Best North Carolina Health Insurance (2023 Plans)

CareSource North Carolina Co. is the best health insurance provider in North Carolina, receiving a score of 72 out of 100.

This company excels in affordability and claims management, in addition to having low out-of-pocket costs. Notably, it has a claims denial rate of 0%, which means it accepts all policyholder claims.

MoneyGeek’s rankings were based on Silver plans in North Carolina, consisting of 24 EPO plans, 59 HMO plans, six POS plans and eight PPO plans.

Aetna is the top health insurance provider in North Carolina for low out-of-pocket health insurance costs. This company received a MoneyGeek score of 80 out of 100 for its affordable monthly premiums and low MOOP costs.

It offers the second cheapest plan among the evaluated insurers while having one of the lowest MOOP costs. Its denial rate of 0% indicates that virtually all of its policyholders’ claims are approved.

To find the top provider in North Carolina for this category, we reviewed eight Gold EPO plans, 27 Gold HMO plans, two Gold POS plans and four Gold PPO plans.

Aetna is the top provider of cheap health insurance in North Carolina, receiving a MoneyGeek score of 78 out of 100.

In this category, we placed greater emphasis on premium affordability in our scoring. Keep in mind that plans with lower monthly premiums often have higher out-of-pocket costs, which may be a worthwhile trade-off if you do not frequently need medical care.

MoneyGeek reviewed Silver plans in North Carolina to rank insurers in this category. We analyzed 24 Silver EPO plans, 59 Silver HMO plans, six Silver POS plans and eight Silver PPO plans.

MoneyGeek also analyzed the cheapest health insurance in North Carolina for those who just want the cheapest rates.

Aetna offers the best health insurance for low-income residents in North Carolina, receiving a MoneyGeek score of 77 out of 100.

This evaluation was based on Silver plans in North Carolina that provide cost-sharing reductions (CSRs) and have low monthly premiums. This included a total of 24 EPO plans, 59 HMO plans, six POS plans and eight PPO plans.

CSRs are discounts that reduce your average MOOP costs and deductible expenses if your income is below 250% of the federal poverty level (FPL). This helps lower your MOOP costs without raising your monthly premium.

Silver plans usually cover about 70% of health care costs, but cost-sharing may cover more based on your income. In North Carolina, for instance:

• If your annual income is between $27,180 and $33,975 (201%–250% of the FPL), you may be eligible for a health insurance plan that covers approximately 73% of your health care costs.
• If your annual income is between $20,385 and $27,180 (151%–200% of the FPL), you may be eligible for a plan that covers approximately 87% of your health care costs.
• If your annual income is below $20,385 (up to 150% of the FPL), you may be eligible for a plan that covers approximately 94% of your health care costs.

The income brackets and corresponding health care coverage percentage may change depending on your household size.

Aetna offers the best health insurance for young adults in North Carolina, with a MoneyGeek score of 84 out of 100.

Our ranking was determined by evaluating providers that offer Bronze, Expanded Bronze and Catastrophic plans in North Carolina. These plans typically have lower premiums and higher out-of-pocket costs. Catastrophic plans are only available to individuals under the age of 30.

We reviewed 24 EPO plans, 64 HMO plans, six POS plans and eight PPO plans to find the best insurer for young adults in the state.

Health insurance companies may offer various types of plans to their customers. We found the best providers in North Carolina for different plan types:

• HMO: CareSource North Carolina Co. (MoneyGeek score: 71 out of 100)
• PPO: WellCare (MoneyGeek score: 80 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)

Our recommendations for health insurance providers are limited to Silver plans, which offer an ideal balance between cost and coverage for the most number of people.

In North Carolina, there are a total of 24 EPO plans, 59 HMO plans, six POS plans and eight PPO plans.

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 do not recommend them as an alternative to health insurance, as they don’t cover all the essential health benefits that are included in Affordable Care Act (ACA)-compliant plans.

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.

Medicare is a federal health insurance program that provides subsidized health care services to eligible adults age 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 years of age or older.

When shopping for health insurance, it’s normal to have questions about cost and availability. Here are some answers to frequently asked questions about health insurance in North Carolina.