Live Worry-Free. Find the Right Medicare Plan in NC. in Wilson County
North Carolina
in North Carolina
Wilson County, NC residents have access to 8 Medicare plans for 2026 through Blue Cross NC, and Health Plans of NC agents are available at no cost to help local beneficiaries compare every option and find coverage that works with providers at UNC Health Wilson and ECU Health.
Wilson County is home to approximately 15,000 Medicare-eligible residents, representing 19.0% of the county's total population of 78,648, and those residents have access to a full range of Medicare coverage types for 2026. Local health systems including UNC Health Wilson and ECU Health, along with facilities such as Wilson Medical Center at 1705 Tarboro St SW, ECU Health Family Medicine, and Eastern Carolina Pathology, accept Medicare and participate in local carrier networks. Coverage options span Medicare Advantage HMO, HMO-POS, and PPO plans, a standalone Part D prescription drug plan, a Dual Special Needs Plan for those on both Medicare and Medicaid, and Medicare Supplement policies that allow access to any Medicare-accepting provider nationwide.
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 Enhanced | HMO-POS | $47.00/month |
Blue Medicare PPO Enhanced | PPO | $53.00/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 Wilson County provide coordinated care through a defined local network that includes ECU Health Family Medicine and affiliated providers.
Medicare Advantage HMO-POS plans offer in-network access to Wilson Medical Center and local specialists, with limited flexibility to seek care outside the network when needed.
Medicare Advantage PPO plans allow Wilson County beneficiaries to visit both in-network providers such as Wilson Medical Center and out-of-network facilities at a higher cost-sharing level.
Medicare Supplement (Medigap) plans allow Wilson County residents to see any provider that accepts Medicare nationwide, including regional hospitals in Rocky Mount, Smithfield, and Raleigh.
Part D Prescription Drug Plans are available as standalone coverage that can be paired with Original Medicare or a Medicare Supplement policy used at local Wilson County pharmacies.
Dual Special Needs Plans (D-SNP) are available in Wilson County for residents who qualify for both Medicare and Medicaid, providing coordinated benefits through local health system networks.
Blue Cross NC offers eight Medicare plans in Wilson County for 2026, covering HMO, HMO-POS, PPO, Part D, and D-SNP plan types, with several plans carrying a $0 monthly premium beyond the required Part B amount. Each plan connects beneficiaries to local providers including Wilson Medical Center, ECU Health Family Medicine, Eastern Carolina Pathology, and Synchrony Energetics, as well as regional facilities in Rocky Mount and the greater Raleigh area depending on plan structure. Beneficiaries should confirm that their specific providers participate in the network of the plan they select before enrolling.
Blue Medicare Medical Only, HMO-POS, $0.00 per month, provides access to local Wilson County Medicare-accepting providers within the Blue Cross NC HMO-POS network.
Blue Medicare Essential, HMO, $0.00 per month, coordinates care through a defined HMO network that includes ECU Health Family Medicine and Wilson Medical Center.
Blue Medicare Essential Plus, HMO-POS, $0.00 per month, offers HMO-POS flexibility allowing some out-of-network access while keeping local Wilson County providers in-network.
Blue Medicare Enhanced, HMO-POS, $47.00 per month, provides an enhanced benefit tier with HMO-POS network access to Wilson County providers including Wilson Medical Center.
Blue Medicare PPO Enhanced, PPO, $53.00 per month, gives Wilson County beneficiaries the broadest network flexibility including out-of-network access to regional hospitals in Rocky Mount and Raleigh.
Blue Medicare Freedom+, HMO-POS, $0.00 per month, combines a $0 premium structure with HMO-POS network access to local Wilson County health system providers.
Healthy Blue Medicare DSNP, HMO-POS, $0.00 per month, is a Dual Special Needs Plan designed for Wilson County residents enrolled in both Medicare and Medicaid.
Blue Medicare Rx Enhanced PDP, standalone Part D plan, $163.20 per month, provides prescription drug coverage that can be paired with Original Medicare or a Medigap policy used at Wilson County pharmacies.
Wilson County's Medicare Advantage plans for 2026 range from $0.00 per month for plans such as Blue Medicare Medical Only, Blue Medicare Essential, Blue Medicare Essential Plus, Blue Medicare Freedom+, and Healthy Blue Medicare DSNP, to $47.00 per month for Blue Medicare Enhanced and $53.00 per month for Blue Medicare PPO Enhanced, giving beneficiaries meaningful premium flexibility. The standalone Blue Medicare Rx Enhanced PDP carries a monthly premium of $163.20 and is designed for those who prefer Original Medicare or a Medigap policy rather than a bundled Advantage plan. Wilson County's median household income of $51,381 means that even modest monthly premium differences can have a real impact on household budgets, and many residents may qualify for programs that reduce or eliminate those costs entirely.
Part A: $0 premium for most Wilson County 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.
Blue Cross NC is the Medicare carrier serving Wilson County for 2026, offering a total of 8 plans across multiple plan types to meet the diverse needs of local beneficiaries. Those plan types include Medicare Advantage HMO, HMO-POS, and PPO structures, a standalone Part D prescription drug plan, and a Dual Special Needs Plan for dual-eligible residents. Blue Cross NC's carrier network connects directly to Wilson County facilities including Wilson Medical Center, ECU Health Family Medicine, Eastern Carolina Pathology, and Synchrony Energetics, meaning the plan a beneficiary selects will determine which local providers they can access at the lowest cost-sharing levels. The plan type chosen also affects access to specialists and facilities in nearby markets, including Nash General Hospital in Rocky Mount, UNC Health Johnston in Smithfield, and Raleigh-area providers such as WakeMed, Rex Hospital, and Duke Raleigh Hospital. Health Plans of NC agents compare every Blue Cross NC Medicare plan available in Wilson County side-by-side at no cost, helping beneficiaries identify which plan structure best aligns with their existing provider relationships.
Blue Cross NC, offers Medicare Advantage HMO, HMO-POS, PPO, Part D PDP, and D-SNP plan types, with a total of 8 plans available in Wilson County for 2026.
Wilson County's uninsured rate of 12.8% and poverty rate of 21.0% reflect the financial pressures many local residents face, and a significant share of Medicare beneficiaries may qualify for programs that substantially reduce their out-of-pocket Medicare costs. Extra Help, also known as the Low Income Subsidy, is a federal program that can reduce Part D prescription drug costs to near $0 for eligible Wilson County residents who meet income and resource limits. Medicare Savings Programs can cover the Part B premium entirely for qualifying beneficiaries, and residents who are enrolled in both Medicare and Medicaid may be eligible for the Healthy Blue Medicare DSNP, a Dual Special Needs Plan that coordinates both benefits in a single plan. Health Plans of NC agents check eligibility for all available assistance programs at no cost to Wilson County residents, ensuring that no beneficiary pays more than necessary.
Extra Help (Low Income Subsidy) can reduce Part D prescription drug costs to near $0 for eligible Wilson County residents who meet federal income and resource thresholds.
Medicare Savings Programs may cover the Part B monthly premium entirely for qualifying Wilson County beneficiaries with limited income and assets.
The Healthy Blue Medicare DSNP is available for Wilson County residents enrolled in both Medicare and Medicaid, providing coordinated coverage through a single $0-premium plan.
NC Medicaid may provide additional health coverage assistance for low-income Wilson County residents who do not yet qualify for Medicare or need supplemental support.
Health Plans of NC agents check eligibility for Extra Help, Medicare Savings Programs, and D-SNP enrollment at no cost to Wilson County residents during any enrollment period.
Health Plans of NC licensed agents serve Wilson County residents at no cost, comparing every available Medicare Advantage, Medicare Supplement, and Part D plan side-by-side to help you find the right coverage for your health needs, your preferred local providers, and your budget. Call 800-797-0327 today to speak with a local agent, get a free personalized plan comparison, or get help enrolling or making changes to your Medicare coverage.
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 Wilson County
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.
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 |
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
Wilson County ZIP Codes include: 27813, 27822, 27851, 27873, 27880, 27883, 27893, 27894, 27895, and 27896
