Ranked 13 of 15 states · median $828/mo · CMS PY2026
Licensed Independent Agent · NPN #22052447 · 21 States
A 40-year-old occupational therapist 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.
When you use coverage regularly, the annual total is driven by what each visit costs and whether the clinician you already see is contracted. A plan $40 cheaper that drops your specialist is not cheaper. These rankings pair median premium with how many carriers actually file in the state.
Occupational context: Lifting and transfer injuries; repetitive 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 occupational therapist 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 occupational therapist 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 |
|---|---|---|---|---|
| Bladen | $649 | Ambetter of North Carolina | $7,000 | 4 |
| Scotland | $649 | Ambetter of North Carolina | $7,000 | 4 |
| Pender | $686 | Ambetter of North Carolina | $7,000 | 4 |
| Macon | $702 | Ambetter of North Carolina | $7,000 | 4 |
| Transylvania | $702 | Ambetter of North Carolina | $7,000 | 5 |
| Watauga | $731 | AmeriHealth Caritas Next | $6,100 | 2 |
The spread across just these six is $82/month — $986 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 occupational therapist 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
Cross-state numbers are useful for understanding whether North Carolina is treating you well, not for arbitrage. You cannot buy an out-of-state exchange plan. If you are a occupational therapist weighing a relocation for other reasons, the premium difference is a real line item worth putting in the decision.
If you file a Schedule C as a occupational therapist, the categories that usually show up are: Licensing, equipment, malpractice insurance, CE. The health premium itself is normally an above-the-line deduction under IRC §162(l), which reduces AGI rather than requiring you to itemize. Your CPA should confirm it against your actual situation.
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.
It cannot happen on an exchange plan. Rating in North Carolina uses four inputs only: age, ZIP code, tobacco use and how many people are on the policy. Trade, injury history and pre-existing conditions are all excluded from pricing by law.
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 Occupational Therapists in North Carolina and a blog covering deductibles, subsidies and special enrollment.
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