North Carolina Medicare Plans

At first look, Medicare in North Carolina may seem like a very complex and difficult system. It also requires a lot of decisions that will have a lasting effect on your healthcare, costs, and finances. With all that said, the initial choice is a simple one; you must choose Original Medicare or Medicare Advantage.

If you choose Original Medicare, then you will have the further option of getting a Medicare Supplement plan. The Medicare Supplements in NC are policies that provide money to cover the balances left by Medicare for your hospital and outpatient medical services such as deductibles.

Let’s take a closer look at each type of coverage.

Medicare Supplement

Medicare Supplements pay after Medicare in North Carolina. Most importantly, they cover 20 percent coinsurance for outpatient services that Part B doesn’t pay for. You can use a Medicare Supplement in every state, and with any doctor or provider that accepts Medicare. Medicare Supplements are also renewable as long as you keep up the monthly payments. The insurance companies who offer them can never drop you because of a new health condition.

NC Medicare supplement plans also do not change their benefits from year to year. The coverage you buy is the coverage you’ll keep for the long term.

Medicare Supplement Plans have been standardized into ten different plans. Each one is labelled with a letter such as Plan A, Plan B, Plan C, etc. This allows you to shop for plans without worrying that one insurance company offers something different than another. All Plan A offers will provide the same benefits, and so on. You can shop and compare prices between many insurance companies.

The most popular plans are Plans F, G, and N.

Plan F is a comprehensive plan, and it covers all of the gaps in Medicare. Plan F pays the deductibles for Part A and Part B.

Plan G is similar to Plan F but does not pay the Part B deductible. This plan has moderately high premiums but your only out of pocket is the $183 Part B deductible.

Plan N has lower premiums and higher out of pocket payments. You’ll pay for your own Part B deductible, Part B excess changes and some copays for doctor or ER visits.  It's a good option for budget-conscious buyers because it will cover a wide range of gap costs.


Medicare supplement coverage is excellent coverage and solves a financial problem for people by paying the gap amounts. It comes at a cost that may be beyond the reach of some consumers though. Medicare Advantage Plans can be a solution with lower premiums and built-in prescription benefits.

Medicare Advantage Plans

Congress enacted Medicare Part C plans in the last 1990s to provide private insurance choices for older Americans. Part C are also called Medicare Advantage plans, and these plans must equal Original Medicare coverage but can do so with different payment methods and innovations from the private insurance industry. For example, you will pay copays for your services as you go along. Some companies include extras in their plan benefit designs, like gym memberships or vision exams.

Medicare Advantage offers an all-in-one approach. These plans combine hospital and medical coverage with options that also include Part D built in.

When enrolled in a Medicare Advantage plan, you will receive your healthcare from a managed care organization. Advantage plans are usually HMO, or PPO type managed care. You can get advice from a primary care physician along with referrals to network resources such as specialists. It’s very important to check and make sure that your favorite doctors are in the network.

With HMO networks, you cannot see providers outside the network at all except in emergencies. A PPO type plan will usually pay some part for services outside of the network, but you will spend more for those services than you would in the network.

It’s important to mention that you cannot combine Medicare Supplement with a Medicare Advantage plan. You also cannot add a standalone prescription plan if you have Medicare Advantage with a Prescription Option.

Conclusion

It is natural to be cautious about medical care. The choices you make can have a big impact on your health and finances. It is good to know that Medicare with a Medicare supplement offers an excellent combination of coverage, choice, and flexibility. Original Medicare leaves you free to choose your doctors, hospitals, and medical care providers.

Medicare Supplements pay most of the charges left to you by Medicare Part A and Part B. We at Boomer Benefits understand the difficulty of so many choices. We can help find the best combination of health, medical, and prescription coverage to meet your needs. Call us; we can help.