Best North Carolina Health Insurance (2024 Plans)

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.

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.

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.

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.

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.

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.

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).

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 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.

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.