Find an Affordable Health Insurance Plan in Clemmons, North Carolina
in North Carolina
Nationwide (BlueCard®)
Blue Advantage® is a PPO health plan from Blue Cross and Blue Shield of North Carolina (Blue Cross NC) offering the company's largest nationwide network of doctors, specialists, and hospitals. More than 95% of North Carolina doctors and 98% of North Carolina hospitals are in-network, and coverage travels with you nationwide through the BlueCard® program, which is accepted in nearly 200 countries and territories worldwide.
Because it's a PPO, Blue Advantage gives you the fewest restrictions on which doctors you can see: no referrals to see a specialist, and out-of-network care is still covered (at a lower benefit level). It typically carries a higher premium than Blue Cross NC's in-state-only plans, so it's the plan we recommend when provider choice and nationwide access matter more than getting the lowest possible premium.
Blue Advantage is built for people who want the fewest restrictions on which doctors they can see. It's a strong fit if you travel frequently for work or split time between two states, have an established specialist relationship you don't want to disrupt, want emergency care covered at the in-network rate anywhere in the world, or simply value provider choice over the lowest possible monthly premium.
It's a weaker fit if you rarely leave North Carolina and don't need nationwide access. In that case, Blue Care offers nearly identical in-state provider access at a lower premium, and one of the regional Blue Home plans may lower your premium even further if your doctors belong to a single health system.
Nationwide network – Nationwide (BlueCard®)
Network: Anywhere in the U.S. and abroad2; 95%+ of NC doctors.1
Out-of-area care: Covered (lower benefit level).
Offered in Bronze, Silver, and Gold tiers.
Notes
Blue Cross NC Provider Internal Data; percentages indicated represent the Blue Cross NC PPO Network as of April 7, 2025.
Covered in nearly 200 countries and territories worldwide through the Blue Cross and Blue Shield Association BlueCard program. www.geo-blue.com/ (Accessed March 2025). BlueCard coverage varies for each Blue Cross and Blue Shield plan. For more complete details, including benefits, limitations, and exclusions, please refer to your certificate of coverage.
Blue Advantage is available on and off Marketplace in all North Carolina counties, except the following where it is available only off Marketplace: Alamance, Caswell, Chatham, Durham, Franklin, Johnston, Lee, Orange, Person, and Wake.
Blue Advantage is a PPO, which means you don't need a referral to see a specialist, and you're never limited to a single network — you're just paying more if you step outside it. If you see an in-network provider, you get the plan's full benefit level. If you see someone out-of-network, the plan still pays, just at a reduced benefit level, and you're responsible for the difference.
Because Blue Cross NC has more than 95% of North Carolina doctors and 98% of North Carolina hospitals in-network, most members rarely need to use that out-of-network benefit — but it's there if your situation calls for it.
Blue Advantage is the only Blue Cross NC individual plan built for people who leave the state. Through the BlueCard® program, your in-network benefits travel with you anywhere in the U.S. — so if you split time between two states, have kids away at college, or travel for work, you're not stuck finding a new plan or a new doctor.
Emergency care is covered at the in-network rate worldwide, including in nearly 200 countries and territories through BlueCard Worldwide®.
Blue Advantage typically carries a higher premium than Blue Cross NC's in-state-only plans like Blue Care® or the regional Blue Home℠ plans. That's the trade-off for the broadest network and out-of-network safety net Blue Cross NC offers. Like every Blue Cross NC ACA plan, it's available in Bronze, Silver, and Gold tiers, and most applicants qualify for a premium tax credit that lowers the monthly cost based on income and household size.
If nationwide access isn't something you need, it's worth comparing Blue Advantage against Blue Care or a Blue Home plan first — you may get nearly identical in-state coverage for meaningfully less.
You can enroll during the annual Open Enrollment Period (November 1 – January 15) or during a Special Enrollment Period if you've had a qualifying life event — a job change, a move, a new dependent, or losing other coverage.
A licensed Health Plans of NC agent can confirm your specific doctors are in-network, check what subsidy you qualify for, and compare Blue Advantage against the other six Blue Cross NC plans with you — at no cost. Call 800-797-0327.
Blue Advantage is a PPO (Preferred Provider Organization) plan. That means you can see out-of-network providers — you’ll just pay more — and you generally don’t need a referral to see a specialist. It’s the most flexible network Blue Cross NC offers.
Yes. Blue Advantage includes nationwide in-network access through the BlueCard® program, and emergency care is always covered at the in-network benefit level no matter where you are — including in nearly 200 countries and territories worldwide.
Yes, Blue Advantage is available in all 100 North Carolina counties. In 25 of them it’s available off-Marketplace only, meaning you’d enroll directly (through an agent or Blue Cross NC) rather than through HealthCare.gov. A Health Plans of NC agent can handle either path for you.
Both give you nearly the same broad in-state network (about 95% of NC doctors), but Blue Advantage is a PPO that adds nationwide out-of-network coverage, while Blue Care is an HMO limited to North Carolina with no out-of-network benefit except emergencies. Blue Advantage costs a bit more for that added flexibility.
Our recommendation: choose Blue Advantage if you travel, split time between states, or want maximum provider choice; choose Blue Care if you stay in NC and want to save on premium.
Statewide NC network
Blue Care® is an HMO health plan from Blue Cross NC that offers the company's largest in-state network — more than 95% of North Carolina doctors and 98% of NC hospitals in-network — at a lower monthly premium than the nationwide Blue Advantage PPO.
The trade-off for that lower premium is that Blue Care keeps your care inside North Carolina: outside of urgent and emergency situations, only in-network NC providers are covered, and there's no out-of-network benefit. For NC residents who rarely travel, Blue Care delivers almost the same broad provider choice as Blue Advantage for less money — which is why we often recommend it as the best-value option for people who stay in-state.
Blue Care fits residents who live and receive their care entirely within North Carolina, want broad in-state provider choice without paying for nationwide coverage they won't use, and are comfortable with no out-of-network benefit outside of emergencies.
It's a poor fit if you split time between states, have kids at out-of-state college, or travel frequently for work — non-emergency care outside North Carolina isn't covered. If that's you, Blue Advantage is the better choice.
Statewide network – Statewide NC network
Network: North Carolina only. A large network, with more than 95% of North Carolina doctors and 98% of North Carolina hospitals in-network.
Out-of-area care: Emergency / urgent only.
Offered in Bronze, Silver, and Gold tiers.
Blue Care is available in all North Carolina counties, except: Alamance, Caswell, Chatham, Durham, Franklin, Johnston, Lee, Orange, Person, and Wake.
Blue Care is an HMO built on Blue Cross NC's largest in-state network — more than 95% of North Carolina doctors and 98% of NC hospitals in-network. It's priced lower than the nationwide Blue Advantage PPO because it trades nationwide access for coverage that stays inside North Carolina.
Outside of emergency and urgent care, only in-network NC providers are covered — there's no out-of-network benefit to fall back on, so it's worth confirming your specific doctors participate before you enroll.
Blue Care is sold in every NC county except Alamance, Caswell, Chatham, Durham, Franklin, Johnston, Lee, Orange, Person, and Wake — those counties fall inside the Triangle-area service area for the Blue Home℠ with UNC Health Alliance plan instead. If you live in one of the excluded counties, Blue Care isn't available to you regardless of which providers you use.
Because the in-state network is nearly as broad as Blue Advantage's, most Blue Care members never notice a difference in provider choice day to day — the difference only shows up if you need care outside North Carolina.
Blue Care's premium runs lower than Blue Advantage's specifically because it removes the nationwide and out-of-network safety net. It's offered in Bronze, Silver, and Gold tiers, and most applicants qualify for a premium tax credit that lowers the monthly cost based on income and household size.
You can enroll during the annual Open Enrollment Period (November 1 – January 15) or during a Special Enrollment Period if you've had a qualifying life event — a job change, a move, a new dependent, or losing other coverage.
A licensed Health Plans of NC agent can confirm your doctors are in-network, check your subsidy, and compare Blue Care against Blue Advantage and the regional plans — at no cost. Call 800-797-0327.
Yes. Blue Care is structured as an HMO with a statewide North Carolina network. Outside of urgent and emergency situations, care is only covered when you use in-network NC providers.
Only urgent and emergency care is covered outside your Blue Care network. Routine or non-emergency care while traveling out of state is not covered, so Blue Care is best for people who receive their care in North Carolina.
Blue Care isn’t offered in Alamance, Caswell, Chatham, Durham, Franklin, Johnston, Lee, Orange, Person, or Wake counties. In several of those counties, Blue Home℠ with UNC Health Alliance is offered instead.
Piedmont Triad · Charlotte
Blue Home℠ with Novant Health is a Blue Cross NC plan built around Novant Health's network of more than 2,000 physicians and 900+ locations, including Novant's integrated system of 19 medical centers across the Piedmont Triad and Charlotte area.
It's a single-system regional plan — only Novant Health providers are in-network — offered at a lower premium in exchange for that focused network. We recommend it when Novant is already where you and your family get care and you live in one of the eight eligible counties.
Good fit if you already see Novant Health providers for primary or specialty care, live in one of the eight eligible counties, and want a lower premium in exchange for a single coordinated network.
Poor fit if your regular doctors are with Atrium Health, CaroMont Health, or Cone Health — none of those are in-network here.
Regional network – Piedmont Triad · Charlotte
Network: Novant Health only1 (2,000+ physicians).2
Out-of-area care: Emergency / urgent only.
Offered in Bronze, Silver, and Gold tiers.
Notes
Blue Cross NC has collaborated with Novant Health to bring you Blue Home℠ with Novant Health. Blue Home with Novant Health is a health insurance plan offered by Blue Cross NC that provides access to a limited network of providers. Novant Health is an independent company that is solely responsible for the physicians and medical facilities it owns and operates. Novant Health does not offer Blue Cross or Blue Shield products or services.
Novant Health, www.novanthealth.org/home/about-us/company-information.aspx (Accessed August 2024).
Blue Home with Novant Health is available on and off Marketplace to residents of these North Carolina counties: Cabarrus, Davidson, Forsyth, Mecklenburg, Rowan, Stokes, Union, and Yadkin.
This plan is built around a single system, Novant Health, which is what allows the premium to run lower than Blue Cross NC's broad-network plans. Only Novant Health providers are in-network — outside of emergency and urgent care, Atrium Health, CaroMont Health, and Cone Health are not covered, even for members who live close to those systems.
Novant Health's network spans more than 2,000 physicians and 900+ locations, including its integrated system of 19 medical centers across the Piedmont Triad and Charlotte area. For members already established with a Novant primary care provider or specialist, this plan keeps that relationship intact at a lower monthly cost.
The lower premium reflects the narrower, single-system network. It's offered in Bronze, Silver, and Gold tiers, and most applicants qualify for a premium tax credit based on income and household size.
This plan is available in eight counties across the Piedmont Triad and Charlotte area — Cabarrus, Davidson, Forsyth, Mecklenburg, Rowan, Stokes, Union, and Yadkin. If you live outside those counties, it isn't an option regardless of which providers you use.
You can enroll during the annual Open Enrollment Period (November 1 – January 15) or during a Special Enrollment Period if you've had a qualifying life event — a job change, a move, a new dependent, or losing other coverage.
A licensed Health Plans of NC agent can confirm your Novant Health providers are in-network, check your subsidy, and compare this plan against Blue Advantage® and Blue Care® — at no cost. Call 800-797-0327.
More than 900 locations, including Novant Health’s 19 integrated medical centers and over 2,000 physicians across the Piedmont Triad and Charlotte area.
Atrium Health is out-of-network on Blue Home℠ with Novant Health. You’d need to either switch providers or choose a plan built around Atrium’s network, like Blue Local℠ with Atrium Health.
No. Novant Health is an independent company solely responsible for the physicians and facilities it owns and operates; it does not offer Blue Cross or Blue Shield products.
Charlotte / Piedmont · NC & SC
Blue Local℠ with Atrium Health is a Blue Cross NC plan built around Atrium Health's network of 20 hospitals and 700+ care locations across North and South Carolina. It includes two children's hospitals — Levine Children's Hospital (nationally ranked in 10 pediatric specialties) and Brenner Children's Hospital — plus the Atrium Health Wake Forest Baptist Comprehensive Cancer Center, one of only three comprehensive cancer centers in North Carolina.
This is a single-system regional plan offered at a lower premium, with only Atrium Health providers in-network. We especially recommend it for families who may need pediatric specialty care or comprehensive cancer care and live in one of the 17 eligible counties across the Charlotte and Piedmont regions.
Good fit if you have a child who needs or may need care at Levine or Brenner Children's Hospital, are managing a cancer diagnosis and want access to a comprehensive cancer center, or live in one of the 17 eligible counties across the Charlotte/Piedmont region.
Poor fit if your regular doctors are with CaroMont Health, Cone Health, or Novant Health — all three are out-of-network.
Regional network – Charlotte / Piedmont · NC & SC6
Network: Atrium Health only1 (incl. Levine Children’s4).
Out-of-area care: Emergency / urgent only.
Offered in Bronze, Silver, and Gold tiers.
Notes
Blue Cross NC has collaborated with Atrium Health to bring you Blue Local with Atrium Health, a health insurance plan offered by Blue Cross NC that provides access to Atrium Health’s comprehensive network of providers. Atrium Health is an independent company and is solely responsible for the physicians and medical facilities it owns/operates. Atrium Health does not offer Blue Cross or Blue Shield products or services.
Atrium Health, atriumhealth.org/about-us/newsroom/news/atrium-health-earns-multiple-us-news-and-world-report-honors (Accessed September 2023).
Atrium Health Wake Forest Baptist, www.wakehealth.edu/about-us (Accessed August 2022).
Atrium Health, www.atriumhealth.org/about-us (Accessed August 2022).
Atrium Health Wake Forest Baptist, www.wakehealth.edu/locations/facilities/comprehensive-cancer-center (Accessed September 2023).
Atrium Health, https://2023yir.advocatehealth.org/ (Within the full report) (Accessed September 2024).
Blue Local with Atrium Health is available on and off Marketplace to residents of these North Carolina counties: Anson, Cabarrus, Cleveland, Davidson, Davie, Forsyth, Gaston, Guilford, Lincoln, Mecklenburg, Randolph, Rowan, Stanly, Stokes, Union, Wilkes and Yadkin.
This plan is built around a single system, Atrium Health, which is what keeps the premium lower than Blue Cross NC's broad-network plans. Only Atrium Health providers are in-network — outside of emergency and urgent care, CaroMont Health, Cone Health, and Novant Health are not covered.
Atrium Health's network spans 20 hospitals and more than 700 care locations across North and South Carolina, including two children's hospitals — Levine Children's Hospital, nationally ranked in 10 pediatric specialties, and Brenner Children's Hospital — plus the Atrium Health Wake Forest Baptist Comprehensive Cancer Center, one of only three comprehensive cancer centers in North Carolina.
This makes it a particularly strong option for families who may need pediatric specialty care or anyone managing a cancer diagnosis, since that care is coordinated within one system rather than requiring referrals across networks.
The lower premium reflects the narrower, single-system network. It's offered in Bronze, Silver, and Gold tiers, and most applicants qualify for a premium tax credit based on income and household size.
This plan is available across 17 counties in the Charlotte and Piedmont regions. If your doctors are with CaroMont, Cone, or Novant instead, this plan won't cover them outside of an emergency.
You can enroll during the annual Open Enrollment Period (November 1 – January 15) or during a Special Enrollment Period if you've had a qualifying life event — a job change, a move, a new dependent, or losing other coverage.
A licensed Health Plans of NC agent can confirm your Atrium Health providers are in-network, check your subsidy, and compare this plan against Blue Advantage® and Blue Care® — at no cost. Call 800-797-0327.
Yes — Levine Children’s Hospital, nationally ranked in 10 pediatric specialties, is part of the in-network Atrium Health system on Blue Local℠ with Atrium Health, along with Brenner Children’s Hospital.
Yes — the Atrium Health Wake Forest Baptist Comprehensive Cancer Center is one of only three comprehensive cancer centers in North Carolina and is in-network on this plan.
Those systems are out-of-network on Blue Local℠ with Atrium Health. This plan only covers Atrium Health providers in-network, except for emergency and urgent care.
Every Blue Cross NC individual plan comes in three “metal” tiers that describe how you and the plan split covered costs. Bronze plans have the lowest monthly premium but pay about 60% of covered costs, so you pay roughly 40% when you use care. Silver plans pay about 70% (you pay ~30%), and Gold plans pay about 80% (you pay ~20%) in exchange for a higher premium.
As a rule of thumb: Bronze suits people who rarely use care and want the lowest premium, Gold suits people who use regular or ongoing care, and Silver is the middle ground. Silver is also the only tier that unlocks Cost-Sharing Reductions (CSRs) — extra savings on deductibles and copays if your income qualifies — so many subsidy-eligible shoppers get the best overall value from a Silver plan. A licensed Health Plans of NC agent can run the numbers for your situation at no cost.
The most important step before choosing any plan is confirming your doctors, specialists, and preferred hospitals are in that plan’s network. Networks differ a lot between Blue Cross NC plans — a doctor who is in-network on one plan may be out-of-network, and far more expensive, on another.
You can check each plan’s provider directory on bcbsnc.com, or — the easier route — call a Health Plans of NC agent at 800-797-0327 and we’ll verify your specific providers before you enroll, at no charge.
Most North Carolinians who buy their own coverage qualify for a premium tax credit — a subsidy based on your income and household size that lowers what you pay each month. Subsidy amounts and eligibility rules can change from year to year, so the only way to know your real price is to run a personalized quote.
Health Plans of NC can check your subsidy eligibility and show you the after-subsidy premium for any of these plans for free. Call 800-797-0327 or request a quote online.
You can enroll during the annual Open Enrollment Period, which runs each fall (generally starting November 1) for coverage that begins the following year. Outside that window, you can still enroll if you have a qualifying life event — such as losing other coverage, moving, marriage, or having a baby — which opens a 60-day Special Enrollment Period.
Because enrollment dates and rules can change, it’s worth confirming the current deadline. A Health Plans of NC agent can tell you whether you’re eligible to enroll right now — call 800-797-0327.
Nothing. Health Plans of North Carolina is an independent, authorized agency licensed to sell Blue Cross NC plans, and our help — comparing plans, checking your doctors, estimating subsidies, and enrolling — is completely free to you. Agents are paid by the insurance company, and the plan price is the same whether you enroll with us or on your own.
Call 800-797-0327 to talk with a licensed local agent.
| Carrier | Distinct plans |
|---|---|
| Blue Cross and Blue Shield of NC | 30 |
| Ambetter of North Carolina | 14 |
| Oscar Health Plan of North Carolina | 14 |
| UnitedHealthcare | 13 |
| Cigna Healthcare | 10 |
| AmeriHealth Caritas Next | 8 |
| Total | 89 |
Source: CMS QHP Landscape PY2026, Individual Market Medical, updated August 26, 2026 (data.healthcare.gov). Counts distinct Plan IDs offered on the Marketplace in Forsyth County, once per carrier.
in Forsyth County
Health Plans of NC is a licensed insurance agency authorized by Blue Cross NC. Our agents help individuals, families and self-employed people in Clemmons, North Carolina compare health plans and apply for premium tax credits at no cost to you.
Find affordable health insurance in Clemmons, North Carolina with Health Plans of NC. Health Plans of NC helps residents of Clemmons, North Carolina find and enroll in the right health insurance coverage for 2026, with local expertise and access to plans that connect members to nearby providers like Novant Health Forsyth Medical Center. Whether you are self-employed, between jobs, or simply reviewing your options during open enrollment, Health Plans of NC offers free, personalized guidance at every step.
Plan Network | Type | Network Coverage |
|---|---|---|
Blue Advantage® | PPO | Largest nationwide network, 95%+ of NC doctors in-network |
Blue Care® | HMO | Broad statewide network, 95%+ of NC doctors in-network |
Blue Local℠ with Atrium Health | EPO | Available in Clemmons, North Carolina |
Blue Home℠ with Novant Health | EPO | Available in Clemmons, North Carolina |
Clemmons, North Carolina has a population of 21,574 and has experienced 0.0% growth since 2020, with 8.5% of residents being foreign-born, reflecting a community that benefits from diverse and accessible coverage pathways. Major employers in the area include Wake Forest Baptist Medical Center, Winston-Salem/Forsyth County Schools, Forsyth Memorial Hospital, Novant Health, and Wake Forest University, many of which offer employer-sponsored benefits that form a key layer of coverage for working adults. Residents who fall outside employer plans can access ACA Marketplace coverage, Medicaid, CHIP, COBRA, short-term plans, or small business SHOP options through the guidance of Health Plans of NC.
ACA Marketplace coverage is available to Clemmons residents who are self-employed or work for smaller local businesses not connected to large employer networks like those at Wake Forest University.
Medicaid provides free or low-cost coverage for qualifying Clemmons residents, including those employed in part-time or seasonal roles at area health systems like Novant Health.
Employer-sponsored insurance is a primary coverage path for many Clemmons adults working at major local employers such as Wake Forest Baptist Medical Center and Winston-Salem/Forsyth County Schools.
COBRA continuation coverage allows Clemmons residents who recently left a position at Forsyth Memorial Hospital or another major employer to temporarily maintain their existing group health benefits.
Short-term health plans can serve as a bridge for Clemmons residents in transition between jobs at local employers, offering limited coverage while permanent options are being arranged.
Small business SHOP Marketplace plans are an option for Clemmons entrepreneurs and small business owners who want to offer group coverage to employees without access to large employer networks like those at Novant Health or Wake Forest Baptist Medical Center.
For 2026, Clemmons residents can choose from four distinct plan networks offered through Blue Cross NC, each connecting members to different combinations of local hospitals and health systems in Forsyth County. The available networks include Blue Advantage, Blue Care, Blue Local with Atrium Health, and Blue Home with Novant Health, giving residents meaningful flexibility in how they access primary care, specialist services, and hospital care. Health Plans of NC can help Clemmons residents compare these networks side-by-side to ensure their preferred providers at Atrium Health Wake Forest Baptist or Novant Health Forsyth Medical Center are included before enrolling.
Blue Advantage, offered as a PPO, provides the largest nationwide network and includes access to over 95% of North Carolina doctors, making it a strong choice for Clemmons residents who travel frequently or want maximum flexibility.
Blue Care, an HMO, covers a broad statewide network with more than 95% of North Carolina doctors in-network, connecting Clemmons residents to providers across Forsyth County and beyond.
Blue Local with Atrium Health is an EPO available in Clemmons, North Carolina, designed around the Atrium Health Wake Forest Baptist system for residents who prefer coordinated care within that network.
Blue Home with Novant Health is an EPO available in Clemmons, North Carolina, built around Novant Health Forsyth Medical Center and well-suited for residents who already have established care relationships within the Novant system.
All four plan networks cover the 10 essential health benefits required by the ACA, including preventive care, emergency services, prescription drugs, and mental health coverage, regardless of which network a Clemmons resident selects.
Bronze plans in Clemmons, North Carolina start at approximately $476.59/month before subsidies. Silver plans start at $612.52/month. Gold plans start at $633.41/month. With a median household income of $84,326, many residents qualify for premium tax credits. Subsidies may reduce your monthly premium significantly based on income.
Bronze plans in Clemmons start at $476.59 per month for a 35-year-old, offering the lowest premiums available on the ACA Marketplace in exchange for higher deductibles and out-of-pocket costs.
Silver plans start at $612.52 per month and are the only tier eligible for cost-sharing reductions, which can lower deductibles and copays for Clemmons residents who qualify based on income.
Gold plans start at $633.41 per month and offer lower out-of-pocket costs throughout the year, making them a strong fit for Clemmons households with frequent medical needs.
Clemmons residents earning between 100% and 400% of the federal poverty level may qualify for premium tax credits that reduce their monthly costs, sometimes to as little as $0 per month for a Silver plan.
Households in Clemmons with incomes near the local median may still qualify for partial premium tax credits depending on household size, age, and the specific plan selected through Blue Cross NC.
Health Plans of NC calculates exact subsidy amounts for Clemmons residents at no cost, ensuring families and individuals make enrollment decisions based on their true net premium after tax credits.
For 2026, Blue Cross NC is one of six ACA Marketplace carriers serving Clemmons, North Carolina, offering a total of 30 individual and family health insurance plans in Rating Area 10. These plans are organized across four distinct networks: Blue Advantage, Blue Care, Blue Local with Atrium Health, and Blue Home with Novant Health, spanning PPO, HMO and EPO plan types. The Blue Local with Atrium Health network is built around Atrium Health Wake Forest Baptist, while Blue Home with Novant Health centers care around Novant Health Forsyth Medical Center, giving Clemmons residents direct alignment with the two largest health systems serving Forsyth County. Choosing the right network affects whether a Clemmons resident can see their preferred specialist, primary care doctor, or hospital in-network, which directly impacts both care continuity and out-of-pocket costs. Health Plans of NC compares every available Blue Cross NC plan side-by-side at no cost, helping residents identify the best fit for their provider preferences and budget.
Blue Cross NC: plans across four networks, 30 total plans available in Clemmons, North Carolina for 2026 through the ACA Marketplace in Rating Area 10.
North Carolina expanded Medicaid in December 2023, extending free or low-cost coverage to adults earning up to 138% of the federal poverty level, a change that opened eligibility to thousands of previously uninsured residents across Forsyth County. In Clemmons, the uninsured rate is 4.5%, representing approximately 1,000 residents who may not yet have explored their Medicaid or Marketplace eligibility. The poverty rate in Clemmons stands at 7.9%, meaning a meaningful share of residents may qualify for Medicaid at little or no cost. Children in families earning up to 210% of the federal poverty level may qualify for NC Health Choice, the state's CHIP program, and Health Plans of NC offers free eligibility checks to help Clemmons families determine whether Medicaid, CHIP, or a Marketplace plan is their best option.
Working adults in Clemmons who are between jobs or employed part-time without employer benefits may qualify for Medicaid if their income falls at or below 138% of the federal poverty level.
Children in Clemmons whose families have incomes up to 210% of the federal poverty level may be eligible for NC Health Choice, which provides comprehensive low-cost coverage through the CHIP program.
Pregnant women in Clemmons are eligible for Medicaid coverage with an expanded income threshold, ensuring access to prenatal and delivery care at area health systems throughout the pregnancy.
Seniors with low income in Clemmons may qualify for dual eligibility, receiving both Medicaid and Medicare to cover costs that Medicare alone does not fully address.
Clemmons residents living with disabilities may qualify for Medicaid regardless of age, and with the town's 7.9% poverty rate, a significant portion of the community may be eligible for this coverage pathway.
Health Plans of NC licensed agents serve Clemmons, North Carolina residents at no cost, comparing every available 2026 plan side-by-side to match your budget, preferred providers, and coverage needs. Call 800-797-0327 today to speak with a local agent who can guide you through enrollment and ensure you get the most out of your available benefits.
Call 800-797-0327 (toll free) to speak with a licensed Health Plans of NC agent serving Clemmons, North Carolina
Email [email protected] with questions about plans available in your zip code
Find a licensed agent and book directly at healthplansofnc.com/agents
No cost, no pressure. Compare every 2026 plan available in Clemmons, North Carolina at no charge.
Clemmons, North Carolina ZIP Codes include: 27012
