Best North Carolina Health Insurance (2024 Plans)


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ByMark Fitzpatrick
Edited byMegan Hull
ByMark Fitzpatrick
Edited byMegan Hull

Updated: May 22, 2024

Advertising & Editorial Disclosure

MoneyGeek Logo IconBest Health InsuranceNorth Carolina
2024

Best Health Insurance in North Carolina

Why Trust MoneyGeek? We downloaded plan data for North Carolina directly from the Centers for Medicare & Medicaid Services (CMS). MoneyGeek’s scoring methodology balances costs, claims approval and plan types to find the best providers in the state.

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Plan data was updated with the CMS exchange data released in October 2023 for the 2024 enrollment period.

176Plans Analyzed
 
18Providers Compared

Best Overall for Health Insurance in North Carolina

Ambetter offers the best health insurance in North Carolina, with a MoneyGeek score of 86. Ambetter has plans with cost-effective options, lower-than-average out-of-pocket costs and lower rates of claim denials.

For this analysis, we examined 70 Silver health insurance plans in North Carolina.

MoneyGeek Pick: Ambetter

Ambetter

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Affordable monthly premiums

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Limited out-of-pocket expenses

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Low claims denial rate

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Only offers HMO plans

COMPANY HIGHLIGHTS

MoneyGeek's top pick for the best health insurance in North Carolina is Ambetter. The issuer offers 19 Silver HMO plans at an average monthly monthly rate of $507. The average maximum out-of-pocket (MOOP) cost for these plans is $5,400.

Ambetter provides only Silver HMO plans. HMO plans tend to have affordable premiums but require referrals to see specialists and members to see health care providers within their network (except in emergencies). Ambetter has a denial rate of about 15%, lower than many of its competitors.

Plan Recommendations

MoneyGeek recommends the following Silver plans from Ambetter:

  • Clear Silver with Atrium Health: $507 per month; $5,400 MOOP
  • Clear Silver with Atrium Health + Vision + Adult Dental: $527 per month; $5,400 MOOP
  • Clear Silver: $548 per month; $5,400 MOOP

Best Health Insurance in North Carolina for Low Out-of-Pocket Costs

With a MoneyGeek score of 79 out of 100, CareSource provides the best health insurance in North Carolina for low out-of-pocket costs. In addition to low out-of-pocket costs, this provider offers affordable plan options and has a lower-than-average claims denial rate.

For this analysis, MoneyGeek evaluated six Gold EPO, 26 Gold HMO, two Gold POS and four Gold PPO plans in North Carolina.

MoneyGeek Pick: CareSource

CareSource

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Affordable premium rates

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Low out-of-pocket costs

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Few claims denied

COMPANY HIGHLIGHTS

MoneyGeek's top pick for the best health insurance in North Carolina for low out-of-pocket costs is CareSource. It offers six Gold plans, a metal tier known for lower maximum out-of-pocket expenses. CareSource's average monthly premium for these plans is $644, with an average MOOP cost of $7,733.

CareSource has a denial rate of 20%, lower than most of the competition — that means this provider is more likely to approve a claim you submit.

Plan Recommendations

MoneyGeek recommends the following Gold and Platinum plans:

  • CareSource Marketplace Core Gold: $608 per month; $7,000 MOOP
  • CareSource Marketplace Core Gold Dental, Vision, & Fitness: $619 per month; $7,000 MOOP
  • CareSource Marketplace Diabetes Gold: $661 per month; $7,500 MOOP

Best Cheap Health Insurance in North Carolina

Ambetter is the best cheap health insurance provider in North Carolina, earning a MoneyGeek score of 89. This provider offers plans with low rates, low out-of-pocket costs and fewer claim denials.

For this category, MoneyGeek evaluated 70 Silver plans in North Carolina. This included 12 Silver EPO plans, 48 Silver HMO plans, four Silver POS plans and six Silver PPO plans. MoneyGeek placed more emphasis on plans with low monthly premiums in determining the most affordable provider; however, note that plans with lower premiums tend to have higher out-of-pocket costs.

MoneyGeek Pick: Ambetter

Ambetter

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Low claims denial rate

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Affordable premium rates

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Low out-of-pocket costs

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Only HMO plans available

COMPANY HIGHLIGHTS

MoneyGeek's top pick for the best cheap health insurance in North Carolina is Ambetter. It offers 19 different Silver plans at an average premium of $551 per month and an average maximum out-of-pocket cost of $7,767. This provider has a claims denial rate of 15%, lower than most of the competition.

Ambetter only offers Silver HMO plans. HMO plans tend to have affordable monthly costs but usually require you to choose a primary care physician and get referrals to see specialists. You'll also need to see providers within your plan's network except in emergencies.

Plan Recommendations

MoneyGeek recommends the following cheap Silver plans:

  • Clear Silver with Atrium Health: $507 per month; $5,400 MOOP
  • Clear Silver with Atrium Health + Vision + Adult Dental: $527 per month; $5,400 MOOP
  • Standard Silver with Atrium Health: $504 per month; $9,100 MOOP

Best Health Insurance for Low Income in North Carolina

Ambetter offers the best health insurance in North Carolina for those with low income, scoring 89 out of 100. Compared to other providers in the state, Ambetter has lower-than-average premiums, out-of-pocket costs, and claim-denial rates.

For this analysis, we focused on Silver plans eligible for cost-sharing reductions (CSRs) in North Carolina. We evaluated 12 EPO plans, 48 HMO plans, four POS plans and six PPO plans.

We gave more weight to plans with lower monthly premiums and included only those with cost-sharing reductions (CSRs). CSRs lessen your health care costs if you earn within certain income levels. Typically, a Silver plan pays for about 70% of health care costs, but with a Silver plan with CSRs, more could potentially be covered based on your income:

  • If you earn between $27,180 and $33,975 annually (201–250% of the federal poverty level), you can expect about 73% of your health insurance costs to be covered.
  • If you make $20,385 to $27,180 annually (151–200% of the federal poverty level), you can expect about 87% of your costs to be covered.
  • If you make less than $20,385 annually (up to 150% of the federal poverty level), you can expect about 94% of your costs to be covered.

These income brackets shift if you have more or fewer people living in your household.

MoneyGeek Pick: Ambetter

Ambetter

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Low premium rates

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Minimal out-of-pocket costs

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Infrequent claim denials

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Provider only offers HMO plans

COMPANY HIGHLIGHTS

MoneyGeek's top pick for the best health insurance in North Carolina for those with low income is Ambetter. The provider offers cost-effective plans for people earning below 250% of the federal poverty level. Ambetter offers 19 Silver CSR plans at an average rate of $551 per month. The average MOOP cost for these plans is $6,590.

The provider only offers HMO plans, which generally have lower premiums and may include benefits like care coordination. The company's denial rate is 15%, meaning it approves claims more frequently than competitors.

Plan Recommendations

Ambetter's top-rated plan offers lower out-of-pocket expenses for the same premium for people in different income brackets. Here are some of the lower overall out-of-pocket costs based on income levels:

  • 151-200% of the FPL: $507 per month; $1,600 MOOP
  • Up to 150% of the FPL: $507 per month; $550 MOOP

Best Health Insurance for Young Adults in North Carolina

With a MoneyGeek score of 85 out of 100, Ambetter provides the best health insurance for young adults in North Carolina. Ambetter offers relatively affordable plans in terms of monthly premiums and MOOP expenses; this provider also denies fewer claims than its competition.

For this category, we evaluated three Bronze HMO plans, 12 Expanded Bronze EPO plans, 37 Expanded Bronze HMO plans, four Expanded Bronze POS plans, six Expanded Bronze PPO plans, three Catastrophic EPO plans, one Catastrophic HMO plan, one Catastrophic POS plan and one Catastrophic PPO plan. Note that only individuals younger than 30 can buy Catastrophic plans.

MoneyGeek Pick: Ambetter

Ambetter

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Low out-of-pocket expenses

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Few claims denied

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Affordable monthly premiums

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Only HMO plans available

COMPANY HIGHLIGHTS

Ambetter is MoneyGeek's pick for the best health insurance in North Carolina for young adults. This insurer has 17 Expanded Bronze plans for young people to choose from, with an average monthly premium of $365 and an annual MOOP expense of $8,769.

All the plans offered by Ambetter in North Carolina are HMOs, which typically means you must stay in-network to get coverage. HMOs often encourage using a primary care physician (PCP) to manage your care and require that all referrals for specialty care be made through your PCP. Its claims denial rate is 15%, lower than many of its competitors.

Plan Recommendations

MoneyGeek recommends the following plans for young adults:

  • Choice Bronze HSA with Atrium Health: $297 per month for 18-year-olds and $333 per month for 26-year-olds; $7,250 MOOP
  • Choice Bronze HSA with Atrium Health + Vision and Adult Dental: $309 per month for 18-year-olds and $346 per month for 26-year-olds; $7,250 MOOP
  • Choice Bronze HSA: $321 per month for 18-year-olds and $360 per month for 26-year-olds; $7,250 MOOP

Best Health Insurance by Plan Type in North Carolina

Health insurance companies offer different types of plans. In North Carolina, 12 Silver EPO plans, 48 Silver HMO plans, four Silver POS plans and six Silver PPO plans are available. The best providers for all plan categories are:

  • HMO: Ambetter (MoneyGeek score: 93 out of 100)
  • EPO: Blue Cross Blue Shield (MoneyGeek score: 100 out of 100)
  • POS: Blue Cross Blue Shield (MoneyGeek score: 100 out of 100)
  • PPO: Blue Cross Blue Shield (MoneyGeek score: 60 out of 100)

MoneyGeek's recommendations only include Silver plans. These plans balance monthly premiums and the amount you pay when you use health care services. They work well for people who go to the doctor or need health services somewhat frequently.

MoneyGeek Pick for PPO: Blue Cross Blue Shield

Blue Cross Blue Shield
COMPANY HIGHLIGHTS

MoneyGeek's pick for the best health insurance in North Carolina for Silver PPO plans is Blue Cross Blue Shield. This provider offers four Silver PPO plans, with an average monthly premium of $637 and an average MOOP of $9,363. The provider's denial rate is 17%, which means it denies fewer claims than average.

PPO plans let you choose your doctors and visit specialists without a referral. This is good if you like making your own health care choices. However, note PPO plans tend to cost more than other types, so they might not be best if you're on a tight budget.

Plan Recommendations

We suggest the following Silver PPO plans from Blue Cross Blue Shield:

  • Blue Advantage Silver Standard | Nationwide Doctors & Meds: $630 per month; $9,100 MOOP
  • Blue Advantage Silver Preferred | 3 Free PCP | $3 Generics: 620 per month; $9,450 MOOP

MoneyGeek Pick for EPO: Blue Cross Blue Shield

Blue Cross Blue Shield
COMPANY HIGHLIGHTS

MoneyGeek's top pick for the best health insurance in North Carolina for Silver EPO plans is Blue Cross Blue Shield. This provider offers twelve Silver EPO plans in the state; the average premium for these plans is $501 per month, and the average MOOP expense is $9,353. Blue Cross Blue Shield has a denial rate of 17%, about the average rate of denying claims.

Silver EPO plans have both benefits and drawbacks. These plans are fairly popular, being the third most common plan. EPO plans usually don't require a referral to see a specialist, making it easier to get care when needed. However, you'll have to stay in the plan's network of providers to be covered (unless it is an emergency), narrowing your choice of providers.

Plan Recommendations

We suggest the following Silver EPO plans from Blue Cross Blue Shield:

  • Blue Home Silver Standard | with UNC Health Alliance: $492 per month; $9,100 MOOP
  • Blue Local Silver Standard | with Atrium Health: $502 per month; $9,100 MOOP

MoneyGeek Pick for POS: Blue Cross Blue Shield

Blue Cross Blue Shield
COMPANY HIGHLIGHTS

MoneyGeek's top pick for the best health insurance in North Carolina for Silver POS plans is Blue Cross Blue Shield, which offers four different plans. The average monthly premium for these plans is $557, and the average annual MOOP cost is $9,363. Blue Cross Blue Shield has a denial rate of about 17%, the average of its competition.

Silver POS plans can be helpful for folks who need somewhat frequent medical care and want the flexibility of covered out-of-network providers. However, keep in mind that seeing an out-of-network provider will be more expensive than an in-network provider.

Plan Recommendations

We suggest the following Silver POS plans from Blue Cross Blue Shield:

  • Blue Value Silver Standard | Statewide Doctors: $551 per month; $9,100 MOOP
  • Blue Value Silver Preferred | 3 Free PCP | $10 Generic Drugs: $543 per month; $9,450 MOOP

MoneyGeek Pick for HMO: Ambetter

Ambetter
COMPANY HIGHLIGHTS

In North Carolina, MoneyGeek's top pick for the best insurance provider for Silver HMO plans is Ambetter. It offers an average plan rate of $551 monthly and an average MOOP expense of $7,767 annually. The provider has a denial rate of 15%, meaning they deny fewer claims than their competitors.

Silver HMO plans can be a good option because they usually cost less each month than other types. However, HMOs require that you see doctors in your plan’s network except in emergencies. If you need to see a specialist, you must first be referred by your PCP. These plans are great if you want to save on monthly payments and have doctors in the network close to you.

Plan Recommendations

We suggest the following Silver HMO plans from Ambetter:

  • Clear Silver with Atrium Health: $507 per month; $5,400 MOOP
  • Clear Silver with Atrium Health + Vision + Adult Dental: $527 per month; $5,400 MOOP

Best Short-Term Health Insurance in North Carolina

National General Accident & Health is the top short-term health insurance provider in North Carolina, with a MoneyGeek score of 85 out of 100. Short-term health insurance is a good option for individuals who need temporary coverage. However, we don't recommend it as an alternative to health insurance, as it doesn't cover all the essential health benefits that are included in plans compliant with the Affordable Care Act (ACA).

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MoneyGeek Top Pick: National General Accident & Health
National General Accident & Health

We recommend National General Accident & Health as the best short-term health insurance provider in North Carolina because it offers higher coverage limits than other competitors in the state. Additionally, it offers flexible contract terms, which range from three months to three years.

How to Find the Best Health Insurance for You in North Carolina

When shopping for health insurance in North Carolina, it's important to consider your budget and health care needs. This includes determining how much you’re willing to pay each month versus out-of-pocket for medical services.

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    Understand when a health insurance plan will cover you

    Doctors who have contracts with your health insurance provider are known as in-network providers. Out-of-network doctors aren't contracted with your insurance.


    North Carolina has 12 EPO plans, 48 HMO plans, six PPO plans and four POS plans. HMO and EPO plans tend to cost less monthly but have fewer provider choices and require you to seek care in-network. PPO and POS plans allow more flexibility for out-of-network care but tend to have higher monthly premiums.

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    Weigh the cost of premiums vs. the cost of care

    Choosing the right health insurance plan is about finding your ideal balance between what you pay monthly and how much you pay for medical services. If you go to the doctor infrequently, a plan with a low premium might be best. But if you need more care, a plan with a higher monthly cost and a lower MOOP limit could save you money in the long run.


    In North Carolina, the Silver plan from Ambetter with the lowest MOOP limit ($5,400) costs $507 per month. If this plan covers the doctors and services you need, it’s an excellent choice because it has both a low monthly cost and a low max out-of-pocket limit.

Consider North Carolina Medicare or Medicaid if You’re Eligible

Medicare is a federal health insurance program that provides subsidized health care services to eligible adults 65 and older or those with a qualifying illness or disability. It is divided into three parts:

  • Part A (Hospital Insurance) covers inpatient hospital stays, some home health care, nursing facilities and hospice care.
  • Part B (Medical Insurance) covers outpatient care, such as doctor visits and preventive services.
  • Part D (Prescription Drug Coverage) helps cover the cost of prescription medication and vaccines.

We have resources available to help you find the best Medicare Advantage plan in North Carolina and the best Medicare Supplement plan in North Carolina.

Medicaid is a federal program that provides health coverage for individuals with incomes below a certain level determined by the state. To qualify for North Carolina Medicaid, you must be a resident of North Carolina, a U.S. national, citizen, permanent resident or legal alien and meet certain income criteria. You may qualify if you’re pregnant, responsible for a child 18 years of age or younger, blind, have a disability or a family member in your household with a disability or are 65 or older.

FAQ About Health Insurance in North Carolina

Finding an ideal health insurance plan can be complicated due to concerns about price and availability. MoneyGeek answers some frequently asked questions to help you research options.

What is the best health insurance provider in North Carolina for 2024?
What should you look for when shopping for the best health insurance plan in North Carolina?

About Mark Fitzpatrick


Mark Fitzpatrick headshot

Mark Fitzpatrick has analyzed the property and casualty insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. Currently, he leads P&C insurance content production at MoneyGeek. Fitzpatrick has been quoted in several insurance-related publications, including CNBC, NBC News and Mashable.

Fitzpatrick earned a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his knowledge of economics and insurance to bring transparency around financial topics and help others feel confident in their money moves.