Find Your Most Affordable Health Insurance Plan in Wake County
in North Carolina
Wake County residents can compare 17 health insurance options for 2026.
Blue Home with UNC Health Alliance is a good option if you wish to get care from UNC Health and its affiliated doctors and hospitals. Since the majority of doctors in this plan are in the same network, it’s easier for them to work together on your behalf.
UNC Health’s network of hospitals and providers including more than 1,800 primary care providers.2
A provider network that includes UNC Medical Center, nationally ranked in one adult and nine pediatric specialties by U.S. News;3 along with UNC Rex Hospital, rated by U.S. News as high performing in 16 adult procedures and conditions.4
All doctors outside the UNC Health Alliance provider network are considered out-of-network and not covered for Blue Home with UNC Health Alliance, including: Cone Health, Duke Health and WakeMed. 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.
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.
Blue Advantage - Off Marketplace 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.
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 | HMO | 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 HMO 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 HMO 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.
HMO plan structures under Blue Home with UNC Health Alliance require Wake County enrollees to select a primary care provider and obtain referrals before seeing specialists within the UNC Health network.
PPO 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 the sole carrier offering individual and family ACA Marketplace health insurance plans in Wake County for 2026, with 17 total plans 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 HMO, 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 HMO 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 17 individual and family health insurance plans in Wake County for 2026, including HMO 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 |
|---|---|---|
Central Regional Hospital | 300 Veazey Dr, Butner, NC 27509 | (919) 764-2000 |
Duke Raleigh Hospital | 3400 Wake Forest Rd, Raleigh, NC 27609 | (919) 954-3000 |
Granville Health System | 1010 College St, Oxford, NC 27565 | (919) 690-3000 |
Holly Hill Hospital | 3019 Falstaff Rd, Raleigh, NC 27610 | (919) 250-7000 |
Nash General Hospital | 2460 Curtis Ellis Dr, Rocky Mount, NC 27804 | (252) 962-8000 |
PAM Specialty Hosp Of Rocky Mt | 1051 Noell Ln, Rocky Mount, NC 27804 | (252) 451-2300 |
Rex Hospital | 4420 Lake Boone Trl, Raleigh, NC 27607 | (919) 784-3100 |
Strategic Behavioral Ctr Rlgh | 3200 Waterfield Dr, Garner, NC 27529 | (919) 800-4400 |
UNC Health Johnston | 509 N Brightleaf Blvd, Smithfield, NC 27577 | (919) 934-8171 |
UNC Hospitals At Wakebrook | 111 Sunnybrook Rd, Raleigh, NC 27610 | (984) 974-4800 |
WakeMed Cary Hospital | 1900 Kildaire Farm Rd, Cary, NC 27518 | (919) 350-8000 |
WakeMed North Hospital | 10000 Falls Of Neuse Rd, Raleigh, NC 27614 | (919) 350-8000 |
WakeMed Raleigh Campus | 3000 New Bern Ave, Raleigh, NC 27610 | (919) 350-8000 |
Wilson Medical Ctr | 1705 Tarboro St SW, Wilson, NC 27893 | (252) 399-8040 |
Clinic | Address | Phone |
|---|---|---|
Angier Pediatric & Adult Med | 441 Lakestone Commons Ave, Fuquay Varina, NC 27526 | (919) 577-0481 |
Benson Area Medical Ctr Inc | 11801 Vogel St, Raleigh, NC 27617 | (919) 207-4403 |
Beverly Medical Ctr | 6008 Creedmoor Rd, Raleigh, NC 27612 | (919) 844-4552 |
Brier Creek Medical Pavilion | 10207 Cerny St, Raleigh, NC 27617 | (919) 634-6269 |
Carolina Neuropsychology Svc | 3900 Barrett Dr # 102, Raleigh, NC 27609 | (919) 859-9040 |
Carolinas Center For Med | 3600 Glenwood Ave # 120, Raleigh, NC 27612 | (919) 461-5500 |
Clayton Dialysis Ctr | 86 Healthpark Way, Clayton, NC 27520 | (919) 550-7456 |
Clinton Dialysis Unit | 545 E Market St, Smithfield, NC 27577 | (919) 934-2826 |
Duke Raleigh Hosp Palliative | 3404 Wake Forest Rd, Raleigh, NC 27609 | (919) 862-5400 |
Duke Raleigh Hosp Pre | 3300 Executive Dr, Raleigh, NC 27609 | (919) 954-3940 |
Duke Raleigh Hosp | 3404 Wake Forest Rd, Raleigh, NC 27609 | (919) 862-5718 |
Duke Rheumatology Raleigh | 3480 Wake Forest Rd # 414, Raleigh, NC 27609 | (919) 613-2243 |
Duke Spine-Pain Mgmt-Raleigh | 3480 Wake Forest Rd, Raleigh, NC 27609 | (919) 862-5367 |
Duke Women's Health Heritage | 3000 Rogers Rd, Wake Forest, NC 27587 | (919) 385-2940 |
Eastern Carolina Pathology | 2693 Forest Hills Rd SW # B, Wilson, NC 27893 | (252) 234-2841 |
ECU Health Family Medicine | 1704 Glendale Dr. SW, Wilson, NC 27893 | (252) 246-8960 |
Fastmed Family Medicine | 11491 US 70 Business Hwy W, Clayton, NC 27520 | (919) 550-2484 |
Fastmed Family Medicine | 5156 N Carolina 42, Garner, NC 27529 | (919) 329-5000 |
Goshen Medical Ctr Inc | 1624 White Oak Church Rd, Apex, NC 27523 | (941) 267-2042 |
Granville Medical Ctr | 1010 College St, Oxford, NC 27565 | (919) 690-3000 |
Karissa Binkley | 1021 W Williams St # 105, Apex, NC 27502 | (919) 961-9885 |
Meso & Beyond Medical Ctr | 1000 N Main St # 100, Fuquay Varina, NC 27526 | (919) 285-4373 |
Pai Wellness Group | 9380 Falls Of Neuse Rd # 101, Raleigh, NC 27615 | (919) 529-3355 |
Rocky Mt Medical Park | 901 N Winstead Ave, Rocky Mount, NC 27804 | (252) 937-8507 |
Siemens Medical Solutions | 209 Gregson Dr, Cary, NC 27511 | (919) 461-0132 |
Smithfield Pulmonology | 706 Wilkins St # A, Smithfield, NC 27577 | (919) 989-1800 |
Southern Wake Medical Ctr | 415 Wake Chapel Rd, Fuquay Varina, NC 27526 | (919) 552-9143 |
Synchrony Energetics Incl | 3201 Nash St NW # A, Wilson, NC 27896 | (252) 373-4722 |
UNC Fertility | 7920 Acc Blvd # 300, Raleigh, NC 27617 | (919) 908-0000 |
Voyage Anesthesia PC | 101 Forest Dr # D, Knightdale, NC 27545 | (919) 341-0188 |
Wake Health Svc | , Franklinton, NC 27525 | (919) 494-5246 |
WakeMed Brier Creek Healthplex | 8001 T W Alexander Dr, Raleigh, NC 27617 | (919) 350-8000 |
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
