Changing plans

Medicare Open Enrollment in North Carolina (2027 Plans)

Medicare's Annual Enrollment Period runs October 15 to December 7, 2026 in North Carolina, and changes take effect January 1, 2027. You can join, switch or drop a Medicare Advantage or Part D plan. For 2027, CMS lists 106 Medicare Advantage plans open to everyone and 11 standalone drug plans in North Carolina. If your plan is ending, you have until February 28, 2027.

By the Benefits Life Editorial Team, licensed insurance agents · Reviewed November 13, 2026

Quick answers

When is Medicare open enrollment for 2027?: October 15 to December 7, 2026. Coverage you choose starts January 1, 2027.
What if my plan is ending in 2027?: You can choose new coverage until February 28, 2027. Choose by December 31 so there's no gap. You can also buy certain Medigap policies without health questions until 63 days after your plan ends.
Can I change plans after December 7?: If you're in a Medicare Advantage plan, you can make one change from January 1 to March 31, 2027. Other changes need a special enrollment period.
Is Medigap part of open enrollment?: No. Medigap has its own rules, and North Carolina has no Medigap birthday rule or yearly switching right, so switching Medigap policies usually means health questions.
Do State Health Plan retirees use the same dates?: No. The State Health Plan's own Open Enrollment for 2027 ran October 12 to 30, 2026, and it has closed. Joining an outside Medicare Advantage or Part D plan removes you from the Plan's group Medicare Advantage coverage.

When is Medicare open enrollment for 2027?

The Annual Enrollment Period (AEP), often called open enrollment, runs October 15 to December 7, 2026, the same dates in every state. Changes take effect January 1, 2027. You can make more than one change; the last one you make by December 7 counts.

Date	What happens
By September 30, 2026	Your Medicare Advantage or Part D plan sends its Annual Notice of Change for 2027.
October 12 to 30, 2026	The State Health Plan's own Open Enrollment for retirees (now closed).
October 15, 2026	Medicare open enrollment opens.
December 7, 2026	Open enrollment closes. Changes start January 1, 2027.
December 31, 2026	Last day to replace a plan that's ending without a gap in coverage.
January 1, 2027	New coverage starts. The Medicare Advantage Open Enrollment Period opens.
February 28, 2027	Special enrollment period ends for people whose plan didn't renew.
March 31, 2027	The Medicare Advantage Open Enrollment Period ends.

What can you change?

Switch from Original Medicare to a Medicare Advantage plan.
Switch from a Medicare Advantage plan back to Original Medicare.
Change from one Medicare Advantage plan to another.
Join, switch or drop a Part D drug plan.

To join a Medicare Advantage plan you need Part A and Part B and must live in the plan's service area. In North Carolina, plans are approved county by county. See Medicare Advantage in North Carolina and Part D in North Carolina.

How many plans does North Carolina have for 2027?

CMS's 2027 Landscape file lists 106 Medicare Advantage plans open to everyone in North Carolina from 16 companies, 57 special needs plans, and 11 standalone Part D plans from 6 companies. North Carolina is its own Part D region, so the same standalone drug plans are sold in all 100 counties. Medicare Advantage choice depends on your county: Guilford County has 57 plans open to everyone, Mecklenburg 50, Buncombe 44, Wake 35 and Carteret 11. Find yours on the counties page.

What changes in Part D for 2027?

The yearly cap on what you pay out of pocket for covered Part D drugs is $2,400 in 2027. After you reach it, you pay nothing more for covered drugs that year.
A Part D plan's deductible can be no more than $700 in 2027.
Covered insulin costs no more than $35 for a month's supply.
You can still spread drug costs over the year in monthly payments through the Medicare Prescription Payment Plan; ask your plan.

CMS publishes the 2027 Part A and Part B premiums and deductibles separately each fall; see Medicare costs in 2027. Plans also change their drug lists, pharmacy networks and premiums each year, which is why the Annual Notice of Change matters.

What should you check in your Annual Notice of Change?

Find the notice. Your Medicare Advantage or Part D plan mails it by September 30. It lists what changes on January 1.
Check your drugs. Make sure each prescription is on the plan's 2027 drug list, and look for new prior authorization or quantity limits.
Check your doctors and hospitals. Confirm they're in the plan's 2027 network, including specialists you travel to in the Triangle, Charlotte, the Triad or Asheville, and any hospital across the state line in Virginia, Tennessee, South Carolina or Georgia.
Check your pharmacy. Make sure it's still in network, and whether it's a preferred pharmacy.
Compare costs. Look at the premium, deductible, copays and the plan's out-of-pocket limit for 2027.
Look for a non-renewal letter. If the plan is ending or leaving your county, you get a separate notice. Keep it; it shows your right to buy Medigap without health questions.

What if your Medicare Advantage plan is ending in 2027?

If you do nothing, you go back to Original Medicare on January 1, without drug coverage. Based on CMS data, two companies stop selling regular Medicare Advantage plans in some North Carolina counties for 2027: one leaves 13 counties, mostly in western North Carolina (Avery, Buncombe, Burke, Henderson, Madison, McDowell, Mitchell, Polk, Transylvania and Yancey) plus Wake, Johnston and Chatham; the other leaves Rutherford County. Six companies also end some plans in counties where they keep others. At least 30,654 North Carolinians must choose new coverage. Every county still has Medicare Advantage plans open to everyone.

Choose by December 7 during open enrollment, or by December 31 using the non-renewal special enrollment period, so your new coverage starts January 1.
You have until February 28, 2027 to choose a Medicare Advantage or Part D plan, but coverage starts the first of the month after you choose.
Medigap without health questions: because your plan is ending, you can buy Medigap Plan A, B, D, G, K or L (or C or F if you were eligible for Medicare before 2020) from any company selling it in North Carolina, applying from 60 days before to 63 days after your coverage ends. If you're under 65 and have Medicare because of a disability, North Carolina law gives you a right to Plan A, D or G within 63 days (G.S. 58-54-45(b)).

See North Carolina plans ending in 2027 for the companies and counties, and my plan is ending in 2027 for step-by-step help.

State Health Plan retirees: your dates came first

If you're a retired teacher or state employee with Medicare, your coverage runs on the State Health Plan's calendar, not Medicare's.

The Plan's 2027 Open Enrollment ran October 12 to 30, 2026, and it has closed. Medicare's December 7 deadline doesn't reopen your choice among the Base Plan, the Enhanced Plan (the Plan's group Medicare Advantage options) and the 70/30 Plan.
Don't join an outside plan by accident. If you're in the Plan's group Medicare Advantage coverage and enroll in any other Medicare Advantage or Part D plan, the Plan says you will be disenrolled and moved to the 70/30 Plan. The Plan also warns members not to confirm personal information to callers.
Keep Parts A and B. Both must be in effect for the Plan's Medicare Advantage options.
LGERS retirees: retiree health coverage, if any, depends on your former employer. Ask them before you change anything.

See State Health Plan retirees and Medicare and State Health Plan vs. individual Medicare plans. Military retirees with TRICARE For Life must keep Parts A and B; see military, veterans and TRICARE in North Carolina.

After December 7: the Medicare Advantage Open Enrollment Period

From January 1 to March 31, 2027, if you're in a Medicare Advantage plan, you can make one change: switch to another Medicare Advantage plan, or drop your plan, return to Original Medicare and join a Part D plan. The change starts the first of the following month. This period isn't for people in Original Medicare who want to join a Medicare Advantage plan or switch Part D plans. See what is the Medicare Advantage Open Enrollment Period.

Special enrollment periods that run all year

Moving out of your plan's area, within North Carolina or from another state. See moving to North Carolina with Medicare.
NC Medicaid or Extra Help: you can switch drug plans, or leave Medicare Advantage for Original Medicare with a drug plan, once a calendar month. Medicare also has a monthly window for joining an integrated D-SNP, but every D-SNP in North Carolina for 2027 is a coordination-only plan, so that window has no North Carolina plan to use. See Extra Help in North Carolina and D-SNPs in North Carolina.
Losing employer or union coverage, for example when you retire from a North Carolina employer. See working past 65.
Moving into, living in or leaving a nursing home or other institution.
A declared emergency or disaster, such as a hurricane, that kept you from making a choice you were eligible to make. After Helene, that window ran through February 28, 2025. See hurricanes, floods and Medicare in North Carolina.

All dates are on Medicare enrollment periods and can I change my plan after open enrollment.

Medigap isn't part of open enrollment

Open enrollment doesn't let you buy or change Medigap without health questions. Your one guaranteed window at 65 is the 6 months that start the first month you're both 65 and enrolled in Part B. North Carolina has no birthday, anniversary or yearly switching rule (G.S. 58, Article 54). Outside that window, you can buy Medigap without health questions only in a guaranteed-issue situation, such as your Medicare Advantage plan ending or the 12-month trial right after your first Medicare Advantage plan. If you buy a policy, you have 30 days to return it for a full refund (G.S. 58-54-30). Think this through before leaving Medigap for Medicare Advantage. See Medigap in North Carolina and Medigap vs. Medicare Advantage in North Carolina.

How should you compare plans?

Start with your drugs, doctors and pharmacy, then compare costs for a typical year and a hard one. Medicare's Plan Finder at Medicare.gov lists plans in your ZIP code, and 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048) has information on all your options. 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. You can also meet licensed insurance agents in North Carolina.

Avoiding scams during open enrollment

Medicare won't call you to sell a plan or ask for your Medicare number.
Agents and plans can't call you, text you or come to your door without your permission.
Don't give your Medicare number to anyone who contacts you out of the blue. If you have State Health Plan coverage, a call that enrolls you in another plan can cost you your group coverage.
Report suspected Medicare fraud to 1-800-MEDICARE or the Senior Medicare Patrol national line, 1-877-808-2468. Complaints about an insurance agent go to the NC Department of Insurance complaint page. See Medicare fraud in North Carolina.

Your open enrollment checklist

Read your Annual Notice of Change. Note any change to drugs, network, costs, or a non-renewal letter.
Check your retiree coverage rules. If you have State Health Plan, LGERS employer, federal or TRICARE coverage, confirm what's allowed before you change anything.
Check whether your plan is ending. Compare your letter with North Carolina plans ending in 2027.
List your prescriptions, doctors and pharmacy. Bring the list when you compare.
Compare plans sold in your county. Use Plan Finder or talk with a licensed insurance agent.
Decide by December 7, 2026. If your plan is ending, decide by December 31 to avoid a gap.
Watch for your new plan's welcome letter and ID card. Keep your old card until January 1.

Sources

Every question in this guide

Frequently asked questions

What happens if I do nothing during open enrollment?

If your plan is renewing, you stay in it for 2027 with the changes listed in its Annual Notice of Change. If your Medicare Advantage plan is ending and you do nothing, you go back to Original Medicare on January 1 without drug coverage.

What is the Medicare Annual Notice of Change?

It's the notice your Medicare Advantage or Part D plan sends by September 30 listing what changes on January 1: costs, covered drugs, network and benefits. Read it before December 7 so you can switch if the plan no longer fits.

Can I leave my Medicare Advantage plan if my doctor leaves the network?

Usually not on that basis alone. Medicare evaluates special enrollment periods for a significant change in a plan's network case by case. Otherwise use open enrollment, through December 7, or the January 1 to March 31 window.

Can I switch plans if I move within North Carolina?

Yes, if you move out of your plan's service area or to an address with new plan options. Your chance starts the month you move and lasts 2 full months after; if you tell your plan before you move, it can start the month before.

My North Carolina Medicare Advantage plan is ending in 2027. What should I do?

Choose a new Medicare Advantage plan, or Original Medicare with a Part D plan, by December 31, 2026 so it starts January 1. Your special enrollment period lasts until February 28, 2027, and you can buy certain Medigap policies without health questions, applying up to 63 days after your coverage ends.

Medicare in your North Carolina county

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Licensed insurance agents for North Carolina

These independent insurance agents are licensed in North Carolina and work with Benefits Life, the publisher of this site. When they enroll you in a plan, the agent and Benefits Life may be paid by the insurance company. Learn more.