Find Your Most Affordable Health Insurance Plan in Winston-Salem, North Carolina
in North Carolina
Forsyth County residents can compare 14 health insurance options for 2026.
Blue Advantage gives you access to our largest nationwide network. This is a good option if you want a broad choice of in-network doctors, specialists and hospitals.
More in-network providers in North Carolina, with over 95% of doctors and 98% of hospitals in-network1
Fewer restrictions on which providers you can see
Nationwide access to in-network providers through BlueCard®2
Emergency services covered at the in-network benefit level regardless of where you go for care
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 to residents in all North Carolina counties EXCEPT the following, where it is available only off Marketplace: Alamance, Anson, Cabarrus, Caswell, Chatham, Cleveland, Davidson, Davie, Durham, Forsyth, Franklin, Gaston, Johnston, Lee, Lincoln, Mecklenburg, Orange, Person, Rowan, Stanly, Stokes, Surry, Union, Wake, and Yadkin.
Blue Home with Novant Health is a good option if you wish to get care from Novant Health’s provider network and its affiliated doctors and hospitals. Since the majority of doctors in this plan are in the same network, it’s easier for them to work together on your behalf.
Novant Health’s network of hospitals, doctors and affiliated providers including over 2,000 physicians.2
A provider network that includes more than 850 locations, including Novant Health’s not-for-profit integrated system of 19 medical centers.2
All doctors outside the Novant Health provider network are considered out-of-network and not covered for Blue Home with Novant Health. Out-of-network benefit coverage is not available except for emergency services, urgent care and for medically necessary covered services when an in-network provider is not reasonably available per the access to care standards of Blue Cross and Blue Shield of North Carolina (Blue Cross NC).
Out-of-state providers are also out-of-network and not covered. When traveling outside of North Carolina or the United States, only emergency services and urgent care will be covered at the in-network benefit level. All other non-emergency services will be out-of-network and not covered.
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.
Blue Local with Atrium Health is a good option if you wish to get care from Atrium Health and its affiliated doctors and hospitals. Since the majority of doctors in this plan are in the same health care system, it’s easier for them to work together on your behalf.
A provider network that includes: Atrium Health Carolinas Medical Center – named “Best Hospital” in the Charlotte metro region.2
Atrium Health Wake Forest Baptist (pre-eminent academic health system).3
Two children’s hospitals: Levine Children’s Hospital (nationally ranked in eight specialties)4 and Brenner Children’s Hospital.
Atrium Health Wake Forest Baptist Comprehensive Cancer Center – one of only three comprehensive cancer centers in North Carolina.5
26 hospitals and more than 650 care locations in NC and SC.6
All doctors outside the Atrium Health provider network are considered out-of-network and not covered for Blue Local with Atrium Health, including: CaroMont Health, Cone Health, Novant Health and their affiliated providers. Out-of-network benefit coverage is not available except for emergency services, urgent care and for medically necessary covered services when an in-network provider is not reasonably available per the access to care standards of Blue Cross and Blue Shield of North Carolina (Blue Cross NC).
Out-of-state providers are also out-of-network and not covered. When traveling outside of North Carolina or the United States, only emergency services and urgent care will be covered at the in-network benefit level. All other non-emergency services will be out-of-network and not covered.
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.
Blue Care gives you access to our largest statewide network. This is a good option if you want a broad choice of in-network doctors, specialists and hospitals.
More than 92% of doctors and 97% of hospitals in North Carolina are in-network.1
All doctors outside the Blue Care provider network are considered out-of-network and not covered. Out-of-network benefit coverage is not available except for emergency services, urgent care and for medically necessary covered services when an in-network provider is not reasonably available per the access to care standards of Blue Cross and Blue Shield of North Carolina (Blue Cross NC).
Out-of-state providers are also out-of-network and not covered. When traveling outside of North Carolina or the United States, only emergency services and urgent care will be covered at the in-network benefit level. All other non-emergency services will be out-of-network and not covered.
Blue Care is available in all North Carolina counties, except: Alamance, Caswell, Chatham, Durham, Franklin, Johnston, Lee, Orange, Person, and Wake.
in Forsyth County
Find affordable health insurance in Winston-Salem, North Carolina, NC with Health Plans of NC. Health Plans of NC helps Winston-Salem, North Carolina residents find affordable 2026 health insurance coverage, with licensed agents who understand the local provider landscape including Atrium Health Wake Forest Baptist and the specialists, clinics, and hospitals that serve this community every day.
Plan Network | Type | Network Coverage |
|---|---|---|
Blue Advantage | PPO | Largest nationwide network, 95%+ of NC doctors in-network |
Blue Care | PPO | Broad statewide network, 92%+ of NC doctors in-network |
Blue Local with Atrium Health | PPO | Available in Winston-Salem, North Carolina |
Blue Home with Novant Health | PPO | Available in Winston-Salem, North Carolina |
Winston-Salem, North Carolina is home to 250,887 residents, a population that has seen 0.0% growth since 2020 and includes 10.7% foreign-born residents who may need bilingual or culturally responsive coverage guidance. Major employers such as Wake Forest Baptist Medical Center, Winston-Salem/Forsyth County Schools, Forsyth Memorial Hospital, Novant Health, and Wake Forest University each offer different employer-sponsored insurance arrangements, making it important for residents to compare workplace coverage against marketplace alternatives. Health systems including Atrium Health Wake Forest Baptist and Novant Health Forsyth Medical Center anchor the local provider network, and residents have multiple pathways to coverage depending on employment status, household size, and health needs.
ACA Marketplace coverage provides Winston-Salem residents with comprehensive plans that include access to Atrium Health Wake Forest Baptist and Novant Health Forsyth Medical Center for preventive, specialist, and emergency care.
Medicaid expansion now covers qualifying low-income adults in Winston-Salem, connecting them to primary and specialty care at local health systems without monthly premium costs.
Employer-sponsored insurance is available to many Winston-Salem workers through major local employers such as Winston-Salem/Forsyth County Schools, Wake Forest University, and Novant Health, often with substantial premium contributions.
Short-term health plans may offer temporary gap coverage for Winston-Salem residents between jobs or waiting for open enrollment, though they do not include the full benefits of ACA-compliant plans.
COBRA continuation coverage allows former employees of Winston-Salem employers such as Forsyth Memorial Hospital or Wake Forest Baptist Medical Center to maintain their existing group plan temporarily after a qualifying life event.
Small business SHOP Marketplace plans give Winston-Salem small business owners a structured way to offer group coverage to employees, potentially including access to Novant Health Forsyth Medical Center and other local providers.
For 2026, Winston-Salem residents can choose from four distinct plan networks offered through the ACA Marketplace, each structured as a PPO and connecting enrollees to different combinations of local and statewide providers. Blue Advantage and Blue Care offer the broadest provider access across North Carolina, while Blue Local with Atrium Health and Blue Home with Novant Health are tailored networks built around Winston-Salem's two flagship health systems. Selecting the right network ensures that residents retain in-network access to the hospitals, specialists, and primary care clinics they already use throughout Winston-Salem.
Blue Advantage, a PPO network, provides the largest nationwide provider access, covering more than 95% of North Carolina doctors and connecting Winston-Salem residents to a wide range of local and out-of-area specialists.
Blue Care, a PPO network, offers broad statewide coverage reaching more than 92% of North Carolina doctors, giving Winston-Salem residents strong in-network access to local providers and facilities.
Blue Local with Atrium Health, a PPO network, is built around Atrium Health Wake Forest Baptist and is designed specifically for Winston-Salem residents who primarily use that system for their medical care.
Blue Home with Novant Health, a PPO network, centers on Novant Health Forsyth Medical Center and affiliated Novant Health clinics, making it a strong choice for Winston-Salem residents already established with Novant providers.
All four PPO networks in Winston-Salem for 2026 cover the 10 essential health benefits required under the ACA, including preventive care, emergency services, prescription drugs, and mental health services.
Residents should verify that their specific doctors, specialists, and preferred Winston-Salem facilities are in-network before selecting a plan, as network tiers vary in geographic scope and provider participation.
Bronze plans in Winston-Salem, 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 $57,673, many residents qualify for premium tax credits. Subsidies may reduce your monthly premium significantly based on income.
Bronze plans in Winston-Salem start at $476.59 per month for a 35-year-old before subsidies, offering the lowest premiums with higher out-of-pocket costs when care is needed.
Silver plans begin at $612.52 per month before subsidies and are the only tier eligible for cost-sharing reductions, which can lower deductibles and copays significantly for qualifying Winston-Salem residents.
Gold plans start at $633.41 per month before subsidies and provide lower out-of-pocket costs at the point of care, making them a strong value for residents who use medical services frequently.
Winston-Salem residents with household incomes between 100% and 400% of the federal poverty level qualify for premium tax credits, and enhanced subsidies extend savings further up the income scale beyond that range.
Some Winston-Salem residents with incomes near the lower end of the subsidy eligibility range may qualify for a $0 premium Silver plan after tax credits are applied, dramatically reducing the cost of comprehensive coverage.
Out-of-pocket maximums for 2026 ACA plans cap the total annual cost-sharing exposure for Winston-Salem enrollees, providing financial protection against high medical bills even on lower-tier Bronze plans.
Blue Cross NC is the sole ACA Marketplace carrier serving Winston-Salem, North Carolina for 2026, offering a total of 14 plans across multiple coverage tiers in Rating Area 10. Those 14 plans are organized across four PPO networks: Blue Advantage, Blue Care, Blue Local with Atrium Health, and Blue Home with Novant Health, each designed to serve different provider preferences and coverage priorities. Blue Local with Atrium Health connects enrollees directly to Atrium Health Wake Forest Baptist and its affiliated facilities, while Blue Home with Novant Health centers coverage around Novant Health Forsyth Medical Center and the broader Novant system throughout the region. The network a Winston-Salem resident selects determines which hospitals, specialists, and primary care providers are available at in-network cost-sharing rates, making this decision as important as the metal tier selected. Health Plans of NC compares every available Blue Cross NC plan side-by-side at no cost, helping Winston-Salem residents identify the plan that best matches their provider relationships and coverage needs.
Blue Cross NC: PPO plans across four networks, 14 total ACA Marketplace plans available in Winston-Salem, North Carolina for 2026 in Rating Area 10.
North Carolina expanded Medicaid in December 2023, and Winston-Salem residents earning up to 138% of the federal poverty level now qualify for free or very low-cost coverage through the state Medicaid program. Currently, 11.9% of Winston-Salem residents, representing approximately 30,000 people, remain uninsured, and many of them may now be eligible for Medicaid or marketplace subsidies they have not yet claimed. 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 pediatric care throughout Winston-Salem. Health Plans of NC offers free eligibility checks and can help Winston-Salem residents determine in minutes whether they qualify for Medicaid, CHIP, or subsidized marketplace coverage.
Working adults in Winston-Salem who earn low wages or work part-time without employer coverage may qualify for expanded Medicaid at no monthly premium cost.
Children in Winston-Salem households at or below 210% of the federal poverty level may be eligible for NC Health Choice, providing comprehensive pediatric coverage at little to no cost.
Pregnant women in Winston-Salem qualify for Medicaid coverage with an expanded income threshold, ensuring access to prenatal, delivery, and postpartum care at local health systems.
Seniors with low income in Winston-Salem may qualify for dual Medicaid and Medicare coverage, helping to offset premiums, copays, and long-term care costs not covered by Medicare alone.
With a poverty rate of 17.9% in Winston-Salem, a substantial portion of the local population may qualify for Medicaid or CHIP, and Health Plans of NC can help those residents confirm eligibility and complete enrollment at no cost.
Health Plans of NC licensed agents serve Winston-Salem, North Carolina residents at absolutely no cost, comparing every available 2026 plan side-by-side and guiding each client through enrollment, subsidy calculations, and Medicaid eligibility checks. Call 800-797-0327 today to speak with a local agent who knows the Winston-Salem coverage landscape and can help you find the right plan for your family, your budget, and your doctors.
Call 800-797-0327 (toll free) to speak with a licensed Health Plans of NC agent serving Winston-Salem, 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 Winston-Salem, North Carolina at no charge.
Winston-Salem, North Carolina ZIP Codes include: 27101, 27102, 27103, 27104, 27105, 27106, 27107, 27108, 27109, 27110, 27111, 27113, 27114, 27101, 27102, 27103, 27104, 27105, 27106, 27107, 27108, 27109, 27110, 27111, 27113, 27114, 27115, 27116, 27117, 27120, 27127, 27130, 27150, 27151, 27152, 27155, 27156, 27157, 27198, 27199, 27116, 27117, 27120, 27127, 27130, 27150, 27151, 27152, 27155, 27156, 27157, 27198, and 27199
