Key Takeaways
- Choose a plan by December 15 for January 1, or by January 15 for February 1.
- Cigna won't offer North Carolina Marketplace plans in 2027.
- Five insurers remain: Ambetter, AmeriHealth Caritas, Blue Cross NC, Oscar and UnitedHealthcare.
- Average rates rise about 14.1% before subsidies.
- Since December 2023, adults under 138% of the poverty level can get NC Medicaid.
In This Guide
North Carolina Open Enrollment Dates and Deadlines
North Carolina shops on HealthCare.gov rather than a state-run exchange. These are the dates that apply statewide.| Date | What happens in North Carolina |
|---|---|
| November 1, 2026 | You can start shopping for 2027 plans |
| December 15, 2026 | Enroll by today for coverage on January 1 |
| January 15, 2027 | Enrollment closes; plans chosen now start February 1 |
What's Changing in the North Carolina Marketplace
North Carolina's lineup shrinks from six insurers to five, according to healthinsurance.org. Enrollment also fell sharply in 2026, from about 975,000 to 761,000 people.Cigna Is Leaving
Cigna is exiting the ACA Marketplace in every state where it sells, including North Carolina. Its plans run through December 31, as long as you keep paying. After that, you need a plan from another insurer. Our guide to Cigna leaving the marketplace walks through your next steps.Rate Changes by Insurer
Final rates before subsidies rise about 14.1% on average for 2027. That is much milder than 2026, when they climbed about 27.7%. Here is how each insurer compares.| Insurer | Average change |
|---|---|
| Ambetter of North Carolina | +8.4% |
| AmeriHealth Caritas | +9.3% (proposed) |
| Blue Cross and Blue Shield of NC | +15.8% |
| Oscar | +16.5% |
| UnitedHealthcare | +27.4% |
Rate changes per healthinsurance.org. Your own change depends on your plan, age and county. In 2026, many families moved to bronze plans to save on premiums. Bronze picks rose from 45% to 64% of enrollees. Before you do the same, compare a silver plan too.
Switching From Cigna? Get a Side-by-Side ComparisonA licensed Vivna agent can compare Ambetter, Oscar and UnitedHealthcare plans for your doctors and county, free. Call 888-730-6031 or request a free quote online.
How Subsidies Work in North Carolina Now
North Carolina expanded Medicaid on December 1, 2023. Since then, adults earning up to 138% of the poverty level can qualify for NC Medicaid. Above that line, Marketplace tax credits apply. Help is still strong for many families. In 2026, about 87% of enrollees qualified for a subsidy, and they paid about $97 a month on average. However, the 400% income cap is back now that the extra federal help has ended.| Household size | 138% (Medicaid line) | 400% (subsidy cap) |
|---|---|---|
| 1 person | $22,025 | $63,840 |
| 2 people | $29,863 | $86,560 |
| 3 people | $37,702 | $109,280 |
| 4 people | $45,540 | $132,000 |
Based on 2026 federal poverty guidelines used for 2027 coverage. If you earn under 250%, look at silver plans with cost sharing reductions. Near the top? Read about the ACA subsidy cliff. Also note two 2027 changes. NC Medicaid adds a federal work requirement in January, and fewer lawfully present immigrants qualify for tax credits.
How to Enroll in a North Carolina Marketplace Plan, Step by Step
- Confirm your insurer. Cigna members need a new company for 2027.
- Gather documents. Have Social Security numbers, income records and your current plan card.
- Estimate next year's income. Count everyone on your tax return.
- Update your HealthCare.gov application. You can also call a licensed agent to do it together.
- Compare plans in your county. Check networks, drug coverage and deductibles, not just premiums.
- Enroll by December 15. Then pay your first premium for a January 1 start.
If You Miss the North Carolina Open Enrollment Deadline
After January 15, you need a qualifying life event to get a Marketplace plan. Losing job coverage, marriage and moving all count. Our special enrollment period guide lists every option. Without a life event, you still have a path. Vivna sells UnitedHealthcare short-term health insurance in North Carolina. It is not ACA coverage, but it can fill a gap until next fall. Call 888-730-6031 to compare.North Carolina Open Enrollment FAQs
When does open enrollment end in North Carolina?
It ends January 15, 2027. To start coverage January 1, enroll by December 15.What happens to my Cigna plan in North Carolina?
It ends December 31. Choose a new Marketplace plan during open enrollment to keep coverage and your tax credit.Can I get Medicaid instead of a Marketplace plan?
Yes, if you earn up to 138% of the poverty level. NC Medicaid accepts applications all year.Does Vivna charge for help?
No. Our help is free, and you pay the same premium as buying on your own.Next Steps for North Carolina Open Enrollment
First, find out whether your insurer is staying. Next, update your income and household details. Finally, compare plans and enroll by December 15. Call 888-730-6031 and we will help you choose.Sources
- healthinsurance.org: North Carolina health insurance marketplace
- HealthCare.gov: Dates and deadlines
- HealthCare.gov: Special Enrollment Period
Related Guides
- Open enrollment health insurance guide
- North Carolina health insurance
- Cigna leaving the marketplace
- Cost sharing reductions
- Special enrollment period
About the author: Heather Sprague
Heather is the owner and agent of record at Vivna Insurance, a licensed independent agency in Deerfield Beach, Florida. She helps families and self-employed workers compare marketplace, short-term and supplemental plans.
Licensed health insurance agent, Vivna Insurance (Agency NPN 19168641). Call 888-730-6031.
Reviewed by Michael Sprague, licensed health insurance agent.
Vivna Insurance is a licensed independent agency, not a government website, and is not HealthCare.gov. Our help is free; we are paid by the insurance companies we work with. Plan availability, rates and savings vary by county and income.
