Medicare in North Carolina
Written by: Bryan Strickland
Reviewed by: Shikita Nunnery, Licensed Insurance Agent
Key Takeaways
Medicare is a federal health insurance program open to all North Carolinians age 65 and older who are U.S. citizens or permanent residents.
Original Medicare in North Carolina offers coverage for hospital stays and doctor visits. Drug and supplemental coverage are also options.
Medicare Advantage in North Carolina is another way to get Part A and Part B while also offering coverage like dental and vision.
Thanks to the Wright Brothers and Michael Jordan, the state of North Carolina is “First in Flight.”
Manning the first motorized airplane or leaping skyward against basketball’s giants can be hazardous to your health. GoHealth is here to serve the health concerns of all North Carolinians.
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See My OptionsWho Is Eligible for Medicare in NC?
Any U.S. citizen age 65 or older that calls North Carolina home is eligible to enroll in the federal Medicare healthcare insurance program. Some people under 65 also may qualify for Medicare in NC:
- Residents who have received 24 months of Social Security Disability Insurance payments or Railroad Board benefits payments are eligible.
- Residents with end-stage renal disease or with Lou Gehrig’s disease (also known as ALS) are eligible.
How Much Does Medicare Cost in North Carolina?
While most Medicare offerings have different options with differing costs, Parts A and B are the starting point and have some set costs.
- Part A is hospital insurance and doesn’t have a monthly premium for anyone who has worked at least 10 years.
- Part B is medical insurance and has a standard monthly premium of $174.70 for 2022.
There are scenarios where you may pay less or more for Medicare in NC based on your income.
Other Medicare offerings have varying costs, including:
- Part D, the drug coverage provided by private insurance companies aligned with federal guidelines for Original Medicare beneficiaries.
- Medigap, the supplemental insurance provided by private insurance companies for Original Medicare beneficiaries.
- Medicare Advantage, also known as Part C, offered by private insurance companies that replaces Original Medicare, bundles drug and supplemental coverage and offers additional coverage like dental and vision.
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Call TodayHow Do I Apply for Medicare in North Carolina?
Your choices for applying for Medicare in North Carolina include:
- Enrolling online with the Social Security Administration.
- Visiting a local Social Security office.
- Enrolling over the phone at 1-800-772-1213 (TTY: 1-800-325-0778).
If you are receiving Social Security benefits before you turn 65, you may be automatically enrolled in Original Medicare. If not, you have to apply for enrollment. Your first chance to sign up is during your Initial Enrollment Period, which is a seven-month window that begins three months before the month of your 65th birthday.
Does North Carolina Have Free Healthcare?
Each state determines how to administer Medicaid, a federal/state program to help those in financial need with their healthcare costs regardless of age. North Carolina, for example, has a program that allows some people over the state’s income limit for Medicaid to participate while being responsible for a Medicaid deductible.
The North Carolina Department of Health and Human Services has an online tool to help North Carolinians determine if a financial assistance program may be an option for them.
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Get Help NowWhat Does Medicare Cover?
Medicare plans in North Carolina help reduce your out-of-pocket costs for hospital stays (Part A) and doctors visits (Part B). You can choose to add a Part D plan to help with prescription costs. Medicare Advantage in North Carolina (Part C) can substitute for Original Medicare to bundle Parts A, B, and D, as well as supplemental coverage.
All Medicare in NC must offer certain coverages. These 10 essential health benefits are:
1. Outpatient care
2. Emergency service
3. Maternity and newborn care
4. Prescription drugs
5. Pediatric services
6. Laboratory services
7. Rehabilitation and habilitation services
8. Mental health and substance abuse
9. Preventive or wellness services
10. Hospitalization
Are Medicare Advantage Plans Good in All States?
Medicare Advantage plans can offer more benefits than Original Medicare, often with more affordable premiums. The other side of the coin is that while Original Medicare can be used in all states, most Medicare Advantage plans feature a regional network of providers.
But, with an abundance of Medicare Advantage plans available, there’s a good chance that a plan features doctors that you already use. A GoHealth licensed insurance agent can find a Medicare Advantage plan that fits your needs and can check whether your doctors are in network.
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Find My Ideal MA PlanMedicare in North Carolina by the Numbers
Medicare
North Carolina
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Table reflects the latest Beneficiary Demographics Data: Medicare Geographic Variation – by National, State & County
Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.
North Carolina Medicare Resources & Contacts
To be certain you are not leaving anything on the table, let us help. A GoHealth licensed insurance agent can assess your coverage or explain which North Carolina-based resources, like these, may be able to help:
Nationwide Resources
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Medicare guide
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare guide
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare guide
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Medicare guide
Low Income and Medicare Guide
For individuals with a qualifying income status
Medicare guide
A Caregiver’s Guide
For individuals with a qualifying income status