Individual health insurance offers personalized coverage outside of employer or government plans. ACA-compliant plans cover essential benefits such as preventive care, maternity care, and prescription drugs. Enjoy flexibility to choose between tiers (Bronze–Platinum) and types (HMO, PPO), plus subsidies to improve affordability.
Individual health insurance provides personalized coverage for yourself and your family, independent of employer-sponsored plans. It’s a great option if you’re self-employed, between jobs, or seeking flexibility beyond what your employer offers. With the help of a knowledgeable agent, you can find an affordable plan that fits your health needs and budget.
Protection from High Costs
: Accidents and illnesses can happen at any age—health insurance prevents massive medical bills.
Access to Care
: Broader provider networks and options mean better treatment choices.
Peace of Mind
: Comprehensive coverage ensures you’re prepared for unexpected health events.
At Health Plans of NC, we specialize in helping North Carolinians find the right plan for their lifestyle and finances.
Individual health insurance is purchased directly from private insurers (not through an employer or government programs like Medicare/Medicaid). Most plans are Affordable Care Act (ACA)-compliant, meaning they cover the 10 essential health benefits and cannot deny coverage based on pre-existing conditions.
Freedom to Choose Your Plan
Select from Bronze, Silver, Gold, or Platinum tiers based on your needs—lower premiums with higher out-of-pocket costs (Bronze) or higher premiums with lower costs (Platinum).
Customized Coverage Tailor benefits to your health needs. Choose from:
EPO (Exclusive Provider Organization)
HMO (Health Maintenance Organization)
POS (Point of Service)
PPO (Preferred Provider Organization). PPOs often allow more provider flexibility.
Premium Tax Credits & Subsidies
Through the ACA Marketplace, many qualify for income-based subsidies (now available to those above 400% of the federal poverty level thanks to the American Rescue Plan). Subsidies can significantly reduce monthly premiums.
Open Enrollment Period
Enroll or change plans from November 1 to January 15 each year. Changes take effect January 1. Special Enrollment Periods apply for life events (e.g., marriage, job loss, or moving).
Dedicated Coverage
Unlike group plans, individual insurance focuses solely on you and your family, offering portability if you change jobs.
Factor | Individual Health Insurance | Group Health Insurance |
Availability | May require underwriting in non-ACA plans | Guaranteed even with pre-existing conditions |
Plan Choice | Complete freedom to select the best plan | Limited to employer offerings |
Cost | Often higher (no employer contribution) | Usually lower (employer subsidizes premiums) |
Coverage | For you and your family | For all eligible employees |
Portability | Stays with you if you change jobs | May end when you leave the job |
ACA-compliant plans must cover 10 essential health benefits:
Ambulatory patient services
Emergency services
Hospitalization
Maternity and newborn care
Mental health and substance use disorder services
Prescription drugs
Rehabilitative and habilitative services
Laboratory services
Preventive and wellness services
Pediatric services (including oral and vision care)
Many plans also include adult dental and vision coverage.
Premiums have become more affordable due to subsidies. In North Carolina, qualifying individuals can significantly reduce costs. Plans are generally less expensive than in previous years, especially with premium tax credits.
Some employers offer ICHRA plans, which provide a tax-free monthly allowance for employees to purchase individual health insurance. This gives greater flexibility to choose the best plan.
A licensed agent can:
Compare plans and explain coverage options
Check subsidy eligibility
Guide you through enrollment
Ensure the plan fits your health needs and budget
What’s the main disadvantage of individual plans?
You pay the full premium (no employer contribution), and costs can be higher without subsidies.
Individual vs. family plan?
Family plans often cost less per person. Individual plans suit singles or small households.
Can I keep my plan if I change jobs?
Yes—individual plans are portable.
Best for independent contractors?
Individual plans or ICHRA options provide flexibility and comprehensive coverage.
Contact Health Plans of NC today for personalized guidance and a free quote. Our licensed agents are here to help you find the right individual health insurance plan in North Carolina. Phone: 800-797-0327 Get your free quote online now!