Find Your Most Affordable Health Insurance Plan in Transylvania 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 |
| Oscar Health Plan of North Carolina | 8 |
| Total | 59 |
Source: CMS QHP Landscape PY2026, Individual Market Medical, updated August 26, 2026 (data.healthcare.gov). Counts distinct Plan IDs offered on the Marketplace in Transylvania County, once per carrier.
in North Carolina
Find affordable health insurance in Transylvania County, NC with Health Plans of NC. Health Plans of NC helps Transylvania County, NC residents find and enroll in the right health insurance plan for 2026, with local connections to Transylvania Regional Hospital and major area employers. Whether you are a family, retiree, or individual, Health Plans of NC compares every available option at no cost to you.
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 |
Transylvania County is home to 33,243 residents, a community that has grown 0.8% since 2020, with 3.5% of residents being foreign-born, reflecting a diverse population with varied coverage needs. Major employers such as Transylvania County Schools, Brevard College, Ingles Markets, Transylvania County government, and Transylvania Regional Hospital anchor the local economy and provide a foundation for both employer-sponsored and individual market coverage. Health systems including Transylvania Regional Hospital and Mission Health HCA serve as key anchors for local healthcare access, making it important for residents to understand all available coverage pathways.
ACA Marketplace plans through Blue Cross NC are available to Transylvania County residents who do not have access to qualifying employer-sponsored coverage, including self-employed workers and those between jobs.
Medicaid coverage is available to eligible low-income adults and families in Transylvania County, including those employed part-time at local businesses such as Ingles Markets who may not receive employer benefits.
Employer-sponsored insurance is offered by major Transylvania County employers including Transylvania County Schools, Brevard College, and Transylvania Regional Hospital, covering a significant share of the local workforce.
Short-term health plans may serve as a temporary bridge for Transylvania County residents in transition between jobs or waiting for open enrollment, though they do not meet ACA minimum essential coverage standards.
COBRA continuation coverage allows former employees of Transylvania County employers such as Brevard College or Transylvania County government to maintain their existing group plan benefits for a limited period after leaving employment.
SHOP small business plans through the ACA Marketplace are available to small employers in Transylvania County, including independent businesses in Brevard and Rosman, allowing them to offer group coverage to their employees.
For 2026, Transylvania County residents can choose from plans offered under two Blue Cross NC network options, Blue Advantage and Blue Care, both of which connect enrollees to providers in western North Carolina including Transylvania Regional Hospital in Brevard and Mission Health HCA facilities in Asheville. Blue Advantage is a PPO network with the largest nationwide coverage footprint, while Blue Care is an HMO network with broad statewide access, giving residents flexibility in how they access specialists and hospital care. Health Plans of NC helps residents evaluate which network best fits their regular providers before enrolling.
Blue Advantage PPO connects Transylvania County residents to the largest nationwide provider network, with more than 95% of NC doctors in-network, including providers at Transylvania Regional Hospital and Mission Health HCA.
Blue Care HMO offers broad statewide network access with more than 95% of NC doctors in-network, well-suited for residents who primarily seek care at Transylvania Regional Hospital and regional specialty clinics like Mission Urology-Brevard.
Both Blue Advantage and Blue Care plans allow Transylvania County residents to see specialists without requiring a primary care referral, providing flexibility for those managing ongoing conditions.
Blue Advantage PPO plans are particularly beneficial for Transylvania County residents who travel frequently or who may need to access out-of-area providers beyond the western North Carolina region.
Blue Care HMO plans are a strong fit for Transylvania County residents centered in Brevard, Rosman, and Pisgah Forest who primarily use local and regional providers within the Mission Health HCA system.
All 2026 plans available in Transylvania County include access to Transylvania Regional Hospital at 260 Hospital Dr, Brevard, as a key in-network facility under both Blue Advantage and Blue Care network structures.
Bronze plans in Transylvania County start at approximately $491.92/month before subsidies. With a median household income of $64,523, many residents qualify for premium tax credits. Subsidies may reduce your monthly premium significantly based on income.
Bronze plans in Transylvania County start at $491.92 per month for a 35-year-old before subsidies, offering the lowest premiums with higher deductibles, best suited for healthy adults who want catastrophic protection.
Silver plans start at $644.87 per month before subsidies and are the only tier eligible for cost-sharing reductions, which can lower deductibles and out-of-pocket costs for qualifying Transylvania County households.
Gold plans start at $669.68 per month before subsidies and offer lower out-of-pocket costs throughout the year, making them a strong choice for residents who expect frequent medical visits or ongoing care.
Transylvania County households earning up to 400% of the federal poverty level qualify for ACA premium tax credits, and many working families in Brevard and surrounding towns are eligible for meaningful monthly savings based on the county median income of $64,523.
Residents earning between 100% and 150% of the federal poverty level may qualify for enhanced subsidies under the Inflation Reduction Act, potentially reducing monthly Silver plan premiums to as little as $0.
Health Plans of NC agents calculate exact subsidy amounts for every Transylvania County applicant at no cost, ensuring families do not leave available premium tax credits on the table during enrollment.
Blue Cross NC is one of five ACA Marketplace carriers serving Transylvania County for 2026, offering a total of 18 individual and family plans across the county. These plans are structured under two network options, Blue Advantage and Blue Care, giving residents a choice between the largest nationwide network and a broad statewide network. Blue Advantage connects Transylvania County enrollees to an extensive national provider directory with more than 95% of NC doctors in-network, while Blue Care provides broad statewide access with more than 95% of NC doctors in-network, including local facilities such as Transylvania Regional Hospital and Mission Health HCA. The network a resident selects directly determines which hospitals, specialists, and clinics they can access at in-network rates, making the choice between Blue Advantage and Blue Care a critical decision for anyone relying on providers like Mission Urology-Brevard or Asheville Cardiology Associates at Highlands. Health Plans of NC compares all 18 Blue Cross NC plans side by side at no cost, helping Transylvania County residents identify the best combination of network, coverage tier, and monthly premium for their situation.
Blue Cross NC, one of five ACA Marketplace carriers in Transylvania County for 2026, offering 18 individual and family plans under the Blue Advantage and Blue Care networks.
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 made thousands of Transylvania County residents newly eligible for coverage. Currently, 11.8% of Transylvania County residents, approximately 4,000 people, remain uninsured, and many of them may now qualify for Medicaid or subsidized Marketplace coverage without realizing it. Children in households earning up to 210% of the federal poverty level may qualify for NC Health Choice, the state's CHIP program, providing low-cost or no-cost coverage for families that earn too much for Medicaid but still need affordable options. Health Plans of NC offers free eligibility checks for Transylvania County residents who want to find out whether they or their children qualify for Medicaid, CHIP, or a subsidized Marketplace plan.
Working adults in Transylvania County who are employed part-time or in jobs without employer benefits may qualify for NC Medicaid if their household income falls at or below 138% of the federal poverty level.
Children in Transylvania County whose families earn too much for Medicaid but still need affordable coverage may be eligible for NC Health Choice, the state CHIP program, at little or no cost.
Pregnant women in Transylvania County are eligible for expanded Medicaid coverage throughout pregnancy and for a period after delivery, ensuring access to prenatal and postnatal care at local facilities.
Seniors and adults with disabilities in Transylvania County who have low income may qualify for combined Medicare and Medicaid coverage, reducing their out-of-pocket costs for medical and long-term care services.
With a poverty rate of 14.2% in Transylvania County, a significant share of local families may be eligible for Medicaid or CHIP, and Health Plans of NC can help determine eligibility and assist with enrollment at no cost.
Health Plans of NC licensed agents serve Transylvania County residents at no cost, comparing every available 2026 plan side by side to find the best fit for your health needs and budget. Call 800-797-0327 today to speak with an agent who can guide you through enrollment and help you maximize any savings you qualify for.
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 Transylvania 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 |
Transylvania County ZIP Codes include: 28708, 28712, 28718, 28747, 28766, 28768, 28772, and 28774
