Medicare in North Carolina: 2026 Plans, Costs, and Enrollment Guide

North Carolina Medicare Snapshot

North Carolina is one of the strongest-quality Medicare markets in the country — 155 MA plans from 17 carriers covering 100 of 101 counties for 2026, with an average CMS star rating of 4.14/5.0, well above the national average (CMS CY2026 Landscape). North Carolina's plan mix is heavily PPO-weighted: 47 PPO, 30 HMO-POS, 21 HMO, 13 HMO D-SNP, and 11 HMO C-SNP plans.

The average consolidated MA premium is $20.97/month (median $0) — most North Carolina beneficiaries can find a $0-premium plan. The standard Medicare Part B premium is $202.90/month in 2026. On the supplement side, North Carolina has one of the deepest Medigap markets in the country with 63 carriers offering Plan G, using attained-age rating.

Plan Types Available in North Carolina

Medicare Advantage (Part C)

In North Carolina, 155 MA plans are available for 2026 from 17 carriers (CMS CY2026 Landscape). Plan type mix: 47 PPO, 30 HMO-POS, 21 HMO, 13 HMO D-SNP, and 11 HMO C-SNP. PPOs dominate the market, which works well for beneficiaries who want broader provider choice across the state — particularly important given North Carolina's geographically dispersed mountain west and coastal east.

County availability ranges from 99 MA plans in Forsyth County (Winston-Salem) to 20 plans in Carteret County (coastal). Top carriers by plan count: UnitedHealthcare (35 plans), Humana (30 plans), and Devoted Health (20 plans). The state-wide average star rating of 4.14 is among the highest in the country.

Medigap (Medicare Supplement)

North Carolina has one of the deepest Medigap markets in the country, with 63 carriers offering Plan G in the TPP rate database (TPP rate DB, CY2026). The full set of 12 federally standardized plan letters (A through N, plus HDG and HDF) is offered statewide under standard federal rules. North Carolina uses attained-age rating — premiums increase as you age.

Plan F is closed to new enrollees as of January 1, 2020 under MACRA / the 21st Century Cures Act; the same closure applies to High-Deductible Plan F (HDF) — only beneficiaries who became Medicare-eligible before January 1, 2020 may still purchase Plan F or HDF. High-Deductible Plan G (HDG) is the post-2020 high-deductible Medigap option and is offered in North Carolina by 45 carriers. See our MA vs Medigap comparison →

Standalone Part D (Prescription Drug Plans)

North Carolina is CMS PDP Region 8 — North Carolina alone. For 2026, there are 12 standalone PDP plans from 6 carriers. Average total premium is $71.70/month (CMS CY2026 Landscape).

Costs in North Carolina

Medicare Advantage Premiums

The average consolidated MA premium in North Carolina is $20.97/month (median $0) (CMS CY2026 Landscape). The standard Medicare Part B premium is $202.90/month in 2026.

The top three carriers by plan count are UnitedHealthcare (35 plans), Humana (30 plans), and Devoted Health (20 plans) (CMS CY2026 Landscape). Average star rating is 4.14 — among the highest in the country.

Medigap Premiums — Plan G and HDG

Medigap premiums in North Carolina vary by carrier, age, gender, tobacco use, and rating method (attained-age in NC, so rates rise with age). Across the 63 carriers offering Plan G in North Carolina (non-tobacco rates, ages 65–85), monthly premiums range from approximately $102 to $774/month (TPP rate database, CY2026) — the wide spread reflects both age-band variation and carrier-level pricing differences in this large market.

High-Deductible Plan G (HDG) is offered by 45 North Carolina carriers; premiums range from approximately $31 to $745/month across ages 65–85, non-tobacco rates (TPP rate database, CY2026). HDG works well for beneficiaries who want catastrophic protection at a lower monthly cost and can absorb the $2,950 deductible (2026).

Part D Costs and the LIS Benchmark

For 2026, North Carolina Part D premiums average $71.70/month across 12 standalone PDP plans. The CMS Low Income Subsidy (LIS / Extra Help) benchmark premium for PDP Region 8 (North Carolina) is $36.17/month (CMS CY2026 Regional Rates and Benchmarks).

North Carolina-Specific Medicare Rules

North Carolina Medigap Protections

North Carolina follows standard federal Medigap rules. You have a 6-month Medigap Open Enrollment Period that starts the month you are both 65 or older and enrolled in Medicare Part B. During this guaranteed-issue window, insurers cannot deny you coverage or charge higher premiums based on your health history.

After this window closes, medical underwriting applies and coverage is not guaranteed. North Carolina does not have a Birthday Rule or other annual switch right. Enrolling in Medigap during the initial Open Enrollment Period is especially important. NC uses attained-age rating, so when comparing carriers, ask for both current premium and a projection over 5–10 years.

Medicare Savings Programs (MSPs)

North Carolina offers Medicare Savings Programs (MSPs) administered by the North Carolina Department of Health and Human Services (NCDHHS):

• QMB (Qualified Medicare Beneficiary): Covers Part A and Part B premiums, deductibles, and cost-sharing.
• SLMB (Specified Low-Income Medicare Beneficiary): Covers Part B premiums only.
• QI (Qualifying Individual): Also covers Part B premiums; subject to annual appropriations.

Apply through your local NCDHHS office or contact North Carolina SHIIP (1-855-408-1212) for free enrollment assistance. MSP enrollment also automatically qualifies you for Extra Help / LIS on Part D. Learn more about MSPs →

North Carolina SHIIP

North Carolina SHIIP (Seniors' Health Insurance Information Program) provides free, unbiased counseling on all Medicare options statewide. SHIIP is administered by the NC Department of Insurance.

Phone: 1-855-408-1212
Website: https://www.ncdoi.gov/consumers/consumer-resources/seniors-insurance-information/shiip

Enrolling in Medicare in North Carolina

Standard Enrollment Periods

• Initial Enrollment Period (IEP): 7-month window centered on your 65th birthday month. Enroll at ssa.gov or call 1-800-772-1213.
• Annual Election Period (AEP): October 15 – December 7 each year.
• Medicare Advantage Open Enrollment Period (OEP): January 1 – March 31.
• Medigap Open Enrollment Period: 6-month guaranteed-issue window starting when you are 65+ and enrolled in Part B. After this window, medical underwriting applies (NC has no Birthday Rule).
• Special Enrollment Periods (SEPs): Learn more →

North Carolina SHIIP Counseling

Contact SHIIP at 1-855-408-1212 for free one-on-one Medicare guidance statewide.

Frequently Asked Questions