Guides · Health insurance
2027 health insurance open enrollment in North Carolina: dates and what changed
Updated November 5, 2026
Open enrollment for 2027 health plans on HealthCare.gov runs November 1, 2026 through January 15, 2027. If you buy your own coverage in North Carolina, this is the one time each year you can sign up or switch plans without a special reason.
The deadlines
- December 15, 2026: pick a plan by this date and your coverage starts January 1, 2027.
- January 15, 2027: open enrollment ends. Plans picked between December 16 and January 15 start February 1.
After January 15, you can only sign up if you have a qualifying life event, such as losing job-based coverage, moving, getting married or having a baby.
What changed for 2027
The extra (enhanced) premium tax credits that lowered prices for many people ended after 2025. If your premium jumped, that is likely why. The regular premium tax credits still exist, so it is worth checking what you qualify for rather than assuming you can't get help.
Don't just let it renew
If you do nothing, HealthCare.gov usually renews you into the same or a similar plan. That is easy, but plans, prices and doctor networks change every year. Before you renew, check:
- Your monthly premium for 2027, after any tax credit.
- The deductible and the out-of-pocket maximum, not just the premium.
- Whether your doctors, hospitals and prescriptions are still covered. In Western NC, check the Mission and AdventHealth locations you actually use.
- Whether your household income estimate for 2027 is right. A wrong estimate can mean paying back part of your tax credit at tax time.
You might qualify for Medicaid
North Carolina expanded Medicaid in December 2023. Many adults ages 19 to 64 with lower incomes now qualify, including people who work. If your income dropped, check NC Medicaid before you buy a plan.
Dental, vision and supplemental coverage
Most health plans for adults don't cover routine dental or vision. You can add those separately. Supplemental plans, such as accident, hospital or critical illness coverage, pay you cash when something specific happens and can help with a high deductible.
On Medicare or turning 65?
Medicare has its own enrollment periods and rules. For free, unbiased help, call Medicare at 1-800-MEDICARE or the NC Seniors' Health Insurance Information Program (SHIIP) at 1-855-408-1212.
Dates from HealthCare.gov.