Choosing a health care plan doesn’t have to be overwhelming. Here’s what you need to know.
- Schedule a virtual visit with a Blue Cross and Blue Shield of North Carolina (Blue Cross NC) expert
- Get face-to-face support at a Beyond Blue Neighborhood Center
- Reach out to your trusted authorized agent
Everyone under the age of 65 has the opportunity to purchase health insurance during the Open Enrollment Period (OEP). Whether you’re enrolling for the first time or exploring new plan options, Blue Cross NC is here to help you understand what’s available, what’s changing, and steps to take next.
Open Enrollment begins
Enroll by this date for coverage starting January 1
Final deadline for coverage starting February 1
You may qualify if you:
- Live in the U.S. (in one of the 50 states or Washington, D.C.)
- Are a U.S. citizen, U.S. national, or lawfully present immigrant
Marketplace coverage is not available for:
- People who already have health insurance from a job, Medicaid, or Medicare
- Individuals who are currently incarcerated
- Young adults who have aged out of a parent’s plan (usually at age 26)
- Individuals and families who don’t get coverage through an employer
- People with pre-existing conditions (Marketplace plans are required to cover them)
- Lowest monthly premiums, higher out-of-pocket costs
- Best for healthy individuals needing coverage mainly for emergencies
- Moderate premiums and costs
- Unlocks extra savings if you qualify for subsidies
- Great for lower-income households
- Higher monthly premiums, lower costs when getting care
- Ideal for those with ongoing health needs or regular prescriptions
Federal subsidies, also called premium tax credits, may lower your monthly cost. The federal government offers two types of subsidies for those who qualify:
- Advanced Premium Tax Credit (APTC) - Lowers monthly premiums
- Cost-Sharing Reductions (CSRs) - Lowers deductibles, copays, and coinsurance (available only on Silver plans)
You may qualify for both, significantly reducing your costs. More Information About Subsidies
Open Enrollment is your once-a-year window to take control of your health care coverage for the year ahead. During Open Enrollment, you’ll be able to:
- Sign up for a new health care plan
- Switch to a different plan that better meets your needs
- Update your information to ensure you get the right coverage and savings
If you miss this period, you may have to wait an entire year - unless you qualify for a Special Enrollment Period due to a major life change (like losing other coverage, getting married, or having a baby).
- Gather basic personal information – You'll need the names, Social Security numbers, birthdates, and immigration status (if applicable) of each member of your household.
- Total your income – Your household income determines if you qualify for subsidies.
- Gather key documents - Pay stubs, tax returns, or W-2s will help you verify your income.
- Review current coverage - If you already have health insurance, determine if it meets your needs in light of what you anticipate for the coming year like prescriptions or planned procedures.
- Compare Marketplace plans - Compare plans based on premiums, deductibles, provider networks, and coverage options.
- Compare provider networks - See which of your preferred doctors, hospitals, and specialists are in-network with different plans. And see if your prescriptions are covered under each plan’s formulary (list of covered drugs).
- Blue Cross NC is here to help - Speak with an expert at the Beyond Blue Neighborhood Center nearest you.
- Estimate your potential subsidy – Since 2021, many people have received extra savings, called enhanced premium tax credits, from the federal government to offset the cost of their Marketplace health plans. But starting in 2026, those extra savings from the government are going away. You can estimate your 2026 subsidy with our Subsidy Calculator starting November 1.
- Report your income – To receive the correct subsidy amount and avoid potential fees, be sure to update your income information before you enroll.
- Avoid the $5 monthly fee – If you’re in a $0 premium plan and don’t update your information during OEP, a $5 monthly fee may apply.
We know rising health care costs can be a challenge. At Blue Cross NC, we’re working to change that by:
- Serving all 100 North Carolina counties
- Reinvesting in health solutions, not shareholders
- Helping you compare procedure and prescription costs
- Improving provider access and removing outdated care barriers
- Tackling big issues like youth mental health
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
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© 2025 Blue Cross and Blue Shield of North Carolina. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Blue Cross NC is an abbreviation for Blue Cross and Blue Shield of North Carolina. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association.