Best Health Insurance Plans in North Carolina 2025

Plans with lower costs, such as premiums, deductibles, copays, coinsurance and out-of-pocket maximums, score the best.

We evaluate plans’ costs using marketplace health plan datasets. These enormous spreadsheets include as many as 149 discrete data points for over 100,000 plan offerings in 31 states that use the federal marketplace (other states use their own separate marketplaces).

It’s not feasible to evaluate every kind of cost in every scenario, so we use these as a sample:

Premiums

Premiums have the highest weight in our scoring. We compare each plan’s unsubsidized premium for a 30-year-old individual as a level playing field for comparison. We score plans based on how cheap they are compared to other plans of the same type and metal — Silver HMOs vs. other Silver HMOs, for example.

Deductibles

The amount you need to pay out of pocket before your plan starts to pay for its share of covered benefits. The lower the deductible, the better.

Out-of-pocket costs

We analyze each plan’s copays, coinsurance and deductibles for primary care visits, specialist appointments, emergency care and several tiers of prescription drugs.

Plans score higher if they made covered medical care and prescription drugs more easily accessible.

We evaluate plans’ coverage using the same marketplace health plan datasets that we use to analyze costs along with additional data from government-provided “public use files.”

All marketplace plans have to cover the same essential health benefits, but some plans’ coverage is more usable than others. We score them on how coverage works.

Pre-deductible benefits

We give a strong scoring preference to plans that cover certain benefits before (and also after) you’ve met the deductible. Plans get lower scores when they don’t start to cover things like doctor’s office visits or prescription drugs until you’ve paid the full deductible.

Dental coverage

Plans that cover adult dental care also get more points for coverage than plans that don’t. (Unlike children’s dental care, adult dental care isn’t considered an essential health benefit, so plans may or may not cover it.)

Plans score well when they have fewer denials, lower complaint rates and stronger customer satisfaction surveys.

We use three different data sources to evaluate customer experience:

Customer complaints

We collect and analyze customer complaint data from the National Association of Insurance Commissioners. For each company, we calculate a multi-year average complaint rate.

NerdWallet conducts its data analysis and reaches conclusions independently and without the endorsement of the NAIC.

Denials

Based on claims data from the Centers for Medicare & Medicaid Services, we rank companies based on how often they deny in-network claims. The fewer denials, the better.

Satisfaction scores

We rate plans based on how well or poorly they score on government surveys evaluating customer satisfaction.

Companies earn points based on their medical management programs and rankings on government ratings of medical quality.

We use two sources to score plans’ quality of care:

Government ratings

Marketplace plans get star ratings from the government based on how well they manage members’ health care, monitor conditions and provide certain medical services. We rank plans based on how highly they score on these ratings.

Medical management programs

Some plans offer medical management programs to help members with certain conditions, such as asthma, diabetes, depression, pregnancy and pain management. Plans score points based on how many of these programs they offer.