Who is leaving, what's left in your county, and what to do before the deadline. Last checked October 5, 2026.
One insurance company is leaving the North Carolina marketplace for 2027.
Altogether, 87 of North Carolina's 100 counties lose at least one marketplace insurer. In 29 of them, only one marketplace insurer is left.
I'm Sam Jaber, a licensed health insurance broker serving North Carolina. Cigna has confirmed it's withdrawing from the state's individual insurance market, including coverage sold both through and outside the marketplace. Most of North Carolina is affected. Existing Cigna plans end December 31, 2026, so members must select replacement coverage for 2027.
Cigna offered marketplace coverage in 87 of North Carolina's 100 counties. Its exit means fewer choices in the larger cities, although several companies remain. Using this year's plans, Wake County has three marketplace companies, Mecklenburg has four, and Guilford and Forsyth have five apiece. If you're in Raleigh, Charlotte or the Triad, I'd concentrate on finding a plan that includes the doctors you actually see.
Along the coast and across the coastal plain, the situation is tighter. Based on this year's service areas, Blue Cross and Blue Shield of NC would be the sole marketplace company in 29 counties for 2027. Those include Pitt County around Greenville, Onslow around Jacksonville, Craven around New Bern, Nash and Edgecombe around Rocky Mount, Wilson, Wayne County around Goldsboro, Lenoir around Kinston, Dare and Currituck in the Outer Banks, much of the northeast between Elizabeth City and Halifax County, and Chatham County in the Piedmont. If you're automatically transferred to another marketplace plan in one of those counties, there won't be another company to choose. I'd personally verify that your doctors participate before accepting the new coverage.
You might be facing another unwanted switch. Aetna exited North Carolina's marketplace for 2026, and people who moved to Cigna afterward must now change again. I'd make this next selection personally rather than leave it to chance.
The departure doesn't reduce marketplace PPO availability. Cigna's coverage was HMO-based, while Blue Cross and Blue Shield of NC offered marketplace PPOs in 90 counties during 2026, and all retain that option. If you're healthy and paying the entire premium, I'd compare those plans with a nationwide PPO. I can arrange one in North Carolina with a network extending beyond the state.
Different state? Pick yours here.
These are the 87 North Carolina counties where at least one marketplace insurer is leaving. For each one you can see who's leaving, how many marketplace insurers are left, and which ones.
Down to one insurer: Beaufort, Bertie, Camden, Carteret, Chatham, Chowan, Craven, Currituck, Dare, Edgecombe, Gates, Greene, Halifax, Hertford, Hyde, Jones, Lenoir, Martin, Nash, Northampton, Onslow, Pamlico, Pasquotank, Perquimans, Pitt, Tyrrell, Washington, Wayne and Wilson counties are left with only Blue Cross and Blue Shield of NC on the marketplace.
On the marketplace, PPO plans were sold in 90 of North Carolina's 100 counties in 2026, and all 90 of those counties still have one after the exits. Those PPO plans come from Blue Cross and Blue Shield of NC.
| County | Insurer leaving | Insurers left | Who's left (2026 plans) | Marketplace PPO after |
|---|---|---|---|---|
| Alamance | Cigna | 4 | AmeriHealth Caritas; Blue Cross and Blue Shield of NC; Oscar; UnitedHealthcare | No |
| Anson | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; Oscar | Yes |
| Avery | Cigna | 3 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC | Yes |
| Beaufort | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Bertie | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Bladen | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Brunswick | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Buncombe | Cigna | 4 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC; Oscar | Yes |
| Cabarrus | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; Oscar | Yes |
| Camden | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Carteret | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Caswell | Cigna | 3 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC | No |
| Chatham | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | No |
| Cherokee | Cigna | 2 | AmeriHealth Caritas; Blue Cross and Blue Shield of NC | Yes |
| Chowan | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Clay | Cigna | 3 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC | Yes |
| Columbus | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Craven | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Cumberland | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Currituck | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Dare | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Davidson | Cigna | 5 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC; Oscar; UnitedHealthcare | Yes |
| Davie | Cigna | 5 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC; Oscar; UnitedHealthcare | Yes |
| Duplin | Cigna | 2 | Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Durham | Cigna | 2 | Ambetter (Centene); Blue Cross and Blue Shield of NC | No |
| Edgecombe | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Forsyth | Cigna | 5 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC; Oscar; UnitedHealthcare | Yes |
| Franklin | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; UnitedHealthcare | No |
| Gaston | Cigna | 2 | Ambetter (Centene); Blue Cross and Blue Shield of NC | Yes |
| Gates | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Graham | Cigna | 3 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC | Yes |
| Granville | Cigna | 3 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC | Yes |
| Greene | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Guilford | Cigna | 5 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC; Oscar; UnitedHealthcare | Yes |
| Halifax | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Harnett | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Haywood | Cigna | 4 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Henderson | Cigna | 4 | AmeriHealth Caritas; Blue Cross and Blue Shield of NC; Oscar; UnitedHealthcare | Yes |
| Hertford | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Hoke | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Hyde | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Jackson | Cigna | 4 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Johnston | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; UnitedHealthcare | No |
| Jones | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Lee | Cigna | 2 | Ambetter (Centene); Blue Cross and Blue Shield of NC | No |
| Lenoir | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Macon | Cigna | 3 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC | Yes |
| Madison | Cigna | 4 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC; Oscar | Yes |
| Martin | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| McDowell | Cigna | 4 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC; Oscar | Yes |
| Mecklenburg | Cigna | 4 | Ambetter (Centene); Blue Cross and Blue Shield of NC; Oscar; UnitedHealthcare | Yes |
| Mitchell | Cigna | 4 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC; Oscar | Yes |
| Montgomery | Cigna | 2 | Ambetter (Centene); Blue Cross and Blue Shield of NC | Yes |
| Moore | Cigna | 2 | Ambetter (Centene); Blue Cross and Blue Shield of NC | Yes |
| Nash | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| New Hanover | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Northampton | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Onslow | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Orange | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; UnitedHealthcare | No |
| Pamlico | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Pasquotank | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Pender | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Perquimans | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Person | Cigna | 3 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC | No |
| Pitt | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Polk | Cigna | 4 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC; Oscar | Yes |
| Randolph | Cigna | 4 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Richmond | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Robeson | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Rockingham | Cigna | 4 | AmeriHealth Caritas; Blue Cross and Blue Shield of NC; Oscar; UnitedHealthcare | Yes |
| Rowan | Cigna | 2 | Ambetter (Centene); Blue Cross and Blue Shield of NC | Yes |
| Rutherford | Cigna | 4 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Sampson | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Scotland | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Stokes | Cigna | 4 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC; UnitedHealthcare | Yes |
| Swain | Cigna | 3 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC | Yes |
| Transylvania | Cigna | 4 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC; Oscar | Yes |
| Tyrrell | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Union | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; Oscar | Yes |
| Vance | Cigna | 3 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC | Yes |
| Wake | Cigna | 3 | Ambetter (Centene); Blue Cross and Blue Shield of NC; UnitedHealthcare | No |
| Warren | Cigna | 3 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC | Yes |
| Washington | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Wayne | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Wilson | Cigna | 1 (only one) | Blue Cross and Blue Shield of NC | Yes |
| Yadkin | Cigna | 5 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC; Oscar; UnitedHealthcare | Yes |
| Yancey | Cigna | 4 | Ambetter (Centene); AmeriHealth Caritas; Blue Cross and Blue Shield of NC; Oscar | Yes |
County data: CMS 2026 marketplace plan data source. Insurers are counted by company, and the table uses each company's 2026 service area, so a company that enters or expands for 2027 isn't counted yet. I'll update it when the 2027 plan list publishes in late October.
You've probably seen a few other names mentioned in news coverage of this. Here's what their actual situations look like.
Your coverage doesn't end immediately just because the insurer is leaving. The existing policy continues through December 31, 2026, and you're entitled to written notice beforehand. Federal requirements call for at least 90 calendar days of notice when an insurer discontinues a plan, or at least 180 calendar days when it withdraws completely from a state's individual market. Haven't received anything yet? Contact your insurer and request the notice.
Here's where people often misunderstand the process. Under federal regulation 45 CFR 155.335, the marketplace may place you with another insurer when your current company has no remaining marketplace plan. That's permission, not a guarantee. State law and the regulator's instructions govern the transfer. Without specific direction, the marketplace chooses a "similar" plan. The regulation doesn't require anyone to verify that your doctors or medications are covered.
Purchased your coverage directly from the insurer rather than through the marketplace? Its automatic re-enrollment provisions don't apply to your policy. You'll have to select replacement coverage on your own.
HealthCare.gov opens enrollment November 1. You should receive 2 notices by that point, one from your insurer and another from the marketplace. The marketplace notice identifies any replacement plan you'll be placed in if you haven't acted by December 15. HealthCare.gov also warns that automatic re-enrollment doesn't happen in every situation.
Choose your replacement no later than December 15 to begin coverage January 1. Enrolling from December 16 through January 15 gives you a February 1 effective date. If your previous policy ends December 31, that means going without coverage for January.
You might still qualify to enroll after the regular window closes. HealthCare.gov recognizes discontinued coverage as a qualifying event, and federal regulations allow 60 days before and 60 days after your old plan's termination to select replacement coverage. I wouldn't rely on that as your first choice. Make sure you're eligible before planning around those dates.
The way I'd approach this depends on your particular situation and where things stand for you. Whichever route makes sense, the next step is the same: let's talk on the phone before the deadline.
If your income puts you outside the tax credit range, you're responsible for the entire marketplace premium, with your choices limited to the insurers serving your county. That's when I'd also consider private coverage. Medically underwritten plans use nationwide PPO networks, and their pricing reflects your health. Healthy applicants may pay less than the marketplace's unsubsidized rate. There are tradeoffs: insurers ask medical questions and can reject an application or exclude a preexisting condition. We'll review those details together before you decide.
Next step: Give me a call, and I'll compare a nationwide PPO quote for your household with the marketplace coverage offered in your North Carolina county.
Regardless of which insurers remain on your county's marketplace, I can help you obtain a nationwide PPO in North Carolina. On the marketplace, PPO plans were sold in 90 of North Carolina's 100 counties in 2026, and all 90 of those counties still have one after the exits. Those PPO plans come from Blue Cross and Blue Shield of NC.
For healthy people paying the entire marketplace premium, it's worth comparing private, medically underwritten PPO coverage. These plans offer networks extending nationwide. I carry health insurance licenses in 36 states, including North Carolina.
Straight answers, no sales pitch.
Cigna (confirmed). Altogether, 87 of North Carolina's 100 counties lose at least one marketplace insurer.
Possibly, but there's no guarantee. Federal rules permit the marketplace to assign a comparable plan from another insurer when state law and regulators allow it. HealthCare.gov specifically cautions that automatic re-enrollment isn't always available. And if your current coverage was purchased outside the marketplace, that process won't apply. My advice is to choose your replacement yourself.
To start coverage January 1 through HealthCare.gov, enroll by December 15. You have until January 15 before open enrollment ends, but selecting a plan after December 15 means it won't take effect until February 1.
Yes. I can help you find a nationwide PPO available in North Carolina. On the marketplace, PPO plans were sold in 90 of North Carolina's 100 counties in 2026, and all 90 of those counties still have one after the exits. Those PPO plans come from Blue Cross and Blue Shield of NC.
Last checked October 5, 2026. I update this page when the 2027 plan list publishes in late October.
Call me with your county, the people who need coverage and the details of your notice. I'll compare the remaining North Carolina marketplace plans with a nationwide PPO quote and help you decide before enrollment ends. I'm licensed in 36 states, and we can handle everything by phone.
Every state on the list, and guides for North Carolina