North Carolina health insurance plans
How individual and family health coverage works in North Carolina, in plain language.
ACA Open Enrollment opens November 1st
Take a look at North Carolina plans, or go ahead and enroll yourself when it opens. Call if you need any help with your application.
Where North Carolina residents shop
North Carolina residents who buy their own coverage shop on HealthCare.gov (federal Marketplace) at www.healthcare.gov/north-carolina/. That is also where income-based help with monthly premiums (premium tax credits) is applied. Enrollment follows the federal HealthCare.gov calendar.
North Carolina began accepting Medicaid eligibility determinations from the federal Marketplace in February 2024, part of the state's continued rollout of Medicaid expansion -- an application that starts on HealthCare.gov can now route directly into NC Medicaid without a separate state application.
Enrolling
Open enrollment dates are set by the marketplace and can change from year to year, so confirm this year’s window on the marketplace site before you plan around it. Outside open enrollment you generally need a qualifying life event, such as losing other coverage, moving, or a change in household size.
What affects the plans you see
- Where you live. Plans and premiums are set by area within North Carolina, so your county matters. Find your county.
- Income and household size. These determine help with premiums and whether you may qualify for Medicaid instead.
- Plan level. Metal levels (Bronze, Silver, Gold, Platinum) trade a lower monthly premium against higher costs when you use care.
NC Medicaid, part of the Department of Health and Human Services (NCDHHS), now accepts Medicaid eligibility determinations coming directly from a HealthCare.gov application, so a single federal application can result in either ACA marketplace coverage or NC Medicaid depending on income.
There's no separate North Carolina-run ACA exchange -- HealthCare.gov handles marketplace shopping and subsidy questions for North Carolina residents directly.
SHIIP (Seniors' Health Insurance Information Program), reachable at 855-408-1212, is North Carolina's free Medicare counseling service, operated by the Department of Insurance and entirely separate from North Carolina Medical Insurance's own free phone help.
Questions
Where do I shop for ACA health plans in North Carolina?
North Carolina residents shop through HealthCare.gov (federal Marketplace) (https://www.healthcare.gov/north-carolina/). An independent agent such as Lander LLC can explain the plans for you, but the marketplace is the only place premium tax credits are applied.
How do I apply for Medicaid in North Carolina?
Medicaid in North Carolina is run through NC Medicaid (NC Department of Health and Human Services) (https://medicaid.ncdhhs.gov). Eligibility depends on income, household size and other factors, and it is decided by the state, not by an insurance agency.
Who regulates insurance in North Carolina?
North Carolina Department of Insurance (NCDOI) (https://www.ncdoi.gov/consumers) regulates insurance companies and agents in North Carolina. You can use it to check that an agent or company is licensed and to file a complaint.
Is there free, unbiased Medicare help in North Carolina?
Yes. SHIIP (Seniors' Health Insurance Information Program) (855-408-1212) offers free Medicare counseling through the State Health Insurance Assistance Program (SHIP), separate from any insurance agency.
Does North Carolina Medical Insurance cost anything to use?
There is no cost to call or to speak with an agent. Insurance premiums and plan costs are set by the insurance companies and are separate from our help.
Questions about North Carolina health plans? Call 855-367-1095
Call Lander LLC to go over your options. There is no cost to call or to speak with an agent, and you are never required to enroll in anything.
Call 855-367-1095Reviewed by Richard Lander, licensed insurance agent (NPN 21255551), Lander LLC. Last updated October 3, 2026. This page is educational and is not a quote, an offer of coverage, or legal or tax advice.