Head-to-head, from CMS Plan Year 2026 data.
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Ohio is the cheaper of the two: a 40-year-old pays about $625/month for the median Silver plan, versus $828 — a difference of $203/month (32%) before subsidies.
| Ohio | North Carolina | |
|---|---|---|
| Median Silver @40 | $625 | $828 |
| Cheapest Silver @40 | $482 | $540 |
| Most expensive county @40 | $924 | $1,128 |
| Age 27 | $395 | $443 |
| Age 60 | $1,023 | $1,147 |
| Carriers | 11 | 6 |
| Counties | 88 | 100 |
| 1-carrier counties | 0 | 0 |
| Plan types | HMO | EPO, HMO, POS, PPO |
Network note: Ohio has no PPO plans in 2026 while North Carolina does. If you work across county or state lines that difference matters more than the premium gap.
Source: CMS Plan Year 2026 Qualified Health Plan Landscape. Full-price filed rates before premium tax credits; not a quote or an offer of coverage.
This page sets two states against each other. For county-by-county carriers, plan data and help actually enrolling, I publish a page for each state on Coverage by County: Ohio or North Carolina. There is also a blog covering deductibles, subsidies and special enrollment periods.
Put your ZIP code in and I will show you the carriers filing in your county, what the cheapest plan costs, and what you would actually pay after any help you qualify for. No cost, and you talk to me — not a call center.
An Ohio-to-North Carolina move triggers a 60-day special enrollment period, so the 6 carriers filing in North Carolina are open to you outside the usual window. The catch is on both ends — you normally need to have carried qualifying coverage for a day or more in the 60 days before moving, and moves made for treatment or travel are excluded.
Your plan will not come with you. Marketplace coverage is sold state by state, so the Ohio policy ends and a North Carolina application begins — new network, new premium, even if the name on the card stays the same.
Some continuity is possible: UnitedHealthcare file in both, out of 11 in Ohio and 6 in North Carolina. Same company is easier paperwork, but it is a different plan on a different network at a different price.
This is the asymmetry that bites. North Carolina has PPO plans across 90 of 100 counties; Ohio sells none in any of its 88. The PPO is the plan type most likely to pay outside its own network, so heading toward Ohio usually costs you the ability to see North Carolina providers for anything short of an emergency.
Splitting the year does not mean splitting the coverage. You can hold a marketplace plan only in your state of primary residence — the address you file from — not one in Ohio and another in North Carolina. The cost lands on care received in whichever of the two you did not choose.
State averages hide enormous county-level spread. Whichever of Ohio or North Carolina you are in, your ZIP is what sets your premium.