North Carolina Medicare Supplement Plans (Medigap)
North Carolina Medicare Supplement Plans were created to go hand in hand with Traditional Medicare. These supplement insurance policies are provided by private insurance carriers in your area. They were created to provide coverage for what’s not covered by Original Medicare.
This includes the out of pocket costs associated with deductibles, copayments and coinsurance. Supplement plans, aka Medigap Plans, are separated into parts and plans. Traditional Medicare is broken down into four parts.
- The first part is your Medicare Part A. This includes your hospitalization coverages.
- The second part is your Medicare Part B. This includes your doctor’s visits and other outpatient medical expenses.
- The third part, Part C, is also known as Medicare Advantage. This can also be called a Medicare Replacement Plan. This plan covers the same as Original Medicare, if not more. However, comes with certain policy limitations.
- The fourth part is Medicare Part D. This is your prescription drug coverage which is not covered by Original Medicare or any Medicare Supplement Plan.
Then there are North Carolina Medicare Supplement Plans. There are ten letter plans that offer coverage in North Carolina to help with costs associated with what Traditional Medicare doesn’t pay. These are offered by private insurance carriers and assist with deductibles, copays, coinsurance and other medical expenses that Medicare doesn’t pay.
What Benefits Does Medicare Cover in North Carolina
Medicare, both Parts A and B, cover many healthcare costs. Any hospitalization and associated costs are covered by Medicare Part A. Whereas, Part B covers your doctor’s office visits and other outpatient costs.
Both’s coverage is only at 80% which leaves you, the beneficiary, with the remaining 20%. Depending on your individual healthcare needs, North Carolina Medicare Supplement Plans can help reduce your out of pocket expenses.
How to Qualify for North Carolina Medicare Supplement Plans
To be eligible for a Medicare Supplement plan, you must first, be 65 years of age and second, be enrolled in Medicare Part B. You have a total of seven months to obtain insurance. Open Enrollment Period (OEP) starts the three months prior to your 65th birthday and continues the month of your birthday and three months after.
Failing to enroll during this time period will result in a penalization.The Part B penalty increases your premium by 10% for each full 12-month period you went without coverage. This will add to the $134.00 a month premium. Make sure to enroll during OEP to avoid any additional OOP costs.
If you currently receive Social Security Disability benefits, or certain Railroad Retirement Benefits, you’re automatically enrolled in Medicare Parts A and B after 24 months. It isn’t required by Federal law for insurance carriers to offer Medicare Supplement plans.
In North Carolina however, the state law allows for enrollment in a Medicare Supplement Plan. There are 10 available policies to choose from. Call today and one of our licensed insurance agents can help provide more information.
When to Sign Up for a Medicare Supplement Plan in North Carolina
The best time to sign up for a Supplement Plan is during the Open Enrollment Period. The 1st day of the month after turning 65 and having been enrolled in Medicare Part B is when an enrollee becomes eligible. You then have an additional 6 months to apply. This is when your granted the Guaranteed Issue (GI) right.
You must enroll during your OEP to avoid coverage denial. With your granted GI, regardless of any pre-existing medical conditions the carriers are required to accept you and are unable to charge more. Without the GI, you may be required to undergo the underwriting process. This can result in higher premiums or denial of coverage due to your existing health issues.
Medicare Supplement Plan Prices in North Carolina
Your insurance premiums are determined by the state’s individual insurance carriers. Determining factors for cost include your age, sex and location. Therefore, a person living in Greenville vs a person living in Charlotte will have different premiums.
Your premiums are also affected depending on which 1 of 3 different pricing methods are used. Community rated pricing, issue-age rated pricing, or attained-age-rated pricing are the three different pricing methods and you can click here for more info.
The Best medicare Supplements in North Carolina
There are 10 Medicare Supplement Plans offered by the numerous private insurance carriers. Regardless of which carrier you choose, the insurance benefits are the same regardless of which state you live in. The only difference will be what they chose to charge. The top 3 letter plans are Plans F, G and N.
North Carolina Medicare Supplement Plan F provides 100% coverage of the deductible in both Medicare Part A and Medicare Part B. The remaining 20% of hospital and doctor’s costs not covered by Original Medicare. Also, Part B coinsurance and copayments are included in this coverage.
Plan F, the most popular of the 10 plans, provides the best coverage. It also has foreign travel coverage which not all plans include. There’s a Plan F High Deductible version that provides the same great benefits, but with a lower monthly premium plus a deductible.
North Carolina Medicare Supplement Plan G is similar to Plan F. The only difference with Plan G is there is no coverage of Medicare Part B’s deductible. In 2018, the deductible costs $183.00 which you will be responsible to pay.
Plans N is the most affordable of all the plans, but with less benefits. It covers your Medicare Part A deductible only and requires the beneficiary to pay small copayments for office and ER visits. Plan N is considered a “cost-sharing” option. Additionally, there is no excess charge coverage which some physicians charge and is allowed in North Carolina.
North Carolina Medicare Advantage Plans
Like North Carolina Medicare Supplement plans, Medicare Advantage plans are offered by private insurance companies. This plan replaces your Original Medicare Part A and Part B.
Medicare Advantage Plans come with restrictions, including coverage limitations and treatment with physicians or hospitals only within the network. While typically cheaper than a Medicare Supplement Plan, overtime your OOP costs are higher. You can avoid escalated charges by opting instead for a Medicare Supplement Plan.
Part D Plans Plans for Medicare in North Carolina
There is no prescription drug coverage offered by Traditional Medicare or any of the North Carolina Medicare Supplement Plans. Obtaining a Medicare Part D Plan provides coverage for any OOP expenses associated with prescription medications. Not only can medication be costly, another downside is the penalty associated without having a Part D Plan.
The Part D penalty starts after your 7 month initial enrollment period. Once your IEP has expired, depending on how long you go without drug coverage, an added charge will be calculated into your monthly premiums.
For the most comprehensive coverage with the least OOP cost, an ideal plan would include Original Medicare, a Medicare Supplement Plan and a Prescription Drug Plan combined.
How to Get Help with North Carolina Medicare Supplement Plans Options
As previously mentioned, Traditional Medicare only provides coverage at 80% leaving the beneficiary to pay the remaining 20%. To avoid costly OOP expenses, one of the North Carolina Medicare Supplement Plans along with a Medicare Part D plan is your best option.
To get hep with these options, as well as answer any of your questions, click or call today. Our licensed insurance agents are here to help and our services are always 100% free. You can also compare rates online here.
Resources for Medicare Help in North Carolina
As with anything in life, insurance and OOP expenses associated with coverage can get pricey. Luckily, there are Medicare Savings Programs available to assist with these costs. State Health Insurance Assistance program, or NCSHIP, can help ease some of the financial burden that comes along with obtaining insurance coverage.
Medicare Fun Facts in North Carolina
The total number of residents that receive benefits from Medicare in North Carolina were just over 1.8 million in 2015, that’s 18% of the population. Out of these residents, 43% were male and 57% were female.
The percentage of beneficiaries enrolled with Medicare that were diagnosed with ESRD was 1.0%. In 2013, out of the total beneficiaries receiving Medicare, 81% enrolled after they turned 65 and 19% were disabled when they enrolled.
North Carolina FAQs
- What doctors accept Medicare in North Carolina? The majority of Specialists and PCP’s take Medicare. To see if your healthcare provider accepts Medicare, or if you are in search of a physician who takes your insurance, you can reference the centers for Medicare and medicaid by clicking here.
- Does Medicare pay for Assisted Living in North Carolina? Medicare does not pay for any Assisted Living Facilities. Medicare covers short-term nursing care facility stays, but unfortunately Assisted Living Facilities are paid OOP by the individual.
- Are Medicare Advantage Plans offered in all North Carolina counties? Yes, Medicare Advantage Plans are offered to residents all over North Carolina. You can get more information regarding these plans including plan/price comparisons by filling out our form or calling. Our licensed agents are available and will be happy to assist you!