Open Enrollment

Commercial Insurance

• Aetna (including Aetna Connected)
• Ambetter
• American Health Alliance
• Assurant Health
• Atlantic Integrated Health/Beacon Company
• Beech Street
• Blue Cross Blue Shield - (excluding Blue Home, Blue Local, Blue Value, and Blue High Performance Network (HPN)
• Cigna Health Care (including Cigna Connect, excluding Cigna Surefit)
• Coventry National
• Coventry Preferred PPO
• Duke Select / Duke Basic (For limited services. Contact Cigna Member Services to confirm participation.)
• First Health PPO
• Great-West Healthcare
• MEDCOST
• Multiplan, Inc.
• NC State Employee Health Plan (administered by Aetna, excludes the Clear Pricing Project)
• OneNet PPO
• Primary Physicians Care
• Private Healthcare Systems (PHCS)

 WakeMed and UnitedHealthcare signed a multi-year contract that will restore in-network access beginning October 15, 2026. 

When it Comes to Medicare, Choose WakeMed

At WakeMed, we understand that navigating Medicare can be challenging. That’s why we are pleased to offer our patients a trusted educational resource through Chapter, an independent Medicare advisor.

Chapter’s Medicare Advisors can help you understand your options and choose the Medicare plan that’s right for you. Whether you're turning 65 or already enrolled, it’s important to have high-quality, affordable coverage that meets your health and wellness needs.

Chapter’s team can help you find a plan that:

• Keeps your trusted WakeMed doctors in-network
• Covers your prescriptions
• Works for your care needs and budget

This optional service is available at no cost to you. Make the most of Medicare and ensure you can continue to receive the same care you’ve come to expect from WakeMed.

To learn more, call 919-421-7997 or visit askchapter.org/wakemed.

Medicare 

• Medicare Part A & B

Supplemental Medicare coverage is provided through private insurance companies.

Medicare Advantage 

• AARP Medicare Advantage by UnitedHealthcare HMO, POS, PPO
• Aetna Medicare HMO, POS, PPO
• Alignment Health HMO, POS, PPO
• Blue Medicare HMO, POS, PPO (in-state and out-of-state)
• ExperienceHealth HMO (excludes WakePET services)
• FirstMedicare Direct SmartHMO (Wake County residents only)
• Healthy Blue + Medicare Dual Eligible Special Needs Plan
• Liberty Medicare Advantage HMO
• PruittHealth Premier HMO (North Carolina and South Carolina PruittHealth Premier enrollees only)
• Wellcare Medicare HMO, PPO (North Carolina residents only)

WakeMed is not participating with the following area Medicare Advantage plans: 

• HealthSpring - Previously known as Cigna Medicare HMO
• Humana Medicare HMO
• UnitedHealthcare HMO

For the above plans, many of their employer sponsored PPO retiree group plans have no out of network benefit penalty. Therefore these members can continue to receive services from WakeMed providers at no additional cost. Further, their PPO plans which do have a benefit differential are accepted at WakeMed. Being a licensed Medicare participating health system, WakeMed accepts CMS payment as payment in full, with no balance billing to the patient except for their plan determined copay, deductible, and coinsurance.

WakeMed is a participant in NC Medicaid & NC Health Choice.

WakeMed currently has a contract with the following Medicaid managed care plans in our region:

• Amerihealth Caritas
• Healthy Blue
• Carolina Complete Health
• UnitedHealthcare Community Plan
• WellCare Health Plans, Inc.

Medicaid Tailored Plans

North Carolina launched the Behavioral Health and Intellectual/Developmental Disabilities Tailored Plan on July 1, 2024. Tailored Plans cover specific Medicaid enrollees who are currently members of NC Medicaid Direct.

• Alliance Health Tailored Plan (includes limited contract for all hospitals, including WakeBrook Hospital, and specialty physicians for defined services)

Other Medicaid Plans

North Carolina launched the Children’s and Families Specialty Plan (CFSP) on December 1, 2025. CFSP covers NC foster children and their adult caregivers who were formerly members of NC Medicaid Direct. Certain WakeMed providers are participating.

• Healthy Blue Care Together Children’s and Families Specialty Plan (CFSP) exclusively administers the NCDHHS/DHB CFSP.