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Medicare Supplement Plans in North Carolina

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What Are Medigap Plans?

Medigap plans are Medicare Supplement Insurance offered by Medicare-approved private insurance companies to help cover cost sharing requirements of Original Medicare Parts A and B.

While Medicare pays for a large percentage of the health care services and supplies you may need, you are still responsible for a portion of the costs in the form of deductibles, copays, and coinsurance. Medigap policies help with these costs and sometimes offer more coverage for excess charges and foreign travel health emergencies.

Medigap plans are standardized by Medicare and regulated by state laws and insurance commissioners. You pay a monthly premium for Medigap. Costs and availability of Medigap plans vary depending on several factors including your age and gender, the insurer, and your state of residence. Learn about Medigap in North Carolina so you can determine which plan best meets your needs.

  • Plans F and G are the most popular and comprehensive Medigap plan types in North Carolina. Plan F is no longer available to people who are eligible for Medicare after December 31, 2019.
  • Monthly premiums for Plan G for a 65-year-old female who doesn’t use tobacco range from $86 to $301.
  • North Carolina requires Medigap insurers to offer at least Medigap plan A to disabled Medicare beneficiaries under age 65, however monthly premiums are much higher.

Medicare Supplement Plans in North Carolina

Compare ratings of some of North Carolina’s Medigap providers:
Insurance company A.M. Best rating NAIC complaint index BBB rating Consumer Affairs
Blue Cross Blue Shield A Above average F 1.2/5
Cigna A Below average No rating 3/5
Humana A- Above average A+ 2.3/5
UnitedHealthcare A- Below average A+ 2.1/5

What Medicare Supplement Plans Cover

Medigap policies serve as your secondary source of insurance after Medicare pays. Medigap fills in the “gaps” between what Medicare pays for covered services and what you are charged. Some plans offer extended coverage for Part B excess charges and foreign travel emergency costs.

There are 10 standardized Medigap plans that are regulated by federal and state governments. Two of the 10 plans (F and G) are the most comprehensive plans and also offer high-deductible versions. All plans are not available in all states.

Medigap policies may include the following benefits:

  • Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
  • Part B coinsurance or copayment
  • The first three pints of blood
  • Part A hospice care coinsurance or copayment
  • Skilled nursing facility care coinsurance
  • Part A deductible
  • Part B deductible (only certain plans for people eligible for Medicare before January 1, 2020)
  • Part B excess charges
  • Foreign travel emergency services
  • Out-of-pocket limits

Do You Need a Medicare Supplement in North Carolina?

Should you consider a Medicare supplement?
Yes, if you:
  • Rely on Original Medicare for your health care coverage. There is no cap on what you may pay for Part A and Part B services, so if you need much healthcare, your out-of-pocket costs for deductibles, copays, and coinsurances may be high and unpredictable. A Medigap plan offsets your portion of costs.
  • Want freedom of choice of providers because you can see any Medicare provider in the U.S.
  • Travel abroad and want coverage for emergency care.
  • Anticipate the need for frequent healthcare now or in the future.
  • Are in your initial open enrollment period and are guaranteed the opportunity to join a plan regardless of your health condition.
  • Can afford the monthly premiums
  • Don’t want a Medicare Advantage Plan
 No, if you:
  • Want a Medicare Advantage Plan with zero or low monthly premiums
  • Don’t mind following the rules and restrictions of a Medicare Advantage Plan to get your healthcare services and drugs.
  • Don’t want to purchase a standalone Part D prescription drug plan
  • Missed your open enrollment period, and the policy you want is not available or the premium cost is too high.
  • Have Medicaid which will pay for most of your out-of-pocket expenses for Medicare
  • Don’t anticipate the need for frequent healthcare now or in the future
  • Have other creditable coverage and don’t need Medicare Part B yet. When you sign up for Part B, your Medigap six-month open enrollment period will start

What Medigap Plans Cost in North Carolina

Expect to pay about $66 to $375 each month for a Medigap plan A, G, or N in North Carolina if you enroll during your open enrollment period. Premiums will vary depending on your insurer and how your premium is rated.

Medigap policies can be rated in three ways:

  • Community rated (or no age-rated): Your premium isn’t based on your age and may only increase due to inflation or other factors. Everyone, regardless of age, is charged the same premium.
  • Issue-age rated (or entry age-rated): Your premium is based on your age when you buy the policy and won’t increase as you grow older. Your premium may only increase due to inflation or other factors.
  • Attained-age-rated: Your premium is based on your age and can increase as you grow older and due to inflation and other factors.

Medigap vs. Medicare Advantage Plans

Medigap and Medicare Advantage Plans are very different. You are eligible for either type of plan when you are enrolled in Medicare Part A and B, but you cannot have both at the same time. Both Medigap and Medicare Advantage Plans are offered by Medicare-approved private insurance companies. You can only choose to join plans that are available in your area.

Compare your options:

Plan type Medigap Medicare Advantage
What it is Medigap is insurance designed to supplement Original Medicare and helps cover your out-of-pocket expenses, like deductibles, copays, and coinsurance you incur when you access your Medicare services. You pay a monthly premium for Medigap. Medigap plans are standardized across the U.S. Benefits, costs, and availability of plans vary depending on your age, gender, tobacco use, and state of residence. Medicare Advantage Plans, on the other hand, are an alternative way to receive your Medicare benefits. These plans must offer all the services Original Medicare does, and frequently add on prescription drug coverage and other services, such as hearing, vision, and dental.
What it covers Covers:
  • Coinsurance
  • Copayments
  • Deductibles
  • Excess Part B charges (some plans)
  • Foreign travel emergency costs (some plans)
 Covers:
  • All Original Medicare services (Part A hospital and Part B medical insurance)
  • Often, Part D prescription drug coverage
  • May offer additional services, including dental, vision, and auditory care
What it works with
  • Original Medicare
  • Part D prescription drug coverage
  • Replaces Original Medicare
  • Network of providers determined by insurer
  • Cannot typically buy separate Part D prescription drug coverage
When it’s best If you frequently access your Part A and B benefits, want your out-of-pocket expenses covered, and want to choose your providers. If you want all of your health and drug coverage through one plan, want extra benefits, and are willing to follow your plan’s rules and network restrictions.

Types of Medigap Plans in North Carolina

Every standardized type of Medigap plan is offered in North Carolina, but Plans F and G offer the most comprehensive coverage and are the most popular. Plans F and G also come in a high-deductible version. Here are some highlights and difference among some of the plans:

Plan F
  • Most comprehensive
  • Covers the Part B deductible
  • Only available to people who were eligible for Medicare before January 2020
 Plan G
  • Most comprehensive for newer beneficiaries
  • Pays for excess Part B charges so you can see any Medicare provider even if they charge more than the Medicare-approved amount
Plan K
  • One of two plans that have an out-of-pocket limit. After you reach the limit and pay your Part B deductible, your plans pays 100%
 Plan L
  • Like Plan K, but has a lower out-of-pocket limit and monthly premiums are higher
Plan M
  • Only pays 50% of Part A deductible, so could cost more if you need inpatient hospitalization
 Plan N
  • Growing in popularity, Plan N has lower premiums but charges a copay for doctor and emergency room visits

Compare Medicare Supplement Options

Medigap Benefits Plan A Plan B Plan C Plan D Plan F* Plan G* Plan K Plan L Plan M Plan N
Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Part B coinsurance or copayment Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes***
Blood (first 3 pints) Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Part A hospice care coinsurance or copayment Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Skilled nursing facility care coinsurance No No Yes Yes Yes Yes 50% 75% Yes Yes
Part A deductible No Yes Yes Yes Yes Yes 50% 75% 50% Yes
Part B deductible No No Yes No Yes No No No No No
Part B excess charge No No No No Yes Yes No No No No
Foreign travel exchange (up to plan limits) No No 80% 80% 80% 80% No No 80% 80%
Out-of-pocket limit** N/A N/A N/A N/A N/A N/A $6,620 $3,310 N/A N/A

* Plans F and G also offer a high-deductible plan in some states. With this option, you must pay for Medicare-covered costs (coinsurance, copayments, and deductibles) up to the deductible amount of $2,700 in 2023 before your policy pays anything. (Plans C and F aren’t available to people who were newly eligible for Medicare on or after January 1, 2020.)

** For Plans K and L, after you meet your out-of-pocket yearly limit and your yearly Part B deductible, the Medigap plan pays 100% of covered services for the rest of the calendar year.

*** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in inpatient admission.

What’s the most popular North Carolina Medigap plan in 2023?

Plan F is the most popular, because it pays the annual Part B deductible and is the most comprehensive plan available. However, because Plan F is only available to Medicare beneficiaries who were eligible before January 2020, Plan G is gaining in popularity. Plan G offers comprehensive coverage, except for the Part B deductible, and is widely available from most insurers.

When to Sign Up for Medicare Supplement Plans in North Carolina

In general, you will get the best price for Medicare Supplement Insurance if you purchase a plan as soon as you are eligible for Medicare and enrolled in Parts A and B.

Medigap Open Enrollment starts on the first day of the month that you turn 65 and are enrolled in both Parts A and B and lasts for six months. An insurance company is not allowed to use medical underwriting to decide whether to accept your application or change the price during this time.

To enroll in a Medigap Plan, contact the insurance company to make sure you are in your open enrollment period or have guaranteed issue rights. Complete the application and determine when you want your policy to start.

There are certain situations which may give you guaranteed issue rights to purchase a Medigap policy, regardless of your health conditions or any preexisting health conditions.

These include:

  • Moving out of the coverage area while in a Medicare Advantage Plan or Medicare SELECT Plan
  • Your existing Medicare Advantage Plan leaving Medicare coverage
  • Your other insurance plan outside of Medicare is ending
  • You are within your trial right period
  • Your plan coverage ends through no fault of your own

How to Choose a Medigap Plan in North Carolina

Consider these factors as you compare Medicare Supplement Insurance plans available in your area:
Monthly premium This is in addition to your Part B monthly premium, so it affects your monthly cash flow. You pay whether or not you access your benefits.  Your premium amount is determined based on the type of plan you get, your age, gender, tobacco use, and state of residence
Benefits Basic coverage for Part A copays and coinsurance and at least a portion of Part B copays and coinsurance, three pints of blood, and hospice care are offered with every type of plan. Other benefits may not be included, so check to see which benefits are most important to you.
Insurance provider Look at ratings and past experience, either your own or other consumers,  with the carrier you are considering. Contact a company representative to get an idea of their customer service and responsiveness.
Extra discounts Some plans and insurers offer added perks or discounts once you become a member. You may have access to discounted hearing aid providers or eyeglass suppliers, for instance.

Medicare Supplement Resources in North Carolina

If you’re feeling confused by the multitude of plan options available, getting in touch with trained, unbiased counselors can be a good first step. North Carolina is home to several organizations that can help you make an informed decision.

Area Agencies on Aging Website | (800) 662-7030 Area Agencies on Aging provide a variety of senior services and connect seniors with available local providers. In addition to Medicare counseling that helps new and current enrollees make informed health insurance decisions, this organization provides information and access to home health services, financial assistance programs, and home-delivered meals. Seniors can access an online map and contact information for AAAs statewide to find the agency serving their local area.
Seniors’ Health Insurance Information Program Website | (855) 408-1212 The North Carolina Department of Insurance operates the State Health Insurance Assistance Program (SHIIP) counselors and volunteers throughout the state. Seniors can get more information about each of their coverage options from an unbiased source. A quick locator tool helps seniors identify their local counselors and schedule appointments. For information about specific plans, seniors are encouraged to contact the provider. Counselors are not affiliated with insurance companies. SHIP operates Monday through Friday.
The Shepherd’s Center of Greater Winston-Salem Website | (336) 748-0217 The Shepherd’s Center acts as the Forsyth County location delivering SHIIP services and Medicare counseling to residents in Winston-Salem and the surrounding areas. Free assistance is offered to Medicare-eligible seniors who have questions about health care coverage or need help changing their insurance plan. Counseling explains how Medicare works, what it covers, and how to enroll. You get unbiased information about comparing plans in simple, easy-to-understand language. Regular “Welcome to Medicare” workshops are held at the Center, providing a solid overview of the available programs and enrollment process.
Kelly Blackwell - Small Profile Image
Kelly Blackwell
Certified Senior Advisor (CSA)®

As a health care professional since 1987, Kelly Blackwell has walked alongside and cared for seniors as they journey through the season of their fourth quarter of life. Blackwell holds a Bachelor of Science in nursing from the University of Northern Colorado, a Master of Science in health care administration from Grand Canyon University, an interprofessional graduate certificate in palliative care from the University of Colorado Anschutz Medical Campus and holds a Certified Senior Advisor® credential from the Society of Certified Senior Advisors.

Blackwell contributes to the University of Colorado-Anschutz blog and has been published in “The Human Touch” distributed by the University of Colorado Center for Bioethics and Humanities. She cowrote “Dying Is” for Pathways Hospice.

A registered nurse, Blackwell understands health insurance choices influence quality of life and are driven by values, goals, and beliefs. She’s passionate about engaging with, educating, and empowering seniors as they navigate the health care system. She’s equipped to lend an experienced, compassionate voice to beneficiaries seeking information about Medicare Advantage Plans.

As a CSA®, Blackwell has access to valuable resources for Medicare beneficiaries. Her work as a bedside nurse and clinical manager has given her the opportunity to see how Medicare rules, regulations, and benefits work when patients need them. With a passion to learn and to make a difference in the lives of seniors, Blackwell supports seniors through Medicare and fourth-quarter life decisions.

Kelly Blackwell - Small Profile Image
Kelly Blackwell
Certified Senior Advisor (CSA)®

As a health care professional since 1987, Kelly Blackwell has walked alongside and cared for seniors as they journey through the season of their fourth quarter of life. Blackwell holds a Bachelor of Science in nursing from the University of Northern Colorado, a Master of Science in health care administration from Grand Canyon University, an interprofessional graduate certificate in palliative care from the University of Colorado Anschutz Medical Campus and holds a Certified Senior Advisor® credential from the Society of Certified Senior Advisors.

Blackwell contributes to the University of Colorado-Anschutz blog and has been published in “The Human Touch” distributed by the University of Colorado Center for Bioethics and Humanities. She cowrote “Dying Is” for Pathways Hospice.

A registered nurse, Blackwell understands health insurance choices influence quality of life and are driven by values, goals, and beliefs. She’s passionate about engaging with, educating, and empowering seniors as they navigate the health care system. She’s equipped to lend an experienced, compassionate voice to beneficiaries seeking information about Medicare Advantage Plans.

As a CSA®, Blackwell has access to valuable resources for Medicare beneficiaries. Her work as a bedside nurse and clinical manager has given her the opportunity to see how Medicare rules, regulations, and benefits work when patients need them. With a passion to learn and to make a difference in the lives of seniors, Blackwell supports seniors through Medicare and fourth-quarter life decisions.

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