Find Your Most Affordable Health Insurance Plan in Wilmington, 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.
Limited statewide network
Blue Value is a Blue Cross NC plan offering a limited statewide network at a lower monthly premium than broader-network options. The network includes Atrium Health Wake Forest Baptist, CaroMont Health, Duke Health Lake Norman Regional Medical Center, Duke LifePoint Healthcare, Novant Health, and UNC Health Alliance — but it does not include the rest of Atrium Health, the rest of Duke Health, or WakeMed Health.
Unlike the single-system Blue Home plans, Blue Value spans several regional systems, but it's still a limited network built to keep premiums low. We recommend it for generally healthy individuals and families who prioritize the lowest premium and are flexible about which specific doctors and hospitals they use — as long as you confirm your providers are in the Blue Value network first.
Good fit if you're generally healthy and rarely need specialist care, prioritize the lowest possible premium over provider choice, and are flexible about which specific doctors and hospitals you use.
Poor fit if you're managing an ongoing condition and want a stable relationship with one large hospital system, or if your regular doctors are with the excluded parts of Atrium Health, Duke Health, or WakeMed.
Limited network – Limited statewide network
Network: A limited multi-system NC network.
Out-of-area care: Emergency services and urgent care outside of NC are covered at the in-network benefit level. All other non-emergency covered services are covered at the out-of-network benefit level.
Offered in Bronze, Silver, and Gold tiers.
Blue Value is available on and off Marketplace to residents of these North Carolina counties: Alexander, Brunswick, Burke, Caldwell, Catawba, Cleveland, Columbus, Duplin, Gaston, Iredell, Lincoln, New Hanover, Onslow, Pender, and Surry.
Blue Value trades network breadth for the lowest premium among Blue Cross NC's individual plans. Unlike the single-system Blue Home and Blue Local plans, it spans several regional health systems rather than just one — but the network is still limited. Care from providers outside the Blue Value network is covered only at the higher-cost out-of-network benefit level, so you pay the least by staying with the specific systems in the network.
The Blue Value network includes Atrium Health Wake Forest Baptist, CaroMont Health, Duke LifePoint Healthcare (including Lake Norman Regional Medical Center), Novant Health, and UNC Health Alliance. It does not include the rest of Atrium Health, the rest of Duke Health, or WakeMed Health — so a provider being “Atrium” or “Duke” isn't enough to confirm coverage; the specific facility matters.
Because the network mixes several systems rather than centering on one, this plan works best for people who don't have an established relationship with a specific health system and are comfortable confirming coverage facility-by-facility.
Blue Value is generally the lowest-premium option Blue Cross NC offers, which makes it attractive if you're healthy and expect to use care infrequently. 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 15 counties, mostly in the western Piedmont and southeastern coastal areas of the state.
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 providers are in the Blue Value network, check your subsidy, and compare this plan against the others — at no cost. Call 800-797-0327.
Blue Value is positioned as a lower-premium option because it uses a limited network. Whether it’s actually the cheapest for you depends on your age, county, and subsidy eligibility, so get a personalized quote to confirm.
The Blue Value network includes Atrium Health Wake Forest Baptist, CaroMont Health, Duke Health Lake Norman Regional Medical Center, Duke LifePoint Healthcare, Novant Health, and UNC Health Alliance. It does not include the rest of Atrium Health, the rest of Duke Health, or WakeMed Health.
Emergency and urgent care are covered at the in-network rate anywhere. All other care outside North Carolina is covered only at the higher out-of-network benefit level, so Blue Value is best for people who get their care in NC.
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 | 27 |
| Ambetter of North Carolina | 15 |
| UnitedHealthcare | 13 |
| Cigna Healthcare | 10 |
| Total | 65 |
Source: CMS QHP Landscape PY2026, Individual Market Medical, updated August 26, 2026 (data.healthcare.gov). Counts distinct Plan IDs offered on the Marketplace in New Hanover County, once per carrier.
in New Hanover County
Find affordable health insurance in Wilmington, North Carolina, NC with Health Plans of NC. Health Plans of NC helps Wilmington, North Carolina residents find the right health insurance coverage for 2026, with access to plans that connect directly to local providers like Novant Health New Hanover Regional Medical Center and major employers such as UNC Wilmington and New Hanover County Schools.
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 Value | POS | Value-focused HMO with lower premiums |
Wilmington, North Carolina is home to 118,578 residents and has seen 0.0% population growth since 2020, reflecting a stable community with consistent healthcare coverage needs across a diverse workforce. Major employers including Novant Health New Hanover Regional, New Hanover County Schools, UNC Wilmington, the County of New Hanover, and Walmart anchor the local economy and drive demand for both employer-sponsored and individual health coverage. With 5.7% of residents being foreign-born, Health Plans of NC ensures all community members can navigate available options, from ACA Marketplace plans to Medicaid, with clear and accessible guidance.
ACA Marketplace coverage through Blue Cross NC gives Wilmington residents access to plans that connect directly to Novant Health New Hanover Regional Medical Center and Cape Fear Memorial Hospital.
Medicaid coverage is available to qualifying low-income Wilmington residents following North Carolina's expansion in December 2023, covering individuals and families who may not afford private insurance.
Employer-sponsored insurance is a primary coverage source for thousands of Wilmington residents employed by large local organizations such as New Hanover County Schools and UNC Wilmington.
Short-term health plans may serve Wilmington residents in coverage gaps, such as those transitioning between jobs at major employers like Walmart or the County of New Hanover.
COBRA continuation coverage allows Wilmington residents who recently left employment at organizations like Novant Health New Hanover Regional to maintain their existing plan temporarily while seeking new coverage.
Small business SHOP Marketplace plans are available to Wilmington small business owners who want to offer group coverage to employees, with access to the same Blue Cross NC networks serving local health systems.
For 2026, Wilmington, North Carolina residents can choose from plans across three Blue Cross NC networks, Blue Advantage, Blue Care, and Blue Value, each offering different levels of provider access and cost structures through HMO and PPO arrangements. Blue Advantage and Blue Care are plans that provide broad access to providers including those affiliated with Novant Health New Hanover Regional Medical Center and Cape Fear Memorial Hospital, while Blue Value is a POS plan designed for residents seeking lower premiums with a more defined provider network. Health Plans of NC helps Wilmington residents review each network's provider directory to confirm their preferred doctors and facilities are in-network before enrolling.
Blue Advantage, a PPO plan, offers the largest nationwide network with over 95% of North Carolina doctors in-network, including providers affiliated with Novant Health New Hanover Regional Medical Center.
Blue Care, an HMO plan, provides a broad statewide network covering over 95% of North Carolina doctors in-network, connecting Wilmington residents to providers at Cape Fear Memorial Hospital and surrounding practices.
Blue Value, a POS plan, focuses on value-driven coverage with lower premiums and a structured provider network suited for Wilmington residents who prefer predictable care coordination.
Plan structures under Blue Advantage and Blue Care allow Wilmington residents to see specialists at facilities like Cape Fear Memorial Hospital without requiring a primary care referral.
Plan structure under Blue Value requires Wilmington residents to coordinate care through a primary care physician, which can streamline access to routine services within the defined network.
All three plan networks, Blue Advantage, Blue Care, and Blue Value, are offered through the ACA Marketplace in Wilmington's Rating Area 7, giving residents meaningful choices based on provider preference and coverage needs.
Bronze plans in Wilmington, North Carolina start at approximately $403.47/month before subsidies. Silver plans start at $518.72/month. Gold plans start at $536.24/month. With a median household income of $63,900, many residents qualify for premium tax credits. Subsidies may reduce your monthly premium significantly based on income.
Bronze plans in Wilmington, North Carolina start at $403.47 per month for a 35-year-old, offering the lowest monthly premiums with higher deductibles before coverage kicks in.
Silver plans start at $518.72 per month and are the only tier eligible for cost-sharing reductions, making them the most financially advantageous option for residents who qualify.
Gold plans start at $536.24 per month and provide lower out-of-pocket costs at the point of care, benefiting residents who anticipate frequent medical services throughout the year.
Wilmington residents with household incomes near or below the area median of $63,900 may qualify for premium tax credits that reduce monthly costs well below published starting prices.
Some lower-income Wilmington residents may qualify for a zero-dollar premium Silver plan after federal premium tax credits are applied, making comprehensive coverage essentially free each month.
Out-of-pocket maximums for 2026 ACA plans cap the total annual cost a Wilmington resident pays, providing financial protection against high medical expenses regardless of which tier is selected.
For 2026, Blue Cross NC is one of four ACA Marketplace carriers serving Wilmington, North Carolina, offering a total of 27 individual and family plans in Rating Area 7. These 27 plans are available across three distinct networks, Blue Advantage, Blue Care, and Blue Value, which include PPO, HMO and POS plan structures giving residents meaningful flexibility in how they access care. Blue Advantage and Blue Care connect Wilmington residents to the broadest provider networks in North Carolina, while Blue Value provides a more focused POS network at lower premium price points. The network a resident selects directly determines which Wilmington-area providers and facilities they can access in-network, making it essential to verify that preferred doctors and hospitals are included before enrolling. Health Plans of NC compares every available Blue Cross NC plan side by side at no cost, helping Wilmington residents identify the plan that best fits their provider preferences and budget.
Blue Cross NC, one of four ACA Marketplace carriers in Wilmington, North Carolina, offers 27 plans for 2026 across structures under Blue Advantage and Blue Care and a POS structure under Blue Value in Rating Area 7.
North Carolina expanded Medicaid in December 2023, opening eligibility to adults earning up to 138% of the federal poverty level and significantly broadening coverage access across the state. In Wilmington, North Carolina, 11.6% of residents, approximately 14,000 people, remain uninsured, and many of them may now qualify for Medicaid or subsidized Marketplace coverage without realizing it. Children in families earning up to 210% of the federal poverty level may qualify for NC Health Choice, the state's CHIP program, providing low-cost coverage for minors whose families earn too much for Medicaid but still need affordable options. Health Plans of NC offers free eligibility checks so Wilmington residents can quickly determine whether they qualify for Medicaid, CHIP, or a subsidized Marketplace plan.
Working adults in Wilmington earning at or below 138% of the federal poverty level may now qualify for full Medicaid coverage following North Carolina's December 2023 expansion.
Children in Wilmington families earning up to 210% of the federal poverty level may qualify for NC Health Choice, providing comprehensive low-cost coverage for minors.
Pregnant women in Wilmington may qualify for Medicaid at higher income thresholds than standard adult eligibility, ensuring prenatal and postpartum care remains accessible.
Wilmington's poverty rate of 16.3% means a significant share of the local population may be eligible for Medicaid at little to no monthly cost, particularly households with children or part-time workers.
Seniors and individuals with disabilities in Wilmington who have low incomes may qualify for both Medicare and Medicaid simultaneously, often called dual eligibility, which can eliminate most out-of-pocket costs.
Health Plans of NC licensed agents serve Wilmington, North Carolina residents at no cost, comparing every available 2026 plan side by side and guiding you through enrollment so you get the right coverage for your needs and budget. Call 800-797-0327 today to speak with a local agent who can find your best plan options and calculate any subsidies you may qualify for.
Call 800-797-0327 (toll free) to speak with a licensed Health Plans of NC agent serving Wilmington, 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 Wilmington, North Carolina at no charge.
Wilmington, North Carolina ZIP Codes include: 28401, 28402, 28403, 28404, 28405, 28406, 28407, 28408, 28409, 28410, 28411, and 28412
