CheapestHealth InsuranceNorth CarolinaCheapest Health Insurance in North Carolina (2024 Plans)
Compare Rates and Save on Car Insurance
By , Content Director
Updated: Nov 30, 2023
Selecting metal tiers besides Silver may alter costs. In North Carolina, AmeriHealth offers affordable Bronze, while Blue Cross Blue Shield provides the lowest premiums for Catastrophic, Expanded Bronze, Silver and Gold tiers.
If you are looking to balance monthly premiums with quality claims and coverage, you can learn more from MoneyGeek's analysis of the best health insurance in North Carolina.
CheapestHealth InsuranceNorth CarolinaMost Affordable Health Insurance in North Carolina
Cheapest Silver Plan - Blue Cross Blue Shield
Cheapest Gold Plan - Blue Cross Blue Shield
Cheapest Bronze Plan - AmeriHealth
Cheapest Expanded Bronze Plan - Blue Cross Blue Shield
Cheapest Catastrophic Plan - Blue Cross Blue Shield
Cheapest Health Insurance in North Carolina by Metal Tier
Blue Home Silver Preferred from Blue Cross Blue Shield stands out as the most cost-effective option in the popular Silver tier for residents of North Carolina, with a monthly price tag of $485. Silver plans are typically the most common choice among consumers. Bronze tier plans like AmeriHealth Caritas Next Bronze Classic can be a more affordable alternative for those willing to trade lower monthly premiums for potentially higher out-of-pocket costs.
Health insurance premiums are based on metal tiers, with each tier representing a balance between monthly costs and the extent of coverage, where higher premiums typically mean lower out-of-pocket expenses and deductibles.
Here are the most affordable health insurance plans from each metal tier:
- Catastrophic: Blue Home Catastrophic | 3 PCP $35 | Integrated | with UNC Health Alliance ($233 per month) - Available only to individuals under 30 or with a qualifying hardship exemption.
- Bronze: AmeriHealth Caritas Next Bronze Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals ($351 per month)
- Expanded Bronze: Blue Home Bronze | HSA Eligible | Integrated | with Novant Health ($360 per month)
- Silver: Blue Home Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | with UNC Health Alliance ($485 per month)
- Gold: Blue Home Gold | 3 Free PCP | $10 Tier 1 Rx | with UNC Health Alliance ($503 per month)
For more options and to find cheap health insurance that meets your needs, be sure to explore various plans and providers.
WHAT ARE METAL TIERS?
In the North Carolina health insurance marketplace, consumers have access to various metal tiers, including Bronze, Expanded Bronze, Silver, Gold and Catastrophic plans. These tiers signify different levels of cost-sharing between the insurer and the policyholder.
Bronze plans typically have the lowest premiums but come with higher out-of-pocket expenses when care is needed. For example, a Bronze plan might cost $351 per month with a maximum out-of-pocket of $9,450. These plans are designed for individuals who want to keep their monthly costs down and are comfortable with paying more when they access services.
On the other hand, Gold plans have higher premiums, like the $503 monthly cost seen in our data, but lower costs when you receive care, with this example having a maximum out-of-pocket of $9,100. These plans are better suited for individuals who expect to need more health care services and prefer to have more predictable costs throughout the year.
Silver plans strike a balance between moderate premiums and out-of-pocket costs. Silver plans are eligible for cost-sharing reductions for individuals earning below 250% of the Federal Poverty Level, which lowers the amount you have to pay for deductibles, copayments and co-insurance. This makes health care much more affordable for lower-income individuals and families. For instance, while the standard Silver plan might have a monthly premium of $485 and a maximum out-of-pocket of $9,450, these amounts could be significantly lower with the cost-sharing reductions.
Catastrophic plans are also available for those under 30 or with hardship exemptions. They are designed to protect against very high medical costs with a lower premium, like the $233 monthly cost for 26-year-old buyers in the data provided.
Selecting the right tier involves weighing the monthly premium against potential out-of-pocket expenses while considering your overall health care needs. Those with lower incomes should pay special attention to Silver plans for the additional savings offered through cost-sharing reductions.
Cheapest Silver Plans in North Carolina
The most cost-effective Silver tier health insurance plan in North Carolina is the Blue Home Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | with UNC Health Alliance offered by Blue Cross Blue Shield, at a monthly cost of $485.
Here are the three most affordable Silver plans in North Carolina:
- Blue Home Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | with UNC Health Alliance from Blue Cross Blue Shield ($485 per month)
- AmeriHealth Caritas Next Silver Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals from AmeriHealth ($491 per month)
- Blue Home Silver Standard | with UNC Health Alliance from Blue Cross Blue Shield ($492 per month)
Silver plans are ideal for individuals who anticipate needing moderate health care services, prefer lower deductibles and do not want to pay high premiums. Customers with lower income might be eligible for cost-sharing reductions, which reduce out-of-pocket expenses like deductibles, copayments and co-insurance. These reductions make care and treatment more accessible and affordable when services are needed.
Cheapest Gold Plans in North Carolina
The most economical Gold tier health plan in North Carolina is the Blue Home Gold | 3 Free PCP | $10 Tier 1 Rx | with UNC Health Alliance offered by Blue Cross Blue Shield at $503 per month.
Here are the three most cost-effective Gold health plans in North Carolina:
- Blue Home Gold | 3 Free PCP | $10 Tier 1 Rx | with UNC Health Alliance from Blue Cross Blue Shield ($503 per month)
- Blue Home Gold Standard | with UNC Health Alliance from Blue Cross Blue Shield ($503 per month)
- Blue Local Gold | 3 Free PCP | $10 Tier 1 Rx | with Atrium Health from Blue Cross Blue Shield ($513 per month)
Gold plans are suited for customers who anticipate needing frequent health care services. These plans tend to have higher monthly premiums but lower out-of-pocket costs when accessing care. Gold plans are often preferred by those who want the security of more predictable health care spending and are willing to pay a higher premium for this predictability.
Cheapest Bronze Plans in North Carolina
The most affordable Bronze plan in North Carolina is the AmeriHealth Caritas Next Bronze Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals from AmeriHealth at a monthly cost of $351.
The three most affordable Bronze plans in North Carolina are:
- AmeriHealth Caritas Next Bronze Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals from AmeriHealth ($351 per month)
- UHC Bronze Essential from UnitedHealthcare ($442 per month)
- Connect Bronze 9450 Indiv Med Deductible from Cigna ($536 per month)
Bronze plans are typically well-suited for individuals who desire lower monthly premiums and are healthy enough not to require frequent medical care. These plans offer essential health benefits and provide coverage for major medical events. However, customers should be prepared for higher out-of-pocket costs when accessing care, making these plans a good fit for those who prefer lower monthly costs and the financial ability to manage higher costs for actual medical services.
Cheapest Expanded Bronze Plans in North Carolina
The most affordable option in the Expanded Bronze tier in North Carolina is the Blue Home Bronze | HSA Eligible | Integrated | with Novant Health plan, offered by Blue Cross Blue Shield for $360.
The top three most cost-effective Expanded Bronze plans in North Carolina are:
- Blue Home Bronze | HSA Eligible | Integrated | with Novant Health from Blue Cross Blue Shield ($360 per month)
- Blue Local Bronze | HSA Eligible | Integrated | with Atrium Health from Blue Cross Blue Shield ($363 per month)
- Blue Home Bronze | 3 Free PCP | $20 Tier 1 Rx | Integrated | with UNC Health Alliance from Blue Cross Blue Shield ($367 per month)
Expanded Bronze plans are designed for individuals who want lower monthly premiums while still receiving substantial coverage for major medical events. These plans typically come with higher out-of-pocket maximums, making them a strategic choice for those who are generally healthy and do not expect frequent medical care. People who prefer to pay less on a monthly basis and can manage higher expenses when they do utilize health care services might find these plans to be a suitable option.
Cheapest Catastrophic Plans in North Carolina
The most affordable Catastrophic plan in North Carolina is the Blue Home Catastrophic | 3 PCP $35 | Integrated | with UNC Health Alliance from Blue Cross Blue Shield, with a monthly cost of $233.
The three most affordable Catastrophic plans in North Carolina are:
- Blue Home Catastrophic | 3 PCP $35 | Integrated | with UNC Health Alliance from Blue Cross Blue Shield ($233 per month)
- Blue Local Catastrophic | 3 PCP $35 | Integrated | with Atrium Health from Blue Cross Blue Shield ($238 per month)
- Blue Home Catastrophic | 3 PCP $35 | Integrated | with Novant Health from Blue Cross Blue Shield ($249 per month)
Catastrophic plans like the Blue Home Catastrophic | 3 PCP $35 | Integrated | with UNC Health Alliance are ideal for individuals under 30 or those with a hardship exemption, as they primarily provide protection in worst-case scenarios. They feature low monthly premiums and a high deductible, meaning they cover essential health benefits after you've paid a significant amount out of pocket. These plans are suitable for those seeking coverage for severe or unexpected illnesses or injuries while maintaining lower monthly costs.
Cheapest Health Insurance in North Carolina for Those With Low Income
In North Carolina, individuals earning less than 250% of the Federal Poverty Level can benefit from cost-sharing reductions (CSRs) on Silver plans. These CSRs help by decreasing deductibles and out-of-pocket expenses, making health care more accessible.
The most affordable Silver plan for those earning between $14,580 and $21,870 a year is the Blue Home Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | with UNC Health Alliance from Blue Cross Blue Shield, with a Maximum Out-of-Pocket cost of $1,150.
The two cheapest Silver plans with their maximum out-of-pocket costs are:
- Blue Home Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | with UNC Health Alliance from Blue Cross Blue Shield (Monthly Cost: $485, Maximum Out-of-Pocket: $1,150)
- AmeriHealth Caritas Next Silver Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals from AmeriHealth (Monthly Cost: $491, Maximum Out-of-Pocket: $1,800)
In North Carolina, CSRs are only available with Silver plans, and the mentioned annual income figures are for a single individual. Household size will affect these income thresholds.
WHAT IS A COST-SHARING REDUCTION?
Cost-sharing reductions (CSRs) are discounts that lower the amount you spend on Silver health insurance plan deductibles, copayments and co-insurance, available to those with incomes between 100% and 250% of the Federal Poverty Level. Qualifying individuals will see reduced out-of-pocket costs, like a Max Out of Pocket decrease. For example, without CSRs, the Max Out of Pocket might be $7,900, but with a strong CSR level, it could reduce to $1,000, significantly lowering potential health care expenses.
Cheapest Health Insurance in North Carolina by Plan Type
In North Carolina, Health Maintenance Organization (HMO) plans are the most popular type of health insurance plan.
The most affordable HMO health plan in North Carolina is the AmeriHealth Caritas Next Silver Classic from AmeriHealth, which costs $491 per month.
- HMO: AmeriHealth Caritas Next Silver Classic + $0 Virtual Care 24/7 + $0 Preventive Care + No-Referrals from AmeriHealth ($491 per month)
- EPO: Blue Home Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | with UNC Health Alliance from Blue Cross Blue Shield ($485 per month)
- POS: Blue Value Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Statewide Doctors from Blue Cross Blue Shield ($543 per month)
- PPO: Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors from Blue Cross Blue Shield ($620 per month)
In addition to HMO plans, North Carolinians can also choose from EPO (Exclusive Provider Organization), POS (Point of Service) and PPO (Preferred Provider Organization) plans. EPO plans offer a balance of flexibility and cost. They typically require patients to stay within a network of doctors, but you do not need referrals for specialists.
POS plans combine elements of HMO and PPO plans, giving you the option to pay less if you use doctors within the network. However, you will still have coverage if you go outside of the network.
PPO plans afford the most freedom to see any doctor or specialist without a referral, which makes them a good choice for those desiring maximum flexibility. Note that this comes at a higher cost.
These diverse plan types cater to a range of health care needs and preferences among residents across the state.
WHAT'S THE DIFFERENCE BETWEEN PLAN TYPES?
In North Carolina, the most common plan type is the Health Maintenance Organization (HMO). Other available plan types in the state are Exclusive Provider Organization (EPO), Point of Service (POS) and Preferred Provider Organization (PPO).
Here are the key differences among these plan types:
Health Maintenance Organization (HMO)
- Pros: HMOs typically have lower premiums and out-of-pocket costs than other plans. They often offer a simple process with a primary care physician (PCP) managing your care and referrals to specialists.
- Cons: You may have limited freedom to see doctors outside of the HMO network, and seeing a specialist usually requires a referral from your PCP.
Exclusive Provider Organization (EPO)
- Pros: EPO plans often provide a moderate level of freedom to choose your health care providers within a specific network without the need for a PCP or referrals.
- Cons: You generally have no coverage for out-of-network care except in emergencies, which could result in higher costs if you go outside the network.
Point of Service (POS)
- Pros: POS plans combine features of HMOs and PPOs, offering more flexibility in choosing health care providers and allowing both in-network and out-of-network services.
- Cons: You'll typically pay less out-of-pocket when using in-network providers, but receiving care outside the network will require more paperwork and higher costs. A referral from a PCP is often necessary for specialist visits.
Preferred Provider Organization (PPO)
- Pros: PPOs provide the greatest flexibility to see any health care providers without the need for referrals, including specialists. They also offer both in-network and out-of-network care.
- Cons: PPOs often come with higher premiums and out-of-pocket costs, such as copayments or co-insurance, and the cost difference between in-network and out-of-network services can be significant.
Cheapest Health Insurance in North Carolina by County
Health insurance rates and availability of certain plans vary by county in North Carolina.
Comparing the most affordable plans in the largest and smallest counties by population shows this variation:
- Wake: Silver S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 from Aetna ($452 per month)
- Tyrrell: Silver S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 from Aetna ($645 per month)
The following table displays all available plans in each county in North Carolina.
Health Insurance Costs in North Carolina by Age and Metal Tier
In North Carolina, health insurance rates go up with age. A Silver plan costs an 18-year-old $409, while a 60-year-old pays $1,215 for the same plan. That's a $806 difference, showing how costs increase for older adults.
Metal tiers show how much coverage a plan gives. A Bronze plan for a 40-year-old costs $470, but a Gold plan with more coverage is higher at $594. That makes the Gold plan cost more by $124 per month.
What to Know About Health Insurance in North Carolina
MoneyGeek analyzed all the health insurance options in North Carolina. We cover private insurance in the marketplace with its Bronze, Expanded Bronze, Silver, Gold and Catastrophic plans. We also explain Medicaid and Medicare. We aim to help users understand their choices for health care. By giving clear information, we make it easier for people to decide what insurance is best for them.
Private Health Insurance in the North Carolina Marketplace
In North Carolina, the open enrollment period for private health insurance through the Health Insurance Marketplace typically starts on November 1 and ends on December 15 each year. During this window, residents can shop for, compare and purchase health insurance plans. If individuals miss this deadline, they may have to wait until the next open enrollment unless they qualify for a Special Enrollment Period (SEP). You can be eligible for the SEP if you experience certain life events such as marriage, having a baby or losing other health coverage. Outside of these periods, one cannot usually enroll in or change a marketplace health insurance plan.
Medicaid in North Carolina
Medicaid is a health care assistance program jointly funded by the federal and state governments to help low-income individuals and families afford medical services. In North Carolina, eligibility for Medicaid is determined by various factors, including income level, family size and categories such as being pregnant, a parent or caretaker of a dependent child, elderly, blind or disabled. Some low-income adults without children may also qualify under expanded coverage options. Applicants must meet citizenship or legal residency requirements and reside in North Carolina to receive benefits under the state’s specific eligibility rules.
Medicare in North Carolina
Medicare is a federal health insurance program primarily for individuals aged 65 or older. It is also available to younger people with disabilities or specific diseases like End-Stage Renal Disease. In North Carolina, eligibility follows the same federal guidelines. Medicare is composed of different parts: Part A covers hospital stays and some skilled nursing care; Part B covers doctors' services and outpatient care; Part C, also known as Medicare Advantage, is an alternative that bundles A, B and usually D; and Part D covers prescription drug costs.
MoneyGeek found the best Medicare Advantage Plans in North Carolina and the best Medicare Supplement plans in North Carolina.
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?
Dr. Greg Page
Assistant Professor of the Practice of Health Care Management at the Phillips School of Business at High Point University
Jeff Bolles, Ph.D.
Interim MBA Director at the University of North Carolina at Pembroke
North Carolina Health Insurance FAQ
When looking for health insurance, you may have questions about cost and availability. MoneyGeek responded to frequently asked questions about cheap private health insurance in North Carolina to help you learn more.
About Mark Fitzpatrick
sources
- HealthCare.gov. "Federal Poverty Level (FPL)." Accessed November 30, 2023.
- HealthCare.gov. "How to Pick a Health Insurance Plan." Accessed November 30, 2023.
- HealthCare.gov. "Special Enrollment Period (SEP)." Accessed November 30, 2023.