Do I get a guaranteed right to buy Medigap if my plan leaves North Carolina?

When the right applies

North Carolina's Medigap rule, 11 NCAC 12 .0843, adopts the national model standards, which follow federal law. You have a guaranteed-issue right to Medigap if you're in a Medicare Advantage plan and:

• the plan leaves Medicare or stops serving the area where you live (a non-renewal), or
• you move out of the plan's service area, or
• the plan broke its contract with you or misled you when you enrolled.

You have the right only if you switch to Original Medicare, not if you join another Medicare Advantage plan. For 2027, two companies stop selling regular Medicare Advantage plans in some North Carolina counties, mostly in the western mountains plus Wake, Johnston, Chatham and Rutherford, and six companies end some plans. At least 30,654 North Carolinians must choose new coverage. See North Carolina plans ending in 2027.

How to use it

1. Find your non-renewal letter. It shows the date your plan ends. Keep a copy; the Medigap company may ask for it.
2. Choose a plan letter. Your right covers Plans A, B, D, G, K and L, and C or F if you were eligible for Medicare before January 1, 2020. Plans with the same letter have the same benefits from every company.
3. Compare companies. North Carolina doesn't require one pricing method. A company that prices by attained age must tell you in writing that the premium rises as you age and show a 10-year illustration (G.S. 58-54-25(f)).
4. Apply in time. Apply as early as 60 days before your plan ends and no later than 63 days after. Start the policy January 1 if your plan ends December 31.
5. Join a Part D plan too. Medigap doesn't cover prescriptions. Choose one of the 11 standalone drug plans by December 31 for January 1 coverage.

You have 30 days after delivery to return a new North Carolina Medigap policy for a full premium refund (G.S. 58-54-30).

When the right doesn't apply

• Your plan continues with changes. An Annual Notice of Change isn't a non-renewal.
• You simply decide to leave a Medicare Advantage plan that's still offered, after your first 12 months.
• Your letter says you're being moved to another plan from the same company. Ask 1-800-MEDICARE (1-800-633-4227) whether you have a right in that case.

Problems with a Medigap company can go to the NC Department of Insurance complaint page. To compare Medigap policies from the companies they work with, you can request a call from a licensed insurance agent. More on Medigap in North Carolina.

Related questions

Sources

• Medicare.gov — Guaranteed issue rights
• Medicare.gov — When can I buy a Medigap policy? (60 days before to 63 days after)
• Medicare.gov — Choosing a Medigap Policy (guaranteed issue rights)
• North Carolina General Assembly — G.S. Chapter 58, Article 54 (58-54-25, 58-54-30, 58-54-45)
• NC Office of Administrative Hearings — 11 NCAC 12 .0843, Medicare supplement insurance
• Social Security Act §1882(s)(3), guaranteed issue for eligible persons

More questions in this guide

• Can I change my Medicare plan after open enrollment ends?
• Can I switch from Medicare Advantage back to Original Medicare in North Carolina?
• My Medicare Advantage plan is ending in 2027 in North Carolina. What do I do?
• What is the Medicare Advantage Open Enrollment Period?
• When is Medicare open enrollment in North Carolina?
• Which Medicare companies are leaving North Carolina in 2027?

Part of the guide: Medicare Open Enrollment in North Carolina (2027 Plans) · All questions

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