Comparing Plans Made Easier
Health Care Reform has made it easier than ever to compare health insurance plans.
Plans are divided into different metallic levels—Bronze, Silver, and Gold—with various coverage options, deductibles, co-payments, and coinsurance requirements. You can choose the plan that best fits your needs during the annual open enrollment period: November 1st – December 15th.
If you experience a qualifying life event (e.g., marriage, divorce, new baby, loss of coverage, or relocation), you may be eligible for a special enrollment period, with documentation required.
Healthcare Has Changed
Visiting the hospital has become more complex over the last few years.
For over 20 years, The Mair Agency has helped thousands of North Carolina residents find the right health insurance for themselves and their families. We exclusively work with Blue Cross Blue Shield of North Carolina, known for quality coverage and excellent customer service.
Blue Cross's Ease-Of-Use
When you choose a Blue Cross NC plan, you’ll receive:
- Customer Service Support: Local professionals are ready to answer your questions quickly and accurately.
- Online Member Tools: Access Blue Connect from any mobile phone, tablet, or laptop for everything you need to manage your health plan.
- Doctor and Hospital Choices: Blue Cross NC offers a wide range of network options to fit your needs.
- Worldwide Coverage: With the BlueCard program, your health plan travels with you, ensuring coverage wherever you go.
Key Benefits of BCNC Plans
- No Waiting Period for Pre-Existing Conditions
- Preventive Care Benefits: Covered services include annual exams, diabetes screenings, mammograms, and more.
- Essential Health Benefits:
- Preventive Care
- Professional Services
- Hospital Services
- Outpatient Services
- Urgent and Emergency Care
- Maternity Services
- Mental Health and Substance Abuse Services
- Pediatric Dental and Vision Care
Affordable Care Act (ACA) Plans in North Carolina
The individual and family health plans we offer through Blue Cross NC are Affordable Care Act (ACA) plans, often called Obamacare plans.
The ACA sets the ground rules for health insurance you buy on your own. ACA plans cannot turn you down or charge you more because of your health history, must cover the essential health benefits listed above, and have no annual or lifetime dollar limits on those benefits. Young adults can also stay on a parent’s plan until age 26.
The North Carolina Health Insurance Marketplace
North Carolina uses the federal Health Insurance Marketplace at HealthCare.gov, where residents shop for ACA plans and apply for premium tax credits. You do not have to sort through it alone. Our licensed agents compare Blue Cross NC ACA plans with you, including Blue Advantage and Blue Value, check whether you qualify for savings, and help you complete your enrollment.
What’s Changing for 2027 ACA Coverage
- Enhanced tax credits have ended: The larger premium tax credits available from 2021 through 2025 have expired. Savings now follow the original ACA rules, so households earning more than 400% of the FPL generally do not qualify.
- Tax-time repayment limits are gone: Starting with 2026 coverage, if your income ends up higher than you estimated, you may owe back more of your advance premium tax credit when you file your taxes. Report income changes to the Marketplace as soon as they happen.
- Bronze plans now pair with an HSA: Bronze plans can now be paired with a Health Savings Account (HSA), giving you a tax-advantaged way to save for deductibles and other out-of-pocket costs.
- Prices change every year: Premiums and plan options are updated each fall, so review your coverage during open enrollment even if you plan to keep the same plan. See the 2027 ACA open enrollment dates and deadlines.
Common Questions About the Affordable Care Act
Is Obamacare the same as the Affordable Care Act?
Yes. Obamacare is a common nickname for the ACA. ACA plans, Marketplace plans, and Obamacare plans all describe the same type of coverage.
Are ACA plans private insurance?
Yes. ACA plans are private health insurance plans sold by companies like Blue Cross NC. The Marketplace is where you compare them and apply for savings, but the coverage itself comes from the insurance company.
Who can buy an ACA plan in North Carolina?
Most North Carolina residents who are U.S. citizens or lawfully present and are not enrolled in Medicare can buy an ACA plan. Whether you also qualify for lower costs depends on your household income and size. See if you are eligible for a subsidy.
Does an ACA plan cost more if I use an agent?
No. ACA plan premiums are the same whether you enroll on your own or with a licensed agent, so our guidance comes at no extra cost to you.
What happens to my ACA plan when I turn 65?
Most people move from ACA coverage to Medicare at 65. Your Marketplace plan does not end on its own, so plan your Medicare start date and your ACA plan cancellation together. Learn the basics of Medicare.
Do You Qualify for Health Insurance Subsidies?
The federal government offers financial assistance (subsidies) to individuals and families based on income and household size.
To qualify, you must:
- Be between 100% and 400% of the Federal Poverty Level (FPL).
- Not be eligible for public coverage (Medicaid, CHIP, Medicare, or military insurance).
- Not have access to employer-provided insurance unless it does not meet minimum essential coverage or is considered unaffordable (if the self-only premium exceeds 9.56% of your household income).
- Income below 138% of the FPL may qualify you for Medicaid or CHIP if your state has expanded Medicaid.
- Income between 100% and 250% of the FPL may qualify you for cost-sharing reductions on Silver plans.
Cost assistance is determined by your Modified Adjusted Gross Income (MAGI), which includes the head of household’s income and the Adjusted Gross Income (AGI) of any dependents. If you file as single, only your MAGI counts.
Understanding Federal Poverty Levels (FPL)
Federal Poverty Levels (FPL) are used to determine eligibility for cost assistance when purchasing insurance through the Health Insurance Marketplace. They also help determine Medicaid and CHIP eligibility, among other assistance programs.
| Family Size | 48 Contiguous States | Alaska | Hawaii |
|---|---|---|---|
| 1 | $15,060 | $18,810 | $17,310 |
| 2 | $20,440 | $25,540 | $23,500 |
| 3 | $25,820 | $32,270 | $29,690 |
| 4 | $31,200 | $39,000 | $35,880 |
| 5 | $36,580 | $45,730 | $42,070 |
| 6 | $41,960 | $52,460 | $48,260 |
| 7 | $47,340 | $59,190 | $54,450 |
| 8 | $52,720 | $65,920 | $60,640 |
Chart based on: https://aspe.hhs.gov/poverty-guidelines
For households with more than 8 people, add $5,140 per additional member in the contiguous states, $6,430 in Alaska, and $5,910 in Hawaii.
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