This guide, including the FAQs below, was developed to help you understand the health coverage options and possible financial assistance available to you and your family in North Carolina.
The health plan options found in North Carolina’s ACA Marketplace/exchange are designed to cover people who don’t have access to Medicare, Medicaid, or an employer’s health plan. North Carolina uses the federally run health insurance exchange platform — Healthcare.gov — for residents to purchase its ACA Marketplace plans.
North Carolina’s Marketplace provides access to health insurance products from nine private insurers, all of which plan to continue to offer Marketplace coverage in 2025. 1
The federal government helps pay for insurance through an advance premium tax credit if you buy coverage from the exchange and are eligible for the tax credit based on your income. Some enrollees are also eligible for cost-sharing reductions, which reduce out-of-pocket costs on Silver-level plans for eligible enrollees.
North Carolina Medicaid expansion took effect on December 1, 2023, making hundreds of thousands of North Carolina residents newly eligible for Medicaid. Some were previously in the coverage gap, while others were previously eligible for subsidies to offset the cost of Marketplace coverage. 2
