Health insurance in Gaston County, North Carolina
3 insurers sell 60 marketplace plans here, and 11.1% 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
3 insurers sell marketplace plans in Gaston County, offering 60 plans between them, roughly 20 each. Each insurer averages about 20 plans, so most of the choice here is between products from the same company rather than between companies. The number has not changed since the previous plan year.
How many people here have no coverage
11.1% of Gaston County's 197,709 under-65 residents have no health coverage — 21,931 people. That is close to the North Carolina rate of 10.2%, and puts Gaston County in the middle half of the 1,817 counties on this site (855th).
A market taking in new buyers
17,371 Gaston County residents selected a marketplace plan for 2026: 88 per thousand under-65 residents, 945th of 1,817. That is close to the 78 per thousand typical of published counties. 3,437 — 20% — were new rather than renewing, an unusually high share.
Gaston County against North Carolina
Gaston County is the 10th largest of the 24 North Carolina counties we publish. Its uninsured rate runs 0.9 points higher than North Carolina overall and its 3 insurers sit between the state's 2 and 6. Marketplace use is close to the North Carolina rate.
| Gaston County | North Carolina | Published median | |
|---|---|---|---|
| Uninsured, under 65 | 11.1% | 10.2% | 9.9% |
| Insurers selling | 3 | 2–6 | 4 |
| Plans offered | 60 | — | 57 |
| Selections per 1,000 | 88 | 87 | 78 |
| New rather than renewing | 20% | 17% | 15% |
Counties of a similar size nearby
| County | Under 65 | Uninsured | Insurers | Plans |
|---|---|---|---|---|
| New Hanover County | 189,547 | 8.9% | 4 | 65 |
| Johnston County | 212,182 | 10.5% | 4 | 44 |
| Buncombe County | 213,948 | 11.7% | 5 | 59 |
Buncombe County has 5 insurers against this county's 3 — a reminder that the county line, not the state line, is what decides your options.
60 plans is a lot to work through. Start with network type, then the metal tiers. Other North Carolina counties.