Does the NC State Health Plan pay for Medicare Part B?

What you pay to Medicare

• Part B premium: $202.90 a month for most people in 2026. CMS publishes 2027 amounts in the fall; see Medicare costs in 2027.
• IRMAA: if your modified adjusted gross income from two years earlier was above $109,000 (single) or $218,000 (joint) for 2026 premiums, you pay a higher Part B premium and, with Part D coverage, a Part D surcharge. Try the IRMAA calculator.
• Part A: most people pay no Part A premium because they or a spouse paid Medicare taxes long enough. About 93% of North Carolina's state and local government workers have Social Security coverage, so most qualify.

The Plan's 2027 Open Enrollment materials say it plainly: you must maintain Part A and Part B to be in the Plan's Medicare Advantage options, and you must keep paying the Part B premium to the federal government. On the 70/30 Plan, dropping Part B doesn't save money overall, because the Plan pays as if Part B had paid and leaves you that share.

Help paying Part B in North Carolina

North Carolina's Medicare Savings Programs are called MQB (Medicare Qualified Beneficiary). Each has its own income limit, set as a percentage of the federal poverty level, and a resource limit of $9,950 for one person or $14,910 for a couple:

Apply through ePASS or your county Department of Social Services (DSS). Qualifying also gets you Extra Help with Part D drug costs, which works with Part D coverage, not the 70/30 Plan's drug benefit. See Medicare Savings Programs in North Carolina.

The full Plan guide: State Health Plan retirees and Medicare. To review your costs and options, you can request a call from a licensed insurance agent.

Related questions

Sources

• State Health Plan — 2027 Open Enrollment Medicare outreach presentation
• Medicare.gov — Medicare costs
• Medicare.gov — Medicare Savings Programs
• NCDHHS — MA-2252, Non-MAGI Medicaid income and reserve limits (effective April 1, 2026)
• NC Medicaid — How to apply
• Congressional Research Service — Social Security Coverage of State and Local Government Employees (R46961)

More questions in this guide

• Are NC state employees hired after 2021 eligible for retiree health coverage?
• Can I drop the State Health Plan and buy my own Medicare plan in NC?
• Can my spouse stay on the State Health Plan when I go on Medicare?
• Do federal retirees in North Carolina need Medicare Part B with FEHB?
• Do LGERS retirees get State Health Plan coverage with Medicare?
• Do North Carolina state retirees need Medicare Part B?
• What happens to my State Health Plan coverage when I turn 65?
• What Medicare plans does the NC State Health Plan offer retirees?

Part of the guide: State Health Plan retirees and Medicare in North Carolina · All questions

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