Find an Affordable Health Insurance Plan in Durham County
in North Carolina
Nationwide (BlueCard®)
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 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.
Triangle area
Blue Home℠ with UNC Health Alliance is a Blue Cross NC plan built around UNC Health's provider network, including more than 1,900 primary care providers, UNC Medical Center (nationally ranked in 4 adult and 9 pediatric specialties by U.S. News & World Report), and UNC Rex Hospital (rated high-performing in 1 adult specialty and 21 adult procedures and conditions).
Like the other Blue Home plans, this is a single-system regional network offered at a lower premium than broad-network options — only UNC Health Alliance providers are in-network. We recommend it for Triangle-area residents who already rely on a UNC Health doctor, especially for complex or pediatric care.
Good fit if you have an ongoing relationship with a UNC Health specialist, especially for a complex or chronic condition, prefer pediatric care coordinated through UNC's academic health system, or live in one of the eligible Triangle-area counties.
Poor fit if your regular doctors are with Cone Health, Duke Health, or WakeMed — all three are out-of-network here.
Regional network – Triangle area
Network: UNC Health Alliance only1 (incl. UNC Medical Center).2
Out-of-area care: Emergency / urgent only.
Offered in Bronze, Silver, and Gold tiers.
Notes
Blue Cross NC has collaborated with UNC Health to bring you Blue Home℠ with UNC Health Alliance. Blue Home with UNC Health Alliance is a health insurance plan offered by Blue Cross NC that provides access to a limited network of providers. UNC Health is an independent company that is solely responsible for the physicians and medical facilities it owns and operates. UNC Health does not offer Blue Cross or Blue Shield products or services.
UNC Health, www.unchealthcare.org/health-alliance/ (Accessed August 2024).
U.S. News and World Report, www.usnews.com/best-hospitals/area/nc/university-of-north-carolina-hospitals-6360260 (Accessed August 2024).
U.S. News and World Report, www.usnews.com/best-hospitals/area/nc/rex-healthcare-6361210 (Accessed August 2024).
Blue Home with UNC Health Alliance is available on and off Marketplace to residents of these North Carolina counties: Alamance, Caswell, Chatham, Durham, Franklin, Johnston, Lee, Nash, Orange, Person, and Wake.
This plan is built around a single system, UNC Health Alliance, which keeps the premium lower than Blue Cross NC's broad-network plans. Only UNC Health Alliance providers are in-network — outside of emergency and urgent care, Duke Health and WakeMed are not covered, even though both operate in the same Triangle-area counties.
The network includes more than 1,900 primary care providers, UNC Medical Center — nationally ranked in four adult and nine pediatric specialties by U.S. News & World Report — and UNC Rex Hospital, rated high-performing in one adult specialty and 21 adult procedures and conditions.
For members managing a complex or chronic condition, or families needing pediatric specialty care, having that care coordinated through one academic health system is often the main draw of this plan over a broader but less integrated network.
The lower premium is the trade-off for narrowing to one system. 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 11 Triangle-area counties, including Wake, Durham, and Orange. If your doctors are with Duke Health or WakeMed instead, this plan won't cover them outside of an emergency.
You can enroll during the annual Open Enrollment Period (November 1 – January 15) or during a Special Enrollment Period if you've had a qualifying life event — a job change, a move, a new dependent, or losing other coverage.
A licensed Health Plans of NC agent can confirm your UNC Health providers are in-network, check your subsidy, and compare this plan against Blue Advantage® and Blue Care® — at no cost. Call 800-797-0327.
Yes — UNC Medical Center, nationally ranked by U.S. News & World Report in several adult and pediatric specialties, is part of this network, along with more than 1,900 primary care providers across the Triangle.
No. Duke Health and WakeMed are out-of-network on Blue Home℠ with UNC Health Alliance, along with their affiliated providers. If your regular doctors are with Duke or WakeMed, this isn’t the right plan.
No. UNC Health is an independent company solely responsible for its physicians and facilities. Blue Cross NC partners with UNC Health to offer this plan design, but UNC Health does not sell Blue Cross or Blue Shield products.
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 | 9 |
| Ambetter of North Carolina | 15 |
| Cigna Healthcare | 7 |
| Total | 31 |
Source: CMS QHP Landscape PY2026, Individual Market Medical, updated August 26, 2026 (data.healthcare.gov). Counts distinct Plan IDs offered on the Marketplace in Durham County, once per carrier.
in North Carolina
Find affordable health insurance in Durham County, NC with Health Plans of NC. Health Plans of NC helps Durham County residents find and compare affordable health insurance coverage, connecting families and individuals to plans that work with leading local institutions like Duke University Health System and employers such as Fidelity Investments.
Plan Network | Type | Network Coverage |
|---|---|---|
Blue Advantage® | PPO | Largest nationwide network, 95%+ of NC doctors in-network (off-Marketplace only) |
Blue Home℠ with UNC Health Alliance | EPO | UNC Health hospitals and affiliated providers |
Durham County is home to 329,405 residents, a population that has grown 1.4% in recent years, with 15.2% of residents born outside the United States, reflecting a diverse community with varied coverage needs and language preferences. Major employers including Duke University, Fidelity Investments, Durham Public Schools, Cisco Systems, and the Veterans Administration provide a foundation of employer-sponsored coverage for many working residents, while health systems such as Duke University Hospital, Duke Regional Hospital, UNC Hospitals, and the Durham VA Medical Center anchor the county's care infrastructure. Beyond employer plans, Durham County residents can access individual and family marketplace coverage, Medicaid, CHIP, COBRA continuation coverage, and small business SHOP plans, giving households and employers a range of pathways to protection.
ACA Marketplace coverage connects Durham County individuals and families to Blue Cross NC plans that work with Duke University Hospital and other major local providers.
Medicaid coverage is available to qualifying low-income Durham County adults, children, and families, with eligibility screening available through Health Plans of NC at no cost.
Employer-sponsored insurance is offered by large Durham County employers including Duke University, Cisco Systems, and Fidelity Investments, covering a significant share of the county workforce.
Short-term health plans can provide temporary gap coverage for Durham County residents between jobs or waiting for open enrollment, though benefits are more limited than ACA plans.
COBRA continuation coverage allows Durham County employees who leave positions at employers like Durham Public Schools or the Veterans Administration to maintain their existing group plan for a defined period.
Small business SHOP plans are available to Durham County employers who want to offer group health benefits to their teams, with Health Plans of NC agents available to guide small business owners through their options.
For 2026, Durham County residents can choose from plans offered under two Blue Cross NC plan networks: Blue Advantage and Blue Home with UNC Health Alliance, with Blue Advantage available exclusively off-Marketplace and Blue Home with UNC Health Alliance available through the ACA Marketplace. These networks differ significantly in how they connect enrollees to local hospitals and health systems, making network selection one of the most important decisions Durham County residents will make during enrollment. Health Plans of NC agents help Durham County residents evaluate which network aligns with their preferred providers, whether that is Duke University Hospital, Duke Regional Hospital, or UNC Hospitals.
Blue Advantage, a PPO network available off-Marketplace only, provides access to the largest nationwide provider network, including Durham County hospitals and specialty facilities.
Blue Home with UNC Health Alliance, an EPO network, connects Durham County enrollees to UNC Health hospitals and affiliated providers, including UNC Hospitals in Chapel Hill.
Blue Home with UNC Health Alliance lets enrollees choose a primary care provider to help coordinate care, and no referrals are needed for specialist care within the UNC Health Alliance network.
Blue Advantage's PPO structure allows Durham County residents to see in-network providers without referrals, offering greater flexibility for those who see multiple specialists.
Durham County residents enrolled in Blue Home with UNC Health Alliance should verify that their preferred local providers, including any Duke-affiliated clinics, are in-network before selecting this plan.
Health Plans of NC compares both available networks side-by-side so Durham County residents can choose the plan structure that best fits their care preferences and provider relationships.
Bronze plans in Durham County start at approximately $403.47/month before subsidies. With a median household income of $79,501, many residents qualify for premium tax credits. Subsidies may reduce your monthly premium significantly based on income.
Bronze plans in Durham County start at $403.47 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 $518.72 per month before subsidies and are the only tier eligible for cost-sharing reductions, which lower deductibles and copays for qualifying Durham County enrollees.
Gold plans start at $536.24 per month before subsidies and feature lower out-of-pocket maximums, making them a strong option for Durham County residents who use healthcare services frequently.
Durham County residents with a household income near the county median of $79,501 may qualify for partial premium tax credits that reduce monthly costs across all available metal tiers.
Lower-income Durham County households may qualify for $0 monthly Silver plan premiums under enhanced federal subsidy rules currently in effect for marketplace enrollees.
Out-of-pocket maximums for 2026 ACA plans cap the total annual cost-sharing exposure for Durham County enrollees, providing a financial ceiling for those who need significant medical care during the year.
Blue Cross NC is one of three ACA Marketplace carriers offering individual and family health insurance plans in Durham County for 2026, with 9 total plans on the Marketplace, plus Blue Advantage plans off the Marketplace, available across multiple coverage tiers. The carrier offers two plan networks in the county: Blue Advantage, a PPO available off-Marketplace, and Blue Home with UNC Health Alliance, an EPO available through the Marketplace. Blue Home with UNC Health Alliance connects Durham County enrollees to UNC Health hospitals and affiliated providers, while Blue Advantage offers access to the largest nationwide network for off-Marketplace enrollees. The network a Durham County resident selects determines which local hospitals, clinics, and specialists they can access at in-network rates, making the choice between these two networks a critical step in the enrollment process. Health Plans of NC compares every available Blue Cross NC plan side-by-side at no cost, helping Durham County residents identify the right combination of network, tier, and plan structure for their needs.
Blue Cross NC, offering 9 individual and family ACA Marketplace plans, plus Blue Advantage plans off the Marketplace, in Durham County for 2026, available as EPO and PPO plan types across multiple metal 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, a change that opened eligibility to many previously uninsured Durham County residents. Currently, 11.6% of Durham County residents, approximately 38,000 people, remain uninsured, and a meaningful share of that population may now qualify for Medicaid or subsidized marketplace coverage without being aware of their eligibility. Children in Durham County families earning up to 210% 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 offers free eligibility checks for Durham County residents who want to determine whether they or their children qualify for Medicaid, CHIP, or another assistance program.
Working adults in Durham County who earn up to 138% of the federal poverty level and were previously uninsured may now qualify for full Medicaid coverage following North Carolina's expansion.
Children in Durham County families with incomes up to 210% of the federal poverty level may be eligible for NC Health Choice, the state CHIP program, at little or no cost.
Pregnant women in Durham County are eligible for Medicaid coverage with higher income thresholds than the standard adult expansion limit, ensuring prenatal and delivery care access.
Durham County residents with disabilities may qualify for Medicaid based on disability status and income, with eligibility criteria that differ from the standard expansion pathway.
With a poverty rate of 12.0% in Durham County, a significant share of the population may qualify for Medicaid or CHIP, and Health Plans of NC can perform a free eligibility screening to confirm coverage options.
Health Plans of NC licensed agents serve Durham County residents at no cost, comparing every available plan side-by-side and guiding enrollees through the full application and enrollment process. Call 800-797-0327 today to speak with an agent who knows Durham County's health insurance options and can help you find the right plan for your 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 Durham 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 |
|---|---|---|
Duke Regional Hospital | 3643 N Roxboro St, Durham, NC 27704 | |
Duke University Hospital | 2301 Erwin Rd, Durham, NC 27705 | |
North Carolina Specialty Hospital | 3916 Ben Franklin Blvd, Durham, NC 27704 | |
Durham VA Medical Center | 508 Fulton St, Durham, NC 27705 |
Clinic | Address | Phone |
|---|---|---|
BDIHS Durham | 249 E NC Highway 54, Unit 310, Durham, NC 27713 | |
Health Care for the Homeless | 412 Liberty St, Durham, NC 27701 | |
Holton Wellness Center | 401 N Driver St, Durham, NC 27703 | |
Lincoln CHC -Durham County Human Services | 414 E Main St, Durham, NC 27701 | |
Lincoln Community Health Center Incorporated - Lakewood | 2020 Chapel Hill Rd, Suite 28, Durham, NC 27707 | |
Lincoln Community Health Center | 1301 Fayetteville St, Durham, NC 27707 | |
Lyon Park Clinic | 1313 Halley St, Durham, NC 27707 | |
Walltown Clinic | 815 Broad St, Durham, NC 27705 |
Durham County ZIP Codes include: 27503, 27701, 27702, 27703, 27704, 27705, 27706, 27707, 27708, 27709, 27710, 27711, 27712, 27713, 27715, 27717, and 27722
