How health insurance works in North Carolina
North Carolinians buying their own coverage have two markets: HealthCare.gov (healthcare.gov), where plans from Blue Cross Blue Shield of North Carolina, Ambetter, Aetna CVS Health, and UnitedHealthcare are guaranteed-issue and priced on income, and the private shared-network market, where PPO plans on Cigna, Aetna and PHCS PPO are underwritten and priced on age and health.
Medicaid is expanded (since December 2023) in North Carolina. North Carolina has no state individual mandate.
What it costs
Full-price marketplace plans for a 40-year-old in Charlotte commonly run $550–$850 a month in 2026; with a subsidy, often under $300. Private PPOs for the same healthy person run roughly $320–$480. North Carolina has a flat state income tax, so the self-employed premium deduction helps at both the federal and state level.
The North Carolina picture
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.