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 health insurance broker, and North Carolina is one of my licensed states. Cigna is confirmed as leaving the individual market in North Carolina, on and off the marketplace, and that touches most of the state. Its plans run through December 31, 2026, and Cigna members need a new plan for 2027.
Cigna sold marketplace plans in 87 of North Carolina's 100 counties. In the big metros, its departure trims a long list. Based on this year's plans, Wake County keeps three marketplace companies, Mecklenburg four, and Guilford and Forsyth five each. Around Raleigh, Charlotte and the Triad, your job is mostly confirming your doctors in whatever plan you pick.
The story is different in the coastal plain and down the coast. In 29 counties, Blue Cross and Blue Shield of NC would be the only marketplace company selling for 2027, based on this year's service areas. That covers Greenville in Pitt County, Jacksonville in Onslow, New Bern in Craven, Rocky Mount across Nash and Edgecombe, Wilson, Goldsboro in Wayne County, Kinston in Lenoir, the Outer Banks in Dare and Currituck, and much of the northeast from Elizabeth City to Halifax County, plus Chatham County in the Piedmont. If the marketplace moves you automatically there, there's only one company it can move you to, so check your doctors in that network yourself.
Some of you are on your second forced move. Aetna left the North Carolina marketplace for 2026, and anyone who landed on Cigna after that now has to move again. Pick this one yourself.
One thing the exit doesn't change is PPO access. Cigna sold HMO plans, and Blue Cross and Blue Shield of NC's marketplace PPO plans were sold in 90 counties in 2026, all of which keep them. If you're healthy and pay full price, I'd still price a nationwide PPO next to the marketplace. You can get one in North Carolina through me, and its network isn't tied to 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.
A few other names come up in the news about this. Here's where each one actually stands.
When an insurance company leaves, your plan doesn't stop overnight. It runs through December 31, 2026, and the company has to tell you in writing first. Federal rules require at least 90 calendar days notice when a company drops a plan, and at least 180 calendar days when it leaves a state's individual market entirely. If your company is leaving and you haven't seen that letter, call the company and ask for it.
What happens next is the part people get wrong. If no plan from your company is left on the marketplace, the federal rule (45 CFR 155.335) says the marketplace may move you to a plan from a different company. It doesn't say it will. The move has to fit state law, it follows the state regulator's direction, and without that direction the marketplace picks a "similar" plan. Nothing in that rule checks your doctors or your prescriptions.
If you bought your plan straight from the company, off the marketplace, the marketplace's re-enrollment rule doesn't reach you at all. You need to pick a new plan yourself.
Open enrollment on HealthCare.gov starts November 1. By then you should get 2 letters: one from your current company and one from the marketplace. The marketplace letter tells you which plan, if any, you'll be moved into if you do nothing by December 15. HealthCare.gov is plain that in some cases you won't be automatically re-enrolled.
Pick by December 15 and your new plan starts January 1. Pick between December 16 and January 15 and it starts February 1, which leaves January uncovered if your old plan ended December 31.
Miss open enrollment and you may still have a way in. Losing a plan because it's discontinued is on HealthCare.gov's list of qualifying events, and the federal rule gives you 60 days before and 60 days after the day your old coverage ends to pick a new plan. Don't build your plan around that window. Confirm you qualify before you count on it.
Here's how I'd think about it, depending on where you are. Each path ends the same way: a call with me before the deadline.
If you earn too much for the credit, you're paying the full marketplace price, and now you're paying it for whatever is left in your county. You have another option. Private plans with medical underwriting run on nationwide PPO networks and are priced on your health, which is how the price for a healthy person can come in under the marketplace's full rate. They ask health questions up front, and the company can decline you or leave out a past condition, so we go through the details together before you choose.
Next step: Call me and I'll price a nationwide PPO for your household next to the North Carolina marketplace plans in your county.
Whatever the marketplace looks like in your county, you can still get a nationwide PPO in North Carolina through me. 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.
Private PPO plans with medical underwriting use networks that work across the country, and for a healthy person who pays full price on the marketplace, they're often worth pricing. I'm licensed in 36 states, and North Carolina is one of them.
Straight answers, no sales pitch.
Cigna (confirmed). Altogether, 87 of North Carolina's 100 counties lose at least one marketplace insurer.
Maybe, but don't count on it. The federal rule says the marketplace may move you to a similar plan from a different company, as state law and your state regulator allow. HealthCare.gov says that in some cases you won't be automatically re-enrolled, and if you bought off the marketplace, nobody moves you. Pick your own plan.
On HealthCare.gov, pick by December 15 for coverage that starts January 1. Open enrollment runs to January 15, but a plan picked after December 15 starts February 1.
Yes. You can still get a nationwide PPO in North Carolina through me. 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.
Tell me your county, who's on your plan and what your letter says. I'll show you what's left on the North Carolina marketplace, price a nationwide PPO next to it, and help you pick before the deadline. I'm licensed in 36 states and work by phone.
Every state on the list, and guides for North Carolina