The pieces of your monthly cost (2026)
| Piece | What most people pay | Who pays more or less |
|---|---|---|
| Part A (hospital) | $0 premium | People with fewer than 40 quarters of Medicare-taxed work, theirs or a spouse's, pay up to $565 a month |
| Part B (medical) | $202.90 a month | Higher incomes pay up to $689.90; late enrollees pay a penalty |
| Part D drug plan | Varies by plan | Higher incomes add an IRMAA surcharge of up to $91 |
| Medigap policy | Varies by plan letter, company and age | Set by each company |
| Medicare Advantage plan | Varies by plan and county | Replaces Medigap and usually includes Part D; you still pay Part B |
You also pay deductibles and coinsurance when you get care, such as the Part B deductible of $283 and the Part A hospital deductible of $1,736 in 2026. Part D drug costs are capped at $2,100 a year. See Medicare costs in 2026.
Two common ways to put it together
- Original Medicare, Part D and Medigap: you pay the Part B premium plus a Part D premium and a Medigap premium. You can see any provider that accepts Medicare.
- Medicare Advantage: you pay the Part B premium plus the plan's premium, if any, and the plan's cost sharing up to its yearly limit (no more than $9,250 in network in 2026). See Medigap vs. Medicare Advantage in North Carolina.
Choices differ across North Carolina's 100 counties: for 2027, CMS lists 57 Medicare Advantage plans open to everyone in Guilford County but 11 in Carteret County, and 11 standalone Part D plans statewide.
If you retired from a North Carolina public job
Most North Carolina public jobs are covered by Social Security, so most retired teachers and state and local workers who collect Social Security have Part B taken out of their check. Any State Health Plan premium you owe is separate from Part B. See State Health Plan retirees and Medicare.
Help with costs in North Carolina
- MQB programs: MQB-Q (income up to 100% of the federal poverty level) pays Medicare premiums, deductibles and coinsurance, and MQB-B and MQB-E (up to 135%) pay the Part B premium. North Carolina has an asset test of $9,950 for one person. Apply through ePASS or your county Department of Social Services. See Medicare Savings Programs in North Carolina.
- Extra Help: lowers Part D costs; apply through Social Security.
To add up plan costs for your county, you can request a call from a licensed insurance agent, or see plans for your ZIP code.
Related questions
How much is Part B in 2027?
Where the 2027 amounts stand.
Do I pay a premium for Part A?
The 40-quarter rule and North Carolina public jobs.
What is IRMAA?
Income-based premiums.
Sources
- CMS — 2026 Medicare Parts A & B premiums and deductibles
- Medicare.gov — Medicare costs
- Congressional Research Service — Social Security Coverage of State and Local Government Employees (R46961)
- NC Medicaid — MA-2252 Non-MAGI income and reserve limits (MQB), effective April 1, 2026 (PDF)
- CMS — CY2027 Medicare Advantage and Part D Landscape files (North Carolina counts)
More questions in this guide
- Do I have to pay a premium for Medicare Part A?
- How do I lower my IRMAA after I retire?
- How much is Medicare Part B in 2027?
- What is IRMAA and will I have to pay it?
Part of the guide: Medicare costs in 2026 for North Carolinians · All questions
Frequently asked questions
Is Medicare cheaper in North Carolina than in other states?
The Part A and Part B amounts are the same nationwide. Premiums for Part D, Medigap and Medicare Advantage plans are set by the companies and differ by plan, county and, for Medigap, factors like your age. Compare plans for your own ZIP code.
Do I still pay the Part B premium with a Medicare Advantage plan?
Yes. You keep paying your Part B premium when you join a Medicare Advantage plan, plus any premium the plan charges. That is also true for the State Health Plan's group Medicare Advantage Base Plan and Enhanced Plan.
Does it cost more to live in a county with fewer plans?
Not for Original Medicare, which costs the same in all 100 counties. A county with fewer Medicare Advantage plans, such as Carteret, simply gives you fewer plans to compare, each with its own premium and copays.
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 →
