In the beautiful state of North Carolina, over 800,000 Medicare beneficiaries are on Medicare Advantage plans. Many parts of NC are rural, but residents can access several Medicare Part C options. It works out that about 40% of North Carolinians are enrolled in Advantage programs.
Medicare Advantage plans 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 must 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. Some options allow you to use non-network providers.
These plans will differ depending on your chosen insurance company and where you live. Most counties in NC have between 26 and 50 Medicare Advantage plan options available for their residents.
Medicare Advantage plans available 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 specializing in Medicare to ensure you find the best plan 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
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. Your copays could be a little higher if you have a plan with no monthly premium.
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 among 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. It’s a solid option with the lowest maximum out-of-pocket and a 4-star rating. 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 |
| $0 | $6,700 | LOCAL PPO | 3 | |
| Aetna | $0 | $4,500 | LOCAL PPO | 4 |
Medicare Advantage plans with a zero-dollar drug deductible
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 and 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 |
| $27.00 | $3,600 | HMOPOS | 5 | |
| BCBS of North Carolina | $34.00 | $4,500 | HMO | 4 |
Medicare Advantage plans with a 5-star rating
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 has a 5-star rated plan in NC.
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATINGS |
| $0 | $4,500 | HMOPOS | 5 |
Medicare Advantage plans with a Part B reduction
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 |
| $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! Remember 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
Quite a bit 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. Fill out our online rate form if now isn’t a good time.
