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PPO Health Insurance in North Carolina for the Self-Employed: Where to Find It
Ask for a PPO on HealthCare.gov in North Carolina and you'll mostly find HMOs and EPOs. Here's why, and where PPOs still live.
Why marketplace PPOs vanished
Guaranteed-issue plans attract the highest-cost members, and broad PPO networks are expensive to run for that population. Carriers like Blue Cross Blue Shield of North Carolina, Ambetter, Aetna CVS Health, and UnitedHealthcare responded by narrowing networks and dropping out-of-network benefits. The result: most individual plans in North Carolina are built around one hospital system.
Where PPOs still exist
In the private shared-network market. Carriers lease the national Cigna, Aetna and PHCS PPO PPO networks — the same networks large employers use — and sell underwritten plans on them. No referrals, any in-network specialist, coverage in every state. For self-employed people who travel or want to choose their own doctors, this is usually the only way to get a PPO.
What a North Carolina PPO costs
For healthy individuals, roughly $290–$600 a month depending on age and deductible; families roughly $800–$1,300. You can see live prices on our quoter.
Who qualifies
These plans are underwritten. Generally healthy applicants with no major pre-existing conditions. If that's not you, a marketplace plan is the right answer and we'll say so. Medicaid expansion in late 2023 moved hundreds of thousands of lower-income North Carolinians onto Medicaid — which means the people still shopping are mostly above the subsidy range.
Check your options to see the PPOs available in your ZIP.