North Carolina residents shop for ACA health coverage through HealthCare.gov, the federal marketplace, since the state has not built its own exchange.
North Carolina expanded Medicaid under the ACA after years of debate, so adults earning up to 138% of the federal poverty level generally qualify for coverage through the state's Medicaid program rather than needing a subsidized marketplace plan.
Because expansion is relatively recent in North Carolina compared to some other states, residents who were previously told they didn't qualify for Medicaid should check current eligibility again rather than assuming the old rules still apply. Marketplace shoppers should also compare plan networks across the state's mix of urban centers and rural counties, since choices can vary significantly by region.