North Carolina ACA Health Insurance
100 counties, 6 issuers, 206 plans
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 Healthcare.gov + state-based exchange rate filings (PY 2025) North Carolina ACA marketplace premiums by county and metal tier (Plan Year 2025 Rate Filing) · 2025 CMS publishes Healthcare.gov rate filings annually for the federal exchange; state-based exchanges publish on their own schedules. 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
Related Health & Cost Data
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? ▼
Where is health insurance most expensive in North Carolina? ▼
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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