Find an Affordable Health Insurance Plan in Wilkes 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.
Charlotte / Piedmont · NC & SC
Blue Local℠ with Atrium Health is a Blue Cross NC plan built around Atrium Health's network of 20 hospitals and 700+ care locations across North and South Carolina. It includes two children's hospitals — Levine Children's Hospital (nationally ranked in 10 pediatric specialties) and Brenner Children's Hospital — plus the Atrium Health Wake Forest Baptist Comprehensive Cancer Center, one of only three comprehensive cancer centers in North Carolina.
This is a single-system regional plan offered at a lower premium, with only Atrium Health providers in-network. We especially recommend it for families who may need pediatric specialty care or comprehensive cancer care and live in one of the 17 eligible counties across the Charlotte and Piedmont regions.
Good fit if you have a child who needs or may need care at Levine or Brenner Children's Hospital, are managing a cancer diagnosis and want access to a comprehensive cancer center, or live in one of the 17 eligible counties across the Charlotte/Piedmont region.
Poor fit if your regular doctors are with CaroMont Health, Cone Health, or Novant Health — all three are out-of-network.
Regional network – Charlotte / Piedmont · NC & SC6
Network: Atrium Health only1 (incl. Levine Children’s4).
Out-of-area care: Emergency / urgent only.
Offered in Bronze, Silver, and Gold tiers.
Notes
Blue Cross NC has collaborated with Atrium Health to bring you Blue Local with Atrium Health, a health insurance plan offered by Blue Cross NC that provides access to Atrium Health’s comprehensive network of providers. Atrium Health is an independent company and is solely responsible for the physicians and medical facilities it owns/operates. Atrium Health does not offer Blue Cross or Blue Shield products or services.
Atrium Health, atriumhealth.org/about-us/newsroom/news/atrium-health-earns-multiple-us-news-and-world-report-honors (Accessed September 2023).
Atrium Health Wake Forest Baptist, www.wakehealth.edu/about-us (Accessed August 2022).
Atrium Health, www.atriumhealth.org/about-us (Accessed August 2022).
Atrium Health Wake Forest Baptist, www.wakehealth.edu/locations/facilities/comprehensive-cancer-center (Accessed September 2023).
Atrium Health, https://2023yir.advocatehealth.org/ (Within the full report) (Accessed September 2024).
Blue Local with Atrium Health is available on and off Marketplace to residents of these North Carolina counties: Anson, Cabarrus, Cleveland, Davidson, Davie, Forsyth, Gaston, Guilford, Lincoln, Mecklenburg, Randolph, Rowan, Stanly, Stokes, Union, Wilkes and Yadkin.
This plan is built around a single system, Atrium Health, which is what keeps the premium lower than Blue Cross NC's broad-network plans. Only Atrium Health providers are in-network — outside of emergency and urgent care, CaroMont Health, Cone Health, and Novant Health are not covered.
Atrium Health's network spans 20 hospitals and more than 700 care locations across North and South Carolina, including two children's hospitals — Levine Children's Hospital, nationally ranked in 10 pediatric specialties, and Brenner Children's Hospital — plus the Atrium Health Wake Forest Baptist Comprehensive Cancer Center, one of only three comprehensive cancer centers in North Carolina.
This makes it a particularly strong option for families who may need pediatric specialty care or anyone managing a cancer diagnosis, since that care is coordinated within one system rather than requiring referrals across networks.
The lower premium reflects the narrower, single-system network. 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 17 counties in the Charlotte and Piedmont regions. If your doctors are with CaroMont, Cone, or Novant 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 Atrium 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 — Levine Children’s Hospital, nationally ranked in 10 pediatric specialties, is part of the in-network Atrium Health system on Blue Local℠ with Atrium Health, along with Brenner Children’s Hospital.
Yes — the Atrium Health Wake Forest Baptist Comprehensive Cancer Center is one of only three comprehensive cancer centers in North Carolina and is in-network on this plan.
Those systems are out-of-network on Blue Local℠ with Atrium Health. This plan only covers Atrium Health providers in-network, except for emergency and urgent care.
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 | 27 |
| Ambetter of North Carolina | 15 |
| Oscar Health Plan of North Carolina | 14 |
| AmeriHealth Caritas Next | 8 |
| Total | 64 |
Source: CMS QHP Landscape PY2026, Individual Market Medical, updated August 26, 2026 (data.healthcare.gov). Counts distinct Plan IDs offered on the Marketplace in Wilkes County, once per carrier.
in North Carolina
Find affordable health insurance in Wilkes County, NC with Health Plans of NC. Health Plans of NC helps Wilkes County residents find and compare health insurance plans that connect them with local providers like Atrium Health Wake Forest Baptist Wilkes Medical Center, at no cost to you. Whether you work for Tyson Foods, JELD-WEN, or are self-employed in the Wilkesboro area, licensed agents are ready to help you enroll in the right 2026 coverage.
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 |
Blue Local℠ with Atrium Health | EPO | Available in Wilkes County |
Wilkes County is home to 65,983 residents, with 0.0% population growth since 2020 and 3.3% of residents born outside the United States, reflecting a community with steady and diverse healthcare coverage needs. Major local employers such as Wilkes County Schools, Tyson Foods, Wake Forest Baptist Health, Wilkes County government, and JELD-WEN anchor the workforce and create a range of coverage situations from employer-sponsored plans to individual market options. Atrium Health Wake Forest Baptist Wilkes Medical Center serves as the primary health system for the county, making plan network compatibility with that system a key factor when choosing coverage.
ACA Marketplace coverage is available to Wilkes County residents who do not have access to job-based insurance through employers like JELD-WEN or Tyson Foods.
Medicaid coverage is available to qualifying low-income Wilkes County adults and families following North Carolina's Medicaid expansion in December 2023.
Employer-sponsored group health plans are offered by major Wilkes County employers including Wilkes County Schools, Wake Forest Baptist Health, and Tyson Foods.
COBRA continuation coverage allows Wilkes County workers who leave employers like JELD-WEN or Wilkes County government to temporarily keep their existing group plan.
Short-term health plans may provide limited gap coverage for Wilkes County residents between jobs or waiting for a qualifying enrollment event.
Small business SHOP Marketplace plans allow smaller Wilkes County employers to offer group health coverage to their employees through ACA-compliant options.
For 2026, Blue Cross NC offers plans in Wilkes County across three distinct provider networks, giving residents the ability to choose coverage that aligns with their preferred hospitals and doctors. The available networks include Blue Advantage (PPO), Blue Care (HMO), and Blue Local with Atrium Health (EPO), each offering different levels of statewide and local provider access. Blue Local with Atrium Health is specifically available in Wilkes County and is designed to connect enrollees directly with Atrium Health Wake Forest Baptist Wilkes Medical Center and related facilities.
Blue Advantage, a PPO network, includes over 95% of North Carolina doctors in-network and provides the broadest access to providers across the state including specialists beyond Wilkes County.
Blue Care, an HMO network, covers over 95% of North Carolina doctors in-network and offers broad statewide access for Wilkes County residents who see providers in surrounding areas.
Blue Local with Atrium Health, an EPO network, is available in Wilkes County and is built around Atrium Health Wake Forest Baptist Wilkes Medical Center at 1370 W D St in North Wilkesboro.
Plan structures across all three Blue Cross NC networks allow Wilkes County residents to see out-of-network providers, though at higher cost-sharing compared to in-network visits.
Residents who regularly use Hugh Chatham Memorial Hospital in Elkin or Ashe Memorial Hospital in Jefferson should verify network coverage under their chosen plan before enrolling.
Health Plans of NC agents can compare all three Blue Cross NC networks side-by-side to help Wilkes County residents confirm their specific doctors and hospitals are in-network before selecting a plan.
Bronze plans in Wilkes County start at approximately $403.47/month before subsidies. With a median household income of $50,438, many residents qualify for premium tax credits. Subsidies may reduce your monthly premium significantly based on income.
Bronze plans in Wilkes County start at $403.47 per month for a 35-year-old before premium tax credits, offering the lowest monthly premium with higher deductibles.
Silver plans start at $518.72 per month before subsidies and are the only tier eligible for cost-sharing reductions that lower deductibles, copays, and out-of-pocket maximums.
Gold plans start at $536.24 per month before subsidies and offer lower out-of-pocket costs at the point of care, making them a strong choice for residents with frequent medical needs.
Wilkes County residents with household incomes near or below the county median of $50,438 often qualify for premium tax credits that meaningfully reduce monthly costs across all metal tiers.
Households earning between 100% and 400% of the federal poverty level are eligible for ACA premium tax credits, and those at lower income levels may also qualify for enhanced cost-sharing reductions on Silver plans.
Some lower-income Wilkes County residents may qualify for a $0 premium Silver plan after subsidies are applied, making Silver-level coverage potentially free on a monthly basis.
For 2026, Blue Cross NC is one of four ACA Marketplace carriers offering plans in Wilkes County, with a total of 27 plans available to individuals and families. These 27 plans span three provider networks, Blue Advantage, Blue Care, and Blue Local with Atrium Health, of which only the Blue Advantage PPO covers out-of-network care beyond emergencies and urgent care. Blue Local with Atrium Health connects Wilkes County enrollees directly to Atrium Health Wake Forest Baptist Wilkes Medical Center and its affiliated providers in North Wilkesboro, while Blue Advantage and Blue Care extend access to a broader range of providers across North Carolina. The network you choose directly affects which hospitals and doctors you can see at in-network rates, making it critical to confirm that your preferred providers, whether at Hugh Chatham Memorial Hospital, Ashe Memorial Hospital, or a local primary care clinic, are covered before you enroll. Health Plans of NC compares all 27 Blue Cross NC plans side-by-side at no cost to help Wilkes County residents find the right combination of network access, plan type, and price.
Blue Cross NC, offering 27 ACA Marketplace plans in Wilkes County for 2026 across the Blue Advantage, Blue Care, and Blue Local with Atrium Health 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, which opened eligibility to tens of thousands of previously uninsured residents across the state. In Wilkes County, approximately 8,000 residents remain uninsured, representing an uninsured rate of 11.4%, and many of these individuals may now qualify for Medicaid or subsidized Marketplace coverage without realizing it. Wilkes County's poverty rate of 16.4% means a substantial share of the local population may be eligible for Medicaid at little or no cost. Children in families earning up to 210% of the federal poverty level may qualify for NC Health Choice, the state's CHIP program, and Health Plans of NC can check your eligibility for free with a single call.
Working adults in Wilkes County earning at or below 138% of the federal poverty level may qualify for full Medicaid coverage following North Carolina's 2023 expansion.
Children in Wilkes County households may qualify for NC Health Choice (CHIP), providing low-cost coverage for families who earn too much for Medicaid but still need affordable pediatric care.
Pregnant women in Wilkes County are eligible for Medicaid coverage that includes prenatal care, labor and delivery, and postpartum services through qualifying income thresholds.
Wilkes County's poverty rate of 16.4% means a significant portion of local residents may qualify for Medicaid, cost-sharing reductions, or other low-cost coverage options available in 2026.
People with disabilities and low-income seniors in Wilkes County may qualify for Medicaid programs that cover long-term services, prescription drugs, and care coordination support.
Health Plans of NC licensed agents serve Wilkes County residents at no cost and can compare every available 2026 plan side-by-side to find the option that best fits your budget, your providers, and your healthcare needs. Call 800-797-0327 today to get a free personalized quote and complete your enrollment with expert guidance.
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 Wilkes 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 |
|---|---|---|
Wilkes Medical Center | 1370 W D St, North Wilkesboro, NC 28659 |
Clinic | Address | Phone |
|---|---|---|
Wilkes Community Health Center (Wilkes County Health Department) | 306 College Street, Wilkesboro, NC 28697 | |
Clingman Medical Center | 3369 Clingman Rd, Ronda, NC 28670 | |
Family Medicine | 200 W Park Cir Suite B, North Wilkesboro, NC 28659 | |
Greenway Healthcare | 1404 Willow Ln, N Wilkesboro, NC 28659 | |
Holistic Medical Clinic of the Carolinas | 308 E Main St, Wilkesboro, NC 28697 | |
Hugh Chatham Family Medicine Wilkes | 5229 Rock Creek Rd, Hays, NC 28635 | |
Khot Medical Clinic | 1216 D School St, Wilkesboro, NC 28697 | |
Novant Health Wilkes Medical Associates | 1919 W Park Dr, North Wilkesboro, NC 28659 | |
Procare Medical Clinic | 627 W Park Circle, N Wilkesboro, NC 28659 | |
Riverside Medical Associates | 702 13th St, North Wilkesboro, NC 28659 |
Wilkes County ZIP Codes include: 28606, 28624, 28635, 28649, 28651, 28654, 28656, 28659, 28665, 28669, 28670, 28674, 28685, and 28697
