Medicare Supplement (Medigap) plans in North Carolina are designed to help Medicare beneficiaries pay for out-of-pocket expenses associated with Original Medicare, Part A and Part B, such as copayments, coinsurance, and deductibles. As a North Carolina resident, you may have a number of Medigap plan options, although plan availability may vary within North Carolina.
How Medigap plans work in North Carolina
There are 10 standardized Medicare Supplement plans available in 47 states, including North Carolina. Each Medigap plan is identified by one of 10 letters (A, B, C, D, F, G, K, L, M, and N), and plans of the same letter offer the same benefits. Massachusetts, Minnesota, and Wisconsin are the only three states that have different types of standardized Medigap plans. Remember that you must be enrolled in Original Medicare, Part A and Part B, in order to join a Medigap plan in North Carolina.
The Medigap Open Enrollment Period in North Carolina and the rest of the United States begins the first day you are both age 65 or older and enrolled in Medicare Part B. This period lasts for six months. During that time frame, you can join any Medigap plan available in your area, with any insurance company you choose, and you cannot be denied coverage for pre-existing conditions. In some cases, there may be a waiting period before your coverage for a pre-existing condition begins.
If you miss your Medigap Open Enrollment Period, you may still apply for a Medicare Supplement plan in North Carolina at a later date, but you might:
- Have to undergo medical underwriting (consideration of your medical history)
- Be charged more for your insurance plan
- Face a waiting period before coverage begins
- Be denied coverage altogether
Medigap in North Carolina is designed to supplement, not replace, Original Medicare, so you have to remain enrolled in Original Medicare, and continue paying your Medicare Part B premium. Also note that if you need prescription drug coverage, you may want to think about joining a Medicare Part D Prescription Drug Plan since Medigap plans sold today don’t offer drug benefits.
Types of Medigap plans in North Carolina
Take a look at the coverage available for Medicare beneficiaries under the 10 types of standardized Medicare Supplement plans in North Carolina. In the table below, an X means the Medigap plan covers the corresponding service or item; a blank cell means the plan doesn’t cover it.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A coinsurance and hospital costs up to an additional
365 days after Medicare benefits are exhausted
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility (SNF) care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B ‘excess charges’||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Medicare Part B preventive care coinsurance||X||X||X||X||X||X||X||X||X||X|
|Out-of-pocket limits apply**|
In addition, it may be useful for you to understand the following about Medigap plans in North Carolina:
- Medicare Supplement Plan F is the most comprehensive plan, covering almost 100% of Medicare-associated costs listed above.
- Medicare Supplement Plan N pays 100% of the Medicare Part B coinsurance, but you may still have to pay a copayment of up to $20 on some office visits and up to $50 on emergency room visits.
- Medicare Supplement Plan K and Plan L have out-of-pocket limits that are subject to change each year.
Choosing a suitable Medigap plan in North Carolina
As explained earlier, Medicare Supplement plans in North Carolina with the same letter designation don’t vary in coverage or benefits (so, for example, a Medigap Plan L you buy in one city covers the same out-of-pocket Medicare costs as a Medigap Plan L you buy elsewhere). But be aware that each independent insurance company offering Medicare Supplement plans can determine its own monthly premium structure. This means that if you live in Charlotte in Mecklenburg County, you may pay more or less than a resident of Chapel Hill in Orange County for an identical Medicare Supplement plan. With the possible differences in costs, it may be a good idea to compare all Medicare Supplement plans available in your area, and then choose the Medigap plan in North Carolina that’s suited to your individual budget and health requirements.
As you can see, there are various Medigap plan options available in North Carolina. To start comparing Medicare Supplement plans in your area, feel free to enter your zip code where indicated on this page.
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.