SOPHIA ZAPPOLO
Accepted Insurance for NPI 1740158708
Physician Assistant in Wilson, NC
Accepted Insurance & Health Plans Health Insurance Marketplace
Marketplace plan participation on file for this provider · 2026 plan year
SOPHIA ZAPPOLO, a physician assistant provider in Wilson, NC, is listed as in-network for 129 health insurance plans from 3 insurance companies, led by Blue Cross and Blue Shield of NC, Cigna Healthcare and UnitedHealthcare. This list is compiled from the CMS Health Insurance Marketplace public use files for the 2026 plan year.
Blue Cross and Blue Shield of NC
Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors
Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors
Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors
Blue Advantage Bronze Standard | Nationwide Doctors
Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors
Blue Advantage Gold Standard A | Nationwide Doctors
Blue Advantage Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors
Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors
Blue Advantage Silver Standard | Nationwide Doctors
Blue Care Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Statewide Doctors
Blue Care Bronze Complete | $60 PCP | $20 Tier 1 Rx | Statewide Doctors
Blue Care Bronze HSA Eligible | Integrated | Statewide Doctors
Blue Care Bronze Standard | Statewide Doctors
Blue Care Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Statewide Doctors
Blue Care Gold Standard A | Statewide Doctors
Blue Care Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Statewide Doctors
Blue Care Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Statewide Doctors
Blue Care Silver Standard | Statewide Doctors
Blue Home Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | with UNC Health Alliance
Blue Home Bronze Complete | $60 PCP | $20 Tier 1 Rx | with UNC Health Alliance
Blue Home Bronze HSA Eligible | Integrated | with UNC Health Alliance
Blue Home Bronze Standard | with UNC Health Alliance
Blue Home Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | with UNC Health Alliance
Blue Home Gold Standard A | with UNC Health Alliance
Blue Home Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | with UNC Health Alliance
Blue Home Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | with UNC Health Alliance
Blue Home Silver Standard | with UNC Health Alliance
Blue Local Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | with Atrium Health
Blue Local Bronze Complete | $60 PCP | $20 Tier 1 Rx | with Atrium Health
Blue Local Bronze HSA Eligible | Integrated | with Atrium Health
Blue Local Bronze Standard | with Atrium Health
Blue Local Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | with Atrium Health
Blue Local Gold Standard A | with Atrium Health
Blue Local Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | with Atrium Health
Blue Local Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | with Atrium Health
Blue Local Silver Standard | with Atrium Health
Blue Value Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Limited Statewide Doctors
Blue Value Bronze Complete | $60 PCP | $20 Tier 1 Rx | Limited Statewide Doctors
Blue Value Bronze HSA Eligible | Integrated | Limited Statewide Doctors
Blue Value Bronze Standard | Limited Statewide Doctors
Blue Value Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Limited Statewide Doctors
Blue Value Gold Standard A | Limited Statewide Doctors
Blue Value Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Limited Statewide Doctors
Blue Value Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Limited Statewide Doctors
Blue Value Silver Standard | Limited Statewide Doctors
Cigna Healthcare
Connect Bronze 5500 Indiv Med Deductible
Connect Bronze 6500 Indiv Med Deductible
Connect Bronze CMS Standard
Connect Bronze RD 5000 Indiv Med Deductible
Connect Bronze RD 6000 Indiv Med Deductible
Connect Bronze RD CMS Standard
Connect Gold 1500 Indiv Med Deductible
Connect Gold CMS Standard
Connect Gold RD CMS Standard
Connect myDiabetesCare Bronze
Connect myDiabetesCare Silver
Connect Silver 3600 Indiv Med Deductible
Connect Silver 5000 Indiv Med Deductible
Connect Silver CMS Standard
Connect Silver RD 3500 Indiv Med Deductible
Connect Silver RD 5000 Indiv Med Deductible
Connect Silver RD CMS Standard
UnitedHealthcare
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals
UHC Bronze Standard (No Referrals)
UHC Bronze Standard+ Dental + Vision (No Referrals)
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals)
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals)
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
UHC Gold Standard (No Referrals)
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
UHC Silver Standard (No Referrals)
UHC Silver Value ($0 Virtual Urgent Care, No Referrals)
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
Coverage Questions FAQs
Common questions about this provider’s insurance participation, answered from the CMS Health Insurance Marketplace and Medicare enrollment files.
What insurance does SOPHIA ZAPPOLO accept?
Marketplace files for the 2026 plan year list SOPHIA ZAPPOLO as in-network for 129 plans from 3 insurance companies. The largest networks are Blue Cross and Blue Shield of NC (45 plans), Cigna Healthcare (17 plans), UnitedHealthcare (13 plans). The full list above shows each plan's metal level, network type, and plan IDs.
Is SOPHIA ZAPPOLO enrolled in Medicare?
Yes. CMS enrollment files show this provider accepts Medicare assignment, meaning they agree to accept the Medicare-approved amount as full payment for covered services. The provider is also enrolled in PECOS, which certifies them to order, refer, and prescribe for Medicare beneficiaries.
What network types does SOPHIA ZAPPOLO participate in?
The accepted plans include 39 HMO plans, 18 EPO plans, 9 PPO plans and 9 POS plans. HMO (Health Maintenance Organization) plans cover care from network providers and typically require a primary care referral for specialists. EPO (Exclusive Provider Organization) plans cover network providers only, generally without referral requirements. PPO (Preferred Provider Organization) plans cover out-of-network care at a higher cost and do not require referrals. POS (Point of Service) plans combine HMO-style referrals with partial out-of-network coverage.
Where does this insurance data come from and how current is it?
Plan participation is compiled from the official CMS Health Insurance Marketplace public use files for the 2026 plan year and refreshed as CMS publishes updated files. Networks change during the year, so always verify coverage with the insurance company or the provider's office before scheduling care.
