Medicare Supplement (Medigap) Plans in North Carolina

Original Medicare provides healthcare coverage for millions of Americans. It includes hospital coverage (Medicare Part A) and medical coverage (Medicare Part B). But Medicare in North Carolina doesn’t cover all your healthcare costs. When you access a covered service, Original Medicare pays 80% of the cost, and you pay the remaining 20%. This is called your coinsurance. For other services, you may pay a fixed cost called a copayment. Along with coinsurance and copayments, you also need to meet your Part A and Part B yearly deductible before your healthcare benefits begin.

Your out-of-pocket Original Medicare costs can include:

• Part A and Part B monthly premiums
• Part A and Part B yearly deductible
• Coinsurance
• Copayments

Medicare Supplement Plans, also called Medigap plans, can lower your out-of-pocket costs and fill in the gaps in Original Medicare coverage. Private insurance companies sell Medigap plans, and there are twelve types of Medicare Supplement plans available in North Carolina.

All Medicare Supplement Plans must cover:

• Part A coinsurance for select services, including hospital and hospice care
• Part B coinsurance
• Blood (first 3 pints) needed for a medical procedure

Some Medicare Supplement Plans also offer added benefits such as:

• Part A coinsurance for additional services like skilled nursing facility care
• Part A deductible
• Part B deductible
• Part B excess charges
• Foreign travel medical emergency coverage

You can see exactly what’s covered in each plan using this side-by-side comparison chart. Each plan offers different benefits, so make sure you understand your Medigap options before you purchase a plan.

Medicare Supplement plans help you fill in the gaps in Original Medicare coverage. But they do not cover other benefits like prescription drug coverage — to get drug coverage, you will need to enroll in Medicare Part D. Medigap plans in North Carolina do not include additional benefits such as dental, vision or hearing coverage.

Medicare Supplement plans cover out-of-pocket costs for Original Medicare, but do not cover:

• Medicare Advantage out-of-pocket costs
• Medicare Part D prescription drug costs
• Medicaid plan costs
• Employer health insurance out-of-pocket costs

Medicare Supplement Plans in NC are offered by private insurance companies. While the benefits included in each plan are standardized, the cost is not. Each provider can set their own costs, so it’s a good idea to compare all the plans in your area. This will help you find the best Medigap plan that matches your healthcare needs and your budget.

NC Medicare Supplement Plan premiums range from $30 to $1,414 in 2022 depending on your provider, your age, your health status and when you purchase the plan.

Medigap Plan G High Deductible Plans

There are two high deductible plans available in North Carolina. Medigap Plan F and Medigap Plan G each offer a high deductible plan option. You’ll pay a lower monthly premium, but you will need to pay a yearly deductible before your coverage begins. The Medigap Plan F and Plan G deductible for 2022 is $2,490. After you reach this deductible, your Medigap coverage kicks in.

You can buy a Medigap plan if you’re enrolled in Medicare Part A and Part B. As soon as your Original Medicare coverage begins, you’re eligible for a Medicare Supplement Plan in NC.

You can enroll in a Medigap plan during your Medigap Open Enrollment Period. This starts from the first day your Medicare Part B coverage begins. During your Open Enrollment Period, you can enroll in any Medigap plan available in your area, and plan providers must sell you a plan regardless of your health status. But if you miss your Open Enrollment Period, plan providers may use medical underwriting to deny coverage or offer coverage at a higher rate.

Medigap plans are designed to fill in your cost gaps in Original Medicare. Medigap plans will cover out-of-pocket costs for Medicare Part A and Part B. You must be enrolled in Original Medicare to use a Medigap plan.

Medicare Advantage plans, on the other hand, are an alternative to Original Medicare. These plans include all the same hospital and medical coverage as Original Medicare. They can also offer added benefits like vision or dental services. Medigap plans do not cover any Medicare Advantage plan costs, and you cannot have a Medicare Advantage plan and a Medigap plan at the same time.