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Medicare Supplemental Insurance North Carolina

Now that you are enrolled in Parts A and B you should analyze your options for Medicare Supplemental Insurance North Carolina.  Basically you have two options, a NC Medicare Supplement or NC Medicare Advantage plans.

Below is a general comparison chart for these two types of supplemental insurance in North Carolina. Each one has their pros and cons.  Take a look at this chart and see if one makes more sense for you.


Comparison of Medicare Supplement and Medicare Advantage Plans


Medicare Supplement Plan F
 with Original Medicare

Comparison Medicare Advantage Plan
Must be enrolled in Medicare Part A and B. All applicants must be accepted during Medigap Open Enrollement and Guaranteed Issue Periods. Outside of this time insurance carriers can deny coverage and rate up the premiums Eligibility Must be enrolled in Medicare Part A and B and live in the service area of the provider. All applicants are accepted unless they have End Stage Renal Disease.
Premiums can vary on plan chosen (Plan F is the most expensive), carrier, gender, and health.  Plan F covers 100% of Medicare approved medical expenses.


Premium/Copay/coinsurance/out of pocket maximum

Members of the plan pays the same premium regardless of age, gender and health. Typically you will have copays and/or coinsurance amounts for Medicare approved medical expenses.  Many plans will have an out of pocket maximum.
Their is NO network.  As long as your provider accepts Medicare they accept the plan regardless of the carrier.  No referalls for specialist required. Healthcare Provider Options

HMOs and PPOs are the most common provider networks.

HMO:  Generally in-network coverage only.  Will need referrals from primary provider for specialists.

PPO:  No referrals needed. Covers out of network. Plans have higher premiums but offer more flexibility.

Prescriptions are not covered. 

You can enroll in any PDP (Prescription Drug Plan) of your choice.  Use the site to determine which plan is best for you based on current medications.

Prescription Coverage

Prescription coverage is most often included but you must make sure that it is an MA-PD (Medicare Advantage Prescription Drug) plan.  Some carriers offer Medical only coverage.

Very important to make sure that your prescriptions are in the formualary (and how much will they cost you?) before finalizing this coverage.

Yes as long as you continue to pay the monthly premium. Benefits never change.  You can enroll and disenroll at anytime (however you will likely be subject to underwriting with new carrier). Is the Plan Renewable? Insurance carrier determines benefits and can change yearly. If carrier cancels MA plan you are eligible to enroll in any other carriers MA plan. You will not be without coverage.
Only original medicare. Some carriers give you free gym membership through Silver Sneakers NC What else is covered? Some plans include routine dental, vision, and preventive care. Some carriers give you free gym membership thorugh Silver Sneakers NC.

Don't want to deal with copays and coinsurance amounts.  Like the idea of having 100% coverage (Plan F) for Medicare approved claims, giving you $0 out of pocket exposure.

This plan is ideal for people that travel often or may live in another state for a period of time throughout the year. 

Choice of any doctor anywhere you want (as long as they accept Medicare).

Which one is best for me?

Main goal is to save on monthly premiums and understand the out of pocket exposure of the plan.

If you don't live elsewhere during portions of the year and have access to doctors in the HMO or PPO.

Want a "packaged plan" that includes both medical and prescription coverage.

View NC Medicare Supplement Quotes How do I get a quote? Request Medicare Advantage NC Quote

As you can see there is a lot to go over.  The plan that may be right for you may not be right for your wife or neighbor.  Each persons needs are different and when choosing you Medicare supplemental insurance North Carolina it is imperative to review these with a qualified professional.