North Carolina Health Insurance Help, from HealthCare.gov to Medigap

Reviewed by Steve Turner, CLU, REBC · North Carolina License 18030539 · NPN 18030539 · November 2026

I’m Steve Turner, a licensed health insurance agent and broker, licensed in North Carolina for health insurance, Medicare Supplement, and long-term care. My office is in Tampa, Florida, and I work with North Carolina clients from the mountains to the coast by phone, video, and secure e-signature, on Eastern time like you. Insurance companies pay my commission, so my help costs you nothing, and you pay the same premium you’d pay if you bought directly.

North Carolina is in the middle of real change: an insurer is leaving the Marketplace, Medicaid expansion is adding work requirements, and premiums are rising again. Here’s what that means if you buy your own coverage or are moving onto Medicare.

Buying your own plan on HealthCare.gov

North Carolina uses the federal Marketplace, so you buy individual and family plans through HealthCare.gov.

• 2027 open enrollment: November 1, 2026 to January 15, 2027. Enroll by December 15 for coverage starting January 1.
• Cigna is leaving. It stops selling individual medical plans in North Carolina after 2026. If you have Cigna, you need a new plan for January 1.
• Five insurers remain: Blue Cross and Blue Shield of North Carolina, Ambetter, AmeriHealth Caritas, Oscar, and UnitedHealthcare. Coverage areas differ by county.
• Premiums are up about 14% on average for 2027, before subsidies. That’s on top of large increases for 2026, and the extra federal help ended after 2025, so many people are paying noticeably more.
• Don’t let your plan auto-renew without comparing. If you leave your insurer, HealthCare.gov may move you to another company’s plan, and that plan may not include your doctors.

I’ll compare the plans offered in your county and show you what each would cost after your subsidy.

Medicaid in North Carolina: expansion and new work rules

North Carolina expanded Medicaid in December 2023, so most adults with incomes up to 138% of the federal poverty level can qualify. NC Medicaid also covers children.

Two changes are coming. Federal law adds work requirements for expansion adults starting in 2027: most will need to show work, school, volunteering, or another qualifying activity to stay covered. And North Carolina’s expansion law ends the program automatically if federal funding drops below set levels. If you’re on expansion Medicaid, watch your mail from your county DSS and answer every request on time. If you lose Medicaid, you have 60 days to enroll in a Marketplace plan, and I can help you find one.

Medicare and Medigap in North Carolina

• North Carolina protects Medigap buyers under 65. If you have Medicare because of a disability, insurers must sell you Medigap Plan A, D, or G within six months of enrolling in Part B.
• You get a second chance at 65. When an under-65 Medigap buyer turns 65, North Carolina gives them a new six-month window to buy any Medigap plan at standard rates.
• Your first window at 65 matters most. Outside these windows, insurers can ask health questions and turn you down.
• Thinking about long-term care? I’m licensed to sell long-term care insurance in North Carolina, and it’s usually much more affordable in your 50s and early 60s than later.
• Free counseling: SHIIP (North Carolina’s Seniors’ Health Insurance Information Program) at 855-408-1212.

How working with me from Tampa works

• Phone or video, seven days a week, 7 a.m. to 8 p.m. Same time zone as you.
• Sign on your phone. Applications and forms are signed electronically.
• I check your doctors first. Before I recommend anything, I confirm your doctors, hospital (Atrium, Novant, Duke, UNC Health, or wherever you go), and prescriptions are covered.
• I stay your agent after you enroll for claims, billing issues, income changes, and moves.

North Carolina questions

Is North Carolina still on HealthCare.gov? Yes. North Carolina uses the federal Marketplace, so you can enroll at HealthCare.gov or through a licensed agent.

I have Cigna. What happens on January 1? Cigna is leaving North Carolina’s individual market after 2026, so your plan won’t renew. Choose a new plan by December 15 to avoid a gap.

You’re in Florida. Can you really help me in North Carolina? Yes. I’m licensed by the North Carolina Department of Insurance (license 18030539), and I work with North Carolina clients by phone, video, and e-signature. You can verify my license before we talk.

Talk with Steve

Call or text (813) 388-8373, seven days a week, 7 a.m.–8 p.m. Eastern, or book a call.

Related: Individual & family health insurance · Medicare Supplement plans · All areas we serve