North Carolina now boasts over 11 million residents. Over 2.1 million North Carolina residents are enrolled in Medicare plans. In 2024, 20% of the State’s population was 65 or older, which is one in five people. This southeastern State is home to over 1.8 million senior adults aged 65 and above.
With such demographics, healthcare services such as Medicare have become crucial in the region to aid senior residents in managing their healthcare expenses effectively.
More than 13% of beneficiaries are under age 65. However, they are eligible due to a disability, including end-stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS). Hence, 17% of the population in the region utilizes Medicare programs for cost-efficient healthcare decisions.
Medicare is a fee-for-service health insurance program in the US. The federal government administers the standard Medicare plan. In contrast, private health insurance companies provide Medicare Advantage and Medicare Supplement plans.
Medicare Supplement Plans in North Carolina
The Medicare Supplement Plan, also popularly known as Medigap, is a secondary coverage plan. The primary purpose of a Medigap policy is to lower out-of-pocket costs such as deductibles, copayments, and coinsurance associated with Medicare plans.
These costs aren’t covered by Original Medicare Parts A and B. This means that Medigap only covers what isn’t covered by Original Medicare. You must have an Original Medicare plan with supplemental Medicare, as it is not a stand-alone insurance policy.
In North Carolina, there are 42 insurers offering Medigap plans. Over half a million Medicare beneficiaries have access to stand-alone Medigap coverage.
There are ten standardized plans available for North Carolina residents. These plans are denoted with alphabets (A, B, C, D, F, G, K, L, M, and N).
Plans C and F are only available to those who became eligible for Medicare prior to January 2020. A Plan G for a 65-year-old nonsmoking person ranges from $86 to $302 monthly.
According to the rules and regulations set by the Centers for Medicare and Medicaid Services (CMS), every plan must provide beneficiaries with the same coverage under the same plan.
Medigap plans cover out-of-pocket expenses, including copayments, coinsurance, and deductibles.
- Deductibles are expenses that you cover before Medicare provides coverage for health services. Thus, deductibles apply to all Medicare plans, including the standard Original Medicare.
- A copayment is a fixed payment for a doctor’s visit or a prescription drug. This amount is paid after you pay your deductibles, thus covering certain supplemental benefits.
- Coinsurance is a cost-sharing method in which you pay a percentage of the total amount for specific services after paying your deductibles. Your insurance plan covers the rest of the cost.
General Analysis of Medicare Supplement Plan Providers in North Carolina
| Insurance Company | Plan types offered | Share of North Carolina Medigap members |
| UnitedHealthcare | A, B, C, F, G, K, L, and N. | 23% |
| Blue Cross Blue Shield | A, G, K, and N. | 33.7% |
| Aetna | A, B, C, D, F, G and N. | 4.3% |
| Humana | A, B, C, F, G, K, L, and N | — |
| Cigna | A, F, G, and N | 1.3% |
Types of Medicare Supplement Plans in North Carolina
As of 2024, North Carolina offers residents ten standard Medigap plan types. Medigap F is not available to new members as of January 1, 2020. Plan F is only available to individuals who were eligible for Medicare before 2020.
Plan G is the most popular Medigap plan because of its comprehensive coverage. The average monthly rate for this plan is around $101.30.
The next most popular is Plan N, which offers similar coverage to Plans F and G but with additional charges. The average cost of a Plan N is $97.10 per month for a 65-year-old and $136.44 at age 75.
All Medigap policies are standardized, meaning that Plan N provides the same core benefits regardless of the insurance provider. However, Plan N does not cover the Medicare Part B deductible or Part B excess charges anywhere in the State.
Cost Breakdown of Three Most Popular Medicare Supplement Insurance Plans in North Carolina
The most popular supplement plans in North Carolina are Medigap Plan F, G, and N. The cost for these plans varies.
Here’s a detailed cost breakdown for these popular North Carolina Medigap plans.
Medicare Supplement Plan F
In North Carolina, there are 43 companies offering Medicare Supplement Plan F. The availability and monthly premiums vary depending on an individual’s age, sex, health status, and location.
Despite being one of the most popular Medigap plans across North Carolina, Medigap Plan F is no longer available to new applicants. Beneficiaries who were eligible for Medicare before January 1, 2020, can sign up for plan F. People who already have plan F can keep it.
In North Carolina, Medicare recipients pay an average of $198.30 monthly for Medigap Plan F.
Medicare Supplement Plan G
There are 44 companies offering Plan G Medicare Supplement in North Carolina. Medigap Plan G is one of the most popular Medicare Supplement plans for those not eligible for Plan F.
Plan G offers extensive coverage for Medicare beneficiaries, with premiums and availability depending on factors such as age, sex, tobacco use, location, and health status. However, it does not cover the Part B deductible. In North Carolina, Medicare recipients pay an average of $101.30 monthly for Medigap Plan G.
Medicare Supplement Plan N
About 43 companies offer Plan N in North Carolina. The average cost of Medicare Supplement Plan N is $116.80 per month. This plan is a cost-effective policy that offers comprehensive coverage while requiring some out-of-pocket payments. The availability and monthly premiums vary based on factors such as age, gender, tobacco use, and location.
Cost Determination of Medicare Supplement Plans in North Carolina
Some factors that influence the pricing of Medicare Supplement plans are your location, age, provider, and the various benefits a plan offers. Therefore, different counties have different prices for popular plans such as Medigap Plan F, G, and N. For example, Medicare Supplement in New Hanover County has premiums ranging from as low as $85.30 to as high as $203.69.
Medigap prices are determined in three ways.
- Community-rated: With a community-rated Medigap policy, everyone pays the same monthly premium, regardless of their age. This means that whether you enroll at 65 or 75, your premium remains consistent with other policyholders.
- Issue age-rated: In an issue age-rated Medigap policy, the premium is based on your age at the time of enrollment. The younger you are when purchasing the plan, the lower your premium will be. One of the key benefits of this pricing structure is that your premium does not increase as you get older. However, premiums may still rise due to inflation, increasing healthcare costs, or insurer adjustments.
- Attained age-rated: For an attained age-rated Medigap policy, the premium is based on your current age and increases as you get older. A plan that seems affordable at 65 may become significantly more expensive by 85. While these policies might offer lower initial costs, they can become one of the most expensive options over time. Additionally, inflation and other factors may lead to further premium increases.
Besides these pricing structures, premiums also vary from provider to provider. For example, a Medigap Plan G with Blue Cross Blue Shield of North Carolina costs around $74, while Cigna offers the plan at $119. The average monthly premium cost of a Medicare Supplement Plan in North Carolina can range from $85 to $203.
Cost Comparison of the Top-Rated Medicare Supplement Plans in North Carolina
Due to the standardization, all Medigap plans have to offer the same coverage across the State. This means that all Plan Gs offer the same benefits to enrollees. The only difference is plan availability and premiums. Looking into the price difference can help you make a cost-efficient decision.
Let us look into the prices of the most popular Medigap companies that provide plans G and N in North Carolina.
The table below provides the estimated cost for a 65-year-old non-smoker female.
| Insurance Company | Plan G Monthly Premium | Plan N Monthly Premium |
| Blue Cross Blue Shield | $74 | $97 |
| UnitedHealthcare | $113 | $101 |
| Cigna | $120 | $86 |
Medicare Eligibility in North Carolina
What makes you eligible for Medicare in North Carolina? Medicare has the same eligibility criteria across all the States.
You qualify for Medicare if:
- You are 65 years old or above.
- You have a medical disability.
- You have end-stage renal disease (ESRD).
- You have amyotrophic lateral sclerosis (ALS).
You are eligible for Medicare if the Social Security Administration approves you based on your age or a qualifying disability.
Enrollment Period for Medicare in North Carolina
The best time to purchase a Medigap policy is during the Open Enrollment period. Medicare has two enrollment periods besides open enrollment: your initial enrolment period (IEP) and a general enrolment period (GEP).
You can join, switch plans, or drop your coverage plans from October 15 to December 7 each year. Suppose you’re under 65 and have Medicare because of a disability or End‑Stage Renal Disease (ESRD). In that case, you might not be able to buy the Medigap policy you want, or any Medigap policy, until you turn 65.
Besides your open enrollment period, you can get a Medicare plan during your initial enrollment period (IEP). The IEP is 7 months long, starting 3 months before your 65th birthday and ending 3 months after you turn 65. You can enroll during this period if you haven’t had Medicare before.
If you miss your IEP, you can access Medicare by applying for it during the general enrollment period (GEP) every year between January 1 and March 31. During this period, you can also change your current Medicare plans. For example, if you have a Medicare Advantage plan and want to switch to Original Medicare, you can do so during this period.
Benefits of Medicare Supplement Plans in North Carolina
Medicare beneficiaries can avail themselves of a number of benefits through a Medicare Supplement plan. Medigap policies are designed to cover the gaps in standard Medicare coverage plans. Hence, one of the most important benefits is that a Medicare Supplement plan cuts down the costs associated with Original Medicare. This provides relief to senior adults residing in North Carolina, where healthcare bills are often sky-high.
As the State offers about ten different types of Medigap policies, beneficiaries have a variety of options to choose from. Medigap plans are also standardized by the federal government. Consequently, the same type of plans offer the same benefits. For example, all plan Gs in the State will offer the same standardized benefits to enrollees.
The standardization across the plans simplifies the selection process, as beneficiaries only need to look into the premiums, insurer ratings, and competitive rates.
Another important benefit of Medigap policies is the freedom to choose healthcare providers. Unlike Medicare Advantage plans, Medigap plans do not restrict beneficiaries to a network of healthcare providers.
You can seek treatment outside of your network as long as a healthcare provider or hospital accepts Medicare. This is especially beneficial for those who travel frequently as it doesn’t restrict beneficiaries to a limited network of providers. Therefore, having access to Medigap with Original Medicare proves more beneficial than having a standard Medicare plan.
Resources for Medicare in North Carolina
In North Carolina, numerous organizations provide guidance for Medicare programs. Contacting these agencies can help you make a cost-efficient decision suitable for all your healthcare needs.
| Organization | How you can get help | Website & Contact Info |
| North Carolina Senior Law Project | The North Carolina Senior Law Project supports Legal Aid of North Carolina, which assists senior adults aged 60 and older with their Medicare applications. Their legal experts can help seniors sort out problems with bills and rejected claims. | Website | (877) 579-7562 |
| North Carolina Department of Insurance | The North Carolina Department of Insurance regulates health insurance, ensuring applicants get fair coverage. | Website | (855) 408-1212 |
| Medicare and Seniors’ Health Insurance Information Program (SHIIP) | The North Carolina Medicare and Seniors’ Health Insurance Information Program (SHIIP) aims to connect senior residents with industry experts to help resolve Medicare queries. This program provides counseling and guidance for various Medicare programs. Seniors can opt for in-person or on-call counseling. | Website | (855) 408-1212 |
| North Carolina Area Agencies on Aging | There are 16 Area Agencies on Aging in North Carolina, providing free Medicare assistance to local seniors aged 60 and above. Any of the offices can connect North Carolina residents to a SHIIP counselor for confidential, unbiased health insurance guidance. | Website | (800) 662-7030 |
Compare Medigap Plans in the State of North Carolina With Silveredge
Comprehensive healthcare often results in skyrocketing bills. Programs such as Medicare aim to manage healthcare expenses for beneficiaries. For long-term security, it’s best to enroll yourself in a Medicare plan along with supplemental coverage.
However, you must become familiar with the available plans, coverage, and premiums to avoid hidden costs. Silveredge has industry experts to counsel you regarding Medicare plans in your area.
You can compare plans, look into plan availability, premiums, and more to choose a coverage option that best suits your needs!
