Medicare Advantage Plans in Raleigh, NC

Looking for Medicare Advantage Plans in Wake County? Enter your ZIP below to compare affordable or $0 premium plans in your area.

North Carolina state

There were over 52,000 Medicare Advantage (Medicare Part C) plan members in Wake County in 2019, which accounted for more than one out of every three Medicare beneficiaries across the county.1

Learn more about Medicare Advantage in North Carolina.

2020 Medicare Advantage plans in Wake County and Raleigh

Number of unique plans 3
Weighted average premium $30
Average annual deductible $130.69
Average (in-network) out-of-pocket maximum $4,464
Number of $0 premium plans 2
Number of plans rated four stars or higher 1

Wake County residents had three different Medicare Advantage plans from which to choose in 2019.

Two Raleigh Medicare Advantage plans featured $0 premiums, and one plan was rated four stars or higher based on Medicare Star Ratings.2 Plans rated four stars or higher are considered top-rated Medicare plans.

Premiums, deductibles and other costs may vary. The numbers reported in the table above are taken from the Centers for Medicare and Medicaid Services (CMS). A licensed insurance agent will be able to help you review and compare costs for specific plans available in Wake County or wherever you may live.

List of Medicare Advantage plans in Raleigh and Wake County

Medicare Advantage plans can come in several different forms.

Three out of four Medicare Advantage enrollees in North Carolina belonged to an HMO plan in 2019.

  • HMO (Health Maintenance Organization) plans utilize a network of participating doctors and other health care providers. Care is typically not covered by the plan when received outside of the network. 

  • PPO (Preferred Provider Organization) plans are also available in North Carolina. These plans offer some more flexibility when choosing a doctor and allow for some coverage outside of the plan’s intended network. 

Private Fee-For-Service (PFFS) plans and Medical Savings Accounts (MSA) were also available in North Carolina in 2019. 

In the state of North Carolina, the breakdown of plan types in 2019 was as follows:

Plan type Percentage of North Carolina enrollees (2019)
HMO 76%
PPO 24%
PFFS <1%
MSA <1%

How to Sign up for a Medicare Advantage Plan in Wake County

There are different Medicare enrollment periods in the year during which you may able to sign up for a Medicare Advantage plan in Raleigh and Wake County, depending on your eligibility. 

Medicare IEP graphic

Initial Enrollment Period (IEP)

When you first become eligible for Medicare, you will typically be granted an Initial Enrollment Period (IEP). This period begins three months before you turn 65 years old, includes the month of your birthday and continues for an additional three months. 

Medicare AEP graphic

Annual Enrollment Period (AEP)

The Annual Enrollment Period (AEP, also called the Medicare Open Enrollment Period for Medicare Advantage plans) takes place from October 15 to December 7 each year. This period is open to all eligible Medicare beneficiaries who wish to add, drop or change Medicare plans.  

Special Enrollment Period

If you experience a qualifying circumstance, you may be granted a Special Enrollment Period (SEP) at any time throughout the year to allow you to enroll in a Medicare Advantage plan.

Such circumstances may include situations like moving outside of your plan’s service area or losing your Medicare Advantage plan coverage through no fault of your own. A licensed insurance agent can help you determine if you are eligible for a Special Enrollment Period and what actions you may be able to take during that time. 

Find a Medicare Advantage plan where you live

Medicare Advantage plans can come in a variety of types and can include different benefits, networks, costs and more.

Connect with a licensed insurance agent today for help determining your eligibility and finding the best Medicare Advantage plan for you in Wake County. 

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1 MedicareAdvantage.com's internal analysis of CMS Medicare Advantage landscape source files, accessed May 2019. Data retrieved from www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn.

2 Every year, Medicare evaluates plans based on a 5-star rating system.