North Carolina Medicare Plans
North Carolina Medicare plans, outside of Original Medicare, are sold by private insurance companies.
These are oftentimes a better fit for Medicare beneficiaries.
Medicare Supplements cover the deductibles, copays, coinsurance, and more that Original Medicare doesn’t, saving thousands of dollars. It also gives you the freedom to see any doctor that accepts Medicare. Medicare Advantage plans offer similar coverage to Original Medicare, but offer extras, including prescription drug coverage, and sometimes don’t cost you any additional premium.
North Carolina Medicare plans are offered by a wide variety of insurance companies. Fortunately for residents, the 10 plans offered are those that have been outlined by the federal government.
North Carolina Medicare Plans Open Enrollment
Medicare beneficiaries in North Carolina are eligible for Medicare at age 65.
Initial enrollment begins three months before your birth month and lasts three months after. This is also the time you can apply for Medicare Supplements.
While you can enroll in a supplement at any time, initial enrollment is the best time to do so because you cannot be turned down due to health conditions considering you won’t have to answer health questions on your application. If you miss this window, you’ll likely have to answer health questions to apply, which means you could be turned down by other North Carolina Medicare supplement plans.
North Carolina Medicare Advantage Plans
While Medigap plans give you the most comprehensive coverage, not everyone can afford a Medigap plan. Medicare Advantage is an alternative solution with lower premiums. North Carolina has up to 29 Medicare Advantage plans available, depending on what county you live in.
North Carolina Medicare Advantage plans are private plans that pay instead of Medicare. You get your benefits from the insurance company instead of from Medicare and your provider will bill the plan.
You can only join Medicare Advantage plan at certain times of the year. Once you join, you are locked in for the remainder of that calendar year so make sure your doctors are in the network before enrolling.
Medicare Advantage begins on January 1 and ends on March 31. Those who are already enrolled in Medicare Advantage can switch to a different plan during this open enrollment or opt to have Original Medicare instead.
North Carolina Medicare Part D
There are 26 Part D plans available in North Carolina. If you don’t want to pay out-of-pocket for your prescriptions, be sure to look into Medicare Advantage or a standalone Part D plan. Remember, Original Medicare and Medicare Supplement plans don’t offer coverage for prescription drugs, so if take or anticipate needing a lot of prescription drugs, enrolling in Medicare Part D might be a good option.
North Carolina Medigap Plans
Medicare Supplements in North Carolina cover some, or even all, of the deductibles and coinsurance left over by Original Medicare.
This can save you thousands in out-of-pocket expenses, putting a cap on those costs, and this plan doesn’t limit you to a network of doctors that accept Medicare only.
There are 10 plans lettered A through N that offer standardized coverage. This means all plans lettered the same have to offer the same coverage and the only difference is price. So, be sure to shop your coverage.
Each Medicare standardized supplement plan in North Carolina includes a specific set of benefits.
Medicare Under 65 in North Carolina
Currently, the state legislature only requires Medicare supplement companies to offer Plans A and F to people under 65. If you are on Medicare disability, North Carolina Medigap plans can often be quite costly. This happens because insurance companies know that in order to qualify for Medicare early, you must have a health condition or injury and therefore assumes you will have more medical claims.
Because of this, North Carolina Medicare Advantage plan might be a more affordable option. North Carolina Medicare Advantage plans have an annual enrollment period each year for you to join. You must have Medicare Part A and Part B and lives in the plan service area to be eligible.
As long as you do not have ESRD, you are eligible.
Medicare Advantage for North Carolina Residents Under the Age of 65 with Disabilities
While Medicare is generally reserved for those turning 65, there are cases in which someone may be eligible for Medicare under the age of 65. This includes individuals with disabilities who have received Social Security Disability Income for 24 months or have End Stage Renal Disease (ESRD) or Amyotropic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease).
It is important to note that there is a five-month waiting period after a beneficiary is determined to be disabled before they can begin to collect Social Security Disability Income. People who meet all the criteria for Social Security Disability Income are generally automatically enrolled in Medicare Part A and Part B. For the people who meet the standards, but do not qualify for Social Security Income, have an option to purchase Medicare by paying a Part A premium monthly as well as a monthly Part B premium.
An exception to the 5-month waiting people does apply for those people with ESRD and ALS. These individuals do not have to collect benefits for 24 months in order to become eligible for Medicare.
The requirements for Medicare eligibility for people with ESRD and ALS are:
- ESRD – Generally 3 months after a course of regular dialysis begins or after a kidney transplant
- ALS – Immediately upon collecting Social Security Disability benefits
Regrettably, those with disabilities often have lower incomes, require more health care, and find it more difficult to pay for and obtain care compared to Medicare beneficiaries over 65 years of age. Take our Medicare quiz now to see if you qualify for incredible Medicare benefits, even if you are under the age of 65.
Every state is different, and so obtaining Medicare benefits in North Carolina can be complicated or confusing. If you are disabled or under the age of 65 wondering if you qualify, it is best to contact us directly to see if you are eligible.
What Medicare Advantage benefits am I eligible for under the age of 65 in North Carolina?
At 100 Insure, we can help you discover benefits you might be eligible for including:
- Premiums starting at $0 per month
- Coverage for copays and deductibles
- Prescription drugs
- And transportation to the doctor and pharmacy
That’s right. Our company has helped qualified people under the age of 65 in North Carolina receive benefits like:
- Massage services
- Meals after a hospital
- Food for their service dog
- A gym membership
- Money for vitamins and groceries
- Home improvements
- In home care & aides
- And pest control services
Contact us today to see if you qualify.
Medicare Coverage for Working People in North Carolina with Disabilities
Medicare eligibility for working people with disabilities falls into three distinct time frames.
- Trial work period – extends 9 months after a disabled individual obtains a job
- Second period – This period is for 93 months after the end of the trial work period.
- Third period – An indefinite period following those 93 months.
Keep in mind that Medicare eligibility during each of these periods applies only while the individual continues to meet the medical standard for being considered disabled under Social Security rules.