Medicare Supplement Plans in North Carolina - Medigap Insurance

Medicare Supplement Plans in North Carolina
Medigap Insurance

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North Carolina Medicare beneficiaries enrolled in Medicare Part A and Part B (Original Medicare) have the option to enroll in a Medicare Supplement plan, often referred to as Medigap Insurance.  Medicare Supplements are offered by private insurance companies and provide coverage for healthcare costs that Original Medicare does not cover.  Medicare Supplement policies must cover basic or “core” benefits and these plans help fill the gap between what Medicare pays and what you pay in out of pocket costs.

Important Features of Medicare Supplement Plans in North Carolina:

  • In order to be eligible, you must be enrolled in Medicare Part A and Part B.
  • Most Medicare Supplement plans do not include prescription drug coverage.  Therefore, most Medicare Supplement beneficiaries enroll in a separate Part D prescription drug plan.
  • There are 11 standardized Medicare Supplement plans available in NC: Plans A-N. The standardization of these plans means that the benefits are regulated by the federal government, but insurance companies can offer other unique features.  
  • A Medicare Supplement plan is not the same as a Medicare Advantage plan and you cannot use a Medicare Advantage plan in conjunction with a Medicare Supplement.  
  • A Medicare Supplement or Medigap policy is not a standalone policy.  The plan is structured to supplement Original Medicare or fill the gaps in coverage.
  • Medicare Supplements are accepted by any provider that accepts Medicare.

Enrollment Period:

Medicare Supplement plans have an Open Enrollment Period.  This period begins when the beneficiary is both: Age 65 or older; and enrolled in Medicare Part B.  During this period, the beneficiary cannot be denied coverage, meaning the policy is guaranteed issue.  After the beneficiary’s Open Enrollment Period has ended, the Medicare Supplement policy may be medically underwritten.  This means that rates, eligibility, and coverage for preexisting conditions could be impacted by an individual’s medical history.  The Open Enrollment Period is the best time to enroll in a Medigap policy.  

Premiums:

If you enroll a Medigap plan, you must pay the private insurance company a monthly premium for the Medicare Supplement in addition to the Part B premium paid to Medicare. Insurance companies typically set Medicare Supplement rates in one of three ways:

  • Community-rated – premiums are not age-dependent and are the same for everyone
  • Issue-age-rated – premiums are based on your age when you purchase the policy and will be less expensive the younger you are when you enroll.
  • Attained-age-rated – premiums are based on age and will increase as you get older.  Some attained-age plans increase yearly, while others increase in age bands (ie:  66-69, 70-74, etc.)

If you are a Medicare recipient, Medigap or Medicare Supplement Insurance is one way you can help alleviate your out-of-pocket costs.  For more information about Medicare Supplement plans in North Carolina, contact the helpful professionals at NC Health Plans toll free at 888-765-5400.