In the beautiful state of North Carolina, there are over 800,000 Medicare beneficiaries on Medicare Advantage plans. Many parts of NC are rural but residents have access to several Medicare Part C options. It works out to about 40% of North Carolinians are enrolled in Advantage programs.

How Medicare Advantage Plans Work in North Carolina

With Medicare, most people choose between two paths. One of those pathways is Medicare Advantage plans. These plans are another way to receive your Medicare Benefits.

They are required to cover the same benefits afforded by Original Medicare and can provide additional benefits not covered by Medicare. In many cases, they also include drug coverage.

They usually have little to no premiums and fixed copays for most services. These network-based plans generally require you to get referrals and select doctors from their network. There are some options that allow you to use non-network providers.

These plans will be different depending on the insurance company you choose and where you live. Most counties in NC have between 26 and 50 Medicare Advantage plan options available for their residents.

Medicare Advantage Plans Offers in North Carolina

Unlike Medicare Supplements, Medicare Advantage plans are not subsidized by the federal government. This means that no two plans are the same. It’s important to work with a broker that specializes in Medicare to ensure you find the plan that’s best for you.

Even though they are not standardized, they are regulated by the Centers for Medicare and Medicaid Services.

We’ll discuss a variety of details about Medicare Advantage plans below. First, we’ll go over plans with a zero-dollar premium, then we’ll talk about which options don’t have a deductible.

Next, we’ll cover plans that have 5-star ratings and Part B givebacks. Finally, we’ll discuss some of the additional benefits and how to enroll in a Medicare plan in North Carolina.

Medicare Advantage Plans with a Zero Dollar Premium in North Carolina

Zero-dollar premium plans are one of the most attractive features of Medicare Advantage plans. Many Medicare beneficiaries like to have the option to not pay for the coverage unless they use it. Remember that all things are give and take. If you have a plan with no monthly premium, your copays could be a little higher.

Wellcare has very strong plans this year. They have steadily increased their market share in the Medicare Advantage space. Recently becoming part of Centene healthcare, they are making large strides in strengthening their offerings.

Blue Cross and Blue Shield are one of the most familiar and trusted names in health insurance. In North Carolina, this is no exception. BCBS of NC has a 4-star plan with a zero-dollar premium.

Humana rounds up the top three on our chart. With the lowest maximum-out-of-pocket and a 4-star rating, it’s a solid option. They have been a staple in the Medicare Advantage market for quite a while.

PLAN PREMIUM MOOP PLAN TYPE STAR RATINGS
Wellcare $0 $5,550 LOCAL PPO 3
BCBS of North Carolina $0 $4,900 HMO 4
Humana $0 $4,200 HMO 4
Unitedhealthcare $0 $6,700 LOCAL PPO 3
Aetna $0 $4,500 LOCAL PPO 4

Medicare Advantage Plans with a Zero Dollar Drug Deductible in North Carolina

Medicare Advantage plans could potentially contain a deductible for medicare and drug services.

Humana’s HMO is a great example of a zero-premium, zero-deductible 4-star plan. As mentioned above, their maximum out-of-pocket is less than many of the other options.

Aetna has been a strong player in the Medicare space as well. They are now owned by CVS giving them even more tools and strength to keep their plans on top.

Troy is a small localized Medicare Advantage company in North Carolina. They are fairly new so they have not been assigned a star rating. They are an up-and-coming company to keep an eye on.

PLAN PREMIUM MOOP PLAN TYPE STAR RATINGS
Humana $0 $4,200 HMO 4
Aetna $0 $4,500 LOCAL PPO 4
Troy $0 $5,000 HMO N/A
UnitedHealthcare $27.00 $3,600 HMOPOS 5
BCBS of North Carolina $34.00 $4,500 HMO 4

Medicare Advantage Plans with a 5-Star Rating in North Carolina

A 5-star rating is hard to come by, and insurers that reach that mark excel in taking care of their clients. When a 5-star plan is available in your area you can enroll in that plan outside of normal enrollment periods. As you can see only Unitedhealthcare has a 5-star rated plan in NC.

PLAN PREMIUM MOOP PLAN TYPE STAR RATINGS
UnitedHealthcare $0 $4,500 HMOPOS 5

Medicare Advantage Plans with a Part B Reduction in North Carolina

Part B giveback plans are among some of the most popular Medicare Advantage options. They work a little differently than they sound. Essentially if you enroll in a giveback plan, you’ll have less deducted from your social security check for Medicare Part B monthly.

The amount of the reduction varies from plan to plan for the companies that offer them. They aren’t available in all areas so it’s best to speak with a licensed broker to see what’s in your area.

PLAN PREMIUM MOOP PART B REDUCTION STAR RATINGS
Wellcare $0 $7,550 $75.00 3
Humana $0 $7,550 $50.00 4
BCBS of North Carolina $0 $7,550 $67.00 4
UnitedHealthcare $0 $3,600 $50.00 5
Aetna $0 $6,500 $30.00 4

Ancillary/DVH

As mentioned above many Medicare Advantage plans include additional benefits not covered by Medicare. Since Medicare doesn’t cover these items, a Medicare Supplement won’t either.

Many Part C plans include dental, vision, and hearing benefits. In addition, most have other benefits like over-the-counter allowances and gym memberships.

North Carolina Cities with Estimated Premiums for Medigap Coverage

Charts exist that have estimated premiums for Medicare Supplement coverage for the following cities:

FAQs

Is Medicare Advantage available in North Carolina?

Yes! Keep in mind that much of NC is rural so some areas have significantly more options than others. Speak with a licensed broker to find out what’s available in your area.

Is Humana Medicare available in North Carolina?

Humana offers many Medicare Advantage plans in North Carolina. Their offerings include HMO and PPO style plans.

How much does Medicare Advantage cost in North Carolina?

There are many Medicare Advantage plans throughout NC. Several areas have zero-dollar Medicare Part C options to choose from. Plans vary depending on where you live and the insurance carrier.

How to Get Help Enrolling in a North Carolina Medicare Advantage Plan

There is quite a bit that goes into choosing the correct plan for your needs. You must consider your prescriptions, healthcare providers, health, and budget. It can be a daunting process. Fear not, we’re here to help.

Our licensed agents specialize in all aspects of Medicare. They can help review your situation, needs, and wants. Once that’s complete, they can provide options based on that criteria. Help is just a phone call away. If now isn’t a good time, fill out our online request form.

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by Lindsay Malzone, Lindsay Malzone is the Medicare expert for Medigap.com. She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.