in Forsyth County
Clemmons, North Carolina residents have access to 9 Medicare plans for 2026 through Blue Cross NC, and Health Plans of NC licensed agents are available to help every eligible senior compare and enroll in coverage at absolutely no cost.
Clemmons, North Carolina has a population of 21,574, with approximately 5,000 Medicare-eligible residents representing 21.6% of the community. Seniors in Clemmons have access to multiple Medicare coverage types, including Medicare Advantage, Medicare Supplement, Part D Prescription Drug Plans, and Dual Special Needs Plans designed for those with both Medicare and Medicaid. Both Atrium Health Wake Forest Baptist and Novant Health Forsyth Medical Center accept Medicare and serve Clemmons residents throughout Forsyth County.
Plan Name | Type | Monthly Premium |
|---|---|---|
Blue Medicare Medical Only | HMO-POS | $0.00/month |
Blue Medicare Essential | HMO | $0.00/month |
Blue Medicare Essential Plus | HMO-POS | $0.00/month |
Blue Medicare Choice | HMO | $0.00/month |
Blue Medicare Enhanced | HMO-POS | $30.00/month |
Blue Medicare PPO Enhanced | PPO | $35.00/month |
Blue Medicare Freedom+ | HMO-POS | $0.00/month |
Healthy Blue Medicare (D-SNP) | HMO-POS | $0.00/month |
Blue Medicare Rx Enhanced PDP | PDP | $163.20/month |
Medicare Advantage HMO plans in Clemmons, North Carolina provide bundled hospital and medical coverage through in-network providers at Atrium Health Wake Forest Baptist and Novant Health Forsyth Medical Center.
Medicare Advantage HMO-POS plans in Clemmons, North Carolina offer the structure of an HMO with added flexibility to seek care outside the network when needed, including at area specialty facilities.
Medicare Advantage PPO plans in Clemmons, North Carolina allow seniors to visit both in-network and out-of-network providers, including specialists affiliated with Novant Health Forsyth Medical Center.
Medicare Supplement (Medigap) plans in Clemmons, North Carolina pair with Original Medicare to cover cost-sharing gaps and allow access to any Medicare-accepting provider, including Atrium Health Wake Forest Baptist.
Part D Prescription Drug Plans in Clemmons, North Carolina provide standalone prescription coverage for seniors enrolled in Original Medicare or a Medicare Advantage plan without drug benefits.
Dual Special Needs Plans (D-SNP) in Clemmons, North Carolina are designed for residents who qualify for both Medicare and Medicaid, offering coordinated care through local health system networks.
For 2026, Blue Cross NC offers nine Medicare plans in Clemmons, North Carolina spanning HMO, HMO-POS, PPO, PDP, and D-SNP plan types, each designed to work with local provider networks in Forsyth County. Several plans carry a $0 monthly premium, while others offer enhanced benefits at a modest additional cost, giving Clemmons seniors a range of options to match their health and coverage priorities. Health Plans of NC agents can walk through every plan name, premium, and network detail at no cost to help residents choose the right fit.
Blue Medicare Medical Only, HMO-POS, $0.00 per month, provides hospital and medical coverage through in-network providers connected to Forsyth County health systems.
Blue Medicare Essential, HMO, $0.00 per month, bundles hospital, medical, and typically drug coverage through a coordinated network serving Clemmons and the greater Winston-Salem area.
Blue Medicare Essential Plus, HMO-POS, $0.00 per month, adds point-of-service flexibility to the Essential HMO structure, allowing limited out-of-network access to regional specialists.
Blue Medicare Choice, HMO, $0.00 per month, offers a structured HMO option with coordinated care through providers affiliated with Atrium Health Wake Forest Baptist and Novant Health Forsyth Medical Center.
Blue Medicare Enhanced, HMO-POS, $30.00 per month, delivers expanded benefits over base HMO plans with point-of-service access for Clemmons seniors who want added coverage flexibility.
Blue Medicare PPO Enhanced, PPO, $35.00 per month, provides the broadest network flexibility among Blue Cross NC Advantage plans, allowing Clemmons seniors to see both in-network and out-of-network providers.
Blue Medicare Freedom+, HMO-POS, $0.00 per month, combines $0 premium affordability with point-of-service access for residents who want coverage beyond a standard HMO network.
Healthy Blue Medicare DSNP, HMO-POS, $0.00 per month, is a Dual Special Needs Plan for Clemmons residents who qualify for both Medicare and Medicaid, offering coordinated care through local health systems.
Blue Medicare Rx Enhanced PDP, standalone Prescription Drug Plan, $163.20 per month, provides comprehensive drug coverage for Clemmons seniors enrolled in Original Medicare who need a standalone Part D plan.
In 2026, Blue Cross NC Medicare Advantage plan premiums in Clemmons, North Carolina range from $0.00 per month for plans like Blue Medicare Essential and Blue Medicare Freedom+ to $35.00 per month for the Blue Medicare PPO Enhanced, giving seniors a broad spectrum of cost options. The standalone Blue Medicare Rx Enhanced PDP carries a monthly premium of $163.20, making it important for seniors on Original Medicare to compare drug plan costs carefully before enrolling. With a median household income of $84,326 in Clemmons, some residents may qualify for cost-reduction programs such as Extra Help or Medicare Savings Programs, and a Health Plans of NC agent can evaluate eligibility at no cost.
Part A: $0 premium for most Clemmons, North Carolina residents who paid Medicare taxes for 10 or more years. The Part A hospital deductible is $1,736 in 2026.
Part B: $202.90 per month standard premium in 2026, an increase from $185.00 in 2025. Higher-income residents pay more through income-related monthly adjustment amounts.
Medicare Supplement (Medigap): $80 to $300 or more per month depending on plan letter and age, covers gaps not paid by Original Medicare.
For the 2026 plan year, Blue Cross NC is the Medicare carrier serving Clemmons, North Carolina, offering a total of 9 plans to eligible residents in zip code 27012 and the surrounding Forsyth County area. These 9 plans span multiple plan types including Medicare Advantage HMO, HMO-POS, PPO, a standalone Part D Prescription Drug Plan, and a Dual Special Needs Plan (D-SNP), giving Clemmons seniors a variety of structures to match their care preferences. Blue Cross NC plan networks in Clemmons are built to connect beneficiaries with major local health systems, including Atrium Health Wake Forest Baptist and Novant Health Forsyth Medical Center, ensuring access to the region's leading hospital and specialty services. The plan type a Clemmons senior selects, whether an HMO requiring referrals, a PPO allowing out-of-network access, or a D-SNP for dual-eligible residents, directly determines which local providers, specialists, and facilities are accessible at the lowest cost. Health Plans of NC compares every available Medicare plan side-by-side at absolutely no cost, helping Clemmons residents identify the Blue Cross NC option that best aligns with their providers and health needs.
Blue Cross NC: offers Medicare Advantage HMO, HMO-POS, PPO, D-SNP, and standalone Part D Prescription Drug Plans, with a total of 9 plans available to Medicare-eligible residents in Clemmons, North Carolina for 2026.
Clemmons, North Carolina has an uninsured rate of 4.5% and a poverty rate of 7.9%, meaning a meaningful portion of the community may qualify for federal and state programs that reduce Medicare costs. The Extra Help program, also known as the Low Income Subsidy, can lower or eliminate Part D prescription drug premiums and copays for qualifying Clemmons seniors based on income and asset thresholds. Medicare Savings Programs administered through North Carolina Medicaid can help cover Part B premiums and other cost-sharing for residents who meet eligibility criteria. Health Plans of NC agents check eligibility for all available assistance programs at no cost, ensuring Clemmons seniors do not leave valuable benefits unclaimed.
Extra Help (Low Income Subsidy) reduces Part D prescription drug plan costs to near $0 per month for Clemmons, North Carolina residents who meet federal income and asset guidelines.
Medicare Savings Programs through North Carolina Medicaid can cover Part B premiums and reduce out-of-pocket cost-sharing for low-income Medicare beneficiaries in Clemmons.
The Healthy Blue Medicare D-SNP is available in Clemmons for residents who qualify for both Medicare and Medicaid, providing coordinated benefits and reduced cost-sharing through a single integrated plan.
NC Medicaid provides additional coverage for low-income Clemmons residents who do not yet qualify for Medicare, including long-term care and behavioral health services.
Health Plans of NC licensed agents help Clemmons, North Carolina residents apply for Extra Help, Medicare Savings Programs, and D-SNP enrollment at absolutely no cost.
Health Plans of NC licensed agents serve Clemmons, North Carolina residents at absolutely no cost, comparing every available Medicare plan side-by-side to help seniors enroll in the right coverage and make changes during applicable enrollment periods. Call 800-797-0327 today to speak with a local agent who understands Forsyth County providers and can guide you through every step of the Medicare enrollment process.
Call 800-797-0327 (toll free) or 704-303-8256 to speak with a licensed Medicare agent and schedule a free appointment
Email [email protected] with questions about Medicare plans available in Clemmons, North Carolina
Find a licensed agent and book directly at healthplansofnc.com/agents
No cost, no pressure. Walk-ins by appointment only, phone and email welcome anytime.
Enrolled in Part A and Part B? Get more with Blue Medicare Supplement Original Medicare only covers some of your medical costs. That’s why Blue Cross and Blue Shield of North Carolina (Blue Cross NC) offers reliable Medicare Supplement plans to help lessen the worries over what Medicare doesn’t cover.
• Coverage for the costs not covered by Original Medicare (Parts A and B) • The freedom to see any Medicare-participating provider nationwide that accepts Medicare • Rates as low as $31.50 per month1 • Flexibility to change plans • Fitness benefit and hearing benefit on all five plans
With some insurers, you can get locked into a plan that may not be right for you. But thanks to our exclusive Blue-to-Blue program, if your needs change over time, Blue Cross NC gives you the flexibility to switch Medicare plans:2 • Without additional medical exams • Without underwriting or additional health questions • Without any hassle
You cannot be turned down for Blue Medicare Supplement, and may not have to complete a medical questionnaire, if you meet all of the following criteria: • You are age 65 or older, or under age 65 and are eligible for Medicare due to disability3 • You enroll within six months of enrolling in Medicare Part B • You are not covered by certain Medicaid programs • You are a resident of North Carolina
If you enroll early, you may be eligible for a Medicare Supplement plan without waiting periods for pre-existing conditions. If you wait until after your deadline to enroll, you may have a waiting period for pre-existing conditions.
Fitness memberships at in-network facilities using the designated provider. Unlimited access to the vendor’s online platform. SilverSneakers is more than a traditional fitness program. It’s a way to improve your health and live the life you want.
In the gym:
• Thousands of participating locations4 nationwide with various amenities • Ability to enroll at multiple locations at any time • SilverSneakers classes5 designed for all levels and abilities
At home or on the go: • SilverSneakers LIVE online classes and workshops led by specially trained instructors, 7 days a week • SilverSneakers On-Demand videos available 24/7 • SilverSneakers GO mobile app with personalized program resources, adjustable workout plans, and more
In your community: • Group activities and classes5 offered outside the gym
Always talk with your doctor before starting an exercise program.
TruHearing covers one hearing aid per ear per year for a low copay of $499 for Standard hearing aids, $699 for Advanced hearing aids or $999 for Premium hearing aids. Also, as part of the program, a TruHearing provider will help you choose the best hearing aid for your lifestyle and unique hearing needs.
Blue Cross NC is more than a health insurance company. We’re North Carolinians serving North Carolinians. For over 90 years, we’ve been in your community, giving back and listening to how we can provide access to the quality care you deserve.
• Compare plan benefits • Get a free rate quote
Notes: • For costs and further details of the coverage, including exclusions, any reductions or limitations, and terms under which the policy may be continued in force, contact your agent or the company. • Plan A: BMS A, 1/26; Plan G: BMS G, 1/26; Plan G-HD: BMS HDG, 1/26;Plan K: BMS K, 1/26; Plan N: BMS N, 1/26. • Agent/Agency is an independent authorized Agent/Agency licensed to sell and promote products from Blue Cross NC. The content contained in this site is maintained by Agent/Agency. • Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. • Policy benefits are limited to those approved by Medicare for payment.
Disclaimers: • Blue Cross NC contracts with independent companies to provide supplemental benefits. These companies are responsible for the services they provide. They do not provide Blue Cross or Blue Shield products or services. Marks and trade names are property of their respective owners. This fitness program is not an insurance offering. • SilverSneakers is a registered trademark of Tivity Health, Inc. © 2025Tivity Health, Inc. All rights reserved. • TruHearing is a registered trademark of TruHearing, Inc. TruHearing is an independent company and does not offer Blue Cross or Blue Shield products or services. This program may change or be discontinued at any time. This is not an insurance offering.
1 Example for a female non-smoker, age 65. Premium rates can vary based on a number of factors. Contact Blue Cross NC or your Authorized Independent Agent to learn more. 2 Blue-to-Blue is only available when you switch from one Blue Cross NC medical plan (limitations apply) to a Blue Cross NC Medicare plan. You may only switch during designated times of the year. Certain other limits apply. Contact the plan or your Authorized Independent Agent for more information. 3 Guaranteed acceptance for those under age 65 who have Medicare due to disability is limited to Plan A and Plan G. 4 Participating locations (PL) are not owned or operated by Tivity Health, Inc. or its affiliates. Use of PL facilities and amenities is limited to terms and conditions of PL basic membership. Facilities and amenities vary by PL. Inclusion of specific PLs is not guaranteed and PL participation may differ by health plan. 5 Membership includes SilverSneakers instructor-led group
®, SM are marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. All other marks and names are property of their respective owners. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. U4093, 12/25
Clemmons, North Carolina ZIP Codes include: 27012
