List of Medicare Advantage Plans in North Carolina 2022

• by Christian Worstell
• November 17, 2021

The state of North Carolina is home to 104 different Medicare Advantage plans available for sale in 2022.¹

Plan selection varies by county or zip code. Call to speak with a licensed insurance agent who can help you determine your eligibility to enroll and compare the Medicare Advantage plans that are available in your area of North Carolina.

Types of North Carolina Medicare Advantage plans

There are several different types of Medicare Advantage plans that may be available, though not each type of plan may be available where you live.

North Carolina Health Maintenance Organization (HMO) plans

A Health Maintenance Organization (HMO) plan features a network of participating doctors, pharmacies and other health care providers.

With a Medicare HMO plan, you typically choose a primary care physician (PCP) who coordinates your health care and provides a referral when you need to see a specialist. 

Typically only care that is received within the network of participating providers will be covered by an HMO plan.

In 2022, 95% of Medicare Advantage beneficiaries in North Carolina have access to at least one HMO plan.

North Carolina Preferred Provider Organization (PPO) plans

A Preferred Provider Organization (PPO) plan also typically includes a network of participating providers, but you may be able to receive partial coverage for care you receive outside of your plan network.

If you receive medical services outside of your Medicare PPO plan network, however, you will typically pay higher out-of-pocket costs than you would if you visited an in-network provider.

You typically aren't required to get a referral from a physician in order to visit a specialist when you have a PPO plan, but individual restrictions may vary.

In 2022, 97% of North Carolina Medicare Advantage plan beneficiaries have access to at least one local PPO plan.

North Carolina Private Fee-For-Service (PFFS) plans

Private Fee-For-Service (PFFS) plans allow members to receive care from any provider who agrees to the terms and conditions of the plan and who accepts Medicare. PFFS plans are much less common in North Carolina than HMO and PPO plans.

With most Medicare PFFS plans, you aren’t required to designate a primary care doctor.

Special Needs Plans (SNPs)

Medicare Advantage Special Needs Plans (SNPs) feature benefits that are designed for people with certain medical conditions or who are dual eligible for Medicare and Medicaid.

Medicare SNPs aren’t available in all areas. Depending on where you live and what type of special needs you may have, a licensed insurance agent can help you find a Medicare SNP that may fit your needs, if one is available.

You can also learn more about additional Medicare plans in North Carolina, such as:

• Medicare Supplement Insurance in North Carolina
• Medicare Part D in North Carolina

Medicare Advantage plans in North Carolina

More than 26 million people in America are enrolled in a Medicare Advantage plan in 2022.¹

• The average premium for a Medicare Advantage plan in North Carolina is $49.44 per month in 2022, though many plans feature $0 premiums.²
  
  $0 premium plans may not be available in all areas, so be sure to check with a licensed insurance agent who can help you find any $0 premium plans in your area.
  
  
• The average drug deductible for a Medicare Advantage plan in North Carolina that includes prescription drug coverage is $233.39 per year in 2022.² This is the deductible you must spend on covered drugs before your plan's drug coverage fully kicks in, and it's separate from any medical care deductible your plan may have.

Individual plan costs and premiums may vary.

Every year, Medicare evaluates plans based on a 5-star rating system. 53.8 percent of plans across North Carolina are rated four stars or higher by the Centers for Medicare & Medicaid Services (CMS) in 2022.² A plan that has four or more stars is considered a highly rated Medicare Advantage plan.

How to enroll in a Medicare Advantage plan in North Carolina

Call today to speak with a licensed insurance agent who can help you determine your eligibility to enroll and compare Medicare Advantage plans where you live. A licensed agent may also be able to:

• Verify your Medicare Advantage eligibility
• Ensure that you enroll during a qualified Medicare enrollment period

Connect with a licensed insurance agent today to explore your North Carolina Medicare Advantage plan options. 

¹ Freed M, et al. (Nov. 2, 2021). Medicare Advantage 2022 Spotlight: First Look. https://www.kff.org/report-section/medicare-advantage-2022-spotlight-first-look-appendix.

²  The Best States for Medicare annual report.

About the author

Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.

 

 

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