You have more options than you might think

Affordable Health Insurance starts with a review of your household, care needs and budget. In Charlotte and across North Carolina, options can include NC Medicaid, Marketplace coverage with financial help, and other plans that address specific needs. The Jordan Insurance Agency helps you understand those choices and find a practical path forward.

The first step is to check which programs and plans are available for your situation. Income matters, but so do your doctors, prescriptions, enrollment timing and the benefits you want. This guide explains three routes to explore: NC Medicaid, the HealthCare.gov Marketplace, and additional coverage options, with guidance on how each works.

First, know this: there is no penalty for being uninsured

A lot of people put off dealing with Health Insurance because they're afraid of a fine. Here's the reality for 2026:

  • The federal penalty for not having Health Insurance is $0. That federal fee only applied for plan years 2018 and earlier, and there has been no federal tax penalty since plan year 2019.
  • North Carolina has no state individual-mandate penalty. Only California, Massachusetts, New Jersey, Rhode Island, and Washington, D.C. have state penalties in 2026 (Vermont has a mandate but no penalty).

Coverage can help you manage eligible healthcare expenses even though North Carolina does not impose an individual-mandate penalty. The goal is to find benefits and a premium that fit your needs, with a clear understanding of what the plan pays and what you may pay yourself.

Why did Health Insurance get so expensive for 2026?

If your premium jumped this year, it wasn't your imagination, and it wasn't your fault. A few things happened at once for 2026:

  • Insurers raised gross 2026 premiums by an estimated 26% on average nationwide, the steepest hike since 2018.
  • In North Carolina specifically, the state Department of Insurance approved individual ACA rate increases averaging about 28.6% for 2026, with approved increases ranging from 16.88% to 36.4% depending on the carrier.
  • North Carolina Marketplace plan availability varies by county and ZIP code. Comparing the current options at your address helps you check provider networks, covered prescriptions and premiums before enrolling or renewing.
  • On top of that, the enhanced subsidies that had been softening premiums since 2021 expired at the end of 2025.

Comparing current plans and checking financial-help eligibility are useful steps when your budget or premium changes. Availability varies by county and ZIP code. The Jordan Insurance Agency can review the options offered in your area and explain how the costs and benefits fit your household, at no cost to you.

Cost pressure hits hardest for people who leave work before 65 — that situation has its own answer, how to get health insurance if you retire before 65.

Door #1: NC Medicaid (free or very low cost)

Check Medicaid eligibility early in your review. For people who qualify, it can provide comprehensive benefits at little or no cost.

North Carolina expanded Medicaid on December 1, 2023, opening it up to adults ages 19 to 64 with income up to 138% of the federal poverty level. This was a huge change. Before that, many working adults earned too much for old Medicaid but too little to comfortably buy a Marketplace plan. That gap is now closed.

Who qualifies

  • Adults ages 19 to 64 with household income up to 138% of the federal poverty level, with no asset test (your savings and property don't count against you).
  • Using the official 2026 poverty guidelines, 138% of poverty works out to roughly $22,025 per year (about $1,835 per month) for one person and roughly $45,540 per year (about $3,795 per month) for a family of four using the 2026 HHS poverty guidelines for this Medicaid estimate. Marketplace assistance for 2026 coverage uses the prior year’s poverty guidelines, so the dollar thresholds differ.
  • Children's coverage at higher income levels is also delivered through NC Medicaid. The old NC Health Choice (CHIP) program no longer exists as a separate program; those children moved into NC Medicaid, which removed enrollment fees and copays for them and added benefits.

Approximately 732,000 North Carolinians are now covered through Medicaid expansion, so if you qualify, you are in very good company. Medicaid covers doctor visits, hospital care, prescriptions, and more, typically with little or no monthly premium.

A quick note on the work requirement

NC Medicaid's published guidance, checked October 3, 2026, says the new work and community-engagement requirement is not yet in effect. Under federal changes, NC Medicaid work and community-engagement requirements are scheduled to begin January 1, 2027 for expansion adults 19 to 64, with a number of exemptions (for example, pregnancy and the postpartum period, parents and caregivers of children under 14, people with disabilities, veterans with a 100% disability rating, and others). If you qualify today, that future rule shouldn't stop you from applying now.

How to apply for NC Medicaid

  • Online through ePASS at epass.nc.gov (recommended) or through HealthCare.gov.
  • By phone through your local Department of Social Services or the NC Medicaid Contact Center at 1-888-245-0179 (TTY 711).
  • In person, by mail, or by drop-off at any local Department of Social Services office.

If you're not sure whether your income lands under the Medicaid line, that's exactly the kind of thing The Jordan Insurance Agency can help you figure out before you spend hours filling out forms. To go deeper on eligibility, see our related guides on do I qualify for Medicaid in North Carolina and what the Marketplace (Obamacare) is and how it works.

Door #2: The HealthCare.gov Marketplace with financial help

If your income is above the Medicaid line, the next door is the ACA Marketplace at HealthCare.gov, where two separate kinds of financial help can dramatically lower what you pay.

Premium tax credits (subsidies)

Premium tax credits reduce your monthly premium based on your income and household size. For 2026, the way to think about it is this: eligibility generally runs from 100% up to 400% of the federal poverty level (in an expansion state like North Carolina, Medicaid covers you below 138%, so Marketplace subsidies pick up from there).

The additional pandemic-era premium tax credits ended December 31, 2025, as HealthCare.gov explains. Financial help may still be available under the 2026 income-based rules. Check your household's current eligibility and compare plans before deciding what you can afford:

  • The 400% of poverty "subsidy cliff" is back for 2026. Households earning above 400% of poverty get no premium tax credit, no matter how expensive the plan is. For a single person, 400% of poverty is about $62,600; for a family of four, about $128,600 using the 2025 poverty guidelines for 2026 Marketplace coverage. Medicaid eligibility uses its applicable current guidelines and other program rules.
  • For 2026, check the net premium for each available plan after any tax credit. Your amount depends on your household's eligibility, location and the plan you select.
  • Actual 2026 data showed the average net monthly premium payment rose 58%, from $113 to $178, partly because many people switched to cheaper plans.

A current comparison helps you see which plan offers useful benefits within your budget and how financial help changes the price. For a full walkthrough, see how ACA subsidies (premium tax credits) work.

Cost-sharing reductions (extra savings on Silver plans)

Here's a form of help many people miss. Cost-sharing reductions (CSRs) lower your deductible, copays, and out-of-pocket costs, not just your premium. They are available to households between 100% and 250% of poverty, and they only work on Silver plans, with the richest benefits below 200% of poverty. CSRs were not affected by the enhanced-credit expiration, so they're fully in place for 2026.

This is a big deal if money is tight. Picking a Silver plan when you qualify for CSRs can mean a much lower deductible than the same-priced plan without them. For many shoppers under 250% of poverty, Silver remains the best value in 2026 for exactly this reason.

A clearly-labeled hypothetical

Hypothetical example (for illustration only, not a quote): Imagine Maria, a self-employed graphic designer in Charlotte whose income lands around 200% of the federal poverty level. Because her income is above the Medicaid line but well under 250%, she likely qualifies for both a premium tax credit and cost-sharing reductions. If she chooses a Silver plan to unlock the CSRs, her deductible and copays could be far lower than they would be on a similarly priced plan without that help. If she instead grabbed a Bronze plan without checking, she'd get a lower premium but a much higher deductible, and might pay more the first time she actually needs care. The lesson: the "cheapest premium" isn't always the cheapest plan once you factor in what you'd pay when you get sick. Your real numbers depend entirely on your income, county, and the plans available to you, which is why it's worth having someone run the comparison with you.

Door #3: Additional options for different coverage needs

Depending on your needs and eligibility, other options may help with temporary coverage or specific healthcare costs. Compare the benefits, premium, duration and any remaining out-of-pocket responsibility so you understand the role each plan can play.

  • Bronze plans: the lowest premiums on the Marketplace, but the highest deductibles. Above roughly 250% of poverty, a Bronze or Gold plan can sometimes beat Silver on net price, but below that, you may be giving up valuable cost-sharing help.
  • Short-term health plans: can provide temporary coverage during a transition. North Carolina's current short-term rules generally limit a new policy to 3 months, with no more than 1 additional month of renewal or extension. Benefits and exclusions vary; pre-existing conditions and services such as maternity may not be covered. We can review the available policy terms with you.
  • Hospital indemnity / fixed indemnity plans: pay scheduled cash benefits for covered services, such as a hospital stay, rather than paying a percentage of the bill. Depending on the plan, benefits may also include doctor visits, wellness care, diagnostic services and prescriptions. We explain the schedule, any network savings and the amount you may still owe. These are supplemental benefits, not a substitute for comprehensive ACA coverage.

The Jordan Insurance Agency helps you compare the role of each option: temporary coverage for a transition, scheduled benefits to help with covered expenses, or comprehensive coverage through an eligible program or plan. Short-term and fixed indemnity coverage do not provide all ACA protections. We explain benefits, limits and eligibility together so you can make an informed choice. For more on temporary coverage, see is short-term health insurance a good idea.

Don't forget: a Special Enrollment Period may be open to you

Open Enrollment for 2026 coverage ran November 1, 2025 through January 15, 2026. If you're reading this outside that window, you may still be able to enroll if you've had a qualifying life event, such as losing job-based coverage, moving, getting married, or having a baby. You generally have 60 days after the event to enroll.

And here's a piece of good news that's easy to miss: you can apply for NC Medicaid any time of year. Medicaid isn't tied to Open Enrollment, so if your income qualifies, don't wait. Losing Medicaid or CHIP coverage also opens an extended 90-day window to sign up for a Marketplace plan.

How The Jordan Insurance Agency helps

The Jordan Insurance Agency is an independent insurance agency based in Charlotte, North Carolina, serving clients across the state. We start with your healthcare needs, household and budget, then explain the available options in plain English so you can choose with confidence.

Our review includes doctors, prescriptions, expected care and the premium you can manage. We help you check potential Medicaid eligibility, Marketplace tax credits and cost-sharing reductions, and other available coverage options. We explain how each option pays benefits and what costs remain yours, so the decision reflects more than the monthly premium.

Best of all, working with an agent costs you nothing. We're an independent agency, and agents are paid by the insurance carriers, so your premium is exactly the same whether you enroll on your own or with our help. You get an experienced guide at no extra cost.

Reach out to The Jordan Insurance Agency for personal guidance at no cost to you. We help you compare the options available for your needs, understand enrollment requirements and identify the appropriate application steps. We can assist with eligible Marketplace enrollment and point you to NC Medicaid when that program is the right route. For more on planning costs, see how much Health Insurance actually costs in North Carolina.

For households across the state line, eligibility and available programs can differ. Explore local guidance on our health insurance page for Rock Hill, SC to see how we help South Carolina residents compare their options.

Next step: Ready to explore affordable coverage? The Jordan Insurance Agency will review your needs and budget, check available financial help and explain suitable plan options. Our guidance costs you nothing extra. Reach out for a clear comparison and help with your next steps. For coverage details, review our Health Insurance options and guidance.