There are 282,315 beneficiaries enrolled in Medicare plans in Durham, North Carolina. 169,793 are enrolled in Fee-for-Service Medicare, and 112,522 are enrolled in Medicare Advantage. To learn more about the Medicare plans available to residents in Durham, North Carolina, keep reading.

Supplemental Medicare Plans in Durham, North Carolina

If you’re living in Durham, you can take advantage of Medicare plans in North Carolina available to you. These plans can help you cover medical costs to give you more financial freedom. Supplemental Medicare plans can help you cover even more costs that Medicare alone won’t.

We’re covering the costs of the various plans available to you, but keep in mind: The quotes below are based on a female that is 70 years old.

Average Medicare Advantage Plans in Durham, North Carolina

In Durham, North Carolina, most enrollees are 65-year-old females, coming in at 55.08%, versus 44.92% of males. Medicare Advantage plans in Durham, North Carolina have a 39.86% participation rate. There are 35 Medicare Advantage plans available in Durham.

The average Medicare Advantage plans in North Carolina have either a three or four-star rating out of five. All of them have a $0 premium.

The most affordable option is Cigna (HMO) with a maximum out-of-pocket (MOOP) of $4,600. This plan has a four out of five-star rating, making it an excellent option to choose. It is a health maintenance organization (HMO)

The two next most affordable option is Blue Cross Blue Shield (BCBS) of North Carolina (HMO) with a MOOP of $5,900. This plan has a four out of five-star rating as well.

The next most affordable option is Wellcare (HMO) with a MOOP of $6,000. Wellcare’s Medical Advantage plan has a three out of five-star rating.

PLAN PREMIUM MOOP Plan Type Star Rating
BCBS of North Carolina $0 $5,900 HMO 4
Humana $0 $7,550 LOCAL PPO 4
Wellcare $0 $6,000 HMO 3
Cigna $0 $4,600 HMO 4
UnitedHealthcare $0 $6,700 LOCAL PPO 3

If you’re having trouble picking the best Medicare Advantage plan for you, check out the top 5 Medicare Advantage plans.

Average Medicare Supplement Plans in Durham, North Carolina

North Carolina Medigap is meant to provide you with supplemental coverage. All Medigap plans are standardized federally, so the benefits do not change from state to state. However, the monthly premiums do differ by state.

In Durham, North Carolina, the average Medigap plans vary greatly. The most affordable option is Plan HDG with the lowest premium being $34.58 and the highest premium being $74.96.

On the opposite end of the spectrum, the most expensive plan available is Plan F, with the lowest premium being $119.62 and the highest premium being $370.58.

Right in the middle, we have Plan M, with the lowest premium being $77.82 and the highest premium being $289.66.

LETTER PLAN LOWEST PREMIUM HIGHEST PREMIUM
PLAN A $96.54 $417.35
PLAN B $119.62 $329.92
PLAN C $123.52 $360.42
PLAN D $115.83 $321.67
PLAN F $119.62 $370.58
PLAN HDF $36.02 $78.31
PLAN G $97.52 $322.05
PLAN HDG $34.58 $74.96
PLAN K $49.58 $120.00
PLAN L $62.50 $246.01
PLAN M $77.82 $289.66
PLAN N $79.60 $304.57

If you’re struggling to choose the right Medigap plan, check out the top three Medigap plans.

Average Medicare Part D in Durham, North Carolina

Medigap plans do not cover prescriptions, and only some Medicare Advantage plans do. But medical prescriptions can grow to be costly, especially if you have pricey medications each month. Part D plans in North Carolina can help you financially by covering your prescriptions.

In Durham, North Carolina, every Part D plan available has a deductible of $480. Most of the plans are rated three stars, but Humana has a four-star rating. Humana is on the pricier side, with a $22.70 premium.

On the cheaper end of the spectrum, Aetna has a Part D plan that has a $7.00 premium. If you want to cut your healthcare costs, Aetna may be the best Part D plan for you to enroll in.

Clear Spring is an average Medicare Part D plan available in Durham, North Carolina. This is a popular option. It has an average premium of $18.10.

PLAN PREMIUM DEDUCTIBLE STAR RATING
Aetna $7.00 $480 3
Wellcare $12.90 $480 3
Clear Spring $18.10 $480 2
Humana $22.70 $480 4
Elixir $29.00 $480 3

If you need help covering your medical prescriptions, learn more about Medicare Gap coverage.

Medicare Special Needs Plans in Durham, North Carolina

Special Needs Plans (SNPs) are a subset of Medicare Advantage plans. For beneficiaries with chronic or disabling conditions, an SNP can provide additional coverage. However, these types of plans are only available in certain areas.

For dual-eligible beneficiaries, the most affordable SNP is with Wellcare. It has a premium of $0 and a MOOP of $3,450. This plan is a health maintenance organization (HMO).

If you’d rather choose a local preferred provider organization (PPO), Humana has an affordable option with a $0 premium and a $3,450 MOOP. It has the same cost as Wellcare, but it’s a completely different plan type to fit your needs.

The rest of the options (Aetna, UnitedHealthcare, and BCBS of North Carolina) all have a premium of $0 and a MOOP of $7,550. They’re all HMOs, except UnitedHealthcare, which is a regional PPO.

PLAN PREMIUM MOOP Plan Type Eligibility
Wellcare $0 $3,450 HMO Dual
Aetna $0 $7,550 HMO Dual
Humana $0 $3,450 LOCAL PPO Dual
Unitedhealthcare $0 $7,550 REGIONAL PPO Dual
BCBS of North Carolina $0 $7,550 HMO Dual

FAQs

Is Medicare Available in Durham, North Carolina?

Yes, Medicare is available in North Carolina. Medicare provides healthcare coverage for more than one million residents in North Carolina. You can get covered by Medicare if you are older than 65, or if you qualify with specific disabilities.

What is the Income Limit for Medicare in Durham, North Carolina?

If you’re single, your income limit is $1,064 a month. If you’re married and both you and your spouse are applying, the income limit is $1,437 a month. Don’t forget: Social Security checks do count as income.

What is the Most Popular Medigap Insurance Company in Durham, North Carolina?

Around one out of every three Medigap beneficiaries are enrolled in a plan from UnitedHealthcare. UnitedHealthcare is one of the most popular Medigap insurance companies in Durham, North Carolina.

Does Medicare in Durham, North Carolina Cover Dental?

No, most Medicare plans do not cover dental procedures in Durham, North Carolina. You need additional coverage to help with dental care, including Medicare procedures and supplies like cleanings and tooth extractions.

Are you Automatically Enrolled in Medicare if you’re on Social Security in Durham, North Carolina?

If you already are receiving Social Security benefits, you will automatically be signed up at age 65 for Medicare parts A and B. If your address is accurate, you will receive your Medicare card in the mail without having to do anything extra.

How to Sign Up for Supplemental Medicare in Durham, North Carolina

No two beneficiaries have the same insurance needs. It can be extremely time-consuming and challenging to find the right supplemental Medicare plan to fit your unique needs. But we can help!

We work with every Medicare carrier. We will help you compare the top plans in Durham, North Carolina to find the best one for you. Give us a call, or fill out our quotes form to learn more.

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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.