Compare 2023 North Carolina Medicare Advantage Plans
North Carolina Medicare Advantage Plans (also known as Part-C) are offered by Medicare approved private insurance companies. There are several types of Medicare Advantage Plans available in NC, depending on your location. Some North Carolina MA plans may include extra benefits such as routine vision, hearing care and prescription drug coverage. Some plans may offer coverage for services like transportation to doctor visits, over-the-counter drugs that Part D doesn’t cover, and many services that promote your health and wellness. If you enroll in a Medicare Advantage Prescription Drug plan, you can get all your benefits in one plan. With any MA plan, you still must pay your monthly Part B premium along with any plan premium. To compare different plans available in North Carolina, click on your county below to see a list of available plans, what benefits it offers, its cost and if there are any limitations.
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Giveback Plans in North Carolina
The Medicare Giveback Benefit is a Part B premium rebate provided by some Medicare Advantage plans in North Carolina. If you enroll in a Medicare Advantage plan with this benefit, some or all of your monthly premium will be covered by the plan carrier. The standard Part B monthly premium in 2023 is $164.90. The plan carrier will reduce this cost by “giving back” towards your Part B premium amount. The Part B Giveback will be credited monthly to your Social Security check.
|Plan Name||Plan ID||Provider Name||Premium||Give Back Amount|
|AARP Medicare Advantage Patriot (HMO-POS)
|AARP Medicare Advantage Patriot (PPO)
|AARP Medicare Advantage Rebate (HMO-POS)
|Aetna Medicare Eagle Plan (PPO)
|Aetna Medicare Essential Plan (PPO)
|Blue Medicare Essential (HMO)
||H3449-027||Blue Cross and Blue Shield of North Carolina||$0||$50.00|
|Blue Medicare Freedom+ (PPO)
||H3404-004||Blue Cross and Blue Shield of North Carolina||$0||$67.00|
|Cigna Courage Medicare (HMO)
|Cigna True Choice Savings Medicare (PPO)
|Erickson Advantage Liberty without Drugs (HMO-POS)
|Humana Honor (Regional PPO)
|HumanaChoice H5216-017 (PPO)
|HumanaChoice H5525-035 (PPO)
|Wellcare Giveback Open (PPO)
What is the Best Medicare Advantage Plan in North Carolina
The best Medicare Advantage Plan in North Carolina will be different for each person, due to their specific needs and requirements. A plan that includes your doctors in the plan’s network and your medications on the plan’s formulary is best. You can find MA plans from major carriers like Anthem/Blue Cross Blue Shield, United Healthcare, Humana, Aetna, and Cigna.
Most Popular Plans by Enrollment in North Carolina
|Plan Name||Plan ID||Marketing Name||Premium||Enrollment|
|AARP Medicare Advantage Plan 1 (HMO-POS)||H5253-037
|AARP Medicare Advantage Plan 2 (HMO-POS)||H5253-038
|Blue Medicare Essential Plus (HMO-POS)||H3449-023
||Blue Cross and Blue Shield of North Carolina||$0||41928|
|Humana Gold Plus H1036-291 (HMO-POS)||H1036-291
|Humana Gold Plus H1036-137 (HMO-POS)||H1036-137
Highest CMS Rated Plans with Lowest Premium in North Carolina
|Plan Name||Plan ID||Company Name||Premium||CMS Rating|
|Alignment Health Platinum (HMO-POS)
||Alignment Health Plan||$0|
|Erickson Advantage Liberty without Drugs (HMO-POS)
|Erickson Advantage Liberty with Drugs (HMO-POS)
|HealthTeam Advantage Plan I (PPO)
||CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA||$0|
|Erickson Advantage Signature with Drugs (HMO-POS)
Plans by Provider
Alignment Health Plan
Blue Cross and Blue Shield of North Carolina
CARE N'' CARE INSURANCE COMPANY OF NORTH CAROLINA
Experience Health, Inc.
Medicare Advantage changes in North Carolina, 2023
• The average monthly Advantage plan premium changed from $15.26 in 2022 to $14.05 in 2023. This represents a -7.9% change in average premium.
• 150 Advantage plans are available in 2023, compared to 142 plans in 2022. This represents a 5.6% change in plan options.
• 100% of people with Original Medicare have access to a Part-C plan.
• $0 is the lowest monthly premium for an Advantage plan.
• 100% of people with Original Medicare will have access to a Part-C plan with a $0 monthly premium.
• Through the CMS Value-Based Insurance Design (VBID) Model, 41 plans will offer Medicare Advantage seniors additional options, including reductions in cost sharing (in some cases to zero) for some benefits, such as eliminated Medicare Part D cost sharing; rewards and incentives programs related to healthy behaviors; and customized, innovative benefits that address social determinants of health, such as food insecurity and social isolation, for seniors who receive low income subsidies (Extra Help) and/or chronically ill seniors.
• In North Carolina, 2,102,224 seniors are enrolled in Medicare.
With the passing of the Inflation Reduction Act, people with Medicare prescription drug coverage will have a $35 cost-sharing limit on a month’s supply of each covered insulin products. As well as adult vaccines that are recommended by the Advisory Committee on Immunization Practices (ACIP) at no additional cost.
How do I qualify for Medicare Advantage in North Carolina?
You can join a Medicare Advantage Plan in North Carolina if all these apply:
•You're a U.S. citizen or lawfully present in the U.S.
•You have Medicare Part A and Part B.
•You live in the service area of the plan you want to join.
When can I enroll in a Medicare Advantage Plan in North Carolina?
Open enrollment starts October 15 and runs to December 7, 2022. During this time, seniors eligible for Medicare can compare 2023 coverage options on Medicare.gov. The Medicare Plan Finder provides clear easy-to-use information to allow people to compare options for Medicare Advantage Plans in North Carolina, which may change from year to year.Late September 2022
• The 2023 Medicare & You handbooks are mailed to beneficiaries. Keep the handbook as a reference guide.
• Plan providers begin notifying enrollees about changes to their plans.
• Beneficiaries can begin comparing plans starting October 1.
• Beneficiaries should watch their mail for notices from Medicare with information about changes in 2023.
• Star ratings will be available starting October 11.
• Open enrollment begins October 15.
• Open enrollment ends December 7.January 2023
• Medicare plan coverage begins January 1.January 1 - March 31
The open enrollment period gives you an opportunity to try out an insurance plan. During this period, you can make one switch to a different Advantage Plan, or you can disenroll and return to Original Medicare. If so, you will be able to join a Medicare Prescription Drug Plan. Any changes you make during this period will be effective on the first of the month after the request is received by the provider.During this period (Jan 1 - March 31) you can't:
• Switch from Original Medicare to a MA Plan.
• Join a Prescription Drug Plan if you're on Original Medicare.
• Switch from one Medicare Prescription Drug Plan to another if you're on Original Medicare.
Can I switch to a North Carolina Part-C Plan anytime?
Medicare provides special enrollment periods. You can make changes to your MA plans and Medicare Part-D coverage when certain events happen, like if you move and need Medicare in North Dakota or lose your insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs). Regulations about the type of changes and when you can make changes are different for each SEP.
Are some Medicare Advantage Plans free in North Carolina?
You may be surprised to find some Medicare Advantage Plans are offering a $0 premium. Of course, no Medicare Part-C plan is really $0 cost for you. MA plans are offered by private insurance companies. These companies need to make a profit to pay employees. To offer $0 premiums, providers must make up their costs in other ways. Insurance companies do this through copays, deductibles, and coinsurance.
Why consider a Medicare Advantage Plan?
Many Medicare Advantage Plans offer preventive care and disease management programs to help people better manage their health, and healthy patients generally have better health outcome. With a Medicare Advantage Plan, you may have coverage for things like fitness programs and some vision, hearing, and dental services (like routine check-ups) that Original Medicare doesn't cover.
Also, MA plans may offer lower out-of-pocket expenses for you than Original Medicare. There is a limit from Part-C Plans on what you must pay out-of-pocket each year.
Plus plans may offer coverage for services like transportation to doctor visits, over-the-counter drugs, and services that promote your health and wellness.
Which pre-existing conditions are not covered by MA Plans?
You can join any Medicare Advantage Plan in NC even if you have a pre-existing condition.
How Much Does Medicare Advantage Cost in North Carolina?
The average premium for a Medicare Advantage Plan in 2022 was $19 per month, some premiums cost $0, and others cost over $100. In addition to any premiums your plan may charge, you may have to pay a yearly deductible. Cost-sharing in the form of copays, coinsurance, and deductibles varies depending on your provider. What you pay in a Medicare Advantage Plan in North Carolina depends on several factors. In most cases, you will need to use health care providers who participate in the plan’s network. Some plans will not cover all services from providers outside the plan’s network and service area.
What does Medicare Advantage cover?
Medicare Advantage Plans offer both medical (Part-B) and hospital (Part-A) insurance coverage and additional benefits. Depending on the type of plan you choose.
•Prescription drug coverage. While this isn’t typically covered under original Medicare, most Medicare Advantage Plans offer additional prescription drug coverage and all MAPD plans offer drug coverage. To find out if your medications are covered, check the plan’s formulary or list of covered prescription drugs.
•Dental, hearing, and vision. This includes non-medically necessary coverage, which Original Medicare doesn't always cover. MA plans differ in benefits offered and vary from plan to plan.
How to join a Medicare Advantage Plan
Go to the Medicare Plan Finder and enter your zip code to find and compare plans in your area. You can speak to a licensed Medicare agent at 1-855-778-4180 to help you determine which Medicare Advantage Plan would be best for your health care needs.
How to Choose a Medicare Advantage Plan in North Carolina
Exploring your options could save you a lot of money. When choosing an Advantage Plan, consider the out-of-pocket costs and coverage for your medical needs and prescription drugs, coverage for any current medical issues, and which providers and facilities are included in the plan’s network. You can find out more about the costs and coverage for all the MAPD plans available in North Carolina by selecting your county above.
•Which plan fits your budget. How much is the monthly premium? How much is the annual deductible? How much are the copays and coinsurance? What are the plans' maximum out-of-pocket cost?
•Check CMS star ratings. CMS created the five-star quality rating system to help seniors compare plans being offered. The star rating is on a scale of 1 to 5, with 5 being best.
•Look for your doctors. If you have caregivers and medical facilities you use and prefer, look for plans that include them.
•Prescription Drugs. A Medicare Advantage plan that includes your prescription drug coverage is ideal. Look at the plans Drug List (formulary) for coverage of your current medications. Check if your preferred local pharmacy is included in the plan’s pharmacy network or consider using a mail order pharmacy to lower costs.
•Other coverage. Part-C Plans offer some additional benefits for dental, hearing, vision, gym memberships and transportation to medical appointments.
•Travel coverage. Original Medicare generally doesn’t cover care outside the U.S. You may be able to buy supplemental insurance that offers emergency care when you travel outside of the U.S.
North Carolina Health Insurance Assistance Program (SHIP)
The State Health Insurance Assistance Program (SHIP) is a national program that offers one-on-one counseling and education to seniors. SHIP team members are highly trained and certified to assist people on their Medicare, Medicare Advantage and Medigap and Medicaid benefits. SHIP also assists seniors with low income to apply for benefits, such as Medicaid, Extra Help, (Low Income Subsidy) and Medicare Savings Program which help pay for or reduce healthcare costs.
The Seniors’ Health Insurance Information Program (SHIIP) counsels Medicare beneficiaries and caregivers about Medicare, Medicare supplements, Medicare Advantage, Medicare Part D, and long-term care insurance. The counselors on our toll-free line offer free and unbiased information regarding Medicare health care products. We also help people recognize and prevent Medicare billing errors and possible fraud and abuse through our NC SMP Program. Since the program’s creation in 1986, SHIIP has become a role model for other states and has received two national awards for “innovative” and “exemplary” service.
What is the Best Medicare Advantage Plans in North Carolina?
The best Medicare Advantage Plan will be different for each person, due to their specific needs and requirements. The most popular plan by enrollment in North Carolina is the AARP Medicare Advantage Plan 1 (HMO-POS) with 63990 seniors enrolled.
How Much Does Medicare Advantage Cost in North Carolina
The average premium for a Medicare Advantage Plan in 2022 was $19 per month, some premiums cost $0, and others cost over $100. In addition to any premiums your plan may charge, you may have to pay a yearly deductible.
What is the highest rated plan in North Carolina?
The highest rated plans by the CMS with the lowest premium in North Carolina is Alignment Health Platinum (HMO-POS). It received a 5 star rating. Plans are rated on a one-to-five scale, with one star representing poor performance and five stars representing excellent performance.
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