Find an Affordable Health Insurance Plan in Washington 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 |
| Cigna Healthcare | 10 |
| Total | 28 |
Source: CMS QHP Landscape PY2026, Individual Market Medical, updated August 26, 2026 (data.healthcare.gov). Counts distinct Plan IDs offered on the Marketplace in Washington County, once per carrier.
in North Carolina
Find affordable health insurance in Washington County, NC with Health Plans of NC. Health Plans of NC helps residents of Washington County, NC find affordable health insurance coverage through Blue Cross NC, with local ties to employers like Domtar Paper Company and health systems like ECU Health serving the community.
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 |
Washington County is home to 10,905 residents, a population that has seen a slight decline of 0.9 percent since 2020, with 0.7 percent of residents being foreign-born, reflecting a tight-knit rural community with distinct coverage needs. Major local employers such as Domtar Paper Company, Weyerhaeuser, Affinity Health Partners, and Washington County government offer some workers employer-sponsored benefits, while those without job-based coverage can access individual and family plans through the ACA Marketplace. Health systems including Vidant Washington Hospital and ECU Health anchor healthcare access in the region, making it important for residents to choose coverage that connects them to these local providers.
ACA Marketplace coverage through Blue Cross NC gives Washington County residents without employer benefits access to comprehensive individual and family plans connected to local health systems like ECU Health.
Medicaid coverage is available to qualifying low-income Washington County adults, children, and families, providing free or low-cost care at facilities like Vidant Washington Hospital in Plymouth.
Employer-sponsored health insurance is offered by major Washington County employers such as Domtar Paper Company, Weyerhaeuser, and Affinity Health Partners to eligible full-time workers and their families.
Short-term health plans can serve Washington County residents experiencing gaps in coverage between jobs or life transitions, offering temporary protection while a long-term plan is secured.
COBRA continuation coverage allows Washington County workers who leave employers like Washington County government or Domtar Paper Company to temporarily keep their existing group health benefits.
Small business SHOP Marketplace plans are available to Washington County small business owners who want to offer employee health benefits, including those in industries supported by local employers like Weyerhaeuser.
For 2026, Washington County residents can choose from 18 health insurance plans offered through Blue Cross NC, available under two distinct plan networks: Blue Advantage and Blue Care, both structured as plans that allow access to a broad range of providers. Blue Advantage connects Washington County residents to the largest nationwide PPO network, while Blue Care provides a broad statewide HMO network, giving enrollees flexibility when accessing facilities like Vidant Washington Hospital and ECU Health locations throughout northeastern North Carolina. Health Plans of NC helps residents compare these network options side by side to ensure their preferred local hospitals and clinics are covered before they enroll.
Blue Advantage, a PPO network, covers over 95 percent of NC doctors in-network and connects Washington County residents to a large nationwide provider network including local ECU Health facilities.
Blue Care, an HMO network, covers over 95 percent of NC doctors in-network and gives Washington County residents broad statewide access to hospitals and clinics across northeastern North Carolina.
Both Blue Advantage and Blue Care plans allow Washington County residents to see specialists without referrals, supporting access to specialty care at regional ECU Health locations.
Washington County residents using Vidant Washington Hospital in Plymouth should confirm that facility's in-network status under their chosen Blue Advantage or Blue Care plan before enrolling.
Plan types available under Blue Cross NC in Washington County include structures across Bronze, Silver, Gold, and Catastrophic metal tiers, offering flexibility to match different healthcare usage patterns.
Health Plans of NC agents compare every Blue Advantage and Blue Care plan available in Washington County at no cost, helping residents identify which network best fits their provider preferences.
Bronze plans in Washington County start at approximately $491.92/month before subsidies. With a median household income of $41,750, many residents qualify for premium tax credits. Subsidies may reduce your monthly premium significantly based on income.
Bronze plans in Washington County start at $491.92 per month for a 35-year-old, offering the lowest monthly premiums with higher deductibles, best suited for residents who rarely need medical care.
Silver plans start at $644.87 per month for a 35-year-old and are the only metal tier eligible for cost-sharing reductions, which lower deductibles and copays for qualifying Washington County households.
Gold plans start at $669.68 per month for a 35-year-old, providing lower out-of-pocket costs at the time of care, making them a strong fit for residents with frequent healthcare needs.
Washington County residents with household incomes between 100 and 400 percent of the federal poverty level qualify for Advance Premium Tax Credits that can significantly reduce monthly plan costs below the published starting prices.
Some Washington County households near the county median income of $41,750 may qualify for $0 premium Silver plans after tax credits are applied, making comprehensive coverage highly accessible.
Out-of-pocket maximums vary across all 18 available plans, so Washington County residents should compare total annual costs including deductibles and copays, not just monthly premiums, when selecting a plan.
For 2026, Blue Cross NC is one of two ACA Marketplace carriers serving Washington County, offering 18 health insurance plans to residents in the county. Blue Cross NC plans are available through two network options: Blue Advantage, which features the largest nationwide network with over 95 percent of NC doctors in-network, and Blue Care, which provides a broad statewide network with over 95 percent of NC doctors in-network. Blue Advantage connects Washington County residents to a wide national provider base, while Blue Care focuses on strong statewide access, both supporting care at regional facilities like Vidant Washington Hospital and ECU Health locations. Network choice directly affects which hospitals, clinics, and specialists are considered in-network for Washington County residents, making it critical to verify local provider participation before selecting a plan. Health Plans of NC compares every available Blue Cross NC plan side by side at no cost, helping Washington County families find the right network and plan structure for their healthcare needs.
Blue Cross NC: one of two ACA Marketplace carriers in Washington County, offering 18 total plans across Blue Advantage PPO and Blue Care network options for 2026.
North Carolina expanded Medicaid in December 2023, extending free or low-cost coverage to adults earning up to 138 percent of the federal poverty level, a threshold that makes a large portion of Washington County residents newly eligible. Currently, 8.4 percent of Washington County residents, approximately 1,000 people, remain uninsured, and many of them may qualify for Medicaid or subsidized Marketplace coverage without realizing it. Children in families earning up to 210 percent of the federal poverty level may qualify for NC Health Choice, the state's CHIP program, providing low-cost coverage for kids across Washington County. Health Plans of NC offers free eligibility checks to help Washington County residents determine whether they qualify for Medicaid, CHIP, or a subsidized Marketplace plan.
Working adults in Washington County who earn at or below 138 percent of the federal poverty level now qualify for full Medicaid coverage following North Carolina's December 2023 expansion.
Washington County's poverty rate of 24.7 percent means a substantial share of county residents may be eligible for Medicaid at no cost, covering doctor visits, prescriptions, and hospital care.
Children in Washington County families earning up to 210 percent of the federal poverty level may qualify for NC Health Choice, also known as CHIP, which provides comprehensive low-cost coverage for minors.
Pregnant women in Washington County may qualify for Medicaid coverage that includes prenatal care, labor and delivery, and postpartum services, regardless of immigration or employment status.
Washington County residents with disabilities or seniors with low incomes may qualify for Medicaid programs that cover long-term care, home health services, and other specialized medical needs.
Health Plans of NC licensed agents serve Washington County residents at no cost, comparing all available plans side by side and guiding you through enrollment from start to finish. Call 800-797-0327 today to get personalized help finding the right plan for your household.
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 Washington 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 |
|---|---|---|
Washington County Hospital | 958 US Hwy 64 E, Plymouth, NC 27962 |
Clinic | Address | Phone |
|---|---|---|
Agape Health Services- Plymouth | 115 Adams St, Plymouth, NC 27962 | |
Creswell Primary Care | 9500 NC Highway 94 N, Creswell, NC 27928 | |
Eastern Carolina Geriatric Associates & Family Care Ctr | 105 Commerce St, Powellsville, NC 27962 | |
Plymouth Primary Care Rural Health Clinic | 795 US Hwy 64 E, Plymouth, NC 27962 | |
Martin County Health Department | 198 NC Hwy 45 N, Plymouth, NC 27962 | |
Oneals Family Practice | 454 US Hwy 64 E, Plymouth, NC 27962 | |
Plymouth Primary Care Rural Health Clinic | 1006 US Hwy 64 E, Plymouth, NC 27962 | |
Medical Services of Washington County | 983 US Hwy 64 E, Plymouth, NC 27962 | |
Patriot Physician Services | 1719 Albemarle Beach Rd, Roper, NC 27970 | |
Williamston Hospital Corporation | 543 US Hwy 64 W, Plymouth, NC 27962 |
Washington County ZIP Codes include: 27928, 27962, and 27970
