Find an Affordable Health Insurance Plan in Macon 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 Macon County, once per carrier.
in North Carolina
Find affordable health insurance in Macon County, NC with Health Plans of NC. Health Plans of NC helps Macon County, NC residents find and compare affordable health insurance options, from ACA marketplace plans to employer-sponsored coverage through major local employers like Angel Medical Center and Macon County Schools. Whether you are self-employed, between jobs, or exploring coverage for your family, Health Plans of NC guides you through every available plan at no cost.
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 |
Macon County is a mountain community of 37,533 residents that has grown 1.4% since 2020, with 5.7% of residents being foreign-born, reflecting a diverse population with varied coverage needs. Major employers such as Macon County Schools, Macon County government, Ingles Markets, TaxAct Administrative Services, and Angel Medical Center provide employer-sponsored insurance to many locals, while health systems including Angel Medical Center and Mission Health HCA anchor the local care network. For those without job-based coverage, several additional options exist to ensure Macon County residents can access the care they need.
ACA Marketplace plans are available to Macon County residents who are self-employed, work part-time at employers like Ingles Markets, or do not have access to job-based coverage.
Medicaid expansion coverage is available to qualifying low-income Macon County adults, connecting them to providers within the Angel Medical Center and Mission Health HCA networks.
Employer-sponsored plans are offered by major Macon County employers including Macon County Schools, Macon County government, and Angel Medical Center for eligible employees and their dependents.
Short-term health plans are an option for Macon County residents in temporary coverage gaps, such as those transitioning between jobs at local employers like TaxAct Administrative Services or Ingles Markets.
COBRA continuation coverage allows Macon County residents who leave a qualifying employer, such as Angel Medical Center or Macon County Schools, to maintain their existing plan for a limited period.
Small business SHOP marketplace plans are available to Macon County small business owners who want to offer group health benefits to employees, with guidance available through Health Plans of NC.
For 2026, Macon County residents have access to 18 health insurance plans through Blue Cross NC, available across two plan networks: Blue Advantage and Blue Care, both structured as plans that offer meaningful flexibility in accessing local providers. Blue Advantage connects Macon County residents to the largest nationwide PPO network, while Blue Care provides broad statewide HMO access, both designed to work with key local facilities including Angel Medical Center in Franklin and Highlands-Cashiers Hospital in Highlands. Health Plans of NC helps residents compare every available plan across both networks to find the right combination of coverage and provider access.
Blue Advantage, PPO, connects Macon County residents to the largest nationwide network, giving broad access to Angel Medical Center, Highlands-Cashiers Hospital, and providers beyond western North Carolina.
Blue Care, HMO, provides broad statewide network access for Macon County residents, supporting in-network visits to facilities like Angel Medical Center in Franklin and Mission Health Ctr Highlands.
Both Blue Advantage and Blue Care plans allow Macon County residents to see specialists such as Asheville Cardiology Associates at Highlands-Cashiers Hospital without requiring a primary care referral.
Blue Advantage plans offer the widest provider reach for Macon County residents who travel frequently or require specialty care at facilities outside of western North Carolina.
Blue Care plans are well suited for Macon County residents who primarily seek care locally at providers like Center For Family Medicine in Franklin or Primary Care Franklin and prefer a straightforward statewide network.
Both networks include PPO flexibility, meaning Macon County residents can choose to see out-of-network providers at a higher cost if needed, providing a safety net beyond in-network local facilities.
Bronze plans in Macon County start at approximately $443.10/month before subsidies. With a median household income of $53,298, many residents qualify for premium tax credits. Subsidies may reduce your monthly premium significantly based on income.
Bronze plans in Macon County start at $443.10 per month before subsidies, offering the lowest monthly premium with higher out-of-pocket costs when care is needed.
Silver plans start at $569.49 per month before subsidies and are the only tier eligible for cost-sharing reductions, which can significantly lower deductibles and copays for qualifying residents.
Gold plans start at $588.91 per month before subsidies, providing lower out-of-pocket costs throughout the year, making them a strong fit for residents who use medical services regularly.
Macon County residents with household incomes between 100% and 400% of the federal poverty level qualify for premium tax credits through the ACA marketplace, often reducing monthly costs well below the starting prices listed above.
Some Macon County households may qualify for a $0-premium Silver plan depending on their income and family size, based on enhanced federal subsidies currently available through the ACA.
Health Plans of NC provides free, personalized quotes for Macon County residents that include exact subsidy calculations so you can see your true net monthly premium before enrolling.
Blue Cross NC is one of four ACA marketplace carriers serving Macon County for 2026, offering a total of 18 individual and family health insurance plans across multiple coverage tiers. These plans are available through two networks: Blue Advantage, which carries the largest nationwide provider network, and Blue Care, which provides broad statewide HMO coverage across North Carolina. Both networks connect Macon County residents to critical local facilities including Angel Medical Center in Franklin and Highlands-Cashiers Hospital in Highlands, as well as regional providers like Asheville Cardiology Associates and Mission Health Ctr Highlands. The network a Macon County resident selects directly affects whether they can access providers such as Center For Family Medicine in Franklin or the VA Medical Center in Canton without incurring out-of-network costs. Health Plans of NC compares every available Blue Cross NC plan side by side at no cost, helping Macon County residents choose the plan and network that best fits their provider relationships and budget.
Blue Cross NC: plans available through the Blue Advantage and Blue Care networks, with 18 total plans offered in Macon County for 2026 across Bronze, Silver, Gold, and Catastrophic coverage tiers.
North Carolina expanded Medicaid in December 2023, extending free or low-cost coverage to adults in Macon County earning up to 138% of the federal poverty level. Currently, 14.4% of Macon County residents, approximately 5,000 people, remain uninsured, and many of them may already qualify for Medicaid or CHIP without knowing it. Children in Macon 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 coverage for kids. Health Plans of NC offers free eligibility checks so Macon County residents can quickly find out whether they qualify for Medicaid, CHIP, or a subsidized marketplace plan.
Working adults in Macon County who are employed part-time or in lower-wage positions may qualify for Medicaid expansion if their household income falls at or below 138% of the federal poverty level.
Children in Macon County families with incomes up to 210% of the federal poverty level may qualify for NC Health Choice, providing comprehensive, low-cost coverage for routine and preventive pediatric care.
Pregnant women in Macon County may qualify for expanded Medicaid coverage with higher income thresholds, ensuring access to prenatal and delivery care at Angel Medical Center or other area hospitals.
Macon County seniors with low incomes may qualify for both Medicare and Medicaid simultaneously, known as dual eligibility, which can reduce or eliminate out-of-pocket costs for medical and long-term care.
Macon County residents with disabilities who meet income requirements may qualify for Medicaid, with a county poverty rate of 14.4% suggesting a meaningful share of locals could be eligible for this assistance.
Health Plans of NC licensed agents serve Macon County residents at no cost, comparing every available plan side by side and walking you through enrollment from start to finish. Call 800-797-0327 today to speak with an agent who knows the Macon County market and can help you find the right coverage 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 Macon 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 Center | 124 Center Court, Franklin, NC 28734 | |
Highlands-Cashiers Hospital | 190 Hospital Dr, Highlands, NC 28741 |
Clinic | Address | Phone |
|---|---|---|
Blue Ridge Health - Highlands Cashier | 209 Hospital Dr, Highlands, NC 28741 | |
Blue Ridge Health-Meridian Macon | 674 Highlands Road, Franklin, NC 28734 | |
Mission Health Center Franklin | 190 Riverview St, Franklin, NC 28734 | |
Mountain Area Health Education Center - MAHEC OB/GYN Specialists Franklin | 56 Medical Park Dr STE 300, Franklin, NC 28734 | |
Smoky Mountain Urgent Care | 195 Franklin Plaza Dr, Franklin, NC 28734 | |
Vecinos Health Hub | 19 Smoky Mountain Dr, Franklin, NC 28734 | |
Angel Primary Care | 278 Riverview St, Franklin, NC 28734 | |
Angel Primary Care | 190 Riverview St, Franklin, NC 28734 | |
Burrell Family & Obstetrical Care | 121 Riverview St Ste B, Franklin, NC 28734 | |
Center for Family Medicine | 55 Holly Springs Park Dr, Franklin, NC 28734 |
Macon County ZIP Codes include: 28734, 28741, 28744, 28763, 28775, and 28781
