ACA plans available
64
Plan year
2026 data Public-data reference. official source
Wilkes, North Carolina Health Insurance
Open-data reference.
64 ACA plans from 4 issuers — Plan year 2026
Wilkes, North Carolina offers 64 ACA marketplace plans from 4 issuers for plan year 2026. Bronze plans start at $457/mo and Silver plans start at $553/mo (age 27, before subsidies). Use the tables below to compare premiums, deductibles, and issuers across all metal tiers.
$615
Avg Silver Premium/mo
$555
Benchmark Premium/mo
+23.9%
Year-over-Year Change
$5,031
Avg Deductible
What the Numbers Say About Wilkes
Wilkes, North Carolina has 64 ACA marketplace plans offered by 4 issuers for plan year 2026. The average Silver-tier premium comes in at $615/mo for a 27-year-old non-tobacco user, with the lowest Silver at $553 and the highest at $714. Bronze plans start at $457/mo — useful for healthy enrollees who want catastrophic protection with the lowest monthly outlay.
The benchmark (second-lowest Silver) premium is $555/mo, the figure the IRS uses to calculate your Advance Premium Tax Credit. Enrollees whose expected income-based contribution falls below this amount receive a subsidy for the difference. Across all plans, the average annual deductible is $5,031 and the average out-of-pocket maximum is $9,568 — numbers that matter more than the sticker premium once you actually use care. Year-over-year, average premiums in Wilkes shifted by +23.9%, a signal of how local issuer pricing and risk-pool dynamics are trending.
Issuer count is one of the strongest predictors of affordability: with 4 issuers active in Wilkes, consumers have meaningful competition to pressure premiums lower. This page is informational only and is not insurance, medical, or tax advice — verify your eligibility, network coverage, and final pricing at HealthCare.gov before enrolling. Source: CMS Marketplace PUF, plan year 2026.
Premiums by Metal Level
Bronze
1 plan$457/mo avg
$457 — $457
Silver
24 plans$615/mo avg
$553 — $714
Gold
13 plans$642/mo avg
$574 — $732
Benchmark Premium & Subsidies
The benchmark premium (2nd-lowest Silver plan) in Wilkes is $555/mo for a 27-year-old. This is the amount used to calculate your premium tax credit. If your expected contribution (based on income) is less than the benchmark, you receive a subsidy for the difference. The higher the benchmark, the larger the potential subsidy.
Issuers in market
4
Competitive market
Benchmark Silver
$555 /mo
Sets your subsidy ceiling
Avg deductible
$5,031
Across all metal tiers
Wilkes ACA plans by premium and deductible
Each marker is the Wilkes average for one metal tier (and the local Bronze low / Silver high extremes where data is available). The dashed line marks the federal out-of-pocket-maximum ceiling.
Source: CMS Marketplace PUF for Wilkes, plan year 2026. Bronze = catastrophic-only zone (high deductible). Gold/Platinum = premium-heavy zone (low deductible).
Issuers in Wilkes
| Issuer | Plans | Avg Premium (Age 27) |
|---|---|---|
| Blue Cross and Blue Shield of NC | 27 | $591/mo |
| Ambetter of North Carolina | 15 | $533/mo |
| Oscar Health Plan of North Carolina, Inc | 14 | $560/mo |
| AmeriHealth Caritas Next | 8 | $559/mo |
All Plans in Wilkes
| Plan Name | Metal | Type | Premium (27) | Premium (40) | Deductible | OOP Max |
|---|---|---|---|---|---|---|
| AmeriHealth Caritas Next Bronze Essential + No Referrals AmeriHealth Caritas Next | Bronze | HMO | $457.15 | $557.48 | $10,600 | $10,600 |
| Blue Local Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | with Atrium Health Blue Cross and Blue Shield of NC | Expanded Bronze | EPO | $421.87 | $514.46 | $7,000 | $10,600 |
| Everyday Bronze Ambetter of North Carolina | Expanded Bronze | HMO | $432.13 | $526.97 | $8,450 | $10,150 |
| Standard Expanded Bronze Ambetter of North Carolina | Expanded Bronze | HMO | $433.81 | $529.01 | $7,500 | $10,000 |
| Blue Local Bronze Standard | with Atrium Health Blue Cross and Blue Shield of NC | Expanded Bronze | EPO | $438.93 | $535.26 | $7,500 | $10,000 |
| Blue Local Bronze Complete | $60 PCP | $20 Tier 1 Rx | with Atrium Health Blue Cross and Blue Shield of NC | Expanded Bronze | EPO | $444.78 | $542.40 | $4,000 | $10,600 |
| Everyday Bronze + Vision + Adult Dental Ambetter of North Carolina | Expanded Bronze | HMO | $446.67 | $544.70 | $8,450 | $10,150 |
| Standard Expanded Bronze + Vision + Adult Dental Ambetter of North Carolina | Expanded Bronze | HMO | $448.40 | $546.81 | $7,500 | $10,000 |
| Blue Local Bronze HSA Eligible | Integrated | with Atrium Health Blue Cross and Blue Shield of NC | Expanded Bronze | EPO | $456.20 | $556.33 | $8,500 | $8,500 |
| AmeriHealth Caritas Next Bronze Signature + No Referrals AmeriHealth Caritas Next | Expanded Bronze | HMO | $462.29 | $563.75 | $7,500 | $10,000 |
| Bronze Classic Standard | with Atrium Health Oscar Health Plan of North Carolina, Inc | Expanded Bronze | HMO | $468.15 | $570.89 | $7,500 | $10,000 |
| AmeriHealth Caritas Next Bronze Premier + No Referrals AmeriHealth Caritas Next | Expanded Bronze | HMO | $472.32 | $575.98 | $3,850 | $10,600 |
| Bronze Simple Diabetes | with Atrium Health Oscar Health Plan of North Carolina, Inc | Expanded Bronze | HMO | $477.51 | $582.31 | $5,500 | $10,150 |
| Bronze Classic 4700 | with Atrium Health Oscar Health Plan of North Carolina, Inc | Expanded Bronze | HMO | $479.00 | $584.12 | $4,700 | $9,600 |
| Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Oscar Health Plan of North Carolina, Inc | Expanded Bronze | HMO | $480.32 | $585.73 | $5,500 | $10,150 |
| Bronze Simple Chronic Care CKM | with Atrium Health Oscar Health Plan of North Carolina, Inc | Expanded Bronze | HMO | $487.56 | $594.56 | $5,500 | $10,150 |
| Elite Bronze Ambetter of North Carolina | Expanded Bronze | HMO | $491.00 | $598.76 | $0 | $10,500 |
| Elite Bronze + Vision + Adult Dental Ambetter of North Carolina | Expanded Bronze | HMO | $507.52 | $618.90 | $0 | $10,500 |
| Blue Care Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Statewide Doctors Blue Cross and Blue Shield of NC | Expanded Bronze | HMO | $511.43 | $623.68 | $7,000 | $10,600 |
| Bronze Elite + PCP Saver Plus | with Atrium Health Oscar Health Plan of North Carolina, Inc | Expanded Bronze | HMO | $521.81 | $636.33 | $0 | $10,600 |
| Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors Blue Cross and Blue Shield of NC | Expanded Bronze | PPO | $527.19 | $642.89 | $7,000 | $10,600 |
| Blue Care Bronze Standard | Statewide Doctors Blue Cross and Blue Shield of NC | Expanded Bronze | HMO | $533.27 | $650.31 | $7,500 | $10,000 |
| Blue Care Bronze Complete | $60 PCP | $20 Tier 1 Rx | Statewide Doctors Blue Cross and Blue Shield of NC | Expanded Bronze | HMO | $539.44 | $657.82 | $4,000 | $10,600 |
| Blue Advantage Bronze Standard | Nationwide Doctors Blue Cross and Blue Shield of NC | Expanded Bronze | PPO | $548.22 | $668.53 | $7,500 | $10,000 |
| Blue Care Bronze HSA Eligible | Integrated | Statewide Doctors Blue Cross and Blue Shield of NC | Expanded Bronze | HMO | $552.96 | $674.31 | $8,500 | $8,500 |
| Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors Blue Cross and Blue Shield of NC | Expanded Bronze | PPO | $555.93 | $677.94 | $4,000 | $10,600 |
| Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors Blue Cross and Blue Shield of NC | Expanded Bronze | PPO | $569.90 | $694.98 | $8,500 | $8,500 |
| Blue Local Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | with Atrium Health Blue Cross and Blue Shield of NC | Silver | EPO | $553.05 | $674.43 | $2,800 | $10,600 |
| Clear Silver with $0 Insulin Options Ambetter of North Carolina | Silver | HMO | $555.39 | $677.28 | $7,000 | $7,000 |
| Standard Silver Ambetter of North Carolina | Silver | HMO | $555.56 | $677.49 | $6,000 | $8,900 |
| Blue Local Silver Standard | with Atrium Health Blue Cross and Blue Shield of NC | Silver | EPO | $559.17 | $681.89 | $6,000 | $8,900 |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options Ambetter of North Carolina | Silver | HMO | $570.07 | $695.18 | $5,900 | $8,150 |
| Blue Local Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | with Atrium Health Blue Cross and Blue Shield of NC | Silver | EPO | $571.59 | $697.03 | $3,000 | $10,600 |
| Standard Silver + Vision + Adult Dental Ambetter of North Carolina | Silver | HMO | $574.25 | $700.28 | $6,000 | $8,900 |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Ambetter of North Carolina | Silver | HMO | $589.25 | $718.57 | $5,900 | $8,150 |
| Silver Simple PCP Saver | with Atrium Health Oscar Health Plan of North Carolina, Inc | Silver | HMO | $599.38 | $730.92 | $5,500 | $9,900 |
| AmeriHealth Caritas Next Silver Essential + No Referrals AmeriHealth Caritas Next | Silver | HMO | $599.48 | $731.04 | $6,100 | $9,000 |
| AmeriHealth Caritas Next Silver Signature + No Referrals AmeriHealth Caritas Next | Silver | HMO | $604.62 | $737.31 | $6,000 | $8,900 |
| Silver Classic Standard | with Atrium Health Oscar Health Plan of North Carolina, Inc | Silver | HMO | $607.42 | $740.72 | $6,000 | $8,900 |
| Silver Simple Diabetes | with Atrium Health Oscar Health Plan of North Carolina, Inc | Silver | HMO | $608.30 | $741.80 | $6,500 | $10,000 |
| Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Oscar Health Plan of North Carolina, Inc | Silver | HMO | $610.80 | $744.85 | $6,200 | $9,600 |
| Silver Simple Chronic Care CKM | with Atrium Health Oscar Health Plan of North Carolina, Inc | Silver | HMO | $612.13 | $746.47 | $5,900 | $10,150 |
| Silver Simple Women's Health with Menopause Benefits | with Atrium Health Oscar Health Plan of North Carolina, Inc | Silver | HMO | $613.10 | $747.66 | $6,000 | $10,150 |
| Silver Classic | with Atrium Health Oscar Health Plan of North Carolina, Inc | Silver | HMO | $615.44 | $750.50 | $5,400 | $9,200 |
| AmeriHealth Caritas Next Silver Premier + No Referrals AmeriHealth Caritas Next | Silver | HMO | $617.31 | $752.78 | $400 | $10,200 |
| Blue Care Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Statewide Doctors Blue Cross and Blue Shield of NC | Silver | HMO | $670.24 | $817.33 | $2,800 | $10,600 |
| Blue Care Silver Standard | Statewide Doctors Blue Cross and Blue Shield of NC | Silver | HMO | $679.28 | $828.36 | $6,000 | $8,900 |
| Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors Blue Cross and Blue Shield of NC | Silver | PPO | $690.84 | $842.46 | $2,800 | $10,600 |
| Blue Care Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Statewide Doctors Blue Cross and Blue Shield of NC | Silver | HMO | $692.87 | $844.94 | $3,000 | $10,600 |
| Blue Advantage Silver Standard | Nationwide Doctors Blue Cross and Blue Shield of NC | Silver | PPO | $698.31 | $851.57 | $6,000 | $8,900 |
| Blue Advantage Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors Blue Cross and Blue Shield of NC | Silver | PPO | $714.15 | $870.88 | $3,000 | $10,600 |
| Standard Gold Ambetter of North Carolina | Gold | HMO | $574.32 | $700.37 | $2,000 | $8,200 |
| Blue Local Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | with Atrium Health Blue Cross and Blue Shield of NC | Gold | EPO | $580.26 | $707.60 | $1,800 | $10,600 |
| Blue Local Gold Standard A | with Atrium Health Blue Cross and Blue Shield of NC | Gold | EPO | $586.17 | $714.81 | $2,000 | $8,200 |
| Standard Gold + Vision + Adult Dental Ambetter of North Carolina | Gold | HMO | $593.65 | $723.93 | $2,000 | $8,200 |
| Complete Gold Ambetter of North Carolina | Gold | HMO | $600.41 | $732.18 | $1,450 | $7,500 |
| AmeriHealth Caritas Next Gold Signature + No Referrals AmeriHealth Caritas Next | Gold | HMO | $618.97 | $754.81 | $2,000 | $8,200 |
| Complete Gold + Vision + Adult Dental Ambetter of North Carolina | Gold | HMO | $620.61 | $756.82 | $1,450 | $7,500 |
| AmeriHealth Caritas Next Gold Premier + No Referrals AmeriHealth Caritas Next | Gold | HMO | $642.93 | $784.03 | $850 | $8,500 |
| Gold Classic Standard | with Atrium Health Oscar Health Plan of North Carolina, Inc | Gold | HMO | $654.00 | $797.53 | $2,000 | $8,200 |
| Blue Care Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Statewide Doctors Blue Cross and Blue Shield of NC | Gold | HMO | $703.35 | $857.72 | $1,800 | $10,600 |
| Blue Care Gold Standard A | Statewide Doctors Blue Cross and Blue Shield of NC | Gold | HMO | $712.16 | $868.45 | $2,000 | $8,200 |
| Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors Blue Cross and Blue Shield of NC | Gold | PPO | $724.95 | $884.06 | $1,800 | $10,600 |
| Blue Advantage Gold Standard A | Nationwide Doctors Blue Cross and Blue Shield of NC | Gold | PPO | $732.17 | $892.86 | $2,000 | $8,200 |
Silver Premium Trend (2022-2026)
| Year | Avg Premium | Min | Max | Plans | Issuers |
|---|---|---|---|---|---|
| 2022 | $467/mo | $373 | $794 | 31 | 6 |
| 2023 | $479/mo | $381 | $774 | 29 | 5 |
| 2024 | $485/mo | $388 | $830 | 26 | 5 |
| 2025 | $514/mo | $395 | $926 | 34 | 7 |
| 2026 | $615/mo | $553 | $714 | 24 | 4 |
Health Insurance Guides
Choosing a Metal Level
Bronze vs Silver vs Gold vs Platinum — which tier fits your needs and budget
Understanding ACA Subsidies
How premium tax credits work and how to estimate your subsidy amount
Related Health & Cost Data
Find Doctors
PlainDoctor — Healthcare providers in North Carolina
Hospital Quality Ratings
PlainHospital — CMS star ratings and safety scores
Medicare Plans
PlainMedicare — Medicare Advantage and Part D data
Community Health Data
PlainHealth — CDC community health indicators
Health Access Metrics
PlainHealthAccess — Uninsured rates and provider shortages
Cost of Living
PlainCost — BEA regional price parities
Homeowners Insurance
PlainInsure — Treasury FIO premiums
Frequently Asked Questions
How many ACA plans are available in Wilkes, NC?
There are 64 ACA marketplace plans available in Wilkes from 4 insurance issuers for plan year 2026.
What is the cheapest health insurance plan in Wilkes?
The lowest-premium plan in Wilkes starts at $457/mo (Bronze tier, age 27). Silver plans start at $553/mo. Actual premiums vary by age and may be reduced by premium tax credits.
What is the benchmark premium for Wilkes?
The benchmark (second-lowest Silver) premium in Wilkes is $555/mo for a 27-year-old. This amount determines how much premium tax credit subsidy you may be eligible for.
How have premiums changed in Wilkes?
Average premiums in Wilkes changed by +23.9% year-over-year. Premium trends are tracked from 2022 to 2026 across all metal levels.
What is the average deductible and out-of-pocket maximum in Wilkes?
The average annual deductible across all plans in Wilkes is $5,031, and the average out-of-pocket maximum is $9,568. Bronze plans generally have higher deductibles but lower premiums, while Gold and Platinum plans have lower deductibles but higher monthly costs.
Which insurance companies offer plans in Wilkes?
There are 4 insurance issuers offering ACA marketplace plans in Wilkes, including Blue Cross and Blue Shield of NC, Ambetter of North Carolina, Oscar Health Plan of North Carolina, Inc, and others. Competition among issuers affects plan variety and pricing. More issuers generally mean more choices and potentially lower premiums.
Disclaimer: This page is for informational purposes only and does not constitute insurance or financial advice. Premiums shown are for a 27-year-old non-tobacco user unless otherwise noted. Your actual premium depends on age, location, tobacco use, and subsidy eligibility. Visit HealthCare.gov for official enrollment. Source: CMS Marketplace PUF, PY2026.
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- U.S. Census Bureau ACS — demographic + housing + income data. census.gov/programs-surveys/acs
- BLS Occupational Employment and Wage Statistics (OEWS) — wage + employment by occupation. bls.gov/oes
- BEA Regional Economic Accounts — GDP + personal income by state/metro. bea.gov/data/regional
- U.S. Census Bureau County Business Patterns — establishment + employment by industry. census.gov/cbp
- IRS Statistics of Income (SOI) — tax-return aggregate data. irs.gov/statistics
- data.gov — U.S. federal open-data portal — discovery layer for additional federal sources. data.gov
Related
Data sourced from official U.S. government datasets. See our methodology for details. Retrieved and formatted by PlainHealthPlan Editorial
