North Carolina has no shortage of Medicare options for its residents. Out of 1,448,302 Medicare beneficiaries in the state 811,388 receive their drug coverage from stand-alone Part D drug plans. The majority of the remaining Medicare members use a Medicare Advantage plan. There are 688,499 North Carolinians enrolled in a Part C plan.

North Carolina Medicare Part D Prescription Drug Plans

Part D is the part of Medicare that is specifically for prescription drug coverage. This part of Medicare is technically optional. You will be penalized if you choose not to have drug coverage when first eligible.

This part of Medicare consists of four phases for drug coverage. The four phases are deductible, initial, coverage gap, and catastrophic. Part D is used for drugs you receive from the pharmacy,

We’ll discuss the North Carolina drug plan options that have the lowest premiums, and no deductibles. Next, we’ll talk about the drug plans that have coverage throughout the coverage gap.

Following that, we’ll cover plan adjustments for people with Low-Income Subsidies. Finally, we’ll discuss how many people fall into the different drug phases and how to enroll in a Part D drug plan.

Part D Plans with the Lowest Premium in North Carolina

Aetna has one of the cheapest drug plans in the nation with their SilverScript brand, The comes in right at seven dollars in NC. Aetna is part of CVS which gives them financial strength and insight to continue being a force in the Medicare drug plan market.

Centene-owned Wellcare is really solidifying its place in Medicare. With the second-lowest monthly premium for their drug plan, they continue to improve their plans year over year.

Clear Spring is relatively new to the Medicare drug plan market. They have only been in the space for a few years. They hit some rough patches early on, but for select prescriptions, their coverage is really difficult to beat.

PLAN PREMIUM DEDUCTIBLE STAR RATING GAP COVERAGE
Aetna $7.00 $480 3 No
Wellcare $12.90 $480 3 No
Clear Spring $18.10 $480 2 No
Humana $22.70 $480 4 No
UnitedHealthcare $29.30 $310 4 Yes

Part D Plans with a Zero-Dollar Deductible in North Carolina

When it comes to deductibles, the plans are all allowed to charge one. However, some plan options decided not to have a deductible.

It’s not a surprise that Aetna comes in on top. Aetna’s SilverScript drug plans have been one of the top plans for years.

Wellcare, as we mentioned earlier, is really making strides to solidify itself as a top-tier Medicare option. Here is yet another example of them being in the top three.

UnitedHealthcare rounds out the top three. Backed by AARP, UHC has always been a staple in the Medicare market with Medicare Advantage, Medicare Supplement, and Medicare Part D drug plans.

PLAN PREMIUM DEDUCTIBLE STAR RATING GAP COVERAGE
Aetna $57.70 $0 3 Yes
Wellcare $69.00 $0 3 No
UnitedHealthcare $101.20 $0 3 Yes
BCBS of North Carolina $120.40 $0 3 Yes

Part D Plans with Gap Coverage in North Carolina

The dreaded coverage gap is a nightmare for Medicare beneficiaries. Otherwise known as the donut hole, you’re required to pay 20% of the cost of your prescriptions in this phase. Fortunately, many beneficiaries do not fall into this donut hole.

If you do find yourself hitting the coverage gap annually consider a Part D plan that gives some coverage through the coverage gap.

UnitedHealthcare has a couple of options in the top five that will give some reprieve in the donut hole. UHC’s clients love the way they are there for them to help with questions and help them through the claims process if there is ever an issue.

Aetna’s SilverScript again comes in strong with an option that provides protection in the coverage gap.

Rounding out the top three is Cigna. Cigna is one of the oldest insurers in the Nation. They are staples in the Medicare marketplace and have multiple Medicare plan options.

PLAN PREMIUM DEDUCTIBLE STAR RATING GAP COVERAGE
UnitedHealthcare $29.30 $310 4 Yes
Aetna $57.70 $0 3 Yes
Cigna $59.10 $100 3 Yes
UnitedHealthcare $101.20 $0 3 Yes
BCBS of North Carolina $120.40 $0 3 Yes

Part D Plans with a Low-Income Subsidy in North Carolina

Low-Income Subsidy is a program that helps pay for Part D premiums, coinsurances, and copays. It’s also called Extra Help. The program is income-based and has multiple levels of assistance.

Clear Spring’s plan for $28.20 can lower all the way to zero dollars if you qualify for certain levels of extra help.

Likewise, Aetna and Cigna’s plans shown will reduce to a zero-dollar premium.

Keep in mind that depending on the level of extra help you are limited on how much you will pay to pick up your prescriptions as well.

PLAN PREMIUM DEDUCTIBLE STAR RATING GAP COVERAGE
Clear Spring $28.20 $480 2 No
Aetna $30.10 $480 3 No
Wellcare $30.20 $480 3 No
Cigna $33.30 $480 3 No
Elixir $33.30 $480 3 No

Amount of Beneficiaries that Fall into each Part D Coverage Phase in North Carolina

As mentioned above, the Part D plans have four coverage phases. Below we will show how many people in North Carolina fell into those different phases. The most well-known of the phases is the coverage gap, otherwise known as the donut hole.

As you can see below, the vast majority of North Carolinians stay in the deductible and initial coverage phases. This means less than half will ever see the coverage gap.

Deductible Phase Initial Coverage Phase Coverage Gap Phase Catastrophic Phase
352,443 588,548 171,577 138,362

Cities Located in North Carolina Medicare Supplement Coverage’s Estimated Premiums

Having a visual representation of the numbers associated with the cost of Medicare Supplement plans in North Carolina can be helpful when making a decision. Here are charts for the below cities.:

FAQs

Which insurance company has the cheapest drug plan in North Carolina?

Aetna has the cheapest drug plan in North Carolina. Their SilverScript plan is seven dollars.

How do I find the best Medicare Drug plan in North Carolina?

There really isn’t a way to judge the best drug plan overall. The best plan for you could be different than for someone else. To find the right plan for you, speak with a licensed insurance broker. They will go over your medications and help you find the one that covers your Medications best.

Are all drug plans the same in North Carolina?

All drug plans are different. They must all follow the standard model set by the Centers for Medicare and Medicaid Services. They can have different costs and drugs they cover.

How to Get Help Signing Up for a North Carolina Medicare Part D Plan

We all know that the prescription portion of Medicare is the most complicated. That’s where we excel. Our expert advisors specialize in Medicare and its options. We’re here to help.

We’ll help you find the plan that best fits your individual needs. We’ll also educate you on how the different plans work, and help you enroll in the best plan for you.

You can get assistance by giving us a call or filling 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.