Find Your Most Affordable Health Insurance Plan in Wayne 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 Wayne County, once per carrier.
in North Carolina
Find affordable health insurance in Wayne County, NC with Health Plans of NC. Health Plans of NC helps Wayne County residents find and enroll in the right health insurance plan for 2026, connecting individuals and families with coverage that works alongside major local employers like Seymour Johnson Air Force Base and health systems like UNC Health Wayne. Licensed agents compare every available option at no cost, making it easier to get covered without confusion or overpaying.
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 |
Wayne County is home to 117,606 residents, with a population that has grown 0.2 percent since 2020 and a foreign-born population representing 6.9 percent of the community, reflecting the county's diverse coverage needs. Major employers including Wayne County Schools, Wayne Memorial Hospital, Seymour Johnson Air Force Base, Walmart, and Mount Olive Pickle Company provide a mix of employer-sponsored and individual coverage pathways for workers and their families. Health systems like UNC Health Wayne and Wayne Memorial Hospital anchor local care delivery, making it important for residents to select a plan that keeps these providers in-network.
ACA Marketplace plans are available to Wayne County individuals and families not covered through an employer, offering access to local providers including UNC Health Wayne and Wayne Memorial Hospital.
Medicaid coverage is available to qualifying low-income Wayne County adults and families, providing broad access to area health systems following North Carolina's Medicaid expansion in December 2023.
Employer-sponsored plans cover many Wayne County workers at major employers like Wayne County Schools and Seymour Johnson Air Force Base, often with shared premium costs between employer and employee.
COBRA continuation coverage allows Wayne County residents who lose job-based insurance, such as former employees of Walmart or Mount Olive Pickle Company, to temporarily maintain their existing plan after a qualifying event.
Short-term health plans may serve as a bridge for Wayne County residents between jobs or waiting for a Special Enrollment Period, though they do not include all ACA-required benefits.
SHOP small business plans through the ACA Marketplace allow small employers in Wayne County to offer group health coverage to employees, with potential tax credits available to qualifying businesses.
For 2026, Wayne County residents have access to 18 plans through Blue Cross NC, offered across two plan networks: Blue Advantage and Blue Care, both of which include structures giving enrollees broad flexibility in choosing local providers. Blue Advantage connects Wayne County residents to the largest nationwide PPO network, with more than 95 percent of North Carolina doctors participating in-network, while Blue Care offers a broad statewide HMO network covering more than 95 percent of NC doctors. Both networks are compatible with key local health systems including UNC Health Wayne and Wayne Memorial Hospital, ensuring Wayne County residents can access in-county care for emergency, surgical, and specialty services.
Blue Advantage, PPO network, covers more than 95 percent of NC doctors in-network and connects Wayne County enrollees to UNC Health Wayne and Wayne Memorial Hospital for comprehensive local care.
Blue Care, HMO network, covers more than 95 percent of NC doctors in-network and provides Wayne County residents with broad statewide access including local hospitals and specialty practices.
Both Blue Advantage and Blue Care plans allow Wayne County residents to see specialists without a referral, supporting access to services at facilities like Wayne Memorial Hospital.
Wayne County residents selecting a Blue Advantage plan benefit from the widest possible provider network, which is especially valuable for those who may need out-of-county specialty care.
Blue Care plans in Wayne County offer strong in-network access for residents who primarily use local providers, including primary care and urgent care clinics throughout the Goldsboro area.
Health Plans of NC agents help Wayne County residents compare Blue Advantage and Blue Care side by side to identify which network best fits their provider preferences and care patterns.
Bronze plans in Wayne County start at approximately $401.70/month before subsidies. With a median household income of $58,082, many residents qualify for premium tax credits. Subsidies may reduce your monthly premium significantly based on income.
Bronze plans in Wayne County start at $401.70 per month for a 35-year-old before subsidies, offering the lowest premiums with higher deductibles for those who want catastrophic protection.
Silver plans in Wayne County start at $516.45 per month before subsidies and are the only tier eligible for cost-sharing reductions, which lower deductibles and copays for qualifying enrollees.
Gold plans in Wayne County start at $533.89 per month before subsidies and feature lower out-of-pocket costs per service, making them a strong fit for residents with frequent healthcare needs.
Wayne 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 across all metal tiers.
Households earning near the county's median income of $58,082 may qualify for substantial premium tax credits under the Inflation Reduction Act, making Silver or Gold plans more accessible than the sticker price suggests.
Some Wayne County residents with lower incomes may qualify for a $0 premium Silver plan after advanced premium tax credits are applied at enrollment through the ACA Marketplace.
Blue Cross NC is one of two ACA Marketplace carriers offering plans in Wayne County for 2026, with 18 total plans available to individuals and families across the county. These plans are offered through two networks, Blue Advantage and Blue Care, giving Wayne County enrollees a choice between the largest nationwide provider network and a broad statewide network. Blue Advantage connects residents to more than 95 percent of NC doctors in-network, while Blue Care covers more than 95 percent, and both networks include key local health systems such as UNC Health Wayne and Wayne Memorial Hospital. The network a Wayne County resident selects will directly affect which local hospitals, clinics, and specialists are covered at in-network rates, making this one of the most important decisions in the enrollment process. Health Plans of NC compares every Blue Cross NC plan side by side at no cost, helping Wayne County residents identify the combination of network, premium, and deductible that fits their needs.
Blue Cross NC: one of two ACA Marketplace carriers in Wayne County for 2026, offering 18 plans across the Blue Advantage and Blue Care networks for individuals and families.
North Carolina expanded Medicaid in December 2023, and Wayne County residents with household incomes at or below 138 percent of the federal poverty level may now qualify for free or very low-cost comprehensive coverage. Wayne County's uninsured rate of 12.1 percent, representing approximately 14,000 residents without coverage, reflects a significant gap that Medicaid expansion and the ACA Marketplace are designed to close. Children in families earning up to 210 percent of the federal poverty level may qualify for NC Health Choice, the state's CHIP program, which provides low-cost pediatric coverage. Health Plans of NC offers free eligibility checks for both Medicaid and CHIP, helping Wayne County families determine their options without cost or obligation.
Working adults in Wayne County who earn at or below 138 percent of the federal poverty level may now qualify for full Medicaid coverage following North Carolina's December 2023 expansion.
Wayne County's poverty rate of 16.9 percent means a substantial share of county residents may be eligible for Medicaid at little or no monthly premium cost.
Children in Wayne County families with incomes up to 210 percent of the federal poverty level may qualify for NC Health Choice, providing low-cost dental, vision, and medical coverage.
Pregnant women in Wayne County may qualify for Medicaid coverage that includes prenatal, delivery, and postpartum care through local providers including UNC Health Wayne.
Seniors and people with disabilities in Wayne County with low income may qualify for dual coverage through both Medicare and Medicaid, significantly reducing out-of-pocket healthcare expenses.
Health Plans of NC licensed agents serve Wayne County residents at no cost, comparing every available 2026 plan 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 health needs and budget.
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 Wayne 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 |
|---|---|---|
Carolina East Medical Ctr | 2000 Neuse Blvd, New Bern, NC 28560 | (252) 633-8111 |
Carteret Health Care | 3500 Arendell St, Morehead City, NC 28557 | (252) 499-6000 |
Cherry Hospital | 1401 W Ash St, Goldsboro, NC 27530 | (919) 947-7000 |
ECU Health Beaufort Hosp A | 628 E 12th St, Washington, NC 27889 | (252) 975-4100 |
ECU Health Maynard Children's | 2102 Stantonsburg Rd, Greenville, NC 27834 | (252) 816-3714 |
ECU Health Medical Ctr | 2100 Stantonsburg Rd, Greenville, NC 27834 | (252) 847-4100 |
UNC Lenoir Health Care | 100 Airport Rd, Kinston, NC 28501 | (252) 522-7000 |
Walter B Jones Alcohol & Drug | 2577 W 5th St, Greenville, NC 27834 | (252) 830-3426 |
Wayne MEMORIAL Hospital | 2605 Medical Office Pl, Goldsboro, NC 27534 | (919) 731-6112 |
Wayne UNC Health Care | 2700 Wayne Memorial Dr, Goldsboro, NC 27534 | (919) 736-1110 |
Clinic | Address | Phone |
|---|---|---|
Abhishek K Mishra MD | 701 Doctors Dr, Kinston, NC 28501 | (252) 559-2200 |
Acupuncture Of Eastern NC | 1425 S Glenburnie Rd # 6, New Bern, NC 28562 | (252) 665-3294 |
Audit-Tel | , Greenville, NC 27858 | (252) 353-3331 |
Cape Carteret Family Medicine | 1057d Cedar Point Blvd # D, Cedar Point, NC 28584 | (252) 764-2121 |
Community Care Plan-Eastern | 521 Moye Blvd # C, Greenville, NC 27834 | (252) 816-0830 |
East Carolina Heart Inst | 526 Moye Blvd, Greenville, NC 27834 | (252) 847-5755 |
East Carolina Univ Family Med | 101 Heart Dr, Greenville, NC 27834 | (252) 744-4611 |
East Coast Onsite Medical Care | 505 Greenville Blvd SE, Greenville, NC 27858 | (252) 754-2273 |
Ecu Department-Family Medicine | 101 Heart Dr, Greenville, NC 27834 | (252) 744-2607 |
ECU Health Bover Hospital | 1209 Brown St, Washington, NC 27889 | (252) 975-4308 |
ECU Health Family Medicine-LA | 101 S Carey St, La Grange, NC 28551 | (252) 566-4021 |
ECU Health Gamma Knife Ctr | 2100 Stantonsburg Rd, Greenville, NC 27834 | (252) 847-2611 |
ECU Health Gastroenterology | 521 Moye Blvd # C, Greenville, NC 27834 | (252) 816-0800 |
ECU Health Heart-Vascular Care | 701 Doctors Dr # B, Kinston, NC 28501 | (252) 559-2200 |
ECU Health Sleep Ctr-Grnvll | 4 Doctors Park Medical Dr, Greenville, NC 27834 | (252) 847-7500 |
Goshen Medical Ctr-Fremont | 109 S Sycamore St, Fremont, NC 27830 | (919) 242-4382 |
Goshen Medical Ctr | 2001 Neuse Blvd, New Bern, NC 28560 | (910) 219-1082 |
Goshen Medical Ctr | 325 N Carolina Highway 55, Mount Olive, NC 28365 | (919) 658-5900 |
Healthfirst Medical Ctr Inc | 1201 Carolina Ave, Washington, NC 27889 | (252) 833-0365 |
Lindsey Roberson FNP | 701 Doctors Dr, Kinston, NC 28501 | (252) 559-2200 |
Med Center 1 | 1688 E Arlington Blvd, Greenville, NC 27858 | (252) 353-1464 |
Miracles In Sight | 620 Red Banks Rd, Greenville, NC 27858 | (252) 751-0785 |
Snow Hill Medical Ctr | 1106 Kingold Blvd, Snow Hill, NC 28580 | (252) 747-2921 |
UNC Family Medicine At Rswd | 2600 US Highway 70 W, Goldsboro, NC 27530 | (919) 739-4808 |
Vidant Medical Ctr | 3900 E 10th St, Greenville, NC 27858 | (252) 847-4325 |
Vidant Outpatient Rehab | 2310 Stantonsburg Rd, Greenville, NC 27834 | (252) 847-6603 |
Vitality Health & Wellness | 1429 E Fire Tower Rd # 104, Greenville, NC 27858 | (252) 364-2802 |
Westcare Innovative Healthcare | 2710 Beddard Rd, Grimesland, NC 27837 | (252) 754-0920 |
Wayne County ZIP Codes include: 27530, 27531, 27532, 27533, 27534, 27830, 27863, 28333, 28365, and 28578
