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2026 Medicare Special Needs Plans in Durham County, NC

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In Durham County, NC, there are 28 Medicare Special Needs Plans available for 2026. Approximately 5,924 beneficiaries are enrolled, and about 67% are rated 4 stars or higher based on CMS quality ratings.

Special Needs Plans (SNPs) are one coverage option. Other options may include standard Medicare Advantage plans, Medicare prescription drug coverage, and Medicare Supplement insurance. Visit Medicare Options in Durham County, NC to explore other types of coverage available locally.

At a Glance

Average Monthly Premium
$25.88/mo
Plans with $0 Premium
3
Average MOOP Limit
$8,577 ($9,250 max.)
Star Ratings (Plan Mix)
4+ Stars: 67% · 3 Stars: 33% · Below 3: 0%
Average Part D Deductible
$555.00
Total SNP Enrollment
5,924
SNP Plans with the Highest Enrollment
(as of September 8, 2026)
1. UHC Dual Complete NC-S3 (D-SNP) — 1,952 enrollees
2. UHC Dual Complete NC-D001 (D-SNP) — 1,086 enrollees
3. UHC Complete Care NC-28 (C-SNP) — 720 enrollees

D-SNP Plans (Dual Eligible Special Needs Plans)

Dual Eligible Special Needs Plans (D-SNPs) in Durham County are Medicare Advantage plans for individuals eligible for both Medicare and Medicaid.

  • Total D-SNP Plans: 21
  • Average Monthly Premium: $27.61/mo
  • Beneficiaries Enrolled: 4,812
  • $0 Premium Plans: 0
  • Zero Cost Plans: 14
  • Top D-SNP by Enrollment: UHC Dual Complete NC-S3 (D-SNP) — 1,952 enrollees
  • Plans without Drug Coverage: 0
Comparison table of 2026 D-SNP Medicare Plans available in Durham County, North Carolina
Special Needs Plan CMS Rating* Premium Per Mo MOOP PDP Ded. CMS Plan ID
Humana Dual Select H1036-307
☆☆☆☆☆
 $13 9250.00 $615 H1036-307-0
Humana Gold Plus SNP-DE H1036-167
☆☆☆☆☆
 $14 9250.00 $615 H1036-167-0
Humana Gold Plus SNP-DE H1036-331
☆☆☆☆☆
 $20 9250.00 $615 H1036-331-0
Aetna Medicare Dual
☆☆☆☆☆
 $36 9250.00 $615 H3146-002-0
Aetna Medicare Full Dual Care
☆☆☆☆☆
 $28 9250.00 $615 H3146-022-0
HealthSpring TotalCare
☆☆☆☆☆
 $20 9250.00 $615 H9725-003-0
HealthSpring TotalCare Plus
☆☆☆☆☆
 $28 8200.00 $615 H9725-013-0
UHC Dual Complete NC-D001
☆☆☆☆☆
 $25 9250.00 $615 H5253-041-0
UHC Dual Complete NC-S001
☆☆☆☆☆
 $36 9250.00 $615 H1889-005-0
UHC Dual Complete NC-S2
☆☆☆☆☆
 $36 9250.00 $615 H1889-034-0
UHC Dual Complete NC-S3
☆☆☆☆☆
 $36 9250.00 $615 H5253-184-0
UHC Dual Complete NC-V001
☆☆☆☆☆
 $36 5900.00 $615 H5253-116-0
Healthy Blue + Medicare
☆☆☆☆☆
 $19 9250.00 $615 H9147-001-0
Humana Dual Select H5525-072
☆☆☆☆☆
 $34 9250.00 $615 H5525-072-0
HumanaChoice SNP-DE H5525-036
☆☆☆☆☆
 $30 9250.00 $615 H5525-036-0
Wellcare Dual Access
☆☆☆☆☆
 $32 9250.00 $385 H4073-002-0
Wellcare Dual Liberty
☆☆☆☆☆
 $36 9250.00 $425 H4073-004-0
Wellcare Dual Liberty Open
☆☆☆☆☆
 $26 9250.00 $395 H1914-008-0
Wellcare Dual Reserve
☆☆☆☆☆
 $28 9250.00 $615 H4073-003-0
Troy Medicare for Dual-eligible Beneficiaries
☆☆☆☆☆
 $31 9250.00 $615 H4676-002-0
Liberty Medicare Dual Plan
☆☆☆☆☆
 $15 7550.00 $615 H6351-005-0
What is the total number of D-SNP plans in Durham County?

There are 21 D-SNP plans in 2026, covering 4,812 enrollees.

How much do D-SNP plans cost in Durham County?

The average D-SNP premium in Durham County is $27.61 per month, with 0 plans offering $0 premiums.

What is the most popular D-SNP plan in Durham County?

UHC Dual Complete NC-S3 (D-SNP) is the top D-SNP in Durham County, with 1,952 enrollees.

What is the total number of D-SNP plans in Durham County?

There are 21 D-SNP plans in 2026, covering 4,812 enrollees.

I-SNP Plans (Institutional Special Needs Plans)

Institutional Special Needs Plans (I-SNPs) are Medicare Advantage plans for individuals in long-term or institutional care settings. Plan availability varies by county.

Total I-SNP Plans
4
Average Monthly Premium
$36.20/mo
Beneficiaries Enrolled
117
$0 Premium Plans
0
Average MOOP
$8,638
Top I-SNP by Enrollment
UHC Nursing Home Plan NC-F001 (I-SNP) — 67 enrollees
Plans without Drug Coverage
0
Comparison table of 2026 I-SNP Medicare Plans available in Durham County, North Carolina
Health Plan Name CMS Rating* Premium Per Mo Network
Longevity Health Plan
☆☆☆☆☆
 $36 9250.00 $615 H5374-001-0
UHC Nursing Home Plan NC-F001
☆☆☆☆☆
 $36 9250.00 $615 H0710-034-0
Liberty Medicare Advantage Nursing Home Plan
☆☆☆☆☆
 $36 6800.00 $615 H6351-001-0
PruittHealth Premier
☆☆☆☆☆
 $36 9250.00 $615 H6345-001-0
What is the most popular I-SNP plan in Durham County?

UHC Nursing Home Plan NC-F001 (I-SNP) is the top I-SNP in Durham County, with 67 enrollees.

What is the total number of I-SNP plans in Durham County?

There are 4 I-SNP plans in 2026, covering 117 enrollees.

C-SNP Plans (Chronic Condition Special Needs Plans)

Chronic Condition Special Needs Plans (C-SNPs) are a category of Medicare Advantage plans offered to beneficiaries with qualifying chronic conditions, as defined by CMS program rules.

  • Total C-SNP Plans 3
  • Average Monthly Premium $0.00/mo
  • Beneficiaries Enrolled 995
  • $0 Premium C-SNPs 3
  • Average MOOP $5,817
  • Most Popular C-SNP UHC Complete Care NC-28 (C-SNP) with 720 enrollees
  • C-SNPs Without Drug Coverage 0
Comparison table of 2026 C-SNP Medicare Plans available in Durham County, North Carolina
Health Plan Name CMS Rating* Premium Per Mo Network
Humana Gold Plus - Diabetes and Heart
☆☆☆☆☆
 $0 9250.00 $450 H1036-308-0
UHC Complete Care NC-28
☆☆☆☆☆
 $0 4200.00 $355 H5253-189-0
Liberty Medicare Advantage
☆☆☆☆☆
 $0 4000.00 $0 H6351-004-0

What is the average monthly premium for C-SNP plans in Durham County?

C-SNP plans in Durham County cost $0.00 per month.

Which C-SNP plan has the highest enrollment in Durham County?

The most popular C-SNP plan in Durham County is UHC Complete Care NC-28 (C-SNP), with 720 enrollees.

How many C-SNP plans are available in Durham County?

In 2026, Durham County offers 3 C-SNP plans with 995 enrollees.

County-level figures shown on this page, including plan counts, enrollment totals, averages, and percentage distributions, reflect Medicare Special Needs Plans (SNP) only and are derived from CMS datasets using a standardized aggregation methodology.

Data sources and methodology documentation .

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