Ranked 13 of 15 states · median $828/mo · CMS PY2026
Licensed Independent Agent · NPN #22052447 · 21 States
A 40-year-old dietitian in North Carolina pays a median $828/month for a Silver plan before subsidies — 13th of 15 on cost. The cheapest plan in the state is $540 from Ambetter of North Carolina in Davidson. On median Silver premium, North Carolina ranks 13 of 15 for this occupation.
Patient-facing and standing work means steady, predictable utilization — regular visits, prescriptions, physical therapy. Copay structure and network breadth drive real annual cost more than the headline premium, so these pages rank states on median premium and carrier count together.
Occupational context: Prolonged standing and sedentary counseling strain.
Two things get confused here constantly. Risk exposure decides what coverage you should buy. It does not decide what you are charged — North Carolina carriers rate on age, ZIP, tobacco and family size, full stop. A dietitian with a bad back and a healthy 40-year-old office worker in the same county see the same number.
Premium is set by rating area, so a dietitian in one North Carolina county can pay materially more than one an hour away. Six counties from across the state, cheapest Silver plan for a 40-year-old:
| County | Cheapest Silver @40 | Issuer | Deductible | Carriers |
|---|---|---|---|---|
| Carteret | $834 | Blue Cross and Blue Shield of NC | $2,800 | 2 |
| Tyrrell | $834 | Blue Cross and Blue Shield of NC | $2,800 | 2 |
| Guilford | $542 | Ambetter of North Carolina | $6,000 | 6 |
| Franklin | $584 | Blue Cross and Blue Shield of NC | $2,800 | 4 |
| Burke | $596 | Ambetter of North Carolina | $7,000 | 4 |
| Durham | $603 | Blue Cross and Blue Shield of NC | $2,800 | 3 |
The spread across just these six is $291/month — $3,494 a year for the same metal tier. Statewide the range runs $540 to $1,128. Coverage by County publishes all 100 North Carolina counties individually.
| North Carolina — network and cost | 2026 |
|---|---|
| Median Silver premium @40 | $828 |
| Cheapest Silver @40 | $540 — Ambetter of North Carolina (Davidson) |
| Most expensive Silver @40 | $1,128 |
| Carriers filing in the state | 6 — Ambetter of North Carolina, AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC, Cigna Healthcare |
| Plan types available | EPO, HMO, POS, PPO |
| Counties with only one carrier | 0 of 100 |
North Carolina has 6 carriers filing and 0 of 100 counties served by a single issuer. For a dietitian with an established provider relationship, that carrier count is the number that decides whether you keep your doctor.
Source: CMS Plan Year 2026 Qualified Health Plan Landscape file. 4,859 plan records across 100 North Carolina counties. Full-price filed rates before premium tax credits — verify at enrollment.
Cheaper for the same coverage: Florida ($789), Utah ($805), Texas ($807). More expensive: Arkansas ($828), Nebraska ($875).
Side-by-side: North Carolina vs Utah · North Carolina vs Texas · North Carolina vs Arkansas · North Carolina vs Nebraska
Read the comparison as context, not as a shopping list. Your county of residence determines what you can buy, and for a dietitian that is fixed unless you relocate. Where it is actionable is a move already in progress — that is a qualifying life event, and you have 60 days on either side of it.
Self-employed Dietitians in North Carolina typically deduct: Licensing, CE credits, practice-management software. Health premiums sit separately, above the line under IRC §162(l), and only when neither you nor a spouse could have joined an employer plan — eligibility disqualifies you even if you declined the coverage.
If your household income is above the subsidy range, ACA is not automatically the answer. There are other categories of coverage that may fit, and they work very differently. That is a conversation, not a web page.
The cheapest Silver plan for a 40-year-old in North Carolina is $540 per month from Ambetter of North Carolina, with a state median of $828. Both figures are full price before premium tax credits; most buyers pay less after subsidies.
No. North Carolina exchange plans are guaranteed issue and community rated, so a dietitian pays exactly what anyone else of the same age in the same ZIP pays. Occupation is not on the application as a rating factor.
Yes. Plan types filed for 2026: EPO, HMO, POS, PPO.
North Carolina ranks 13 of 15 states covered here, at a median $828 per month. Indiana is cheapest at $558 and Nebraska is most expensive at $875.
This page compares states. For North Carolina specifically — county-by-county carriers, plan data and enrollment help — I publish that on Coverage by County, including a page written for Dietitians in North Carolina and a blog covering deductibles, subsidies and special enrollment.