Best Health Insurance in North Carolina (2026)

Six insurers compete at Silver in North Carolina's 2026 market. The cheapest and most expensive Silver HMO differ by $3,300 per year. How often you use care determines whether Ambetter or AmeriHealth costs less.
Compare the best health insurance plans in North Carolina below.

Written by Mark Fitzpatrick

Updated: October 2, 2026

Advertising & Editorial Disclosure

Key Takeaways

Ambetter is our first choice for buyers who rarely use care. Its $640 Silver HMO is North Carolina's lowest Silver rate, and its Gold plans are the state's cheapest at an average of $667 monthly.

AmeriHealth is the stronger call for buyers who use care regularly. For $44 more a month, its $2,190 Silver deductible brings net savings that max out at $651 and can't start until care costs pass $2,718 (its deductible plus $528 in extra premium). In a year that reaches both plans' out-of-pocket maximums, Ambetter costs $1,069 less.

Cigna makes sense only if your current providers are already in its HMO network. At $915 monthly for Silver, it costs $3,300 more a year than Ambetter, and deductible savings can't recover that for any buyer.

BCBS is the only carrier in North Carolina offering PPO, EPO and POS plans in 2026. PPO plans cover out-of-network care at a higher cost share. EPO plans remove the specialist referral requirement that HMO plans require. POS plans keep the referral requirement and add out-of-network coverage at a higher cost.

Best Health Insurance Companies in North Carolina

Ambetter has the lowest Silver premium in North Carolina at $640 a month and the lowest Gold HMO premium at $667 a month. Its average Gold MOOP of $5,888 is also the lowest in the state at that tier, per MoneyGeek data.

For buyers who expect to use care regularly, AmeriHealth is a stronger fit. Its $2,190 Silver deductible is $1,179 lower than Ambetter's for $528 more a year in premiums, so it can come out up to $651 ahead, but only after care costs pass $2,718 in a year. In a year that reaches both plans' out-of-pocket maximums, Ambetter's $541 lower MOOP makes it $1,069 cheaper.


Ambetter	Low monthly premiums	$640	$5,347	$3,369	4.6	Standard Silver With Atrium Health
AmeriHealth	Regular care users	$684	$5,888	$2,190	4.5	AmeriHealth Caritas Next Silver Premier + No Referrals
Cigna	Lowest claims denial rate	$915	$5,659	$2,626	4.1	Connect Silver 3600 Indiv Med Deductible

* Rates reflect unsubsidized Silver HMO plans for a 40-year-old. Silver is the benchmark because cost-sharing reductions, which lower deductibles and copays for buyers who qualify by income, apply only at this tier. MOOP is the out-of-pocket maximum, the most you pay for covered care in a year.

For buyers whose current providers are in its network, Cigna's in-network denial rate of 16.1% in 2024 is the lowest of the three carriers we reviewed (Ambetter's is 21.5% and AmeriHealth's 28.2%), below the 19% national average per CMS data. That is a measurable claims processing advantage for buyers managing ongoing care.

SNAPSHOT OF NORTH CAROLINA HEALTH INSURANCE

North Carolina expanded Medicaid in 2023, and more than 600,000 residents have enrolled through expansion. Cost-sharing reductions apply only to the Silver tier. Five of the six main carriers in North Carolina's 2026 individual market offer HMO plans only. BCBS is the only insurer offering EPO, POS and PPO options this year. If you need out-of-network access, BCBS is the only carrier in the state that provides it. AmeriHealth and UnitedHealthcare also sell HMO plans marketed as requiring no referral.

Ambetter

Best Overall

MoneyGeek Rating

4.6/ 5

5/5Affordability

2.8/5Deductible

5/5MOOP

Average Monthly Rate
$640
Average MOOP
$5347
Average Deductible
$3369

pros
- Cheapest HMO plans in the state
- HSA-eligible Expanded Bronze option available, a Bronze tier that allows plans to pay more of your costs than standard Bronze
cons
- HMO structure limits care to in-network providers
- Average deductible across Expanded Bronze plans is $5,982, with individual plans from $5,625 to $6,338
Why We Like It: Ambetter has the lowest Silver premium in the state at $640. Ambetter Gold pairs the lowest average Gold premium, $667, with the lowest average Gold MOOP at $5,888, per MoneyGeek data.
The adult dental add-on costs $15 to $19 per month, and the price varies by Expanded Bronze variant.

When to Avoid It: Ambetter's $3,369 Silver deductible is the highest of the six carriers we reviewed, so a year with moderate care, above $2,718 but short of the out-of-pocket maximum, can cost more here than at AmeriHealth. Rural buyers should verify county-level network coverage first, since BCBS has broader in-network options in some North Carolina counties.

AmeriHealth

MoneyGeek Rating

4.5/ 5

4.8/5Affordability

4.8/5Deductible

3.2/5MOOP

Average Monthly Rate
$684
Average MOOP
$5888
Average Deductible
$2190

pros
- Silver and Gold premiums 9% to 13% below the state average
- HSA-eligible Bronze and Expanded Bronze plans
cons
- HMO plans cover only in-network providers, except in emergencies
- Denied 28.2% of in-network claims in 2024, above the 19% national average
- High $7,950 deductible on Bronze plan
Why We Like It: AmeriHealth's Silver deductible is $1,179 lower than Ambetter's. After its $528 higher annual premium, AmeriHealth's net savings max out at $651 and can't start until care costs pass $2,718 in a year. Once costs reach both plans' out-of-pocket maximums, Ambetter's $541 lower MOOP puts it ahead.

If you use care regularly and can't access Silver cost-sharing reductions, AmeriHealth Gold costs $711 a month with a $1,069 deductible, the second-lowest Gold deductible in the state, per MoneyGeek data. Its Caritas Next Silver Premier doesn't require specialist referrals. AmeriHealth and UnitedHealthcare sell HMO plans marketed as requiring no referrals.

When to Avoid It: AmeriHealth's Bronze plan sets both the deductible and out-of-pocket maximum at $7,950, so you pay every covered care dollar until you reach that ceiling. Healthy buyers wanting Bronze-tier pricing should check Ambetter's HSA-eligible Expanded Bronze from $450 monthly first.

Cigna

MoneyGeek Rating

4.1/ 5

4.2/5Affordability

3.9/5Deductible

4/5MOOP

Average Monthly Rate
$915
Average MOOP
$5,659
Average Deductible
$2,626

pros
- Silver plan MOOP of $5,659, second-lowest among all six carriers in our 2026 analysis
- Below-average claims denial rate of 16.1%, lower than the 19% national average per CMS data
- Specialized Connect MyDiabetesCare Bronze plan not available from other featured carriers
cons
- Offers HMO plans only with network restrictions
- Silver HMO premium of $915 monthly is $167 above the $748 state average for that plan type
Why We Like It: Cigna denied 16.1% of in-network claims in 2024, the lowest of the three carriers we reviewed, which matters most for buyers with ongoing care.

Its Connect MyDiabetesCare Bronze plan ($711 a month at 40) serves members managing diabetes, though Oscar sells a diabetes-branded Bronze plan, Bronze Simple Diabetes, for $509, per MoneyGeek data. Both advantages hold value only if your care team is already in Cigna's network. AM Best affirmed Cigna's financial strength rating of A (Excellent) in March 2026.

When to Avoid It: Cigna's $915 Silver premium costs $3,300 more than Ambetter's per year. Its $743 lower deductible can't offset that, since its $5,659 MOOP is $312 higher. Buyers without an existing Cigna provider relationship should start with Ambetter or AmeriHealth.

Compare Health Insurance Companies in North Carolina

Rate and cost data shift by plan type, metal tier, age and HSA eligibility. Use the filters below to compare all available carriers by the variables that apply to your situation. Set the filters to your age and plan type to see where your rate falls across all six carriers in the state.

Data filtered by:


Ambetter	$640	HMO	Silver	$5,347	$3,369	40	No
Oscar Health Plan Of North Carolina, Inc	$666	HMO	Silver	$5,955	$3,258	40	No
AmeriHealth	$684	HMO	Silver	$5,888	$2,190	40	No
Blue Cross Blue Shield	$840	HMO	Silver	$6,184	$2,330	40	No
UnitedHealthcare	$875	HMO	Silver	$6,103	$2,086	40	No
Cigna Healthcare	$915	HMO	Silver	$5,659	$2,626	40	No

Your Next Step:

Get your real quotes from trusted insurance providers.

*Some providers offer multiple plans of the same type and tier. Rates are based on company averages across all available plans for the given age, plan type and metal tier.

Best Cheap Health Insurance for HMO, PPO, EPO and POS Plans

Ambetter's Silver HMO costs $457 at 18 and $1,359 at 60, or $902 more a month for the same plan type. We recommend Ambetter for HMO coverage at every age because it holds the lowest Silver premium across all four age groups in the table below.
Blue Cross Blue Shield is the only carrier in North Carolina selling EPO, POS and PPO plans for 2026.


18	$457	$472	$519	$618
26	$513	$530	$582	$693
40	$640	$661	$727	$865
60	$1,359	$1,403	$1,543	$1,838

*Average monthly Silver premiums by carrier.

At 26, when coverage on a parent's plan ends, BCBS's EPO costs $17 a month more than Ambetter's $513 HMO. At 40 the EPO costs $21 more a month, or $252 a year, which makes BCBS's EPO the stronger call for buyers who already see a specialist regularly. By 60 the difference grows to $44 a month, and the cheapest Silver HMO costs $16,308 a year with Medicare eligibility five years away.

How Much Does Health Insurance Cost in North Carolina?

HMO plans include the most affordable options in North Carolina's 2026 market, with Bronze coverage averaging $553 monthly and Silver at $748. The highest average a 40-year-old would pay for a Silver plan is $915 at Cigna, $275 above the cheapest option.


EPO	No Data	$518	$661	$686
HMO	$553	$587	$748	$815
POS	No Data	$570	$727	$756
PPO	No Data	$679	$865	$899

*Average monthly premiums for 40-year-olds by plan type, averaged across every plan the six carriers sell at each tier. These are plan-level averages, so they differ from the carrier averages in the comparison table. Rates vary by age and location.

PPO plans cost $2,700 more per year than Ambetter's HMO for out-of-network access that buyers with all in-network providers won't use.

The cheapest Silver EPO costs $252 a year more than the cheapest Silver HMO, so buyers who want specialist access without a referral should price the EPO and AmeriHealth's no-referral HMO before choosing.

How to Find the Best Health Insurance in North Carolina

In North Carolina's 2026 market, the right plan type and carrier depend on how often you expect to use care. Buyers who stay healthy pay less with Ambetter. AmeriHealth's net savings can't start until care costs pass $2,718, and they max out at $651. Ambetter pulls ahead again once costs reach both plans' out-of-pocket maximums.

Match Your Plan Tier to How Much Care You Use
Silver is the only tier that qualifies for cost-sharing reductions, which are available in North Carolina to buyers with income between 138% and 250% of the federal poverty level, since Medicaid covers adults below 138%. At that income range, a Silver plan's out-of-pocket costs fall below what Bronze would cost. Check subsidy eligibility on HealthCare.gov before settling on a tier.

Healthy buyers who rarely use care should look at Bronze. Ambetter and AmeriHealth both offer HSA-eligible Bronze plans under $520 per month at age 40. An HSA lets you set aside pre-tax dollars for future care while keeping monthly costs low.
Check Your Medicaid and Subsidy Eligibility Before Comparing Plans
North Carolina expanded Medicaid in 2023. Buyers with income at or below 138% of the federal poverty level qualify for Medicaid at no premium, and enrollment is open year-round. Check subsidy eligibility on HealthCare.gov before comparing marketplace plans. Whether a marketplace buyer qualifies for a $0 premium plan after tax credits depends on income and county.
Verify Your Providers Are in Network Before Comparing Premiums
Five of the six carriers in North Carolina's 2026 market sell only HMO plans, which don't cover out-of-network care except in emergencies. If your current doctors aren't in a carrier's network, the cheapest premium becomes irrelevant. Check each carrier's provider directory before comparing rates.

BCBS is the only carrier with EPO, POS and PPO plans. EPO plans remove the specialist referral requirement but still restrict you to in-network providers. PPO plans cover out-of-network care at a higher cost share. If out-of-network access is a requirement, the PPO or POS is the plan type to choose.
Know Your Enrollment Window
Open Enrollment is November 1 through January 15. Missing the window means no coverage until the next Open Enrollment, unless a qualifying life event triggers a Special Enrollment Period. Losing job-based coverage, marriage, a divorce that ends your coverage and the birth of a child all qualify. All marketplace enrollment in North Carolina goes through HealthCare.gov.

Which North Carolina Health Insurance Plan Is Right for You?

Ambetter is the right call for buyers who stay healthy. AmeriHealth's advantage is limited to years with regular care, after costs pass $2,718 and before they reach the out-of-pocket maximum.

Premium alone doesn't determine annual cost in North Carolina's 2026 market. In my analysis of the three carriers below, AmeriHealth costs $44 more per month than Ambetter, and its net savings max out at $651 in a year when care costs pass $2,718 without reaching the out-of-pocket maximum. Healthy buyers who stay below the deductible, and buyers who reach both plans' maximums, come out ahead with Ambetter.


Ambetter	You rarely use care and want North Carolina's lowest Silver HMO premium at $640 per month	Your providers are outside its HMO network, you expect moderate care that stays below the out-of-pocket maximum or you live in a rural area where in-network options are limited
AmeriHealth	You expect to use care regularly. AmeriHealth's $2,190 Silver deductible is $1,179 lower than Ambetter's for only $44 more per month, and its net savings max out at $651 in a year when care costs pass $2,718 without reaching the out-of-pocket maximum	You are healthy and considering Bronze tier, the standard Bronze deductible equals the out-of-pocket maximum at $7,950
Cigna	Your care team is already in its HMO network and you want the carrier that denied the fewest North Carolina claims in 2024 (16.1%)	Cost is the primary filter. Cigna's Silver plan costs $3,300 more per year than Ambetter, and its $743 lower deductible ($2,626 vs. $3,369) can't offset that at any level of care

Frequently Asked Questions

North Carolina does not require residents to have health insurance. The state has no mandate or penalty for being uninsured. Residents can still access federal subsidies through the health insurance marketplace. Subsidies reduce or eliminate premiums for buyers who qualify based on income.

North Carolina's open enrollment for health insurance begins November 1 and ends January 15. Select a plan by December 15 to start coverage on January 1. A Special Enrollment Period is available if you have a qualifying life event outside this window.

North Carolina residents can access free health insurance through Medicaid if they meet income requirements. Marketplace buyers who meet income requirements qualify for premium subsidies that reduce or eliminate monthly costs. Whether a lower-income family in North Carolina qualifies for a $0 premium plan depends on household size and the plans available in their county.

How We Chose the Best Health Insurance in North Carolina

Our ranking system evaluates health insurance plans on three cost factors: monthly premiums, deductibles and maximum out-of-pocket limits.
Monthly premium (60%): Lower average premiums for a 40-year-old receive higher ratings.

Maximum out-of-pocket (MOOP) score (20%): MOOP is the annual ceiling on your cost-sharing, and premiums don't count toward it. Lower limits receive better scores.

Deductible (20%): Your deductible is how much you pay for covered care before your plan starts paying. Lower deductibles receive higher ratings.

We standardized all scores within each plan category. The best Silver-tier HMO carrier on each factor gets a perfect 5.0 score, with other carriers rated relative to this top performer.

MoneyGeek analyzed every 2026 health plan offered in North Carolina for people ages 18, 26, 40, 50 and 60. Premium costs shown reflect 40-year-old rates unless stated otherwise. Our review covers all available metal tiers: Catastrophic, Bronze, Expanded Bronze, Silver, Gold and Platinum.

About Mark Fitzpatrick

Mark Fitzpatrick is a licensed Property and Casualty (P&C) Insurance Producer and MoneyGeek's resident expert in insurance and economics. In nearly a decade covering the insurance market at LendingTree and MoneyGeek, he's analyzed hundreds of carriers and millions of rates across auto, home, renters, health and life insurance.

His work has appeared in The Washington Post, The New York Times and NPR. He draws on independent cost and consumer experience data, and no insurance company partnerships affect his recommendations.

Mark studied at Boston College and later earned a master's in economics and international relations from Johns Hopkins University. He worked in financial risk management at State Street before joining MoneyGeek. He's also a five-time “Jeopardy!” champion.

Read Full Bio »

Sources

HealthCare.gov. "Welcome to the Health Insurance Marketplace." Accessed October 4, 2026.
HealthCare.gov. " When can you get health insurance?." Accessed October 4, 2026.
NC Department of Insurance. "Health Insurance Marketplace." Accessed October 4, 2026.
HealthCare.gov. " Special Enrollment Periods." Accessed October 4, 2026.
NC Department of Health and Human Services. "Medicaid Expansion Enrollment Dashboard." Accessed October 4, 2026.

Best Health Insurance in North Carolina (2026)