North Carolina Medicare comparisons
Medigap vs. Medicare Advantage in North Carolina
Costs, networks, mountain and coastal access, and North Carolina's Medigap rules with no birthday rule.
State Health Plan vs. individual Medicare plans
The Base Plan, Enhanced Plan and 70/30 Plan compared with buying your own Medicare coverage.
D-SNP vs. Original Medicare and NC Medicaid
Your Medicare choices if you also have NC Medicaid or a Medicare Savings Program.
Moving to North Carolina: Medigap vs. Medicare Advantage
What happens to the coverage you bring from Florida, New York or another state.
How to use these comparisons
- Start with what you already have. If you have State Health Plan retiree coverage, NC Medicaid, TRICARE For Life or VA care, read that comparison or guide first, because it can change which Medicare choice makes sense.
- List your doctors, hospitals and drugs. Check whether each one works with the coverage you're considering, including any doctors across a state line.
- Check the deadlines. Medicare's Open Enrollment runs October 15 to December 7, 2026, for 2027 coverage. If your plan is ending, see plans ending in 2027 and Medicare enrollment periods.
- Get help if you want it. To compare plans from the companies they work with, you can request a call from a licensed insurance agent, or see plans for your ZIP code.
For background, see Medicare basics, Medicare Advantage in North Carolina, Medigap in North Carolina and State Health Plan retirees and Medicare.
Sources
- Medicare.gov — Compare Original Medicare and Medicare Advantage
- N.C. General Statutes Chapter 58, Article 54 — Medicare Supplement Insurance Minimum Standards
- State Health Plan — Pre-65 retiree presentation (Medicare and the group Medicare Advantage plans)
- NC Medicaid — Medicaid Health Plans and Programs
- CMS — Medicare Advantage and Part D Landscape files, contract year 2027
Frequently asked questions
What is the main Medicare choice in North Carolina?
Whether to use Original Medicare, usually with a Medigap policy and a Part D drug plan, or a Medicare Advantage plan. Original Medicare works with any provider in the country that accepts Medicare, while most Medicare Advantage plans use networks. For 2027, CMS lists 106 Medicare Advantage plans open to everyone across North Carolina, and every county has some.
Can I switch from Medicare Advantage to Medigap later in North Carolina?
You can apply, but outside your 6-month Medigap open enrollment period and guaranteed-issue situations, Medigap companies can review your health and turn you down. North Carolina has no birthday rule or yearly switching right.
Should State Health Plan retirees buy their own Medicare plan?
Check first. If you're in the State Health Plan's group Medicare Advantage plan and join another Medicare Advantage or Part D plan, you're disenrolled from the group plan and moved to the 70/30 Plan. Read our State Health Plan comparison before changing coverage.
Do I need a D-SNP if I have Medicare and NC Medicaid?
No. It's one option. Most people with Medicare and full NC Medicaid get Medicaid through NC Medicaid Direct either way, and can choose Original Medicare with a Part D plan, a regular Medicare Advantage plan, a D-SNP, or PACE if they qualify.
Medicare in your North Carolina county
Plans, local agents and help, county by county: Wake · Mecklenburg · Guilford · Forsyth · Durham · Cumberland · Buncombe · Union · Johnston · Cabarrus · New Hanover · Gaston · Onslow · Iredell · Alamance · Pitt · Davidson · Brunswick · Catawba · Rowan · All 100 counties →
