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Medicare Supplement (Medigap) Plans in North Carolina

Key Takeaways

  • Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). covers hospital and medical care, but it doesn’t cover all your costs. Every time you access covered services, you’ll pay a coinsurance or copayment.
  • Medicare Supplement Plans, also called Medigap plans, can cover your out-of-pocket costs.
  • Private insurance companies in North Carolina offer 12 Medigap plans, including two high-deductible plans.
  • If you’re enrolled in Original Medicare Part A and Part B, you’re eligible for a Medigap plan.

What Are the Coverage Gaps in Original Medicare?

Original Medicare provides healthcare coverage for millions of Americans. It includes hospital coverage (Medicare Part A) and medical coverage (Medicare Part B). But Medicare in North Carolina doesn’t cover all your healthcare costs. When you access a covered service, Original Medicare pays 80% of the cost, and you pay the remaining 20%. This is called your coinsurance. For other services, you may pay a fixed cost called a copayment. Along with coinsurance and copayments, you also need to meet your Part A and Part B yearly deductible before your healthcare benefits begin.

Your out-of-pocket Original Medicare costs can include:

  • Part A and Part B monthly premiums
  • Part A and Part B yearly deductible
  • Coinsurance
  • Copayments

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North Carolina Medicare Supplement Plan Coverage

Medicare Supplement Plans, also called Medigap plans, can lower your out-of-pocket costs and fill in the gaps in Original Medicare coverage. Private insurance companies sell Medigap plans, and there are twelve types of Medicare Supplement plans available in North Carolina.

All Medicare Supplement Plans must cover:

  • Part A coinsurance for select services, including hospital and hospice care
  • Part B coinsurance
  • Blood (first 3 pints) needed for a medical procedure
Some Medicare Supplement Plans also offer added benefits such as:
  • Part A coinsurance for additional services like skilled nursing facility care
  • Part A deductible
  • Part B deductible
  • Part B excess charges
  • Foreign travel medical emergency coverage
You can see exactly what’s covered in each plan using this side-by-side comparison chart. Each plan offers different benefits, so make sure you understand your Medigap options before you purchase a plan.

Are there North Carolina Medicare Supplement Plans with Prescription Drug Coverage?

Medicare Supplement plans help you fill in the gaps in Original Medicare coverage. But they do not cover other benefits like prescription drug coverage — to get drug coverage, you will need to enroll in Medicare Part D. Medigap plans in North Carolina do not include additional benefits such as dental, vision or hearing coverage.

Medicare Supplement plans cover out-of-pocket costs for Original Medicare, but do not cover:

  • Medicare Advantage out-of-pocket costs
  • Medicare Part D prescription drug costs
  • Medicaid plan costs
  • Employer health insurance out-of-pocket costs

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NC Medigap Plan Costs

Medicare Supplement Plans in NC are offered by private insurance companies. While the benefits included in each plan are standardized, the cost is not. Each provider can set their own costs, so it’s a good idea to compare all the plans in your area. This will help you find the best Medigap plan that matches your healthcare needs and your budget.

NC Medicare Supplement Plan premiums range from $30 to $1,414 in 2022 depending on your provider, your age, your health status and when you purchase the plan.

Medigap Plan G High Deductible Plans


There are two high deductible plans available in North Carolina. Medigap Plan F and Medigap Plan G each offer a high deductible plan option. You’ll pay a lower monthly premium, but you will need to pay a yearly deductible before your coverage begins. The Medigap Plan F and Plan G deductible for 2022 is $2,490. After you reach this deductible, your Medigap coverage kicks in.

Medicare Supplement Plan Eligibility & Enrollment in North Carolina

You can buy a Medigap plan if you’re enrolled in Medicare Part A and Part B. As soon as your Original Medicare coverage begins, you’re eligible for a Medicare Supplement Plan in NC.

You can enroll in a Medigap plan during your Medigap Open Enrollment Period. This starts from the first day your Medicare Part B coverage begins. During your Open Enrollment Period, you can enroll in any Medigap plan available in your area, and plan providers must sell you a plan regardless of your health status. But if you miss your Open Enrollment Period, plan providers may use medical underwriting to deny coverage or offer coverage at a higher rate.

Medigap vs. Medicare Advantage in North Carolina

Medigap plans are designed to fill in your cost gaps in Original Medicare. Medigap plans will cover out-of-pocket costs for Medicare Part A and Part B. You must be enrolled in Original Medicare to use a Medigap plan.

Medicare Advantage plans, on the other hand, are an alternative to Original Medicare. These plans include all the same hospital and medical coverage as Original Medicare. They can also offer added benefits like vision or dental services. Medigap plans do not cover any Medicare Advantage plan costs, and you cannot have a Medicare Advantage plan and a Medigap plan at the same time.

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FAQs

Medigap Plan F and Medigap Plan C are not available to newly eligible Medicare beneficiaries. If you first became eligible for Medicare after January 1, 2020, you can’t purchase these Medigap plans. If you were eligible for Medicare before 2020, you may be able to buy a Medigap Plan F or Plan C.
If you’re enrolled in Original Medicare Part A and Part B, you can purchase a Medigap plan if you’re under 65. You can purchase a plan during your Medigap Open Enrollment Period starting from the date your Medicare Part B coverage starts. However, some plans may have different premiums for adults under 65.
During your Medigap Open Enrollment Period, you can take advantage of the Medigap free look period. This 30-day period lets you try out a new Medigap policy without losing your old plan. For example, you can try a Medigap Plan B, but you don’t have to drop your Medigap Plan F if you think that in the long run you may want to keep your first plan.

During the free look period you will pay premiums for both plans. After 30 days, you can cancel your first Medigap plan and stay in the new plan, or you can leave the new plan and keep your first plan.

Medicare Learning Guides

Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.

 

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Before 65 Guide

Understanding health insurance before age 65, especially when considering early retirement

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Medicare Plans Guide

Costs, coverage and enrollment details for each Medicare plan

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Medicare Beneficiary Guide

For those currently enrolled in Medicare

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Low Income and Medicare Guide

For individuals with a qualifying income status

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A Caregiver's Guide

For individuals with a qualifying income status

Sources

This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.

Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.