Find Your Most Affordable Health Insurance Plan in Clay 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.
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 | 18 |
| Ambetter of North Carolina | 15 |
| Cigna Healthcare | 10 |
| AmeriHealth Caritas Next | 8 |
| Total | 51 |
Source: CMS QHP Landscape PY2026, Individual Market Medical, updated August 26, 2026 (data.healthcare.gov). Counts distinct Plan IDs offered on the Marketplace in Clay County, once per carrier.
in North Carolina
Find affordable health insurance in Clay County, NC with Health Plans of NC. Health Plans of NC helps Clay County residents find affordable health coverage through Blue Cross NC, connecting families and individuals served by Murphy Medical Center with plans that fit their lives and budgets.
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 |
Clay County is home to 11,391 residents across communities like Hayesville, Shooting Creek, and Brasstown, and the county has grown 2.7% since 2020, reflecting steady demand for reliable health coverage options. Major local employers including Clay County Schools, the County of Clay, Ingles Markets, Advanced Digital Cable, and Amazon connect many residents to employer-sponsored coverage, while others rely on ACA Marketplace plans or public programs. With 3.8% of residents being foreign-born and healthcare anchored by systems like Murphy Medical Center and Mission Health HCA, Clay County families have a range of coverage pathways to explore with the help of Health Plans of NC.
ACA Marketplace plans through Blue Cross NC give self-employed Clay County residents and those without employer coverage access to comprehensive benefits at local facilities like Erlanger Western Carolina Hospital in Murphy.
Medicaid coverage is available to qualifying Clay County residents, including many who work part-time or seasonal roles at employers like Ingles Markets and may not have access to employer-sponsored benefits.
Employer-sponsored group health insurance is available to many Clay County workers through organizations like Clay County Schools and the County of Clay, providing in-network access to Murphy Medical Center and Mission Health HCA.
Short-term health plans offer Clay County residents between jobs or awaiting open enrollment a temporary coverage bridge to clinics and hospitals in Murphy, Franklin, and Highlands.
COBRA continuation coverage allows Clay County residents who recently left jobs with employers like Advanced Digital Cable or Amazon to maintain their existing health benefits for a limited period.
Small business SHOP plans allow Clay County small business owners to offer group health coverage to employees, helping attract and retain workers in a competitive local job market.
For 2026, Clay County residents can choose from plans offered under two Blue Cross NC networks, Blue Advantage and Blue Care, both of which connect enrollees to hospitals and specialists in western North Carolina. Blue Advantage is a PPO with the largest nationwide network, making it a strong fit for Clay County residents who travel or seek specialty care beyond the immediate area, while Blue Care is an HMO with broad statewide coverage suited to those who primarily use providers in Murphy, Franklin, and Highlands. Health Plans of NC agents can help Clay County residents compare both networks side-by-side to identify which plan structure best aligns with their preferred providers and care patterns.
Blue Advantage, a PPO network, includes 95% or more of NC doctors in-network and provides Clay County residents access to Erlanger Western Carolina Hospital, Angel Medical Center in Franklin, and Highlands-Cashiers Hospital.
Blue Care, an HMO network, covers 95% or more of NC doctors statewide and connects Clay County residents to Murphy Medical Center, Mission Health HCA facilities, and specialist clinics in Franklin and Highlands.
Both Blue Advantage and Blue Care plans are available in Bronze, Silver, and Gold metal tiers, giving Clay County residents flexibility in balancing monthly premiums against out-of-pocket costs at local facilities.
Clay County residents who primarily use providers in Murphy can evaluate whether Blue Advantage or Blue Care offers the strongest in-network access to Murphy Medical Center and surrounding clinics.
Catastrophic plans are available to Clay County residents under age 30 or those with a qualifying hardship exemption, providing low-premium emergency protection tied to the Blue Cross NC network.
Health Plans of NC agents review every Blue Advantage and Blue Care plan option with Clay County residents at no cost, ensuring the chosen network matches their preferred hospitals and specialty care needs.
Bronze plans in Clay County start at approximately $427.27/month before subsidies. With a median household income of $53,645, many residents qualify for premium tax credits. Subsidies may reduce your monthly premium significantly based on income.
Bronze plans start at $427.27 per month for a 35-year-old in Clay County before subsidies, offering the lowest monthly premiums with higher deductibles for those who use medical care infrequently.
Silver plans start at $549.92 per month before subsidies and are the only metal tier eligible for cost-sharing reductions, which lower deductibles and copays for qualifying Clay County households.
Gold plans start at $587.73 per month before subsidies and feature lower out-of-pocket costs per visit, making them a strong value for Clay County residents who regularly see specialists or manage chronic conditions.
Clay County households earning between 100% and 400% of the federal poverty level qualify for premium tax credits, and those earning up to 600% of the federal poverty level may still receive meaningful subsidies under enhanced ACA rules.
Some Clay County households with incomes near the poverty line may qualify for a $0 premium Silver plan after tax credits are applied, making comprehensive coverage accessible at no monthly cost.
Out-of-pocket maximums for 2026 ACA plans cap the total annual spending a Clay County resident will owe, providing financial protection against large medical bills at area hospitals like Angel Medical Center or Erlanger Western Carolina Hospital.
For 2026, Blue Cross NC is one of four ACA Marketplace carriers offering plans in Clay County, with 18 total plans available to individuals, families, and small businesses in this market. Those 18 plans are offered across two networks, Blue Advantage and Blue Care, giving residents meaningful choice in how broadly they can access doctors and hospitals across North Carolina and beyond. Blue Advantage connects Clay County enrollees to the largest nationwide PPO network, while Blue Care provides broad statewide HMO access well suited to residents relying on providers in Murphy, Franklin, and Highlands. The choice between these two networks directly affects whether Clay County residents can access nearby facilities like Erlanger Western Carolina Hospital, Angel Medical Center, and Highlands-Cashiers Hospital at in-network rates. Health Plans of NC agents compare every Blue Cross NC plan side-by-side at no cost, ensuring Clay County residents select the carrier network and metal tier that best matches their provider relationships and financial situation.
Blue Cross NC, plans under Blue Advantage and Blue Care networks, 18 plans available to Clay County residents for 2026 across Bronze, Silver, Gold, and Catastrophic tiers.
North Carolina expanded Medicaid in December 2023, extending free or low-cost coverage to adults earning up to 138% of the federal poverty level, which opened a significant new coverage pathway for Clay County residents. Currently 15.3% of Clay County residents, approximately 2,000 people, are uninsured, and many of them may now qualify for Medicaid or heavily subsidized Marketplace coverage they were not previously eligible for. Children in Clay County families earning up to 210% of the federal poverty level may qualify for NC Health Choice, the state's CHIP program, providing low-cost comprehensive coverage for younger residents. Health Plans of NC offers free eligibility checks to help Clay County residents determine whether they qualify for Medicaid, CHIP, or a subsidized Marketplace plan through Blue Cross NC.
Working adults in Clay County earning at or below 138% of the federal poverty level may qualify for NC Medicaid Expansion at little or no cost, including coverage for visits to Murphy Medical Center and Mission Health HCA facilities.
Children in Clay County families earning up to 210% of the federal poverty level may qualify for NC Health Choice, providing low-cost dental, vision, and medical coverage for a county where nearly 20% of residents are under age 18.
Pregnant women in Clay County may qualify for Medicaid coverage throughout pregnancy and for a period after delivery, ensuring access to prenatal and postnatal care at area hospitals and clinics.
Clay County seniors with low incomes may qualify for dual eligibility programs combining Medicare and Medicaid benefits, helping cover premiums, copays, and long-term care services not covered by Medicare alone.
With a poverty rate of 13.5% in Clay County, a meaningful share of local households may qualify for $0 premium Medicaid plans or heavily subsidized Marketplace coverage, and Health Plans of NC can verify eligibility at no cost.
Health Plans of NC licensed agents serve Clay County residents at no cost, comparing every available Blue Cross NC plan side-by-side and guiding enrollees through the full application and enrollment process. Call 800-797-0327 today to get a free personalized quote and find the plan that best fits your healthcare needs and budget.
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 Clay 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 |
|---|---|---|
Angel Medical Ctr | 124 One Center Ct, Franklin, NC 28734 | (828) 524-8411 |
Cherokee Indian Hospital | 1 Hospital Rd, Cherokee, NC 28719 | (828) 497-9163 |
Erlanger Western Carolina Hosp | 3990 E US 64 Alt, Murphy, NC 28906 | (828) 837-8161 |
Harris Regional Hospital | 68 Hospital Rd, Sylva, NC 28779 | (828) 586-7000 |
Haywood Regional Medical Ctr | 262 Leroy George Dr, Clyde, NC 28721 | (828) 456-7311 |
Highlands-Cashiers Hospital | 190 Hospital Dr, Highlands, NC 28741 | (828) 526-1200 |
Swain Community Hospital | 45 Plateau St # 230, Bryson City, NC 28713 | (828) 488-2155 |
Transylvania Regional Hospital | 260 Hospital Dr, Brevard, NC 28712 | (828) 884-9111 |
Unity Healing Ctr | 448 Sequoyah Trl, Cherokee, NC 28719 | (828) 497-1800 |
Clinic | Address | Phone |
|---|---|---|
Angel Medical Ctr | 56 Medical Park Dr, Franklin, NC 28734 | (828) 542-8411 |
Asheville Cardiology Assoc | 190 Hospital Dr # 104, Highlands, NC 28741 | (828) 274-6000 |
Atlanta Gastroenterology Assoc | 145 Medical Park Ln # K, Murphy, NC 28906 | (404) 257-9000 |
Center For Family Medicine | 55 Holly Springs Park Dr, Franklin, NC 28734 | (828) 349-3550 |
Haywood Regional Medical Ctr | , Waynesville, NC 28786 | (828) 452-8070 |
Mission Community Primary Care | 57 White Owl Ln, Cashiers, NC 28717 | (828) 743-2491 |
Mission Health Ctr Highlands | 190 Hospital Dr, Highlands, NC 28741 | (828) 526-4942 |
Mission Urology-Brevard | 89 Hospital Dr # C, Brevard, NC 28712 | (828) 883-5858 |
Murphy Medical Ctr Emergency | 3990 E US 64 Alt, Murphy, NC 28906 | (828) 837-8300 |
Murphy Medical Ctr Human RSRCS | , Murphy, NC 28906 | (828) 835-7683 |
Murphy Medical Ctr Radiology | 3990 E US 64 Alt, Murphy, NC 28906 | (828) 835-7540 |
Murphy Medical Ctr | 3990 E US Highway 64 Alternate, Murphy, NC 28906 | (828) 835-7502 |
Murphy Medical Ctr | 4130 115 Highway 64 E, Murphy, NC 28906 | (828) 835-7505 |
Orthopedics-Sports Medicine | 190 Riverview St, Franklin, NC 28734 | (828) 349-8260 |
Ozarks Medical Ctr | PO Box 330, Marble, NC 28905 | (417) 257-5802 |
Primary Care Franklin | 190 Riverview St, Franklin, NC 28734 | (828) 349-6800 |
VA Medical Ctr | 45 HI Lane St, Canton, NC 28716 | (828) 298-7911 |
Clay County ZIP Codes include: 28902, 28904, and 28909
