Find an Affordable Health Insurance Plan in Burke County
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 |
| AmeriHealth Caritas Next | 8 |
| Total | 63 |
Source: CMS QHP Landscape PY2026, Individual Market Medical, updated August 26, 2026 (data.healthcare.gov). Counts distinct Plan IDs offered on the Marketplace in Burke County, once per carrier.
in North Carolina
Find affordable health insurance in Burke County, NC with Health Plans of NC. Health Plans of NC helps Burke County, NC residents compare and enroll in health insurance coverage at no cost, connecting families and individuals to plans that work with local providers like UNC Health Blue Ridge in Morganton and Atrium Health Carolinas Medical Center Burke.
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 |
Burke County is home to 87,863 residents, a community that has grown 0.3 percent since 2020 and includes 5.6 percent foreign-born residents who may need guidance navigating health coverage options. Major employers in the county include Broughton Hospital operated by NCDHHS, Burke County Public Schools, Blue Ridge Healthcare Hospitals, Case Farms Processing, and Burke County government, each presenting different coverage situations for their workers and dependents. Residents who do not receive coverage through these employers, or who need to supplement their workplace benefits, have several pathways to comprehensive health insurance through the ACA Marketplace, Medicaid, COBRA, and other options.
ACA Marketplace coverage is available for Burke County residents who are self-employed, work part-time at Case Farms Processing, or do not receive benefits through their employer.
Medicaid coverage connects qualifying low-income Burke County adults and families to providers including the Burke County Health Department and Partners Behavioral Health Management.
Employer-sponsored coverage is available to many Burke County residents working for major employers such as Broughton Hospital, Burke County Public Schools, and Blue Ridge Healthcare Hospitals.
COBRA continuation coverage allows Burke County residents who lose employer-sponsored benefits from employers like Burke County government to maintain their existing plan temporarily.
Short-term health plans may provide a bridge for Burke County residents between jobs or awaiting open enrollment, though these plans do not meet ACA standards and offer limited protections.
Small business SHOP Marketplace plans are available for Burke County small business owners who want to offer group health benefits to their employees and gain access to federal tax credits.
For 2026, Burke County residents can choose from 27 plans offered by Blue Cross NC across three distinct plan networks, each designed to serve different coverage preferences and provider access needs. The available networks include Blue Advantage, Blue Care, and Blue Value, giving residents options ranging from broad nationwide access to value-focused coverage that prioritizes lower monthly costs. Each network connects Burke County enrollees to key local facilities including UNC Health Blue Ridge in Morganton, Broughton Hospital, Caldwell UNC Health Care in Lenoir, and the UNC Health Care Blue Ridge campus in Valdese.
Blue Advantage, a PPO, offers the largest nationwide network with more than 95 percent of North Carolina doctors in-network, including physicians at UNC Health Blue Ridge and surrounding regional facilities.
Blue Care, an HMO, provides broad statewide network coverage with more than 95 percent of North Carolina doctors in-network, supporting access to providers across Burke County and neighboring communities.
Blue Value, a POS, delivers value-focused coverage with lower monthly premiums, connecting Burke County residents to a defined local network of providers including those affiliated with Blue Ridge Healthcare Hospitals.
All three plan networks include access to key Burke County facilities such as UNC Health Blue Ridge at 2201 S Sterling St in Morganton and the UNC Health Care Blue Ridge campus in Valdese.
Burke County residents with specific specialty care needs, such as oncology services at the Levine Cancer Institute at Blue Ridge in Connelly Springs, should confirm in-network status for their preferred providers when selecting a network.
Health Plans of NC agents can compare all three Blue Cross NC networks side by side to help Burke County residents select the plan that keeps their preferred doctors and hospitals in-network at the lowest available cost.
Bronze plans in Burke County start at approximately $491.92/month before subsidies. With a median household income of $55,684, many residents qualify for premium tax credits. Subsidies may reduce your monthly premium significantly based on income.
Bronze plans in Burke County start at $491.92 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 start at $644.87 per month before subsidies and are the only tier eligible for cost-sharing reductions, which lower deductibles and copays for qualifying enrollees.
Gold plans start at $669.68 per month before subsidies and feature lower out-of-pocket costs at the time of care, making them a strong fit for residents who use medical services frequently.
Burke County residents whose household income falls between 100 and 400 percent of the federal poverty level qualify for premium tax credits that reduce monthly marketplace costs based on household size and income relative to the county median of $55,684.
Households earning between 100 and 250 percent of the federal poverty level may qualify for cost-sharing reductions on Silver plans, lowering deductibles and copays for services at local providers.
Some lower-income Burke County residents may qualify for a $0 premium Silver plan after enhanced premium tax credits are applied, providing comprehensive coverage including emergency care, mental health services, and maternity care at no monthly cost.
For 2026, Blue Cross NC is one of four carriers offering ACA-compliant Marketplace plans in Burke County, with 27 plans available to individuals and families across the county. These 27 plans are organized across three networks: Blue Advantage, a PPO with the largest nationwide coverage; Blue Care, an HMO with broad statewide reach; and Blue Value, a POS focused on lower-premium local network access. Each network is designed to connect Burke County residents to different tiers of provider access, from nationwide PPO flexibility under Blue Advantage to the more limited statewide network of the Blue Value POS. Choosing the right network matters significantly in Burke County given the spread of care across Morganton, Valdese, and neighboring Lenoir, where out-of-network costs at regional facilities can be substantial. Health Plans of NC licensed agents compare every available Blue Cross NC plan side by side at no cost, helping residents identify the plan and network that best fits their provider preferences and budget.
Blue Cross NC, doing business as Blue Cross and Blue Shield of North Carolina, offers 27 ACA Marketplace plans in Burke County for 2026, including options under Blue Advantage and Blue Care, and a POS option under Blue Value.
North Carolina expanded Medicaid in December 2023, and Burke County adults whose household income falls at or below 138 percent of the federal poverty level may now qualify for free or low-cost Medicaid coverage. Currently, approximately 10,000 Burke County residents, representing an uninsured rate of 11.5 percent, are without health coverage, and many of these individuals may be eligible for Medicaid or subsidized Marketplace plans they have not yet enrolled in. Children in Burke County families earning up to 210 percent of the federal poverty level may qualify for NC Health Choice, the state's CHIP program, which provides low-cost comprehensive coverage for eligible minors. Health Plans of NC provides free eligibility checks for Burke County residents interested in Medicaid, CHIP, or Marketplace coverage, with no cost or obligation to enroll.
Working adults in Burke County who earn at or below 138 percent of the federal poverty level and do not have access to affordable employer coverage may qualify for full Medicaid benefits.
Children in Burke County families qualify for NC Health Choice (CHIP) if household income is up to 210 percent of the federal poverty level, providing access to pediatric care, dental, and vision services.
Pregnant women in Burke County may qualify for Medicaid coverage that includes prenatal care, labor and delivery services, and postpartum care through local providers like UNC Health Blue Ridge.
Burke County residents with disabilities or who receive Supplemental Security Income may qualify for Medicaid benefits that cover a broad range of medical, behavioral health, and long-term care services.
With a poverty rate of 17.9 percent in Burke County, a significant share of residents may qualify for Medicaid or CHIP and can confirm eligibility at no cost by contacting Health Plans of NC at 800-797-0327.
Health Plans of NC licensed agents serve Burke County residents at no cost, comparing every available plan side by side and guiding individuals and families through enrollment from start to finish. Call 800-797-0327 today to speak with an agent who knows the Burke County market and can help you find the right coverage.
Call 800-797-0327 (toll free) or 704-303-8256 to speak with a licensed agent and schedule a free appointment
Email [email protected] with questions about plans available in Burke County
Find a licensed agent and book directly at healthplansofnc.com/agents
No cost, no pressure. Health Plans of NC agents work for you, not the carrier.
Hospital | Address | Phone |
|---|---|---|
UNC Health Blue Ridge | 2201 S Sterling St, Morganton, NC 28655 | |
Broughton Hospital | 1000 S Sterling St, Morganton, NC 28655 |
Clinic | Address | Phone |
|---|---|---|
Good Samaritan Clinic | 500 E Parker Rd, Morganton, NC 28655 | |
High Country Community Health - Burke Dental | 500 E Parker Rd, Morganton, NC 28655 | |
High Country Community Health - Eastern Burke HCCH | 560 Malcolm Blvd, Connelly Springs, NC 28612 | |
High Country Community Health - Morganton Office 301 E Meeting Street | 301 E Meeting St, Suite 101, Morganton, NC 28655 | |
Blue Ridge Family Practice | 730 Malcolm Blvd Suite 150, Rutherford College, NC 28671 | |
Blue Ridge Healthcare Medical Group | 113-A Foothills Dr, Morganton, NC 28655 | |
Blue Ridge Internal Medicine | 720 Malcolm Blvd Suite 103, Rutherford College, NC 28671 | |
Blue Ridge Internal Medicine | 730 Malcolm Blvd Suite 100, Rutherford College, NC 28671 | |
Blue Ridge Transitional Care Clinic | 111 Foothills Dr Ste A, Morganton, NC 28655 | |
Blue Ridge Urgent Care | 695 W Fleming Dr, Morganton, NC 28655 |
Burke County ZIP Codes include: 28612, 28619, 28628, 28637, 28655, 28666, 28671, 28680, and 28690
