.9% |
| Jackson | $702 | $471 | $750 | 64 | 5 | +29.1% |
| Johnston | $586 | $419 | $624 | 44 | 4 | +23.4% |
| Jones | $731 | N/A | $797 | 28 | 2 | +19.0% |
| Lee | $600 | N/A | $606 | 31 | 3 | +13.2% |
| Lenoir | $731 | N/A | $797 | 28 | 2 | +19.0% |
| Lincoln | $604 | N/A | $649 | 64 | 3 | +25.6% |
| Macon | $696 | $452 | $731 | 51 | 4 | +26.9% |
| Madison | $697 | $452 | $733 | 59 | 5 | +27.2% |
| Martin | $703 | N/A | $768 | 28 | 2 | +16.1% |
| McDowell | $697 | $452 | $733 | 59 | 5 | +27.2% |
| Mecklenburg | $599 | $518 | $667 | 81 | 5 | +30.9% |
| Mitchell | $697 | $452 | $733 | 59 | 5 | +27.2% |
| Montgomery | $682 | N/A | $729 | 43 | 3 | +30.4% |
| Moore | $682 | N/A | $729 | 43 | 3 | +30.4% |
| Nash | $719 | N/A | $769 | 37 | 2 | +27.1% |
| New Hanover | $687 | $487 | $736 | 65 | 4 | +31.7% |
| Northampton | $703 | N/A | $768 | 28 | 2 | +16.1% |
| Onslow | $716 | N/A | $769 | 37 | 2 | +26.2% |
| Orange | $630 | $470 | $668 | 44 | 4 | +19.8% |
| Pamlico | $731 | N/A | $797 | 28 | 2 | +19.0% |
| Pasquotank | $703 | N/A | $768 | 28 | 2 | +17.4% |
| Pender | $687 | $487 | $736 | 65 | 4 | +31.7% |
| Perquimans | $703 | N/A | $768 | 28 | 2 | +17.4% |
| Person | $600 | $452 | $610 | 39 | 4 | +17.4% |
| Pitt | $766 | N/A | $831 | 28 | 2 | +29.3% |
| Polk | $697 | $452 | $733 | 59 | 5 | +27.2% |
| Randolph | $603 | $452 | $642 | 75 | 5 | +27.9% |
| Richmond | $657 | $435 | $705 | 56 | 4 | +35.6% |
| Robeson | $657 | $435 | $705 | 56 | 4 | +35.6% |
| Rockingham | $617 | $452 | $693 | 63 | 5 | +29.9% |
| Rowan | $598 | N/A | $624 | 54 | 3 | +26.7% |
| Rutherford | $702 | $471 | $750 | 64 | 5 | +28.8% |
| Sampson | $657 | $435 | $705 | 56 | 4 | +35.6% |
| Scotland | $657 | $435 | $705 | 56 | 4 | +35.6% |
| Stanly | $574 | N/A | $627 | 52 | 3 | +23.2% |
| Stokes | $604 | $444 | $641 | 75 | 5 | +29.2% |
| Surry | $653 | $444 | $705 | 48 | 3 | +27.5% |
| Swain | $696 | $452 | $731 | 51 | 4 | +26.4% |
| Transylvania | $697 | $452 | $733 | 59 | 5 | +27.2% |
| Tyrrell | $731 | N/A | $797 | 28 | 2 | +19.0% |
| Union | $565 | N/A | $617 | 68 | 4 | +25.6% |
| Vance | $668 | $452 | $685 | 48 | 4 | +28.8% |
| Wake | $586 | $419 | $624 | 44 | 4 | +23.4% |
| Warren | $668 | $452 | $685 | 48 | 4 | +22.2% |
| Washington | $731 | N/A | $797 | 28 | 2 | +19.0% |
| Watauga | $663 | $457 | $689 | 26 | 2 | +18.6% |
| Wayne | $766 | N/A | $831 | 28 | 2 | +29.3% |
| Wilkes | $615 | $457 | $642 | 64 | 4 | +23.9% |
| Wilson | $766 | N/A | $831 | 28 | 2 | +29.3% |
| Yadkin | $587 | $444 | $638 | 89 | 6 | +28.1% |
| Yancey | $697 | $452 | $733 | 59 | 5 | +27.2% |
Health Insurance Guides
ACA Health Insurance in North Carolina
The Affordable Care Act marketplace in North Carolina offers 206 health insurance plans from 6 issuers across 100 counties. Premiums vary significantly by geography: the most expensive county (Edgecombe) averages $766/mo for a Silver plan, while the most affordable (Cabarrus) averages $565/mo.
Many consumers qualify for premium tax credits that significantly reduce monthly costs. Subsidies are based on household income relative to the federal poverty level. The average deductible across plans is $4,840, though lower-deductible options are available at higher monthly premiums.
Frequently Asked Questions
How much does health insurance cost in North Carolina? ▼
What is the cheapest health insurance plan in North Carolina? ▼
How many health insurance companies operate in North Carolina? ▼
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What is the average deductible for health plans in North Carolina? ▼
Disclaimer: This page is for informational purposes only and does not constitute insurance or financial advice. Premiums shown are base rates for a 27-year-old non-tobacco user unless otherwise noted. Actual premiums vary by age, location, tobacco use, and subsidy eligibility. Source: CMS Marketplace PUF.
Read our methodology - how this data is sourced, computed, and verified.
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