Find Your Most Affordable Health Insurance Plan in Madison County
in North Carolina
Madison County residents can compare 17 health insurance options for 2026.
Blue Advantage gives you access to our largest nationwide network. This is a good option if you want a broad choice of in-network doctors, specialists and hospitals.
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 to residents in all North Carolina counties EXCEPT the following, where it is available only off Marketplace: Alamance, Anson, Cabarrus, Caswell, Chatham, Cleveland, Davidson, Davie, Durham, Forsyth, Franklin, Gaston, Johnston, Lee, Lincoln, Mecklenburg, Orange, Person, Rowan, Stanly, Stokes, Surry, Union, Wake, and Yadkin.
Blue Care gives you access to our largest statewide network. This is a good option if you want a broad choice of in-network doctors, specialists and hospitals.
More than 92% of doctors and 97% of hospitals in North Carolina are in-network.1
All doctors outside the Blue Care provider network are considered out-of-network and not covered. Out-of-network benefit coverage is not available except for emergency services, urgent care and for medically necessary covered services when an in-network provider is not reasonably available per the access to care standards of Blue Cross and Blue Shield of North Carolina (Blue Cross NC).
Out-of-state providers are also out-of-network and not covered. When traveling outside of North Carolina or the United States, only emergency services and urgent care will be covered at the in-network benefit level. All other non-emergency services will be out-of-network and not covered.
Blue Care is available in all North Carolina counties, except: Alamance, Caswell, Chatham, Durham, Franklin, Johnston, Lee, Orange, Person, and Wake.
in North Carolina
Find affordable health insurance in Madison County, NC with Health Plans of NC. Health Plans of NC helps residents of Madison County, North Carolina find and enroll in the right health insurance plan for 2026, with local expertise connecting families to coverage that works alongside Mission Hospital and area employers like Mars Hill University and Madison County Schools.
Plan Network | Type | Network Coverage |
|---|---|---|
Blue Advantage | PPO | Largest nationwide network, 95%+ of NC doctors in-network |
Blue Care | PPO | Broad statewide network, 92%+ of NC doctors in-network |
Madison County, home to 21,640 residents with a 2.1 percent population growth since 2020, offers a wide range of health coverage options through the ACA Marketplace, Medicaid, employer-sponsored plans, and other programs suited to the county's diverse workforce. Major local employers such as Madison County Schools, Ingles Markets, Mars Hill University, and Asheville Kombucha Mamas provide employer-sponsored coverage to many working residents, while Mission Hospital and HCA Healthcare anchor the regional health system that most plans connect to. With 1.4 percent of Madison County residents being foreign-born, Health Plans of NC offers multilingual assistance to ensure every community member can navigate available coverage options with confidence.
ACA Marketplace plans are available to Madison County individuals and families who do not receive coverage through a qualifying employer, with Blue Cross NC offering plans that connect members to Mission Hospital and nearby facilities.
Medicaid coverage is available to qualifying low-income Madison County adults following North Carolina's Medicaid expansion, providing access to Mission Hospital and HCA Healthcare facilities at little or no cost.
Employer-sponsored insurance is offered by major Madison County employers including Madison County Schools, Ingles Markets, Mars Hill University, and Asheville Kombucha Mamas to eligible full-time employees and their dependents.
Short-term health plans may serve Madison County residents who are between jobs or waiting for open enrollment, though these plans do not meet ACA minimum essential coverage standards and have limited benefits.
COBRA continuation coverage allows Madison County residents who recently left employment at local organizations such as Ingles Markets or Mars Hill University to temporarily maintain their prior employer-sponsored plan.
Small business SHOP Marketplace plans are available to Madison County small business owners, including independent operators and entrepreneurs, who want to offer group health coverage to their employees through Blue Cross NC.
For 2026, Madison County residents can choose from plans offered under two Blue Cross NC networks, Blue Advantage and Blue Care, spanning PPO plan structures that provide broad access to providers across the region. Blue Advantage is a PPO network covering more than 95 percent of North Carolina doctors and connects Madison County members to Mission Hospital in Asheville, Blue Ridge Regional Hospital in Spruce Pine, and the Mars Hill Medical Center. Blue Care is also a PPO network covering more than 92 percent of North Carolina doctors and provides Madison County residents with strong statewide access including Mission Health facilities, CarePartners Rehabilitation Hospital, and multiple Mission Health clinics serving the greater Madison County area.
Blue Advantage, a PPO network, includes more than 95 percent of NC doctors in-network and connects Madison County members to Mission Hospital, Blue Ridge Regional Hospital, and Mission Health clinics throughout the region.
Blue Care, a PPO network, covers more than 92 percent of NC doctors in-network and gives Madison County residents access to Mission Hospital, CarePartners Rehabilitation Hospital, and area Mission Health outpatient facilities.
Both the Blue Advantage and Blue Care PPO networks allow Madison County members to access specialty care at facilities such as Mars Hill Medical Center and Mission Children's Hospital without requiring a primary care referral.
PPO plan structures available under both Blue Advantage and Blue Care give Madison County residents the flexibility to see out-of-network providers when needed, which is especially useful for residents near the Asheville metro corridor.
Plan tier options within both Blue Advantage and Blue Care networks range from Bronze to Gold coverage levels, allowing Madison County residents to choose the balance of monthly cost and out-of-pocket exposure that fits their medical needs.
Catastrophic plans are available to eligible Madison County residents under age 30 or those qualifying for a hardship exemption, providing a low-cost safety net option within the Blue Cross NC network.
Bronze plans in Madison County start at approximately $403.47/month before subsidies. With a median household income of $58,628, many residents qualify for premium tax credits. Subsidies may reduce your monthly premium significantly based on income.
Bronze plans in Madison County start at $403.47 per month for a 35-year-old before subsidies, offering the lowest monthly premium with higher out-of-pocket costs when care is needed.
Silver plans in Madison County start at $518.72 per month for a 35-year-old before subsidies and are the only tier eligible for cost-sharing reductions, which lower deductibles and copays for qualifying residents.
Gold plans in Madison County start at $536.24 per month for a 35-year-old before subsidies and feature lower out-of-pocket maximums, making them a strong value for residents with frequent medical needs.
Madison County residents with household incomes between 100 percent and 400 percent of the federal poverty level qualify for Advance Premium Tax Credits that can substantially reduce monthly premiums across all metal tiers.
Some Madison County households with incomes just above 100 percent of the federal poverty level may qualify for a $0 premium Silver plan after tax credits are applied, making comprehensive coverage available at no monthly cost.
Out-of-pocket maximums for 2026 ACA plans vary by network and tier, and Health Plans of NC agents help Madison County residents compare total annual cost exposure across all available Blue Cross NC plan options.
Blue Cross NC is the sole carrier offering individual and family ACA Marketplace plans in Madison County for 2026, with 17 total plans available across multiple coverage tiers. These plans are offered through two PPO networks, Blue Advantage and Blue Care, each providing Madison County residents with broad access to physicians and hospitals across North Carolina. The Blue Advantage network connects Madison County members to more than 95 percent of NC doctors, including providers at Mission Hospital and Blue Ridge Regional Hospital, while the Blue Care network covers more than 92 percent of NC doctors with access to Mission Health facilities and CarePartners Rehabilitation Hospital. Choosing between Blue Advantage and Blue Care directly affects which local specialists, clinics, and hospital systems are covered at in-network rates for Madison County residents throughout the plan year. Health Plans of NC licensed agents compare all 17 available Blue Cross NC plans side by side at no cost, helping residents in Marshall, Mars Hill, Hot Springs, and surrounding communities select the most appropriate network and coverage level for their needs.
Blue Cross NC, offering 17 individual and family ACA Marketplace plans in Madison County for 2026, including PPO plan options across the Blue Advantage and Blue Care networks at Bronze, Silver, Gold, and Catastrophic coverage tiers.
North Carolina expanded Medicaid in December 2023, and Madison County residents whose household income falls at or below 138 percent of the federal poverty level may now qualify for comprehensive Medicaid coverage at little or no monthly cost. Currently, 8.7 percent of Madison County residents, approximately 2,000 people, remain uninsured, and many of these individuals may be eligible for Medicaid or low-cost ACA plans but have not yet enrolled. Children in Madison County families earning up to 210 percent of the federal poverty level may qualify for NC Health Choice, also known as CHIP, which provides affordable pediatric coverage including doctor visits, dental, and preventive care. Health Plans of NC offers free eligibility checks for Madison County residents who want to find out whether they qualify for Medicaid, CHIP, or a subsidized Marketplace plan.
Working adults in Madison County who are self-employed, part-time, or employed without employer coverage may qualify for Medicaid if their income falls at or below 138 percent of the federal poverty level.
Children in Madison County whose families earn too much for traditional Medicaid but too little for full-price coverage may qualify for NC Health Choice, the state's CHIP program, at very low or no cost.
Pregnant women in Madison County are eligible for expanded Medicaid coverage that includes prenatal visits, labor and delivery services, and postpartum care through nearby Mission Hospital and Mission Health clinics.
Madison County's poverty rate of 11.4 percent means a meaningful portion of residents may qualify for full Medicaid benefits covering hospital stays, prescriptions, and specialist visits at no monthly premium.
Madison County residents with disabilities or seniors with low income who do not yet have Medicare or who need supplemental assistance may also qualify for Medicaid programs and should contact Health Plans of NC for a free eligibility review.
Health Plans of NC licensed agents serve Madison County residents at no cost, comparing every available plan side by side to find the right coverage for your health needs and budget. Call 800-797-0327 today to speak with a local agent who can walk you through enrollment and make sure you are not leaving any available benefits on the table.
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 Madison 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 |
|---|---|---|
Adventhealth Hendersonville | 100 Hospital Dr, Hendersonville, NC 28792 | (828) 684-8501 |
Asheville Specialty Hospital | 428 Biltmore Ave # 4, Asheville, NC 28801 | (828) 213-5400 |
Asheville VA Medical Ctr | 1100 Tunnel Rd, Asheville, NC 28805 | (828) 298-7911 |
Blue Ridge Regional Hospital | 125 Hospital Dr, Spruce Pine, NC 28777 | (828) 765-4201 |
Broughton Hospital | 1000 S Sterling St, Morganton, NC 28655 | (828) 433-2111 |
Caldwell UNC Health Care | 321 Mulberry St SW, Lenoir, NC 28645 | (828) 757-5100 |
Charles A Cannon Jr Meml Hosp | 434 Hospital Dr, Newland, NC 28657 | (828) 737-7000 |
Forum Health Asheville | 1312 Patton Ave, Asheville, NC 28806 | (828) 252-9833 |
Mission Children's Hospital | 11 Vanderbilt Park Dr, Asheville, NC 28803 | (828) 213-1740 |
Mission Hospital Mcdowell | 430 Rankin Dr, Marion, NC 28752 | (828) 659-5000 |
Mission Hospital | 509 Biltmore Ave, Asheville, NC 28801 | (828) 213-1111 |
Pardee UNC Health Care | 800 N Justice St, Hendersonville, NC 28791 | (828) 696-1000 |
St Luke's Hospital | 101 Hospital Dr, Columbus, NC 28722 | (828) 894-3311 |
St Lukes Hospital | 101 Hospital Dr, Columbus, NC 28722 | (828) 894-3311 |
UNC Health Blue Ridge | 2201 S Sterling St, Morganton, NC 28655 | (828) 580-5000 |
UNC Health Care Blue Ridge | 720 Malcolm Blvd, Valdese, NC 28690 | (828) 580-7640 |
Clinic | Address | Phone |
|---|---|---|
AMCHC | 225 Patton Ave # 200, Asheville, NC 28801 | (828) 412-5315 |
Apex Brain Ctr | 600 Julian Ln # 650, Arden, NC 28704 | (828) 708-5274 |
Asheville Cardiology Assoc-MRN | 472 Rankin Dr # Entrance3, Marion, NC 28752 | (828) 652-0005 |
Asheville Cardiology Assoc | 189 Hospital Dr # 2ndfloor, Spruce Pine, NC 28777 | (828) 274-6000 |
Asheville Cardiology Assoc | 387 US 70 W, Marion, NC 28752 | (828) 274-6000 |
Asheville Cardiology Assoc | 589 Peniel Rd, Columbus, NC 28722 | (828) 274-6000 |
Asheville Children's Med Ctr | 7 Vanderbilt Park Dr # 100a, Asheville, NC 28803 | (828) 258-0969 |
Asheville Orthopaedic Assoc | 1 Hospital Dr, Asheville, NC 28801 | (828) 252-7331 |
Asheville Orthopaedic Assoc | 2315 Asheville Hwy, Hendersonville, NC 28791 | (828) 782-9330 |
Asheville Orthopaedic Assoc | 472 Rankin Dr # Entrance3, Marion, NC 28752 | (828) 252-7331 |
Atrium Health At Hm-Hm Med | 141 Fiddlers Run Blvd, Morganton, NC 28655 | (828) 879-9050 |
Atrium Health At Home | 141 Fiddlers Run Blvd, Morganton, NC 28655 | (828) 580-6450 |
Atrium Health Shelby Women's | 446 N Carolina 108, Rutherfordton, NC 28139 | (980) 487-2570 |
Blue Ridge Med Ctr Mayland | , Spruce Pine, NC 28777 | (828) 765-4113 |
Blue Ridge Med Ctr Yancy Cmps | 800 Medical Campus Dr, Burnsville, NC 28714 | (828) 682-0200 |
Blue Ridge Med Ctr-Yancey Cmps | 125 Hospital Dr, Spruce Pine, NC 28777 | (828) 765-4201 |
Carolina Spine & Neurosurgery | 2315 Asheville Hwy, Hendersonville, NC 28791 | (828) 255-7776 |
Carolinas Healthcare Syst Blue | 1766 Connelly Springs Rd, Lenoir, NC 28645 | (828) 728-8224 |
Carolinas Medical Ctr At Hm | 141 Fiddlers Run Blvd, Morganton, NC 28655 | (828) 580-6441 |
Catawba Valley Medical Ctr | 309 S College St, Morganton, NC 28655 | (828) 326-3803 |
Fastmed Family Medicine | 160 Hendersonville Rd, Asheville, NC 28803 | (828) 210-2835 |
Gastroenterology-Mission | 11 Vanderbilt Park Dr # 2, Asheville, NC 28803 | (828) 213-1740 |
Happy Valley Medical Ctr | 1345 NC Highway 268, Lenoir, NC 28645 | (828) 754-6850 |
Keys Of Hope Medical Ctr | 295 Carson St # K, Marion, NC 28752 | (828) 659-6334 |
Levine Cancer Inst-Blue Ridge | 720 Malcolm Blvd, Connelly Springs, NC 28612 | (828) 580-7536 |
Mars Hill Medical Ctr | 119 Mountain View Rd, Mars Hill, NC 28754 | (828) 689-3507 |
Mauzy-Phillips Ctr | 125 Hospital Dr, Spruce Pine, NC 28777 | (828) 766-3555 |
Mission Children's Outpatient | 11 Vanderbilt Park Dr, Asheville, NC 28803 | (828) 213-1740 |
Mission Children's Specialists | 11 Vanderbilt Prk Dr # 2ndfloor, Asheville, NC 28803 | (828) 213-1740 |
Mission Community Medicine-Brk | 149 W Parker Rd, Morganton, NC 28655 | (828) 433-4933 |
Mission Community Medicine-Nb | 339 Nebo School Rd, Nebo, NC 28761 | (828) 652-6326 |
Mission Community Orthopedics | 189 Hospital Dr # 2ndfloor, Spruce Pine, NC 28777 | (828) 766-3555 |
Mission Community Urological | 189 Hospital Dr # 2ndfloor, Spruce Pine, NC 28777 | (828) 766-3555 |
Mission Health Ctr Highway 70 | 387 US 70 W, Marion, NC 28752 | (828) 652-6386 |
Mission Health Ctr Sugar Hill | 1633 Sugar Hill Rd, Marion, NC 28752 | (828) 652-7776 |
Mission Health Mauzy-Phillips | 189 Hospital Dr # 2ndfloor, Spruce Pine, NC 28777 | (828) 766-3555 |
Mission Health Partners | 50 Schenck Pkwy, Asheville, NC 28803 | (828) 213-3250 |
Mission Hospital-Smoking | 1 Hospital Dr, Asheville, NC 28801 | (828) 213-5527 |
Mission Hospital-St Joseph | 428 Biltmore Ave, Asheville, NC 28801 | (828) 213-1111 |
Mission Medical Oncology | 430 Rankin Dr # Entrance3, Marion, NC 28752 | (800) 506-2550 |
Mission Neurology Svc | 509 Biltmore Ave, Asheville, NC 28801 | (828) 213-1439 |
Mission Neurology-Outpatient | 1 Hospital Dr # 3200, Asheville, NC 28801 | (828) 213-9530 |
Mission Orthopedic Trauma Svc | 1 Hospital Dr # 4200, Asheville, NC 28801 | (828) 213-1994 |
Mission Outpatient Svc Sugar | 1633 Sugar Hill Rd # Entranceb, Marion, NC 28752 | (828) 252-7331 |
Mission St Joseph's Health | 890 Hendersonville Rd, Asheville, NC 28803 | (828) 274-7026 |
Mission Urology-Asheville | 1 Hospital Dr # 4100, Asheville, NC 28801 | (828) 254-8883 |
Mission Urology-Mcdowell | 472 Rankin Dr # Entrance3, Marion, NC 28752 | (828) 659-5700 |
Mission Weight Management | 1 Hospital Dr # 3400, Asheville, NC 28801 | (828) 213-4100 |
Mission Women's Care-Spruce Pn | 189 Hospital Dr # 2ndfloor, Spruce Pine, NC 28777 | (828) 766-3555 |
Mission Workwell-Medical Park | 2 Medical Park Dr # 102, Asheville, NC 28803 | (828) 213-9600 |
Occupational Medicine Ctr | 288 S Ridgecrest Ave, Rutherfordton, NC 28139 | (828) 286-5508 |
Sloop Medical Office Plaza | 436 Hospital Dr, Newland, NC 28657 | (828) 733-0280 |
Stonecreek Health & Rehab LLC | 455 Victoria Rd, Asheville, NC 28801 | (828) 225-3829 |
Surgical Specialist-Carolina | 1998 Hendersonville Rd # 40, Asheville, NC 28803 | (828) 585-2575 |
Valdese Patient Svc Ctr | 730 Malcolm Blvd # 160, Rutherford College, NC 28671 | (828) 580-7456 |
Madison County ZIP Codes include: 28743, 28753, and 28754
