Head-to-head, from CMS Plan Year 2026 data.
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Texas is the cheaper of the two: a 40-year-old pays about $807/month for the median Silver plan, versus $828 — a difference of $21/month (3%) before subsidies.
| Texas | North Carolina | |
|---|---|---|
| Median Silver @40 | $807 | $828 |
| Cheapest Silver @40 | $540 | $540 |
| Most expensive county @40 | $1,409 | $1,128 |
| Age 27 | $443 | $443 |
| Age 60 | $1,146 | $1,147 |
| Carriers | 15 | 6 |
| Counties | 254 | 100 |
| 1-carrier counties | 7 | 0 |
| Plan types | EPO, HMO, POS | EPO, HMO, POS, PPO |
Network note: Texas 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: Texas 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.
Relocating between Texas and North Carolina counts as a qualifying life event. That buys a 60-day special enrollment period, dated from the move, to choose among North Carolina’s 6 filing carriers. Two conditions apply: at least one day of qualifying coverage during the 60 days beforehand, and the move cannot be purely for medical treatment or a holiday.
Nothing transfers. You close the Texas plan and enroll fresh against North Carolina’s 100 counties, which means a new network and a new price regardless of which insurer you land on.
Some continuity is possible: Cigna Healthcare and UnitedHealthcare file in both, out of 15 in Texas 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; Texas sells none in any of its 254. The PPO is the plan type most likely to pay outside its own network, so heading toward Texas 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 Texas and another in North Carolina. The cost lands on care received in whichever of the two you did not choose.
Picking between Texas and North Carolina on the headline number is a mistake. Enter your ZIP and I will show you what is actually filed for you.