North Carolina private health insurance FAQ

North Carolina uses the federally facilitated Marketplace at HealthCare.gov. Open Enrollment for 2027 coverage is November 1, 2026 through January 15, 2027. Enroll or change by December 15, 2026 for coverage that starts January 1, 2027. Enrollments from December 16, 2026 through January 15, 2027 generally start February 1, 2027. After January 15, 2027, you usually need a Special Enrollment Period.

Sources: HealthCare.gov.

Yes. northcarolinaprivatehealthconnected.com is a standalone North Carolina site. It is not written for any other state, and it should not surface for searches about other states. Plan availability in North Carolina depends on your county and ZIP code.

Yes. If you are not eligible for Advanced Premium Tax Credits, or you do not want to use them, you can often buy an ACA plan off the Exchange from an insurer or through an agent. Off-Exchange-only plans are still ACA plans when they are filed that way, but they are not eligible for federal premium subsidies or the enhanced benefits that run through HealthCare.gov.

Sources: CMS Health Insurance Exchange Public Use Files, Plan Attributes, plan year 2027.

Only an official Marketplace eligibility determination can answer that for your household. Credits, when available, apply to eligible HealthCare.gov plans — not to off-Exchange ACA plans and not to short-term policies. Temporary enhanced credits from earlier years have ended; standard credits may still apply if you qualify. We can help you start that check. We will not invent a monthly credit amount on this website.

Sources: HealthCare.gov; HealthCare.gov.

Issuers that offered individual Marketplace (on-Exchange) medical plans in North Carolina for plan year 2027, compiled from official sources cited on the Carriers page. A company may also sell off the Exchange. You must live in the plan’s approved service area. This agency is appointed with these issuers and with the other North Carolina Marketplace/ACA issuers from plan years 2020–2027 listed on the Carriers page. An appointment does not mean every plan is available in every North Carolina county or ZIP code.

Source: CMS Health Insurance Exchange Public Use Files, Plan Attributes, plan year 2027.

No. Short-term limited-duration insurance is not required to comply with ACA protections, is not minimum essential coverage, and does not qualify for premium tax credits. Insurers may deny applications because of medical history, and most of these plans do not cover pre-existing conditions. Expiration of a short-term plan does not by itself create a Marketplace Special Enrollment Period.

Source: DOL/HHS/Treasury, Aug. 7, 2025.

It depends on the product being offered and on current federal and North Carolina rules, which have changed in recent years. In August 2025, federal agencies said they do not intend to prioritize enforcement of the 2024 federal short-term definition pending new rulemaking. Ask for the duration actually being offered and read the outline of coverage; this site will not promise a particular term length.

Source: DOL/HHS/Treasury, Aug. 7, 2025.

If you have a qualifying life event, you may get a Special Enrollment Period. Examples include certain household changes (marriage; birth, adoption, or foster placement; divorce or separation when you lose coverage), a qualifying move, loss of qualifying health coverage (generally within the past 60 days, or expected in the next 60 days; often 90 days after losing Medicaid or CHIP), or an offer of an individual coverage HRA. Some events have specific effective-date rules. Losing short-term coverage is not, by itself, a qualifying event.

Source: HealthCare.gov Special Enrollment Periods.

They are the ten benefit categories ACA individual and small-group plans must cover: outpatient (ambulatory) care, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services including behavioral health treatment, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services and chronic disease management, and pediatric services including oral and vision care.

Source: CMS, essential health benefits.

Adam Chidel is a licensed health insurance agent, CEO of Titan Legacy Insurance Brokerage and President of Chidel Family Insurance Inc. His National Producer Number is 18746906. He is based in Tampa, FL. Call 813-909-5628 or email achidel@titanlegacyins.com. His Florida resident insurance license number is W477560. His Florida license type is 2-15 Resident Health & Life (Including Annuities & Variable Contracts). Office hours are 8am–8pm ET. Our licensed team serves clients in all 50 states. This website is written for North Carolina residents only. You can verify a Florida license on the DFS Licensee Search.

Source: Florida DFS Licensee Search. Florida license W477560. NPN 18746906. License type: Florida DFS, 2-15 Resident Health & Life (Including Annuities & Variable Contracts) Agent License.

No. This is a private agency website. We are not affiliated with HealthCare.gov, HealthCare.gov, HHS, CMS, or the North Carolina Department of Insurance. Official applications and official plan-comparison tools live on those government sites. We cite them so you can check our facts.

Twenty-five active licensed professionals work for you, the consumer, to find the carrier and policy that best fit your needs. As brokers, we are unbiased about which carrier you choose. We help you understand your options, narrow them down, submit applications, and work toward approval for coverage that balances what you pay in total each year — premium, deductible, copays, and prescriptions — against the benefits you receive. Insurance is not black and white. A 30-year-old who mainly goes in for an annual physical and a 55-year-old who takes several brand-name medications and hits a deductible every year should not expect the same year-long cost, or the same “best” plan. On ACA and Marketplace plans, the monthly premium cannot be based on your health or medical history; it may vary only by age, where you live, tobacco use, and whether the plan covers dependents. What still differs — often by a lot — is what you pay when you actually use care. Some private, medically underwritten (non-ACA) plans may consider health history, which can favor a healthier applicant and can mean a decline or a different price if you have significant conditions. ACA plans remain guaranteed issue regardless of health. We compare the total yearly picture, not just the premium.

Sources: HealthCare.gov; CMS Market Rating Reforms.

No. Affordable Care Act and Marketplace plans cannot set your premium based on your health, medical history, or sex. Those premiums may vary only by age, location (rating area), tobacco use, and whether the plan covers an individual or a family. Total yearly cost can still differ a lot because deductibles, copays, coinsurance, and prescription costs depend on how you use care, so the plan that fits is often not the cheapest monthly premium. Some private, medically underwritten (non-ACA) plans may use health history in underwriting and pricing, which can favor a healthier applicant and can mean a decline or a different price if you have significant conditions. ACA plans remain guaranteed issue regardless of health.

Sources: HealthCare.gov, How insurance companies set health premiums; CMS Market Rating Reforms.

We are appointed with the issuers that offered individual ACA or Marketplace plans in North Carolina in plan years 2020 through 2027, grouped by brand on our Carriers page, and with private PPO and other carriers including, but not limited to, the private names listed on that page. PHCS/MultiPlan is a PPO network, not a carrier. We also work with individual and small-business private options for self-employed people. An appointment does not mean every plan is available in every county or ZIP code, and some private brands are not sold in every state.

See the Carriers page for the full list and official sources.

We are available 8am–8pm ET. Call or email and we will respond during those hours.