The Cheapest North Carolina Health Insurance for Individuals and Families
The cost of health insurance in North Carolina varies depending on the type of coverage you purchase. Private health insurance plans are categorized into different metal tiers based on premiums and coverage features. North Carolina residents have five metal tier options to choose from. A Silver plan is often the best option if you are looking for a policy that balances costs and coverage benefits. The average cost of a Silver plan in North Carolina is $566 per month. The cheapest option, Blue Local Silver 6300 (local network with Wake Forest Baptist Health), is provided by Blue Cross and Blue Shield of NC for an average of $428 monthly.
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If you are a North Carolina resident who does not have health insurance from an employer or government program like Medicare, you can apply for a private plan from the North Carolina insurance exchange. Private health insurance plans are available at different costs, so you have options based on the premiums you want to pay and the type of coverage you need. Cheaper plans will typically have high deductibles and out-of-pocket maxes.
MoneyGeek analyzed the cheapest plans in North Carolina for different ages and plan types to help you find the most affordable health insurance in North Carolina. This analysis is based on plans purchased through the North Carolina insurance marketplace.
The Cheapest Health Insurance in North Carolina by Metal Tier
In North Carolina, the metal tiers available are Catastrophic, Bronze, Expanded Bronze, Silver and Gold. Health insurance in North Carolina for each of the five tiers available will have the following average monthly premiums.
- Catastrophic: $268 per month
- Bronze: $415 per month
- Expanded Bronze: $426 per month
- Silver: $566 per month
- Gold: $632 per month
Paying higher monthly premiums for a plan like Gold may be more cost-effective for people with high medical costs. With a Gold plan, you have lower out-of-pocket maxes, and your insurer will cover your medical expenses once you reach the limit.
The table below shows the cheapest plan by monthly premiums for each metal tier. In the North Carolina marketplace, deductibles, premiums and out-of-pocket maxes within a metal tier may vary greatly.
Cost-sharing reductions are available to low-income North Carolina residents who apply for Silver plans. CSR deductions make Silver plans even more affordable, allowing you to get better coverage.
The prices listed are for a sample 40-year-old male for all types of plans available in North Carolina. These rates are for HMO, POS and PPO plans. HMO plans are the most common type of policy in North Carolina.
Cheapest Health Insurance in North Carolina by Metal Tier
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- Metal TierPlanCompanyMonthly CostOOP Max
- CatastrophicBlue Local Catastrophic (local network with Wake Forest Baptist Health)Blue Cross and Blue Shield of NC$211$8,550
- BronzeBlue Local Bronze 8550 (local network with Wake Forest Baptist Health)Blue Cross and Blue Shield of NC$289$8,550
- Expanded BronzeBlue Local Bronze 7000 (local network with Wake Forest Baptist Health, HSA eligible)Blue Cross and Blue Shield of NC$299$7,000
- SilverBlue Local Silver 6300 (local network with Wake Forest Baptist Health)Blue Cross and Blue Shield of NC$428$8,550
- GoldBlue Local Gold 2500 (local network with Wake Forest Baptist Health)Blue Cross and Blue Shield of NC$425$8,550
The Cheapest Health Insurance in North Carolina by Age and Metal Tier
The cost of health insurance in North Carolina will largely depend on how old you are. A 26-year-old purchasing a Silver plan will pay an average of $453 per month, while a 60-year-old will pay much higher premiums of $1,201 monthly on average.
Health Insurance Costs in North Carolina by Age and Metal Tier
Health insurance premiums in North Carolina typically increase as you get older. You can opt for cheaper options like Bronze-tier plans, but the trade-off will be higher out-of-pocket maxes. This means that a low-cost plan can cost you more when you incur high medical expenses.
The costs of this analysis are based on sample profiles, so they may not reflect the rate for your specific income and age combination. Older people may find that they are eligible for certain tax premiums and regulatory policies that make their health insurance plans cheaper. However, you can only get an exact quote for your income and age combination by applying for a plan.
You can find out the different rates for different plans based on metal tiers and ages in the table below. Our informative guide on health insurance in North Carolina will also help you understand your options better.
Cheapest Health Insurance in North Carolina by Age And Metal Tier
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- PlanCompanyMonthly Rate
- CatastrophicPOSBlue Cross and Blue Shield of NC$150
- CatastrophicPOSBlue Cross and Blue Shield of NC$160
- CatastrophicHMOBright Health$161
- CatastrophicPOSBlue Cross and Blue Shield of NC$176
- CatastrophicPOSBlue Cross and Blue Shield of NC$189
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The Cheapest Health Insurance in North Carolina by County
If you live in North Carolina, your premiums for health insurance plans can differ depending on which county you live in. North Carolina and other states have rating areas that factor into the cost of premiums for different counties. North Carolina has 100 counties that are divided into 16 rating areas.
In the most populous county of North Carolina, Wake County, the cheapest Silver plan is Cigna Connect 5500 (with Duke Health and WakeMed) offered by Cigna Healthcare at an average of $425 monthly.
You can use the table below to find the cheapest plan in North Carolina for each metal tier in your county.
These plans are for a sample 40-year-old male in North Carolina purchasing a health insurance plan in that county.
Cheapest Health Insurance Plans in North Carolina by County
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- Metal TierCompanyCheapest PlanMonthly Premium
- AveryCatastrophicBright HealthCatastrophic 3 $0 PCP Visits$299
- BuncombeCatastrophicBright HealthCatastrophic 3 $0 PCP Visits$299
- CherokeeCatastrophicBright HealthCatastrophic 3 $0 PCP Visits$299
- ClayCatastrophicBright HealthCatastrophic 3 $0 PCP Visits$299
- GrahamCatastrophicBright HealthCatastrophic 3 $0 PCP Visits$299
The Cheapest Health Insurance in North Carolina With High Out-of-Pocket Maxes
North Carolina residents can choose a low-cost plan that has high out-of-pocket maxes. This type of plan can be cost-effective for young people who do not have high medical expenses. However, if you incur extensive medical costs, you will pay more out of pocket because these low-cost options have high out-of-pocket maxes.
The most affordable health insurance in North Carolina with a high out-of-pocket maximum is Blue Local Catastrophic (local network with Wake Forest Baptist Health), provided by Blue Cross and Blue Shield of NC at an average of $169 per month for a 26-year-old.
In MoneyGeek’s analysis, a high out-of-pocket maximum plan is defined as a policy with maximum expenses of $8,250 or higher.
Blue Cross and Blue Shield of NC
Blue Cross and Blue Shield of NC offers the cheapest plan for high out-of-pocket maxes in North Carolina. This plan is a Catastrophic-tier plan, which means only North Carolina residents under 30 qualify for it. In some cases, people over 30 who meet the hardship exemption criteria may also be eligible.
The Cheapest Health Insurance in North Carolina With Low Out-of-Pocket Maximums
For people with high medical expenses, a policy with high premiums and a low out-of-pocket max is often the best option. High-premium plans have low out-of-pocket costs, which is an important feature for people who incur medical costs frequently and need sufficient coverage for their expenses.
The cheapest health insurance in North Carolina with low out-of-pocket maximums is Ambetter Balanced Care 25 HSA, offered by Ambetter of North Carolina. This plan costs $562 monthly for the average 40-year-old.
The out-of-pocket maximum for this Ambetter of North Carolina Silver plan is $4,800. This out-of-pocket max is higher than the threshold of $4,250 that MoneyGeek uses to define a plan with a low out-of-pocket maximum. However, the Ambetter Balanced Care 25 HSA plan has the lowest out-of-pocket max in the state.
Ambetter of North Carolina
This plan is a Silver plan with a low out-of-pocket maximum but may have higher premiums than low-cost options in the state.
Cheapest POS/HMO/PPO Health Insurance Plan in North Carolina
When purchasing a health insurance plan, it is important to consider your healthcare needs and preferences. In North Carolina, you can choose from HMO, POS or PPO plans. Health Maintenance Organization plans (HMO) are the most common and affordable type.
An HMO plan provides coverage based on a specific provider network which you are restricted to unless you have an emergency. You will also require a referral to see a specialist on an HMO plan. Preferred Provider Organization (PPO) plans are more costly than HMO policies, but they offer a wider provider network. You do not need a referral to see a specialist if you are on a PPO plan. A Point-of-Service (POS) plan offers the most flexibility in terms of providers, although costs for out-of-network providers are high.
MoneyGeek found that the cheapest Silver plans for each plan type are, on average:
- Cheapest HMO Silver plan: Silver 5000 offered by Bright Health at $468 monthly
- Cheapest PPO Silver plan: Blue Advantage Silver 6300 (broad network) offered by Blue Cross and Blue Shield of NC at $636 monthly
- Cheapest POS Silver plan: Blue Local Silver 6300 (local network with Wake Forest Baptist Health) provided by Blue Cross and Blue Shield of NC at $428 monthly
Cheapest Plan in North Carolina With an HSA
A Health Savings Account (HSA) plan is a low-cost plan that allows you to build up a nest egg from pre-tax contributions. This makes it an excellent option for North Carolina residents in good health and with few medical expenses.
The cheapest plans with HSA options for all available metal tiers in North Carolina are:
- Cheapest HSA Expanded Bronze Plan: Blue Local Bronze 7000 (local network with Wake Forest Baptist Health, HSA eligible) provided by Blue Cross and Blue Shield of NC at an average of $299 per month
- Cheapest HSA Silver Plan: Ambetter Balanced Care 25 HSA provided by Ambetter of North Carolina at an average of $562 per month
If you have an HSA plan, your deductible and out-of-pocket maxes might be high, so you may have to pay out of your savings if you have major medical costs.
What to Know About Health Insurance in North Carolina
The rates used in MoneyGeek’s analysis are based on plan data from North Carolina marketplaces. When you apply for a plan, you may find that you can get even cheaper options. For older and limited-income North Carolina residents, state programs like Medicare and Medicaid are the most affordable options.
Private Health Insurance on the North Carolina Marketplace
North Carolina residents who want to buy private health insurance can choose from the five different metal tier options available in the state. Each of these tiers has varying costs and features to suit different needs.
- Catastrophic: Catastrophic plans are a low-cost option with low premiums, high deductibles and high out-of-pocket maximums. A Catastrophic plan has limited benefits compared to the other tiers. This type of plan is only available to people under 30. Low-income residents may also qualify for a Catastrophic plan under certain state exemptions.
- Bronze: Bronze plans are a low-cost option suitable for people with minimal medical expenses. The out-of-pocket costs for this plan are high, so this type of plan is not ideal for people who frequently incur high medical costs. However, people in good health can choose a Bronze plan to protect against the costs of a medical emergency.
- Expanded Bronze: The Expanded Bronze plan offers more coverage than a Bronze plan. The premiums for this tier will be higher than Bronze and Catastrophic plans but still cheaper than Silver and Gold tiers.
- Silver: Silver plans are in a middle tier that offers a balance between costs and coverage. This type of plan has lower out-of-pocket costs than low-tier plans and more affordable premiums than higher-tier plans. For people with moderate medical expenses, Silver plans are ideal since they offer good coverage at moderate monthly premiums.
- Gold: Gold plans have high monthly premiums, but the low out-of-pocket maxes offset these costs. This makes this type of plan cost-effective for people with high medical expenses. Low out-of-pocket maximums can be reached quickly if you have frequent medical costs, and the insurer will cover your costs above the set maximum. In North Carolina, Gold is the highest-tier option available from the Marketplace
Depending on your income level, you may be able to get even cheaper plans than the ones listed in MoneyGeek’s analysis. If your income is between 100% and 400% of the federal poverty level, you may be eligible for premium tax credits. A two-person household in North Carolina with an income of between $17,420 and $69,680 per year qualifies for premium tax credits.
Open enrollment is the period during which you can enroll for a new health insurance plan or renew your existing plan through the Healthcare Marketplace. Typically, the open enrollment period is between November and December, but due to the ongoing COVID-19 pandemic, the open enrollment period has been extended.
In North Carolina, if your income is between 138% and 250% of the federal poverty level, you qualify for cost-sharing reductions on a Silver plan. These reductions lower your deductible, co-payments and out-of-pocket maxes, making your plan more affordable. If you live in a two-person household in North Carolina with an income of $24,040 to $43,550, you qualify for cost-sharing reductions.
Medicaid in North Carolina
For eligible persons, the cheapest health insurance in North Carolina is Medicaid since it is free. However, to qualify for this government program, you need to meet state guidelines for people with disabilities, very low family income, low-income children or pregnant women. In Medicaid expansion states, you can qualify for Medicaid on income alone, but North Carolina is not one of them.
Medicare in North Carolina
North Carolina residents who are 65 years or older and those with certain illnesses can qualify for Medicare, a federal government program. Medicare may have some costs attached depending on the particular program, although it is not free like Medicaid. However, Medicare is one of the most affordable options for people in North Carolina who are eligible.
Medicare is typically divided into three parts:
- Medicare Part A (Hospital Insurance): This covers expenses arising from inpatient hospital stays, hospice care in a skilled nursing facility and certain types of home health care. This part of Medicare is free for most people.
- Medicare Part B (Medical Insurance): Part B of Medicare requires a premium to get coverage for outpatient care, some doctors' services, medical supplies and preventive services.
- Medicare Part D: Your prescription drug expenses will be covered under Part D of Medicare.
Medicare benefits, premiums and limitations can vary depending on the coverage you choose and certain qualifying factors.
Expert Advice: Finding Affordable Health Insurance in North Carolina
- How do I take advantage of cost-sharing reductions and tax credits for health insurance in North Carolina?
- Outside of plans on the health insurance exchange, where else can I get health insurance in North Carolina?
Assistant Professor of the Practice of Health Care Management at the Phillips School of Business at High Point University
Interim MBA Director at the University of North Carolina at Pembroke
MoneyGeek's research is based on estimates, and the cheapest plan for you will depend on your individual needs and characteristics. This analysis is intended to serve as a guide and no single plan is guaranteed to be the cheapest in North Carolina for you
MoneyGeek collected plans and premiums for health insurance in North Carolina from the Health Insurance Exchange Public Use Files (Exchange PUFs) for all available metal tiers and across several age groups.
Health insurance premiums on this page are an estimate and exclude potential premium tax credits and cost-sharing subsidies that users may be eligible for.
About the Author
- Medicare.gov. "What's Medicare?." Accessed June 18, 2021.