Follow us on Twitter



Medicare Advantage Plans North Carolina

Medicare Advantage Plans North Carolina is also referred to as Medicare Part C.  A Medicare Adavantage (MA) plan is a substitute for Original fee-for-service Medicare. MA policies are subsidized by Medicare, which will pay private insurance carriers to administer health services to seniors that join these programs.

To join a MA plan, you will need to be enrolled in both Medicare Part A and Part B.  You will continue to pay the monthly premium for Part B.  By joining an MA plan you continue to be on Medicare and still have the full priviledges and protections that are permited to all beneficiaries.

Am I Eligible For A Medicare Advantage Plan?

If you are enrolled in Medicare Part A and B, then you are eligible for a Medicare Advantage plan in North Carolina, with the exception if you have End-Stage Renal Disease.

When Can I enroll in a MA Plan?

You can enroll in these plans during your Initial Election Period (IEP) or during the Annual Enrollement Period (AEP).  The IEP is going to be the 3 months prior to the month of your 65th birthday, the month of your 65th birthday and the 3 months after your 65th birthday.  The AEP is at the end of the year.  In 2011, this was the perid from October 15th - December 7th.  Changes made during AEP go into effect January 1.

How much do these plans cost?

Typically, Medicare Advantage Plans North Carolina are going to be much less expensive than a NC Medicare Supplement will cost.  Some carriers offer a $0 premium plan while other may be as high as $100 per month. Benefits and restrictions will vary amongst plans and carriers. It is VERY important to review these options with an /

How do MA Plans Work?

These plans will often work like health coverage you have had in the past in that you have set copays for doctor visits and coinsurance for certain services.  This cost sharing along with the subsidy our government gives them for each member is why the carriers can keep the premiums affordable.  You are often restricted to a network of doctors through a PPO or HMO.  As long as you visit doctors that are in these networks you do have out of pocket limits on your annual expenses you will have for medical attention.

Some MA plans offer your Part D coverage with the advantage plans, these are referred to as MA-PD (Medicare Advantage - Part D). Also there are some plans that only offer medical only coverage.

Things to consider when choosing an MA plan

  • Medicare Advantage plans North Carolina may or may not be the best choice for you. Just because it is cheap doesn't mean it is the best and doesn't mean that it is the worst. When reviewing plan options make sure you consider the following:
    • Copayments for doctors and specialist.  What are they?  Copayments are the set amount that you will pay for the doctor visit.
    • What are the percentages that you will pay for various services
    • Does the plan have an annual deductible (the amount you pay to your Advantage plan before your benefits "kick in")
    • How much is inpatient hospital coverage (can vary greatly from plan to plan)
    • How is out patient surgery covered?
    • Are your prescriptions covered under the prescription plan?
    • What is the annual out of pocket maximum before the plan covers 100%.
  • Are your doctor's in the plans network?  If not how are out of network doctors covered and how much will this cost you?
  • Does the plan offer other benefits like gym membership, some dental reimbursement, etc.?

As you can see there is a lot to go into deciding if a Medicare Advantage plans in NC is right for you.  Please contact us to discuss your options and make sure that you are making the best decision for your medical coverage.