Find Your Most Affordable Health Insurance Plan in Wilson County
in North Carolina
Wilson County residents can compare 16 health insurance options for 2026.
Blue Advantage 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.
Blue Care gives you access to our largest statewide network. This is a good option if you want a broad choice of in-network doctors, specialists and hospitals.
More than 92% of doctors and 97% of hospitals in North Carolina are in-network.1
All doctors outside the Blue Care provider network are considered out-of-network and not covered. 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.
Blue Care is available in all North Carolina counties, except: Alamance, Caswell, Chatham, Durham, Franklin, Johnston, Lee, Orange, Person, and Wake.
in North Carolina
Find affordable health insurance in Wilson County, NC with Health Plans of NC. Health Plans of NC helps Wilson County residents find and compare affordable health insurance plans for 2026, with local expertise covering everything from individual coverage to family plans. Whether you work for Bridgestone Americas, Wilson County Schools, or another local employer, Health Plans of NC makes it easy to explore every available option at no cost.
Plan Network | Type | Network Coverage |
|---|---|---|
Blue Advantage | PPO | Largest nationwide network, 95%+ of NC doctors in-network |
Blue Care | PPO | Broad statewide network, 92%+ of NC doctors in-network |
Wilson County, home to 78,648 residents and experiencing a population change of -0.2 percent since 2020, offers a range of health coverage pathways suited to diverse household situations. Major local employers including Bridgestone Americas, Wilson County Schools, S.T. Wooten Corporation, Truist Bank, and the County of Wilson provide employer-sponsored insurance to a significant share of working residents, while UNC Health Wilson and ECU Health anchor the local provider network for those seeking ACA marketplace or Medicaid coverage. With 6.0 percent of residents being foreign-born, multilingual plan support and accessibility to culturally competent providers through these health systems are important factors for many Wilson County families.
ACA Marketplace coverage through Blue Cross NC gives Wilson County individuals and families access to plans that include UNC Health Wilson and ECU Health facilities in-network.
Medicaid coverage is available to eligible low-income Wilson County residents, with expanded access following North Carolina's Medicaid expansion, providing comprehensive benefits at little or no cost.
Employer-sponsored insurance from major Wilson County employers such as Bridgestone Americas and Wilson County Schools covers a large share of working residents and their dependents.
Short-term health plans may serve Wilson County residents who are between jobs or waiting for open enrollment, though these plans offer more limited benefits than ACA-compliant coverage.
COBRA continuation coverage allows Wilson County employees who lose job-based insurance, such as those previously covered through S.T. Wooten Corporation or Truist Bank, to maintain their existing plan temporarily.
Small business SHOP marketplace plans allow Wilson County employers, including smaller local businesses, to offer ACA-compliant group health insurance to their employees and qualify for potential tax credits.
For 2026, Wilson County residents can choose from plans offered under two Blue Cross NC networks: Blue Advantage and Blue Care, both structured as PPO plans that allow access to a broad range of local and statewide providers. Blue Advantage connects enrollees to the largest nationwide PPO network, with over 95 percent of North Carolina doctors participating in-network, while Blue Care provides broad statewide PPO coverage with over 92 percent of NC doctors in-network, both including key Wilson County facilities such as Wilson Medical Center at 1705 Tarboro St SW. Health Plans of NC agents help Wilson County residents compare both network options side-by-side to ensure that preferred providers like ECU Health Family Medicine on Glendale Dr SW or Eastpointe mental health services are accessible before enrollment.
Blue Advantage, a PPO network, includes Wilson Medical Center and connects Wilson County residents to the largest nationwide provider network, with 95 percent or more of NC doctors participating in-network.
Blue Care, also a PPO network, covers Wilson County residents with broad statewide access, including over 92 percent of NC doctors in-network and key local facilities such as Wilson Medical Center.
Both Blue Advantage and Blue Care PPO plans allow Wilson County enrollees to see specialists at Nash General Hospital in Rocky Mount and UNC Health Johnston in Smithfield without a referral requirement.
Wilson County residents managing chronic conditions, such as those relying on cardiology or oncology services at Wilson Medical Center, should verify specialist availability within their chosen Blue Advantage or Blue Care network.
Mental health and behavioral health services, including Eastpointe, are accessible through both Blue Advantage and Blue Care plans, supporting Wilson County residents seeking behavioral health coverage.
Health Plans of NC compares every Blue Advantage and Blue Care plan option available in Wilson County for 2026, helping residents identify the network and coverage tier that best fits their provider preferences.
Bronze plans in Wilson County start at approximately $443.10/month before subsidies. With a median household income of $51,381, many residents qualify for premium tax credits. Subsidies may reduce your monthly premium significantly based on income.
Bronze plans in Wilson County start at $443.10 per month for a 35-year-old before subsidies, offering the lowest monthly premiums with higher deductibles for those who want financial protection against major medical events.
Silver plans start at $569.49 per month before subsidies and are the only tier eligible for cost-sharing reductions, which lower deductibles and copays for qualifying Wilson County residents.
Gold plans start at $588.91 per month before subsidies and feature lower out-of-pocket costs, making them a strong choice for Wilson County residents who expect frequent medical care throughout the year.
Wilson County residents earning between 100 and 400 percent of the federal poverty level qualify for ACA premium tax credits that can reduce monthly plan costs well below the published starting prices.
Households earning up to 250 percent of the federal poverty level may qualify for cost-sharing reduction plans on the Silver tier, lowering deductibles and copays beyond what the base premium reduction provides.
Some Wilson County residents with incomes just above the Medicaid threshold may qualify for a zero-dollar or near-zero-dollar premium Silver plan after applying all available premium tax credits.
Blue Cross NC is the sole ACA marketplace carrier offering plans in Wilson County for 2026, with 16 total plans available to eligible residents across multiple coverage tiers. These 16 plans are built on two PPO network options, Blue Advantage and Blue Care, giving Wilson County shoppers meaningful choice in terms of network breadth and provider access. Blue Advantage connects enrollees to the largest nationwide PPO network with 95 percent or more of NC doctors in-network, while Blue Care provides broad statewide PPO coverage including over 92 percent of NC doctors, both anchored locally by Wilson Medical Center and supported by regional facilities such as Nash General Hospital and UNC Health Johnston. The network a Wilson County resident selects directly determines which local providers, specialists, and hospitals are accessible at in-network cost-sharing levels, making network comparison a critical step before enrolling. Health Plans of NC agents compare every available Blue Cross NC plan side-by-side at no cost, helping Wilson County residents identify the carrier plan and network combination that best matches their healthcare needs and preferred local providers.
Blue Cross NC: the sole ACA marketplace carrier in Wilson County for 2026, offering 16 plans across Bronze, Silver, Gold, and Catastrophic tiers on both Blue Advantage PPO and Blue Care PPO networks.
North Carolina expanded Medicaid in December 2023, extending eligibility to adults earning up to 138 percent of the federal poverty level and opening comprehensive, low-cost or no-cost coverage to thousands of Wilson County residents who were previously uninsured. Wilson County currently has an uninsured rate of 12.8 percent, representing approximately 10,000 residents without coverage, many of whom may now qualify for Medicaid or subsidized marketplace plans. 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 comprehensive coverage for eligible minors in Wilson County. Health Plans of NC offers free eligibility checks to help Wilson County residents determine whether they qualify for Medicaid, CHIP, or an ACA marketplace plan, with licensed agents available to guide families through the enrollment process at no cost.
Working adults in Wilson 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.
Children in Wilson County families earning up to 210 percent of the federal poverty level may be eligible for NC Health Choice, the state CHIP program, which provides comprehensive low-cost health coverage.
Pregnant women in Wilson County are eligible for Medicaid at higher income thresholds than standard adult eligibility, ensuring prenatal and delivery care is covered for many low-income expectant mothers.
Wilson County seniors with limited income may qualify for dual Medicare and Medicaid coverage, helping to offset costs for premiums, deductibles, and long-term care services.
With a poverty rate of 21.0 percent in Wilson County, a substantial share of residents may qualify for Medicaid or CHIP, and Health Plans of NC can confirm eligibility and assist with enrollment at no cost.
Health Plans of NC licensed agents serve Wilson County residents at no cost, comparing every available plan side-by-side and helping with enrollment from start to finish. Call 800-797-0327 today to speak with a local agent who can identify the right coverage for your household and help you maximize any available savings.
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 Wilson 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 |
Wilson County ZIP Codes include: 27813, 27822, 27851, 27873, 27880, 27883, 27893, 27894, 27895, and 27896
