Medicare in North Carolina

Last Updated : 09/16/20185 min read

In addition to Original Medicare, Part A and Part B, beneficiaries in North Carolina may be able to choose from a range of Medicare plan offerings. Options may include Medicare Advantage, Medicare Part D prescription drug coverage, and Medicare Supplement insurance.

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Types of Medicare coverage in North Carolina

In North Carolina, as in every state, you’re typically eligible for Medicare when you turn 65 or collect disability benefits. Most beneficiaries are automatically enrolled in Original Medicare, Part A and Part B, when they become eligible. But there are other types of Medicare coverage as well. The following list briefly describes the major types of Medicare coverage.

Original Medicare is government-sponsored health insurance consisting of Medicare Part A and Part B.

  • Medicare Part A covers inpatient hospital care, hospice care, and limited skilled nursing and home care.
  • Medicare Part B covers a range of medical services such as (but not limited to) physician services, mental health care, ambulance services, some durable medical equipment, and preventive services such as flu shots.

Medicare Advantage, or Medicare Part C, is an option that provides your Original Medicare benefits through insurance companies that contract with Medicare. Many of them include prescription drug coverage; these are called Medicare Advantage Prescription Drug plans. Not every Medicare Part C plan may be available in every county in North Carolina. You continue paying your Medicare Part B premium when you have any Medicare Advantage plan.
Medicare Part D is optional prescription drug coverage available from insurers that contract with Medicare. You can enroll in a stand-alone Part D Prescription Drug Plan to add to your Part A and Part B coverage, or you can enroll in one Medicare Advantage Prescription Drug plan to provide all of this coverage.
Medicare Supplement plans, also called Medigap plans, are optional insurance policies that may cover certain out-of-pocket costs not covered by Original Medicare. There’s a range of Medigap policies; some may cover deductibles, copayments, and limited foreign travel emergency health care. You must be enrolled in Original Medicare (Part A and Part B) to qualify for a Medigap plan.

Local resources for Medicare in North Carolina

  • North Carolina State Health Insurance Counseling and Assistance Program (SHIP): North Carolina SHIP staff members counsel the state’s Medicare beneficiaries and caregivers on many different topics related to Medicare. The counselors also help beneficiaries and their caregivers recognize and prevent billing errors and possible Medicare fraud. To learn more about the North Carolina SHIP program, visit the North Carolina Department of Insurance website.
  • Medicare Savings Programs in North Carolina: North Carolina may have Medicare Savings Programs (MSPs) for limited-income beneficiaries. You may be eligible for discounts on your out-of-pocket Medicare expenses, such as premiums and deductibles.

How to apply for Medicare in North Carolina

Enrollment in Original Medicare works the same in all states. To qualify for Medicare, you must be either a United States citizen or a legal permanent resident of at least five continuous years. Those who already receive benefits through the Social Security Administration (SSA) or the Railroad Retirement Board (RRB) are enrolled in Original Medicare, Part A and Part B, automatically. Those with qualifying disabilities, including Lou Gehrig’s disease (also known as ALS) or End-Stage Renal Disease (ESRD) may be eligible to enroll before age 65.

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You pay a monthly premium for Medicare Part B, so you have the option of turning it down when your “Welcome to Medicare” packet arrives in the mail. Please note that if you refuse this coverage when you’re first eligible, you could wind up paying more for Part B if you choose to take it down the line unless you sign up through a Special Enrollment Period.

If you do not receive your Medicare red, white and blue card three months prior to turning age 65 or receiving disability , you may manually enroll by visiting your local Social Security office , enrolling online, or signing up over the phone.

  • Visit the Social Security website.
  • Call Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778), Monday through Friday, 7AM to 7PM.
  • If you worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772 (TTY users call 312-751-4701), Monday through Friday, 9AM to 3:30PM.

You can apply for the Medicare options described above (Medicare Part C, Part D, and Medigap) just as soon as you sign up for Original Medicare. Generally, you have to have Original Medicare, Part A and Part B, before signing up for the other options; you need either Part A or Part B to enroll in Medicare Part D, but you need both Part A and Part B to enroll in Medicare Advantage or Medigap. If you enroll when you’re first eligible, you may avoid certain late enrollment penalties.

Are you ready to look into the various Medicare coverage choices available to you? I’ll be happy to go through your options with you.

  • To find out more about me and my experience helping Medicare beneficiaries, click the “View profile” link by my photo.
  • To set up a phone call with me, or to get an email from me listing Medicare plan options in your area, click one of the links below.
  • To see for yourself what plan options you may have, click the Compare Plans button on this page.

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