Ranked 13 of 15 states · median $828/mo · CMS PY2026
Licensed Independent Agent · NPN #22052447 · 21 States
A 40-year-old speech 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.
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: Vocal strain; infectious exposure in clinical settings.
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 speech 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 speech 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 |
|---|---|---|---|---|
| Pamlico | $834 | Blue Cross and Blue Shield of NC | $2,800 | 2 |
| Yadkin | $540 | Ambetter of North Carolina | $6,000 | 6 |
| Union | $575 | Oscar Health Plan of North Carolina | $5,500 | 4 |
| Alexander | $596 | Ambetter of North Carolina | $7,000 | 4 |
| Chatham | $603 | Blue Cross and Blue Shield of NC | $2,800 | 2 |
| Gaston | $634 | Ambetter of North Carolina | $6,000 | 3 |
The spread across just these six is $294/month — $3,523 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 speech 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
A caveat on the table above: rating is by residence, not by job site. A speech therapist 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.
Self-employed Speech Therapists in North Carolina typically deduct: Licensing, materials, malpractice insurance, CE. 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. 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.
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 Speech Therapists in North Carolina and a blog covering deductibles, subsidies and special enrollment.