# Health Insurance Marketplace North Carolina 2027 > North Carolina uses HealthCare.gov. Open Enrollment runs November 1, 2026 to January 15, 2027. Metal tiers, subsidies, and the five 2027 insurers statewide. Canonical: https://christianbrinkleync.com/guides/health-insurance-marketplace-north-carolina ## Quick answer North Carolina uses the federal Marketplace at HealthCare.gov. Open Enrollment for 2027 runs November 1, 2026 to January 15, 2027, and December 15 is the last day to enroll for coverage starting January 1. ## How the Marketplace works in North Carolina North Carolina has no state exchange. Residents buy individual and family coverage through the federal Marketplace at HealthCare.gov, by phone, or with a licensed agent. One application checks Marketplace coverage and, in North Carolina, Medicaid, since the state expanded Medicaid to adults earning up to 138 percent of the federal poverty level. Plans on the Marketplace cover essential health benefits, cannot turn you down for a pre-existing condition, and cannot charge you more for being sick. Your price depends on your income, age, household size, county, and the plan you pick. ## Open Enrollment dates for 2027 Open Enrollment for 2027 coverage runs November 1, 2026 through January 15, 2027. Enroll by December 15, 2026 for coverage starting January 1, 2027. Enroll December 16 through January 15 and coverage starts February 1. Outside Open Enrollment you generally need a qualifying life event, such as losing job-based coverage, moving, marrying, or having a child. That opens a Special Enrollment Period, usually 60 days from the event. Missing the window without a qualifying event generally means waiting for the next Open Enrollment. ## Metal tiers: Bronze, Silver, Gold, Platinum Marketplace plans come in four metal tiers that describe how costs split between you and the insurer. Bronze plans pay about 60 percent of average costs, Silver about 70 percent, Gold about 80 percent, and Platinum about 90 percent. Bronze has the lowest monthly premium and the highest costs when you need care. Platinum is the reverse. Silver is the middle ground, and it is the only tier with cost-sharing reductions, which lower deductibles and copays for people who qualify. Pick the tier by how much care you expect to use, not by the premium alone. ## Health insurance cost: what drives your price Four things move your price most: your age, your tier, your county, and whether you use tobacco. Under federal rules an older adult can be charged up to three times what a younger adult pays for the same plan. In 2026 the average Marketplace enrollee paid $178 a month after tax credits, up 58 percent from $113 in 2025, according to a KFF analysis of actual enrollment data from May 2026. The average deductible rose 37 percent to $3,786 in 2026. For 2027, North Carolina's average approved rate increase is about 14.1 percent, and KFF found insurers proposed a median increase of 15 percent nationally. Your price on HealthCare.gov is the only one that counts. Run your own income and household size before you decide anything. ## Subsidies: premium tax credits and cost-sharing reductions Two kinds of help exist. The premium tax credit lowers your monthly premium, and cost-sharing reductions lower what you pay at the visit. The credit is set by the price of the benchmark plan in your area, the second-lowest-cost Silver plan, and your household income. For 2027 coverage the credit is available to households earning 100 to 400 percent of the federal poverty level. The enhanced credits that removed the income ceiling expired on December 31, 2025, so the 400 percent cliff is back: earn a dollar over 400 percent, about $63,840 for one person or $86,560 for a couple in 2027, and the credit drops to zero. You can take the credit in advance each month, but you reconcile it on Form 8962 with your tax return, and a 2025 federal law removed the cap on repaying excess advance credit for tax year 2026 onward. Report income changes to the Marketplace as they happen. Cost-sharing reductions are available only on Silver plans, for income up to 250 percent of poverty. ## North Carolina's 2027 insurers Five insurers offer Marketplace plans in North Carolina for 2027: Ambetter of North Carolina, AmeriHealth Caritas North Carolina, Blue Cross and Blue Shield of NC, Oscar, and UnitedHealthcare. Blue Cross and Blue Shield of NC is the only insurer with plans in all 100 counties. Availability varies by county, so check your ZIP code. Cigna is leaving the individual market after 2026, and Aetna left after 2025. Approved 2027 rate increases from the state filings include 8.4 percent for Ambetter, 15.8 percent for Blue Cross and Blue Shield of NC, and 27.4 percent for UnitedHealthcare. Those are averages across each insurer's plans, not your premium. ## Self-employed and between jobs If you are self-employed, estimate your annual income for the year ahead and update it when work changes, because your credit is set by that estimate. If you lose job-based coverage, you have two doors at once: COBRA, which keeps your employer plan for up to 18 months at up to 102 percent of the full premium, and a Marketplace plan through a 60-day Special Enrollment Period. Compare both before the 60 days run out. At 65 the Marketplace hands off to Medicare. A Marketplace plan does not replace Medicare, and keeping one past 65 can cost you a late enrollment penalty, so plan the switch in the months before your 65th birthday. ## Metal tiers at a glance | Tier | What it means | | --- | --- | | Bronze | Lowest premium, highest costs when you need care | | Silver | Middle ground, and the only tier with cost-sharing reductions | | Gold | Higher premium, lower costs at the visit | | Platinum | Highest premium, lowest costs at the visit | ## Checklist - [ ] Check your ZIP code: plans and prices vary by county. - [ ] Enroll by December 15, 2026 for coverage starting January 1. - [ ] Run your income and household size on HealthCare.gov before you pick a tier. - [ ] Compare the total year, premium plus deductible, not the premium alone. - [ ] Report income changes to the Marketplace as they happen. ## Frequently asked questions ### When is Open Enrollment for 2027 in North Carolina? November 1, 2026 through January 15, 2027, on HealthCare.gov. Enroll by December 15, 2026 for coverage starting January 1, 2027. Enrollments from December 16 through January 15 start February 1. ### Do I still get a subsidy in 2027? Yes, if your household income is between 100 and 400 percent of the federal poverty level. The enhanced credits expired on December 31, 2025, so above 400 percent, about $63,840 for one person in 2027, the premium tax credit drops to zero. ### What is the cheapest Marketplace plan? Bronze plans have the lowest monthly premiums, but they also have the highest deductibles and out-of-pocket costs. If you expect regular care, a Silver plan with cost-sharing reductions can cost less over the year, even with a higher premium. ### What if I miss Open Enrollment? You generally wait for the next Open Enrollment unless a qualifying life event opens a Special Enrollment Period, usually 60 days from the event. Losing job-based coverage, moving, marrying, and having a child are common qualifying events. ### Can I keep a Marketplace plan after I turn 65? You can, but it is usually the wrong move. At 65 Medicare becomes your coverage, and a Marketplace plan does not replace it. Keeping Marketplace coverage past 65 can cost you a Medicare late enrollment penalty, so plan the switch before your 65th birthday. ## Sources - [IRS: The premium tax credit](https://www.irs.gov/affordable-care-act/individuals-and-families/the-premium-tax-credit) - [Medicare: When you can join, switch, or drop a plan](https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan) ## Related - [COBRA vs Marketplace health insurance](https://christianbrinkleync.com/answers/cobra-vs-marketplace-health-insurance) - [COBRA vs Medicare at 65](https://christianbrinkleync.com/guides/cobra-vs-medicare-at-65) - [Turning 65 and the Marketplace](https://christianbrinkleync.com/guides/turning-65-aca-marketplace-plan) - [Turning 65 in North Carolina](https://christianbrinkleync.com/turning-65) - [Special enrollment](https://christianbrinkleync.com/special-enrollment) --- Educational content only, not financial or tax advice. Published by Christian Brinkley, christianbrinkleync.com.