The state of North Carolina had 63 different Medicare Advantage plans available for sale in 2019.1
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.
Find Medicare Advantage plans in your area
Compare PlansOr call TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!
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.
The 2019 breakdown of Medicare Advantage plan enrollment in North Carolina is illustrated in the chart below.1
Plan type | Percentage of North Carolina enrollees (2019) |
---|---|
HMO | 75.7% |
Local PPO | 24.1% |
Regional PPO | <1% |
PPFS | <1% |
Other Plans | <1% |
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 2019, 75.7% of Medicare Advantage beneficiaries in North Carolina were enrolled in HMO 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 2019, 24.1% of North Carolina Medicare Advantage plan beneficiaries were enrolled in Local PPO 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.
With most Medicare PFFS plans, you aren’t required to designate a primary care doctor.
Less than 1% of North Carolina Medicare Advantage plan beneficiaries in 2019 were enrolled in a PFFS plan.
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:
More than 727,000 people in North Carolina were enrolled in a Medicare Advantage plan in 2019. That accounted for 35 percent of all Medicare beneficiaries.1
Individual plan costs and premiums may vary.
39 plans across North Carolina were rated four stars or higher by the Centers for Medicare and Medicaid Services (CMS) in 2019.2 A plan that has four or more stars is considered a highly rated Medicare Advantage plan.
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:
Connect with a licensed insurance agent today to explore your North Carolina Medicare Advantage plan options.
Find Medicare Advantage plans in your area
Compare PlansOr call TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!
Compare your Medigap plan options by visiting MedicareSupplement.com
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