Find an Affordable Health Insurance Plan in Gates 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 |
| Cigna Healthcare | 10 |
| Total | 28 |
Source: CMS QHP Landscape PY2026, Individual Market Medical, updated August 26, 2026 (data.healthcare.gov). Counts distinct Plan IDs offered on the Marketplace in Gates County, once per carrier.
in North Carolina
Find affordable health insurance in Gates County, NC with Health Plans of NC. Health Plans of NC helps Gates County, NC residents find affordable health insurance coverage, working with local employers like Gates County Schools and nearby health systems to connect families with the right plan for their needs.
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 |
Gates County is a rural community of 10,437 residents in northeast North Carolina, with a population that has shifted by -0.4% since 2020 and a foreign-born resident share of 1.3%, reflecting a tightly knit local community with distinct healthcare access needs. Major employers such as Gates County Schools, Gates County government, Green Forestry, Ashton Lewis Lumber, and Gatesville Nursing anchor the local workforce, and many residents rely on nearby health systems including Sentara Albemarle Medical Center and Vidant Bertie Hospital for routine and specialty care. Health Plans of NC helps Gates County residents navigate every available coverage pathway, from ACA Marketplace plans to Medicaid, ensuring no family goes without a suitable option.
ACA Marketplace coverage is available to Gates County residents who do not receive insurance through employers like Gates County Schools or Green Forestry and need individual or family plans.
Medicaid coverage serves income-eligible Gates County residents, including those employed part-time at local businesses like Ashton Lewis Lumber who may not have access to employer-sponsored benefits.
Employer-sponsored health insurance is offered by larger Gates County employers such as Gates County Schools and Gatesville Nursing, providing group coverage to eligible full-time employees and their families.
Short-term health plans may provide temporary coverage for Gates County residents between jobs or awaiting open enrollment, offering a bridge while transitioning between employers in the local area.
COBRA continuation coverage allows Gates County residents who leave jobs at local employers like Gates County government or Green Forestry to maintain their existing group health benefits for a limited period.
SHOP Marketplace small business plans are available to small employers in Gates County, such as local forestry or lumber businesses, allowing them to offer group coverage to their employees through the ACA small business exchange.
For 2026, Gates County residents have access to 18 health insurance plans through Blue Cross NC, offered across two distinct plan networks, Blue Advantage and Blue Care, both structured as plans that allow access to a broad range of providers without requiring referrals. The Blue Advantage PPO network provides the largest nationwide coverage footprint, while the Blue Care HMO network offers broad statewide access, both connecting Gates County residents to nearby regional facilities including Sentara Albemarle Medical Center in Elizabeth City and ECU Health Chowan Hospital in Edenton. Health Plans of NC helps residents compare all available networks and plan structures side-by-side at no cost to identify the option that best fits their provider relationships and care preferences.
Blue Advantage PPO, the largest nationwide network, gives Gates County residents in-network access to over 95% of NC doctors, including providers at Sentara Albemarle Medical Center in Elizabeth City.
Blue Advantage PPO coverage extends to regional specialty clinics such as ECU Health Endocrinology in Ahoskie and ECU Health Neurology in Edenton, supporting Gates County residents managing complex conditions.
Blue Care HMO provides broad statewide network access covering over 95% of NC doctors, connecting Gates County residents to facilities like ECU Health Roanoke-Chowan Hospital in Ahoskie.
Blue Care HMO supports access to primary care clinics used by Gates County residents, including ECU Health Family Medicine in Hertford and ECU Health Internal Medicine in Edenton.
Both Blue Advantage and Blue Care plans allow Gates County residents to see specialists at ECU Health Orthopedics in Roanoke Rapids and ECU Health Multispecialty in Edenton without a referral requirement.
Selecting the right plan network is especially important for Gates County residents who must travel to reach specialists, making it critical to confirm that preferred providers are in-network before enrolling.
Bronze plans in Gates County start at approximately $476.59/month before subsidies. With a median household income of $61,612, many residents qualify for premium tax credits. Subsidies may reduce your monthly premium significantly based on income.
Bronze plans start at $476.59 per month for a 35-year-old in Gates County before subsidies, offering the lowest available monthly premiums paired with higher deductibles for those who prefer lower upfront costs.
Silver plans start at $612.52 per month before subsidies and are the only tier eligible for cost-sharing reductions, which lower deductibles and copays for qualifying Gates County households.
Gold plans start at $633.41 per month before subsidies, providing lower out-of-pocket costs throughout the year and making them well-suited for Gates County residents with frequent healthcare needs.
Gates County residents with household incomes between 100% and 400% of the federal poverty level qualify for premium tax credits that can significantly reduce monthly costs below the Bronze starting price of $476.59.
Some Gates County households may qualify for $0-premium Silver plans after ACA tax credits are applied, depending on household size and income relative to the federal poverty level.
Gates County residents whose incomes fall near 138% of the federal poverty level should compare subsidized Marketplace plans against Medicaid eligibility to identify the most cost-effective coverage pathway available to them.
For 2026, Blue Cross NC is one of two ACA Marketplace carriers serving Gates County, offering a total of 18 individual and family health insurance plans across two available networks, Blue Advantage and Blue Care. Blue Advantage is a PPO and Blue Care is an HMO, both giving Gates County residents the flexibility to access care without referrals across a broad range of in-network providers in the region. The Blue Advantage PPO network connects residents to the largest nationwide provider base, while the Blue Care HMO network delivers broad statewide access, both reaching key regional facilities like Sentara Albemarle Medical Center and ECU Health Chowan Hospital. Network selection has a direct impact on which local hospitals, primary care providers, and specialists are available at in-network rates, making it essential for Gates County residents to review provider directories carefully before choosing a plan. Health Plans of NC compares every available Blue Cross NC plan side-by-side at no cost, helping residents identify the carrier network and plan tier that best aligns with their provider preferences and budget.
Blue Cross NC, plans across Blue Advantage and Blue Care networks, 18 plans available in Gates County for 2026.
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 Gates County residents who previously had no affordable coverage options. Currently, 6.6% of Gates County residents, approximately 1,000 people, remain uninsured, and a meaningful share of those individuals may now qualify for Medicaid or subsidized Marketplace coverage without realizing it. Gates County's poverty rate of 11.8% means a significant portion of the local population falls within or near Medicaid eligibility thresholds, making it especially important for residents to check their status. Children in Gates County families earning up to 210% of the federal poverty level may qualify for NC Health Choice, the state's CHIP program, providing comprehensive low-cost coverage for young residents, and Health Plans of NC offers free eligibility screenings to help families determine which program best fits their situation.
Working adults in Gates County who earn at or below 138% of the federal poverty level may qualify for full Medicaid coverage at little to no cost following North Carolina's December 2023 expansion.
Children in Gates County households earning up to 210% of the federal poverty level may be eligible for NC Health Choice, the state CHIP program, which provides comprehensive and low-cost health coverage.
Pregnant women in Gates County may qualify for Medicaid coverage with an expanded income threshold, ensuring access to prenatal and maternity care through participating regional providers.
Gates County's poverty rate of 11.8% means that a substantial share of local residents may meet the income criteria for Medicaid, particularly those in part-time or seasonal employment with limited access to employer benefits.
Low-income seniors and individuals with disabilities in Gates County may qualify for dual-eligibility programs that combine Medicaid with Medicare, reducing out-of-pocket costs for those on fixed incomes.
Health Plans of NC licensed agents serve Gates County residents at no cost, comparing every available plan side-by-side and guiding families through enrollment from start to finish. Call 800-797-0327 today to speak with an agent who can help you find the right coverage for your household.
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 Gates 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.
Gates County does not have a hospital within its borders. The hospitals below are located in neighboring counties and serve Gates County residents.
Hospital | Address | Phone |
|---|---|---|
ECU Health Chowan Hospital | 211 Virginia Rd, Edenton, NC 27932 | |
ECU Health Roanoke-Chowan Hospital | 500 S Academy St, Ahoskie, NC 27910 | |
Sentara Albemarle Medical Center | 3050 Halstead Blvd Ext, Elizabeth City, NC 27909 |
Clinic | Address | Phone |
|---|---|---|
Gateway Community Health Centers | 501 Main St, Gatesville, NC 27938 | |
Berry Personalized Primary Care | 704 Main St, Gatesville, NC 27938 | |
Gates County Health Department | 29 Medical Center Rd, Gates, NC 27937 | |
Gateway CHC | 88 US Hwy 158 W, Gatesville, NC 27938 |
Gates County ZIP Codes include: 27926, 27935, 27937, 27938, 27946, 27969, and 27979
