If you’re looking for the best Medigap plans North Carolina offers, managing healthcare costs in retirement is likely a priority. While Original Medicare covers about 80% of medical expenses, the remaining 20% can quickly add up, leaving you with hefty bills. For residents of the Tar Heel State, North Carolina Medigap insurance is designed to bridge this gap, helping to cover out-of-pocket costs and providing financial security as you enjoy your retirement.
With over a decade of experience guiding Medicare beneficiaries, I’ve helped thousands of North Carolinians understand their coverage options and make informed decisions since 2012. My expertise in Medigap insurance ensures you’ll have the clarity you need to compare plan costs, navigate enrollment, and find a plan that suits your healthcare needs.
Table of Contents:
- Understanding Medigap Plans in North Carolina
- Which North Carolina Medigap Plan Is Right For Me?
- How Much Does North Carolina Medigap Insurance Cost?
- What Do North Carolina Medigap Plans Cover?
- When Can I Buy North Carolina Medigap Insurance?
- Where To Buy Medigap In North Carolina
- Local Resources for Medicare Assistance in North Carolina
- Conclusion
Understanding Medigap Plans in North Carolina
There are ten standardized Medigap plans, each labeled with a letter from A to N. However, Plans C and F are no longer available to those newly eligible for Medicare. These policies offer the same benefits regardless of which company you purchase them from.
This means, for instance, that Medigap Plan A from Company X will offer the exact same coverage as Plan A from Company Y. However, prices will vary between providers. This makes shopping around and comparing Medicare Supplement plans critical when choosing the Medicare Supplement plan that suits your needs and budget. Many Medicare Supplement plans in North Carolina also offer additional benefits, like discounts or gym memberships, that could be appealing.
Which North Carolina Medigap Plan Is Right For Me?
With so many options to choose from, it can feel overwhelming to determine the most appropriate plan. Some things to consider are:
- Your budget: Each plan comes with varying premiums, so carefully weigh the costs and coverage.
- Your healthcare needs: Consider if you need more comprehensive coverage or prefer lower premiums but accept some cost sharing.
- Your health status: Your current health and family history play a role in determining premiums. However, you can’t be denied coverage during your Medigap Open Enrollment Period, even with pre-existing health conditions. Learn more about what could cause you to be denied coverage.
The Most Popular North Carolina Medigap Plans
Plan F is consistently ranked as the most popular nationwide, likely due to the complete coverage it offered. However, if you became eligible for Medicare after January 1, 2020, you cannot buy Plan F. The closest alternative to Plan F for those new to Medicare is Plan G, which offers the same coverage minus the Part B deductible.
Plan N also has seen a significant rise in popularity due to its low premiums, balanced with a bit of cost-sharing for office and emergency room visits. Medicare Plan N is one of the most popular plans in North Carolina.
How Much Does North Carolina Medigap Insurance Cost?
Several factors affect the cost of Medigap policies, such as: your age, tobacco use, gender, health history, the insurance carrier you choose, and even your location. In North Carolina, you can expect monthly premiums to run between $86 to $301 or higher, as with Medicare Supplement Plan A for disabled individuals under 65.
If you’re on a budget, there is a High Deductible Medicare Supplement Plan G available that offers very low monthly premiums but comes with a higher annual deductible before the plan starts to pay benefits. To really compare Medigap plans, look at the NAIC’s 2022 Medicare Supplement Loss Ratios which provides helpful insight into carrier pricing practices.
What Do North Carolina Medigap Plans Cover?
North Carolina Medigap insurance is standardized, meaning benefits remain the same no matter which insurance company you choose. It basically picks up where Original Medicare leaves off. You’ll still pay your monthly Part B premium, but the Medigap policy will help cover costs like: copayments, coinsurance, deductibles, excess charges, and in some cases, even foreign travel emergencies. This can save you hundreds or even thousands in healthcare costs, particularly if you have chronic health conditions requiring more frequent doctor visits, hospitalizations, or ongoing prescriptions.
Medicare Supplement insurance doesn’t cover all of your out-of-pocket costs. For example, you’ll need a separate Medicare Part D plan or Medicare Advantage Plan (which includes drug coverage) if you want prescription benefits.
Here is a table comparing what each plan offers for 2024.
| Medigap Benefits | Plan A | Plan B | Plan D | Plan G | Plan K | Plan L | Plan M | Plan N |
|---|---|---|---|---|---|---|---|---|
| Part A Coinsurance | 50% | 75% | ||||||
| Part B Coinsurance | 50% | 75% | *** | |||||
| Blood (first 3 pints) | 50% | 75% | ||||||
| Part A Hospice Care Coinsurance | 50% | 75% | ||||||
| Skilled Nursing Facility Coinsurance | 50% | 75% | ||||||
| Part A Deductible | 50% | 75% | 50% | |||||
| Part B Deductible | ||||||||
| Part B Excess Charges | ||||||||
| Foreign Travel Exchange | 80% | 80% | 80% | 80% | ||||
| Out-of-Pocket Limit | N/A | N/A | N/A | N/A | $6,620 | $3,310 | N/A | N/A |
***Plan N charges a copay of up to $20 for office visits and $50 for emergency room visits unless you are admitted to the hospital.
Remember, this table serves as a basic overview; specific benefits and costs can vary slightly. That’s why reviewing plan details, asking questions, and carefully comparing plans to determine the most suitable choice is crucial. You can easily compare Medigap plan coverage directly on our site.
When Can I Buy North Carolina Medigap Insurance?
It’s important to understand that you usually only have a guaranteed issue right to enroll in North Carolina Medigap insurance without being subject to medical underwriting. Your Open Enrollment Period begins when you turn 65 and are enrolled in Medicare Part B. It lasts six months. There are some instances, such as if you leave your employer-sponsored plan, where a guaranteed issue right applies outside of your initial Open Enrollment Period. It’s crucial to take advantage of this timeframe because insurance companies are not permitted to deny you coverage or charge higher premiums due to health issues during this initial window. You’re also entitled to Medicare Supplements regardless of your pre-existing health conditions.
If you decide to get a Medigap plan after that window closes, you could face a medical underwriting process where carriers will look into your health history before determining your coverage or premiums. You could even be declined if you have a serious pre-existing medical condition, but at least North Carolina offers at least Plan A to disabled Medicare beneficiaries. So act fast to ensure your peace of mind when you become eligible.
Where To Buy Medigap In North Carolina
To obtain quotes and compare different plans, here are some avenues to explore:
- Contacting insurance companies directly: Reach out to companies such as AARP, Mutual of Omaha, or Cigna. It is critical to get multiple quotes from different carriers because prices vary by company.
- Working with a licensed insurance agent or broker: You could use an agent or broker. Agents will typically be limited in the plans they can offer. In contrast, brokers often work with several companies and can show you options from multiple carriers, helping you to find the right fit for your budget. Brokers work directly with their customers to help with plan comparisons, pricing and purchasing the plan.
- Utilizing Medicare’s online plan finder tool: Visit Medicare.gov to use their plan finder tool. While the site is great for viewing available plans in your area, remember that quotes can fluctuate and are not final. Final quotes will come from insurance companies.
It is wise to compare premiums, cost-sharing features of various plans, customer service reputations of insurance companies, and any extra benefits before choosing.
Local Resources for Medicare Assistance in North Carolina
Navigating North Carolina Medigap insurance can be overwhelming, but there’s no need to do it alone. Several local organizations provide valuable support:
- Area Agencies on Aging: Located across the state, AAAs offer numerous services including: North Carolina Medigap information, counseling, and connection with local resources tailored for seniors. You can find your local AAA using their online directory or call (800) 662-7030.
- Seniors’ Health Insurance Information Program: North Carolina’s SHIIP, housed within the Department of Insurance, offers counseling on Medicare benefits, prescription drug plans, and various insurance options, including Medigap. Trained volunteers offer free unbiased guidance by phone or through one-on-one counseling appointments, held statewide. You can reach them at (855) 408-1212.
- The Shepherd’s Center of Greater Winston-Salem: Residents of Forsyth County have the Shepherd’s Center, serving as their SHIIP hub. They provide Medicare and Medicare Supplement insurance counseling to ensure you’re making well-informed decisions about your health coverage needs. They can be reached at (336) 748-0217.
Conclusion
Choosing a North Carolina Medigap insurance plan that is the best fit for you depends entirely on your needs. Once you understand what is offered with North Carolina Medigap insurance, what they cover, and what the pricing looks like – finding a plan should be fairly easy.