Ranked 13 of 15 states · median $828/mo · CMS PY2026
Licensed Independent Agent · NPN #22052447 · 21 States
A 40-year-old realtor 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.
Coverage that only works where you sleep is not coverage if you spend the week elsewhere. The binding question is whether the plan pays out of area at all, and beyond emergencies many HMOs simply do not. States below are ordered by network reach, with the no-PPO states flagged.
Occupational context: High driving exposure; irregular hours; showing-related risk.
None of that changes your price. ACA plans in North Carolina are community rated — premium varies by age, ZIP code, tobacco use and household size only. Your occupation cannot be used to rate you, decline you, or exclude a condition. What it changes is which plan design is the right bet.
Premium is set by rating area, so a realtor 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 |
|---|---|---|---|---|
| Nash | $675 | Blue Cross and Blue Shield of NC | $2,800 | 2 |
| Buncombe | $702 | Ambetter of North Carolina | $7,000 | 5 |
| McDowell | $702 | Ambetter of North Carolina | $7,000 | 5 |
| Cherokee | $722 | AmeriHealth Caritas Next | $6,100 | 3 |
| Moore | $758 | Ambetter of North Carolina | $7,000 | 3 |
| Camden | $826 | Blue Cross and Blue Shield of NC | $2,800 | 2 |
The spread across just these six is $151/month — $1,811 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 realtor 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
A caveat on the table above: rating is by residence, not by job site. A realtor living in North Carolina and working across a state line still buys North Carolina plans. A genuine permanent move does trigger a special enrollment period, but the plan year restarts with a fresh deductible.
Deduction categories that generally fit this trade: Vehicle, NAR dues, MLS fees, E&O insurance, marketing. Note the ordering problem with health premiums: the §162(l) deduction lowers your AGI, and your AGI is what sets your premium tax credit, so the two calculate against each other. That is a CPA conversation and worth having before you enroll, not after.
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 realtor 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 Realtors in North Carolina and a blog covering deductibles, subsidies and special enrollment.