Medicare Supplement Plans in North Carolina

Medicare Supplement Plans in North Carolina are designed to work with Original Medicare (Medicare Part A and Part B). Medicare pays 80% of medically approved health care charges The recipient is responsible for the remaining 20%.

Only recipients enrolled in Part A and Part B may enroll in a Medicare Supplement plan, also called Medigap because these plans help fill in the gaps remaining after Original Medicare pays. Medigap health plans are sold by insurance companies.

They are named after letters of the alphabet (A, B, C, D, F G, K, L, M, and N. Medicare Supplement Plans are standardized, meaning that any plan of the same letter name will offer the same basic core benefits. Insurance companies may add some extra features and set their own prices for the plans they offer.

Most popular Medicare Supplement Insurance plan types in North Carolina

Approximately 48 private insurance companies offer Medicare Supplement plans in North Carolina. Plans A through N are available in N.C. along with a high-deductible G Plan.

Plans F and G are the long-time favorite Medigap health plans in the state.

Beneficiaries becoming eligible for Medicare benefits after December 31, 2019, cannot enroll in Part F. Those who became eligible before January 1, 2020, but who have delayed Medicare enrollment for a reason like continued employment with employer coverage may still be able to enroll in the plan.

Medicare Supplement Plan F

The popularity of Medigap Part F is due to its comprehensive coverage. Although more expensive than Plan G, many people have chosen it because it covers:

• Part A coinsurance and deductible (Hospital)
• Hospital costs for up to 365 days after Original Medicare benefits run out
• Part A coinsurance and copays for Hospice care
• Deductible for Part B
• Part B coinsurance for a preventive office visit
• Part B copayments and coinsurance
• Medicare Part B Excess Charges
• First three pints of blood for medical procedure
• Coinsurance for Skilled Nursing Facility care
• Limited foreign travel emergency care

Medicare Supplement Plan G

For a comprehensive but less expensive Medigap plan, Medicare Supplement G is widely popular. It is the most all-inclusive plan for enrollees becoming eligible for Medicare after January 1, 2020. The one difference from Part F is that with Part G, you have to pay the yearly Part B deductible.

As a trade-off, you get the following advantages:

• Referrals not required
• You can go to any doctor, medical clinic, or hospital that accepts Medicare
• Freedom to change doctors at any time
• Decreased out-of-pocket costs
• Limited medical emergency care when traveling

Medicare Supplement Plan N

Plan N has lower monthly premiums in exchange for doctor’s office and Emergency Room copays. This plan is becoming increasingly popular. People without chronic conditions, who do not visit the doctor’s office frequently, might profit from making occasional copays in exchange for lower monthly premiums. This Medigap plan does not cover the Part B deductible.

All three of the above plans offer 100% coverage of the coinsurance for Skilled Nursing Facility care.

High-Deductible Plan F

As popular as Part F is, many people find the High-deductible version of the same plan attractive. Enrollees in the plan might be people who:

• Desire a lower monthly premium
• Don’t mind paying a higher deductible prior to receiving full coverage
• Have doctor or hospital visits semi-frequently
• Reside in a state where excess charges are allowed
• Frequently travel outside the U.S.

Medicare Supplement Plan F monthly premiums vary according to age, gender, location, health status, and other factors. In North Carolina, they might range from $122.03 to $225.60 depending on the insurance company. Premiums on the high-deductible plan generally run between $40 to $80 per month.

High-Deductible Plan G

Medicare supplement G offers its own high-deductible version. It is available to Medicare recipients who become eligible for Original Medicare after December 31, 2019. This high-deductible plan duplicates the coverage of the standard plan.

Like Medigap F, the high-deductible amount is $2,490. This must be paid by the beneficiary before full coverage begins.

Neither the F nor G standard plan has a deductible of its own. Both are required to pay the deductible for Part B, which is covered by the first $233 paid out of pocket. After paying the $233, Medicare Part B covers 80% of Medicare-approved charges.

After that deductible is paid, the next $2,490 of medical charges must be paid by the beneficiary. Once this amount is paid, the Medigap plan covers 100% of Medicare-approved charges for the rest of the calendar year.

Top-rated Medicare Supplement Insurance Companies in North Carolina

Many private insurance companies sell Medicare Supplement plans in North Carolina. The three leading insurance companies for popularity are listed below:

• Cigna: A 5-star rating (the highest possible) was awarded to Cigna in 2022. Cigna will help you find the best Medigap policy for your needs.
• Aetna: Aetna’s overall weighted average rating for 2022 is 4.0 out of 5 stars. The diversity of plans offered by Aetna will help you find the best coverage for you.
• Mutual of Omaha: An insurance company with a long history of customer satisfaction, one of the first to sell Medicare Supplement plans after Medicare began in 1965. Their 2022 star rating was 2.5 out of 5 stars.

Medicare Supplement Insurance Cost in North Carolina

The cost of Medigap insurance plans vary with the insurance company and may be based on age, gender, smoking status, medical condition, and more. For a 65-year-old, non-smoking woman living in the 27604 zip code (Raleigh, NC), some prices might be as below:

• Plan F: $122.03 – $225.60
• Plan G: $86.46 – $210.48
• Plan N: $76.22 – $150.26

When Can I Apply for a Medicare Supplement Plan?

The best time to apply for a Medicare Supplement Plan is during your individual Medicare Supplement Open Enrollment Period. This is a one-time-only period that begins the month you are both 65 years old and enrolled in Medicare Part B.

During this Open Enrollment Period (OEP), you can choose from all the Medigap health plans available in your state. You cannot be turned down or charged more due to pre-existing conditions. No medical underwriting will be required.

You can apply for a Medigap plan at any time during the year, but you might have to undergo Medical Underwriting and disclose any pre-existing conditions. You could be denied coverage or required to pay a higher premium.

Ready To Learn More?

Medigap plans are not for everyone. Those enrolled in Medicare Part A and B need a Supplement plan to help cover medical expenses not covered by one of these.

Because supplemental Medicare plans do not include drug coverage, most individuals will need to purchase a prescription drug plan. A stand-alone Part D prescription drug plan may be purchased from your insurance company.

Medicare Advantage plans (MA) may be a better option than Supplement plans for some people. This is a different way to receive benefits, and it is administered by an insurance company instead of the government. Many Medicare Advantage plans include drug coverage and some offer extras like vision, hearing, dental, fitness, and wellness benefits.

Medicare Advantage places great emphasis on Medicare preventive care.

Medicare Advantage may be a Home Health Organization (HMO) or a Preferred Provider Plan (PPO). They are based on a specific service area. Full coverage may not be available outside this area.

Those who do not travel abroad often and who need the extra benefits available with Medicare Advantage may find this a good option.

Advantage plans are an alternative way to receive Medicare benefits and can be purchased from an insurance company. Check with an insurance agent to make sure your specific prescription drug is covered. In addition to health insurance, your agent can help you with a life insurance policy.

Also, ask about coverage for care in a Skilled Nursing Facility. Medicare Advantage covers at least what government-issued Medicare covers.

North Carolina Medicare Resources

State Links

https://www.ncdoi.gov/
https://www.medicare.gov/
https://www.cms.gov