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Best Medicare Advantage Plans in North Carolina for 2019

Most people enroll in the best Medicare Advantage plan in North Carolina that will help to manage 2019 healthcare costs that Original Medicare provides. Even though Medicare Part A and Part B cover a wide range of services for doctor’s office visits, hospital visits, temporary skilled care in a nursing home and more, they won’t cover every cost. A Medicare Advantage plan, also called Medicare Part C, will also offer some benefits that won’t be included in Original Medicare.

For example, one advantage that people like about Medicare Advantage plans in North Carolina for 2019 over Original Medicare or Medicare with a Medicare Supplement is that Medicare Part D prescription drug coverage is often included. You can purchase a separate Medicare prescription drug plan in addition to a Medicare Supplement plan, but it’s often not necessary for beneficiaries of Medicare Advantage plans to purchase separate D plans.

Additionally, it is sometimes possible to choose a Medicare Advantage plan that has no monthly premium, although you will still be responsible for paying for the Medicare Part B premium. Read below or talk to one of our insurance agents to learn more about how an Advantage plan can help you get more out of the Medicare program when you purchase from a company like UnitedHealthcare or AARP.

Best Time to Enroll in Medicare Advantage Plans in North Carolina for 2019

The primary requirement for a Medicare Advantage plan in North Carolina is to be enrolled in Medicare Part A and Part B. Except for End Stage Renal Disease ESRD, there are no health underwriting requirements at all. A Medicare beneficiary who suffers from ESRD can enroll in a special plan.

You just need to keep track of the times that you are allowed to enroll in a Medicare Advantage plan:

  • Initial Coverage Election Period: For three months before you turn 65, the month you turn 65, and three months afterward, you can enroll in any Medicare Advantage plan in your area.
  • Annual Election Period: Every year, Medicare beneficiaries get a few weeks in the autumn when they can join, drop, and switch their Medicare Advantage plan in North Carolina.
  • Special Election Periods: Some circumstances can trigger an SEP, such as losing coverage or moving away from a plan network.
  • Medicare Advantage Disenrollment Period: At the beginning of the year, you will have six weeks to drop your Medicare Advantage plan, return to Medicare Part A and Part B, and enroll in Part D if you need drug coverage.

When you enroll in a Medicare Advantage plan in North Carolina for 2019, your insurance company will give you an insurance card. Typically, you will use that car instead of your Original Medicare cards when you need to show insurance at a doctor or hospital.

Popular Kinds of Medicare Advantage Plans in North Carolina for 2019

Medicare Part A and Part B offer standard benefits for everybody. Don’t make the mistake of thinking that each Medicare Advantage plan works the same way. These are the most popular choices for North Carolina Medicare Advantage plans:

  • Health Maintenance Organization HMO plans

    An HMO may have a modest or $0 premium and low copayments. About 30 percent of Georgians choose an HMO. About 42 percent of all MA members choose an HMO in North Carolina.

  • Preferred Provider Organization PPO plans

    In this state, about 56 percent choose a PPO Medicare Advantage plan. These have more flexible rules, but may charge higher rates than an HMO.

  • Special Needs Plans SNPs

    Insurance companies offer Special Needs Plans to people with chronic health conditions or institutional conditions.

  • Dual-Eligible Plans

    A North Carolina Medicare beneficiary who also qualifies for Medicaid may get a Dual-Eligible plan.

  • End Stage Renal Disease ESRD plans

    People who suffer from ESRD will be directed towards one of these Special Needs plans.

Enrollment Figures for Medicare Advantage Plans in North Carolina

These are some North Carolina Medicare Advantage plan enrollment statistics:

  • Percent enrolled in Medicare Part C in North Carolina: 42 percent
  • Number enrolled in North Carolina Medicare Advantage plans: 587,632

These are the largest North Carolina counties by population:

  • Mecklenburg County, North Carolina: 1,076,837
  • Wake County, North Carolina: 1,072,203
  • Guilford County, North Carolina: 526,953
  • Forsyth County, North Carolina: 376,320
  • Cumberland County, North Carolina: 332,546

How Medicare Advantage Plans in North Carolina Cover Prescriptions

One good thing is that you can find many Medicare Advantage Prescription Drug plans with a cheap or even $0 premium rates. These North Carolina Medicare Advantage plans bundle in medical and prescription coverage. If you’re only enrolled in Medicare Part A and Part B, you will barely get any prescription drugs covered at all. Original Medicare may only cover prescriptions in an outpatient or inpatient facility. This benefit may make Medicare Part C plans in North Carolina a good choice for people who rely upon expensive prescriptions for 2019.

As you compare prescription benefits, you will want to note these two things to make sure that you find the best Medicare drug coverage:

  • The formulary: A formulary is simply a list of covered drugs. An insurance company may only cover other prescriptions under special circumstances.
  • Prescription Drug tiers: Even if the insurer will cover drugs, they may have different coverage levels for specialty or brand-name prescriptions than they do for generics.

If you’re currently taking prescriptions, you should compare the plan’s coinsurance and deductibles for those drugs. Also, make sure that the plan covers convenient pharmacies.

Network Rules for Medicare Advantage Plans in North Carolina

Almost all Medicare Part C plans in North Carolina for 2019 rely upon provider networks to help control premiums and costs. Beneficiaries who only have Medicare Part A and Part B may not be used to worrying about finding a network hospital or doctor, so it’s important to understand these network restrictions. Original Medicare doesn’t use provider networks.

  • HMO Medicare Advantage Plans in North Carolina:
    With an HMO, you have to get almost all covered services from in-network providers. Out-of-network services may only be covered in an emergency or other unusual situation. You have to make certain that your favorite doctor or hospital are in-network healthcare providers. You will also need to have a primary care doctor assigned. This PCP must give you a referral in order to get your specialist visits covered.  This Medicare Advantage Plan in North Carolina often has the best premiums with lower copays and out of pocket costs for 2019.

  • PPO Medicare Advantage Plans in North Carolina:
    PPO Medicare Advantage plans will cover out-of-network services at lower rates than they will cover in-network services. You also don’t need to have a PCP or get referrals to see a specialist. You will probably find that an HMO will give you lower out-of-pocket costs, but a PPO may deliver more flexibility. You should compare a variety of options to find the one that works best for you. The two options above are the most common Medicare plans for those who opt for Medicare Advantage.

However, there are other options. For example, there are special needs programs for those with health conditions that cause them to have special needs for health plans. There are also other stand-alone plan options like an MSA (Medicare savings account with high deductible plan) or PFFS (Private Fee-for-Service) plan. For the best Medicare Part C coverage in North Carolina for you, get a complete description of benefits for each plan, and use our plan finder to search for the best rates and health insurance coverage.

Top Rated Providers for Medicare Advantage Plans in North Carolina for 2019

These are a few of the leading providers that you can compare with our tool:

Best North Carolina Medicare Resources

If you have Medicare Part A and Part B and live in Raleigh, Durham, Wilmington or anywhere else in North Carolina, you may benefit from these North Carolina resources:

In addition to using these resources, check out our website or give us a call today for extra help with signing up for a Medicare Advantage or Supplement plan for 2019!