Ranked 13 of 15 states · median $828/mo · CMS PY2026
Licensed Independent Agent · NPN #22052447 · 21 States
A 40-year-old roofer 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 highest out-of-pocket maximum, North Carolina ranks 7 of 15 for this occupation.
Injury exposure means the number that matters is the out-of-pocket maximum, not the premium. A single ER visit and follow-up can hit that ceiling in one month, so these pages rank states by worst-case annual exposure rather than by monthly cost.
Occupational context: One of the highest fall-fatality rates of any US trade; heat illness.
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 roofer 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 roofer 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 |
|---|---|---|---|---|
| Rowan | $586 | Blue Cross and Blue Shield of NC | $2,800 | 3 |
| Alamance | $603 | Blue Cross and Blue Shield of NC | $2,800 | 5 |
| Cleveland | $621 | Oscar Health Plan of North Carolina | $5,500 | 3 |
| Cumberland | $649 | Ambetter of North Carolina | $7,000 | 4 |
| Wilkes | $674 | Blue Cross and Blue Shield of NC | $2,800 | 4 |
| Avery | $702 | Ambetter of North Carolina | $7,000 | 4 |
The spread across just these six is $116/month — $1,396 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 — worst-case exposure | 2026 |
|---|---|
| Lowest annual out-of-pocket maximum | $0 |
| Highest annual out-of-pocket maximum | $0 |
| Cheapest Gold plan @40 | $558 — Ambetter of North Carolina |
| Gold deductible | $2,000 |
| Cheapest Silver @40 | $540 — Ambetter of North Carolina |
| Cheapest Silver @50 | $755 |
For a roofer, the gap between $0 and $0 in annual out-of-pocket maximum is worth more than any premium difference on this page. One serious injury reaches that ceiling regardless of which plan you picked.
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 roofer weighing a relocation for other reasons, the premium difference is a real line item worth putting in the decision.
Self-employed Roofers in North Carolina typically deduct: Tools, truck, fall-protection gear, liability insurance. 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.
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 Roofers in North Carolina and a blog covering deductibles, subsidies and special enrollment.