Ranked 13 of 15 states · median $828/mo · CMS PY2026
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A 40-year-old real estate agent 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 counties covered, North Carolina ranks 3 of 15 for this occupation.
Once your work crosses county and state lines, network geography stops being a detail and becomes the whole decision. An HMO contracted in one metro leaves you paying cash 200 miles down the road, and a handful of states filed no PPO at all for 2026. These rankings lead with reach.
Occupational context: High driving exposure; irregular hours; showing-related risk.
Worth being clear about what this does and does not affect: a carrier in North Carolina cannot ask what you do for a living, cannot charge a real estate agent more than a librarian of the same age in the same ZIP, and cannot exclude anything you were already treated for. Occupation only tells you which plan structure to shop for.
Premium is set by rating area, so a real estate agent 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 |
|---|---|---|---|---|
| Catawba | $596 | Ambetter of North Carolina | $7,000 | 4 |
| Orange | $603 | Blue Cross and Blue Shield of NC | $2,800 | 4 |
| Warren | $641 | Ambetter of North Carolina | $7,000 | 4 |
| Sampson | $649 | Ambetter of North Carolina | $7,000 | 4 |
| New Hanover | $686 | Ambetter of North Carolina | $7,000 | 4 |
| Jackson | $702 | Ambetter of North Carolina | $7,000 | 5 |
The spread across just these six is $107/month — $1,279 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 reach | 2026 |
|---|---|
| Counties in the state | 100 |
| Counties with only one carrier | 0 (0%) |
| Plan types available | EPO, HMO, POS, PPO |
| PPO available on exchange | Yes |
| Carriers filing in the state | 6 |
| Cheapest Silver @40 | $540 — Davidson |
North Carolina has PPO plans available. For a real estate agent covering distance, that single fact outweighs premium: 0 of 100 counties here are served by one carrier, so an HMO bought in one metro may leave you out of network for the rest of your route.
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 real estate agent 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.
Expense categories that typically apply to this trade: Vehicle, licensing, MLS dues, E&O insurance, marketing. Premiums are generally deductible above the line under IRC §162(l) when no employer plan is available to you or your spouse — a question for your CPA, not your agent.
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. Under the ACA, carriers cannot rate, decline, or exclude based on occupation or health history. Rates vary only by age, ZIP code, tobacco use and household size.
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.
Below the cliff. At this income a single-person household remains eligible for a premium tax credit in 2026.
This occupation is below the cliff in all 20 states reported.
What this figure is. It is the median annual wage BLS reports for Real Estate Sales Agents (SOC 41-9022) in North Carolina. BLS surveys wage and salary workers and excludes the self-employed, so it is a benchmark for the occupation in this state — not the income of a self-employed real estate agent. Premium tax credit eligibility is set by household modified adjusted gross income and household size, not by occupation, so treat this as a reference point rather than a determination of what you qualify for.
Why the cliff is back. The enhanced premium tax credits expired on 31 December 2025. For plan year 2026 the 400% FPL limit applies again, so household income above $62,600 ends premium tax credit eligibility outright.
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 Real Estate Agents in North Carolina and a blog covering deductibles, subsidies and special enrollment.
North Carolina loses a carrier this cycle: Cigna is out of the ACA individual market from January 1, 2027, leaving 5 filing here. For Real Estate Agents that is a forced decision, and a better one made in November than in January.
On price the only honest number today is national: the Peterson-KFF read of 2027 filings puts the median proposed rise near 15%, spanning −1% to 54%. Final North Carolina rates are not approved, so any precise 2027 figure quoted for this state is guesswork.
Enrollment opens November 1, 2026. Treat December 15 as the deadline: it guarantees January 1 cover on every marketplace, North Carolina included. Conflicting end dates get quoted because a 2025 rule shortened the window and a court vacated it in June 2026, appeal pending — enrol by the 15th and the argument is irrelevant to you.
Check before renewing: PPOs are sold in 90 of North Carolina’s 100 counties, not all. Whether yours has one decides how much out-of-network care is covered — usually a bigger question for Real Estate Agents than the monthly figure.
You already know you are changing plans — Cigna is leaving. The only real question is whether you pick the replacement or the marketplace picks it for you, and that is a much easier decision made in August than in the second week of December.
Give me a ZIP and I will tell you three things:
Two Real Estate Agents on opposite sides of North Carolina can be quoted very different premiums for the same plan. Your ZIP is what decides it.