Find an Affordable Health Insurance Plan in Wake County
in North Carolina
Nationwide (BlueCard®)
More in-network providers in North Carolina, with over 95% of doctors and 98% of hospitals in-network1
Fewer restrictions on which providers you can see
Nationwide access to in-network providers through BlueCard®2
Emergency services covered at the in-network benefit level regardless of where you go for care
Notes
Blue Cross NC Provider Internal Data; percentages indicated represent the Blue Cross NC PPO Network as of April 7, 2025.
Covered in nearly 200 countries and territories worldwide through the Blue Cross and Blue Shield Association BlueCard program. www.geo-blue.com/ (Accessed March 2025). BlueCard coverage varies for each Blue Cross and Blue Shield plan. For more complete details, including benefits, limitations, and exclusions, please refer to your certificate of coverage.
Blue Advantage is available on and off Marketplace in all North Carolina counties, except the following where it is available only off Marketplace: Alamance, Caswell, Chatham, Durham, Franklin, Johnston, Lee, Orange, Person, and Wake.
Triangle area
Blue Home℠ with UNC Health Alliance is a Blue Cross NC plan built around UNC Health's provider network, including more than 1,900 primary care providers, UNC Medical Center (nationally ranked in 4 adult and 9 pediatric specialties by U.S. News & World Report), and UNC Rex Hospital (rated high-performing in 1 adult specialty and 21 adult procedures and conditions).
Like the other Blue Home plans, this is a single-system regional network offered at a lower premium than broad-network options — only UNC Health Alliance providers are in-network. We recommend it for Triangle-area residents who already rely on a UNC Health doctor, especially for complex or pediatric care.
Good fit if you have an ongoing relationship with a UNC Health specialist, especially for a complex or chronic condition, prefer pediatric care coordinated through UNC's academic health system, or live in one of the eligible Triangle-area counties.
Poor fit if your regular doctors are with Cone Health, Duke Health, or WakeMed — all three are out-of-network here.
Regional network – Triangle area
Network: UNC Health Alliance only1 (incl. UNC Medical Center).2
Out-of-area care: Emergency / urgent only.
Offered in Bronze, Silver, and Gold tiers.
Notes
Blue Cross NC has collaborated with UNC Health to bring you Blue Home℠ with UNC Health Alliance. Blue Home with UNC Health Alliance is a health insurance plan offered by Blue Cross NC that provides access to a limited network of providers. UNC Health is an independent company that is solely responsible for the physicians and medical facilities it owns and operates. UNC Health does not offer Blue Cross or Blue Shield products or services.
UNC Health, www.unchealthcare.org/health-alliance/ (Accessed August 2024).
U.S. News and World Report, www.usnews.com/best-hospitals/area/nc/university-of-north-carolina-hospitals-6360260 (Accessed August 2024).
U.S. News and World Report, www.usnews.com/best-hospitals/area/nc/rex-healthcare-6361210 (Accessed August 2024).
Blue Home with UNC Health Alliance is available on and off Marketplace to residents of these North Carolina counties: Alamance, Caswell, Chatham, Durham, Franklin, Johnston, Lee, Nash, Orange, Person, and Wake.
This plan is built around a single system, UNC Health Alliance, which keeps the premium lower than Blue Cross NC's broad-network plans. Only UNC Health Alliance providers are in-network — outside of emergency and urgent care, Duke Health and WakeMed are not covered, even though both operate in the same Triangle-area counties.
The network includes more than 1,900 primary care providers, UNC Medical Center — nationally ranked in four adult and nine pediatric specialties by U.S. News & World Report — and UNC Rex Hospital, rated high-performing in one adult specialty and 21 adult procedures and conditions.
For members managing a complex or chronic condition, or families needing pediatric specialty care, having that care coordinated through one academic health system is often the main draw of this plan over a broader but less integrated network.
The lower premium is the trade-off for narrowing to one system. It's offered in Bronze, Silver, and Gold tiers, and most applicants qualify for a premium tax credit based on income and household size.
This plan is available across 11 Triangle-area counties, including Wake, Durham, and Orange. If your doctors are with Duke Health or WakeMed instead, this plan won't cover them outside of an emergency.
You can enroll during the annual Open Enrollment Period (November 1 – January 15) or during a Special Enrollment Period if you've had a qualifying life event — a job change, a move, a new dependent, or losing other coverage.
A licensed Health Plans of NC agent can confirm your UNC Health providers are in-network, check your subsidy, and compare this plan against Blue Advantage® and Blue Care® — at no cost. Call 800-797-0327.
Yes — UNC Medical Center, nationally ranked by U.S. News & World Report in several adult and pediatric specialties, is part of this network, along with more than 1,900 primary care providers across the Triangle.
No. Duke Health and WakeMed are out-of-network on Blue Home℠ with UNC Health Alliance, along with their affiliated providers. If your regular doctors are with Duke or WakeMed, this isn’t the right plan.
No. UNC Health is an independent company solely responsible for its physicians and facilities. Blue Cross NC partners with UNC Health to offer this plan design, but UNC Health does not sell Blue Cross or Blue Shield products.
Every Blue Cross NC individual plan comes in three “metal” tiers that describe how you and the plan split covered costs. Bronze plans have the lowest monthly premium but pay about 60% of covered costs, so you pay roughly 40% when you use care. Silver plans pay about 70% (you pay ~30%), and Gold plans pay about 80% (you pay ~20%) in exchange for a higher premium.
As a rule of thumb: Bronze suits people who rarely use care and want the lowest premium, Gold suits people who use regular or ongoing care, and Silver is the middle ground. Silver is also the only tier that unlocks Cost-Sharing Reductions (CSRs) — extra savings on deductibles and copays if your income qualifies — so many subsidy-eligible shoppers get the best overall value from a Silver plan. A licensed Health Plans of NC agent can run the numbers for your situation at no cost.
The most important step before choosing any plan is confirming your doctors, specialists, and preferred hospitals are in that plan’s network. Networks differ a lot between Blue Cross NC plans — a doctor who is in-network on one plan may be out-of-network, and far more expensive, on another.
You can check each plan’s provider directory on bcbsnc.com, or — the easier route — call a Health Plans of NC agent at 800-797-0327 and we’ll verify your specific providers before you enroll, at no charge.
Most North Carolinians who buy their own coverage qualify for a premium tax credit — a subsidy based on your income and household size that lowers what you pay each month. Subsidy amounts and eligibility rules can change from year to year, so the only way to know your real price is to run a personalized quote.
Health Plans of NC can check your subsidy eligibility and show you the after-subsidy premium for any of these plans for free. Call 800-797-0327 or request a quote online.
You can enroll during the annual Open Enrollment Period, which runs each fall (generally starting November 1) for coverage that begins the following year. Outside that window, you can still enroll if you have a qualifying life event — such as losing other coverage, moving, marriage, or having a baby — which opens a 60-day Special Enrollment Period.
Because enrollment dates and rules can change, it’s worth confirming the current deadline. A Health Plans of NC agent can tell you whether you’re eligible to enroll right now — call 800-797-0327.
Nothing. Health Plans of North Carolina is an independent, authorized agency licensed to sell Blue Cross NC plans, and our help — comparing plans, checking your doctors, estimating subsidies, and enrolling — is completely free to you. Agents are paid by the insurance company, and the plan price is the same whether you enroll with us or on your own.
Call 800-797-0327 to talk with a licensed local agent.
| Carrier | Distinct plans |
|---|---|
| Blue Cross and Blue Shield of NC | 9 |
| Ambetter of North Carolina | 15 |
| UnitedHealthcare | 13 |
| Cigna Healthcare | 7 |
| Total | 44 |
Source: CMS QHP Landscape PY2026, Individual Market Medical, updated August 26, 2026 (data.healthcare.gov). Counts distinct Plan IDs offered on the Marketplace in Wake County, once per carrier.
in North Carolina
Find affordable health insurance in Wake County, NC with Health Plans of NC. Health Plans of NC helps Wake County residents compare every available Blue Cross NC health insurance plan side-by-side at no cost, connecting individuals and families to coverage that works with trusted local health systems like WakeMed and UNC Rex Healthcare.
Plan Network | Type | Network Coverage |
|---|---|---|
Blue Advantage® | PPO | Largest nationwide network, 95%+ of NC doctors in-network (off-Marketplace only) |
Blue Home℠ with UNC Health Alliance | EPO | UNC Health hospitals and affiliated providers |
Wake County is home to 1,151,009 residents and has grown at a rate of 1.9 percent annually, reflecting a dynamic and expanding community that includes 14.5 percent foreign-born residents who may be navigating the insurance market for the first time. Major employers such as Wake County Public Schools, NC State University, Amazon, WakeMed, and UNC Rex Healthcare anchor the local economy and shape the types of coverage most residents need. From ACA Marketplace plans to Medicaid and employer-sponsored options, Wake County residents have access to a broad range of coverage structures designed to match their work status, family size, and healthcare needs.
ACA Marketplace coverage through Blue Cross NC connects Wake County residents to plans that include access to local health systems like WakeMed and Duke Raleigh Hospital.
Medicaid coverage is available to qualifying low-income Wake County adults and children following North Carolina's Medicaid expansion, administered through Wake County Human Services.
Employer-sponsored health insurance is offered by major Wake County employers including Wake County Public Schools, NC State University, and Amazon, covering a large share of the working population.
COBRA continuation coverage allows Wake County residents who recently left a job at employers like UNC Rex Healthcare or WakeMed to temporarily maintain their existing group health benefits.
Short-term health plans may serve as a bridge for Wake County residents between jobs or waiting for an open enrollment period, though they offer more limited benefits than ACA-compliant plans.
Small business SHOP Marketplace plans allow Wake County small business owners to offer Blue Cross NC group coverage to employees and compete for talent in the county's fast-growing economy.
For 2026, Wake County residents can choose from Blue Cross NC plans offered across two distinct network structures, each connecting enrollees to different sets of local hospitals, clinics, and specialty providers. The Blue Advantage network is a PPO available off the Marketplace, while the Blue Home with UNC Health Alliance network is an EPO built around UNC Health-affiliated hospitals and providers, including UNC Rex Healthcare. Health Plans of NC agents help Wake County residents evaluate which network structure best fits their existing provider relationships and expected healthcare use throughout the year.
Blue Advantage, a PPO network available off the Marketplace, provides the largest nationwide coverage footprint and gives Wake County residents access to over 95 percent of North Carolina doctors without requiring referrals.
Blue Home with UNC Health Alliance, an EPO network, centers care around UNC Health hospitals and affiliated providers, including UNC Rex Healthcare in Raleigh, making it well-suited for residents already established within that system.
EPO plan structures under Blue Home with UNC Health Alliance let Wake County enrollees choose a primary care provider to help coordinate care, with no referrals needed before seeing specialists within the UNC Health network.
Plan structures under Blue Advantage offer Wake County residents the flexibility to see providers at facilities like WakeMed Raleigh Campus or Duke Raleigh Hospital without needing a referral from a primary care physician.
Wake County residents should confirm that their preferred providers, including those at FastMed Urgent Care, NextCare Urgent Care, or specialty practices like Wake Spine and Pain Specialists, are in-network before selecting a plan.
Health Plans of NC compares both available networks side-by-side for Wake County residents at no cost, ensuring enrollees understand exactly which local hospitals and clinics are covered under each plan structure.
Bronze plans in Wake County start at approximately $491.92/month before subsidies. With a median household income of $101,763, many residents qualify for premium tax credits. Subsidies may reduce your monthly premium significantly based on income.
Bronze plans in Wake County start at $491.92 per month for a 35-year-old, offering the lowest monthly premiums with higher deductibles, best suited for generally healthy adults seeking financial protection from large medical events.
Silver plans in Wake County start at $644.87 per month for a 35-year-old and are the only tier eligible for cost-sharing reductions, which can lower deductibles and out-of-pocket maximums for qualifying households.
Gold plans in Wake County start at $669.68 per month for a 35-year-old, providing lower deductibles and more predictable out-of-pocket costs for residents who use medical services frequently throughout the year.
Wake County residents with household incomes between 100 and 400 percent of the federal poverty level qualify for premium tax credits that can reduce monthly costs well below the published starting prices for Bronze, Silver, and Gold plans.
Households with incomes just above 100 percent of the federal poverty level may qualify for a $0 premium Silver plan after tax credits, making comprehensive mid-tier coverage accessible at little to no monthly cost.
Wake County's median household income of $101,763 means that dual-income households may still qualify for partial subsidies or cost-sharing reductions on Silver plans, keeping annual out-of-pocket maximums manageable for families with moderate healthcare needs.
Blue Cross NC is one of four carriers offering individual and family ACA Marketplace health insurance plans in Wake County for 2026, with 9 total plans on the Marketplace, plus Blue Advantage plans off the Marketplace, available across multiple coverage tiers and structures. These plans are offered through two network types: the Blue Advantage PPO, available exclusively off the Marketplace, and the Blue Home with UNC Health Alliance EPO, which is built around UNC Health-affiliated hospitals and providers throughout the region. The Blue Advantage PPO connects Wake County residents to the largest network of North Carolina physicians and facilities, while the Blue Home with UNC Health Alliance EPO channels care through UNC Rex Healthcare and associated providers for a more coordinated care experience. Network choice matters significantly in Wake County because it determines whether facilities like WakeMed Raleigh Campus, Duke Raleigh Hospital, Holly Hill Hospital, and urgent care centers like FastMed and NextCare are covered at in-network rates. Health Plans of NC compares every available Blue Cross NC plan side-by-side for Wake County residents at no cost, making it easy to identify the right network and coverage tier before the enrollment deadline.
Blue Cross NC, offering 9 individual and family health insurance plans on the Marketplace, plus Blue Advantage plans off the Marketplace, in Wake County for 2026, including EPO options under Blue Home with UNC Health Alliance and PPO options under Blue Advantage, spanning Bronze, Silver, Gold, and Catastrophic coverage tiers.
North Carolina expanded Medicaid in December 2023, extending free or low-cost health coverage to adults with household incomes at or below 138 percent of the federal poverty level, a change that opened new eligibility for thousands of Wake County residents who previously fell into a coverage gap. Wake County currently has an uninsured rate of 8.2 percent, representing approximately 94,000 residents without coverage, many of whom may now qualify for Medicaid or heavily subsidized Marketplace plans as a result of expansion. Children in Wake County families with incomes up to 210 percent of the federal poverty level may qualify for NC Health Choice, the state's Children's Health Insurance Program, which provides comprehensive low-cost coverage for pediatric care. Health Plans of NC offers free eligibility checks for Wake County residents who are unsure whether they qualify for Medicaid, CHIP, or a subsidized Marketplace plan.
Working adults in Wake County who are employed part-time, seasonally, or in gig economy roles and earn at or below 138 percent of the federal poverty level may now qualify for full Medicaid coverage following expansion.
Children in Wake County households earning up to 210 percent of the federal poverty level are eligible for NC Health Choice, providing dental, vision, and medical coverage at little to no cost to the family.
Pregnant women in Wake County qualify for Medicaid coverage that includes prenatal visits, labor and delivery at facilities like WakeMed Raleigh Campus, and postpartum care for a defined period after birth.
Wake County seniors with limited retirement income may qualify for dual eligibility under both Medicaid and Medicare, which together can cover premiums, copays, and long-term care costs.
Wake County's poverty rate of 7.9 percent means a meaningful share of residents are likely eligible for Medicaid at no monthly premium cost and should contact Wake County Human Services or Health Plans of NC to verify their status.
Health Plans of NC licensed agents serve Wake County residents at no cost, comparing every available Blue Cross NC plan side-by-side and guiding individuals and families through enrollment from start to finish. Call 800-797-0327 today to speak with a local agent who understands the Wake County healthcare landscape and can find the right plan for your budget and provider preferences.
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 Wake 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 |
|---|---|---|
UNC Rex Hospital | 4420 Lake Boone Trail, Raleigh, NC 27607 | |
WakeMed Cary Hospital | 1900 Kildare Farm Rd, Cary, NC 27518 | |
WakeMed Raleigh Campus | 3000 New Bern Ave, Raleigh, NC 27610 | |
Holly Hill Hospital | 3019 Falstaff Rd, Raleigh, NC 27610 | |
Raleigh Oaks Behavioral Health | 3200 Waterfield Dr, Garner, NC 27529 | |
Triangle Springs | 10901 World Trade Blvd, Raleigh, NC 27617 |
Clinic | Address | Phone |
|---|---|---|
Advance Axcess | 3509 Capital Blvd, Raleigh, NC 27604 | |
Advance CarePlex - Holly Springs | 9764 Holly Springs Rd, Apex, NC 27539 | |
Advance CarePlex - Wake Forest | 110 Capcom Avenue, Wake Forest, NC 27587 | |
Advance Community Health - Apex | 212 South Salem Street, Apex, NC 27502 | |
Advance Community Health - Cary at Dorcas Plaza | 173 High House Road, Cary, NC 27511 | |
Advance Community Health - Fuquay-Varina | 130 N Judd Pkwy NE, Fuquay Varina, NC 27526 | |
Advance Community Health - Southeast Raleigh - South | 1011 Rock Quarry Road, Raleigh, NC 27610 | |
BDIHS Wake Forest | 620 Doctor Calvin Jones Hwy, Suite 100, Wake Forest, NC 27587 | |
CarePlex at Beacon Point | 1425 Promise Beacon Cir, Raleigh, NC 27610 | |
Horizon at Oak City Cares | 1430 S Wilmington St, Raleigh, NC 27603 | |
NeighborHealth Center Susanne Berger Clinic | 2605 Blue Ridge Rd, Suite 225, Raleigh, NC 27607 | |
Starlight Pediatrics | 500 Holly Springs Road, Holly Springs, NC 27540 |
Talk to a licensed Blue Cross NC agent who lives and works in Wake County. Consultations are free.
Wake County ZIP Codes include: 27502, 27511, 27512, 27513, 27518, 27519, 27523, 27526, 27529, 27539, 27540, 27545, 27560, 27571, 27587, 27588, 27591, 27592, 27597, 27601, 27602, 27603, 27604, 27605, 27606, 27607, 27608, 27609, 27610, 27611, 27612, 27613, 27614, 27615, 27616, 27617, 27619, 27620, 27621, 27622, 27623, 27624, 27625, 27626, 27627, 27628, 27629, 27634, 27635, 27636, 27640, 27650, 27656, 27658, 27661, 27668, 27675, 27676, 27690, 27695, 27697, 27698, and 27699
