North Carolina Insurance Changes 2026

North Carolina's 2026 insurance landscape brings significant health cost hikes for many, with ACA health plan rates increasing significantly (around 28.6% average), expiring federal subsidies impacting affordability, and the State Health Plan introducing salary-based premiums & preferred providers, while UNC Health exits some Medicare Advantage networks, creating big shifts for residents in 2026. Affordable Care Act (ACA) Plans (Individual & Family) Big Rate Hikes: Expect average increases of nearly 28.6%, with specific insurer jumps from 16.88% to over 36%. Subsidy Expiration: Federal enhanced premium tax credits (subsidies) are expiring, meaning many will pay much more out-of-pocket unless new federal action occurs. Open Enrollment: Runs from Nov 1, 2025, to Jan 15, 2026, for 2026 coverage. NC State Health Plan (For State Employees) Salary-Based Premiums: Subscriber-only rates will now be tied to your current salary. Preferred Providers: The plan introduces "Preferred Providers" for lower copays on office visits, ending the tobacco attestation discount. New Surgery Benefit: Partnering with Lantern for $0-cost, no-copay planned surgeries (non-emergency) when using a Lantern provider. Medicare Advantage (MA) & Medicare UNC Health Exits: UNC Health is leaving several major Medicare Advantage networks, impacting provider access. Medigap Concerns: Switching from MA to Original Medicare might make it harder to get a Medigap (supplemental) plan later. Other Key Changes New Laws: A new omnibus bill (HB 737) brings potential fines for failing to report certain data changes by Jan 1, 2026. Auto Insurance: Minimum auto liability limits increased in mid-2025, affecting new/renewed policies.