Health insurance in Buncombe County, North Carolina
5 insurers sell 59 marketplace plans here, and 11.7% of under-65 residents have no coverage at all.
Source: CMS Marketplace Open Enrollment Public Use Files and US Census Small Area Health Insurance Estimates, 2026 release.
Who sells here, and how much choice that gives
5 insurers compete in Buncombe County with 59 plans between them, about 12 plans each. The number has not changed since the previous plan year.
How many people here have no coverage
11.7% of Buncombe County's 213,948 under-65 residents have no health coverage — 25,035 people. That is close to the North Carolina rate of 10.2%, and puts Buncombe County in the middle half of the 1,817 counties on this site (739th).
How much the marketplace is used
24,481 Buncombe County residents selected a marketplace plan for 2026: 114 per thousand under-65 residents, 608th of 1,817. That is above the 78 per thousand typical of published counties. 3,857 of them — 16% — were new rather than renewing.
Buncombe County against North Carolina
Buncombe County is the 8th largest of the 24 North Carolina counties we publish. Its uninsured rate runs 1.5 points higher than North Carolina overall and its 5 insurers sit between the state's 2 and 6. Marketplace use is about 1.3 times the North Carolina rate.
| Buncombe County | North Carolina | Published median | |
|---|---|---|---|
| Uninsured, under 65 | 11.7% | 10.2% | 9.9% |
| Insurers selling | 5 | 2–6 | 4 |
| Plans offered | 59 | — | 57 |
| Selections per 1,000 | 114 | 87 | 78 |
| New rather than renewing | 16% | 17% | 15% |
Counties of a similar size nearby
| County | Under 65 | Uninsured | Insurers | Plans |
|---|---|---|---|---|
| Johnston County | 212,182 | 10.5% | 4 | 44 |
| Union County | 224,411 | 9.0% | 4 | 68 |
| Gaston County | 197,709 | 11.1% | 3 | 60 |
All of them have fewer insurers than this county's 5, which makes it the stronger market locally.
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