Seven steps to a choice
- Start with coverage you already have. State Health Plan retirees, TRICARE For Life beneficiaries, people with NC Medicaid and people on an employer plan have rules that can change the right choice. For example, joining an outside Medicare Advantage or Part D plan removes a State Health Plan retiree from the Plan's group Medicare Advantage plan.
- List your doctors, hospital, pharmacy and drugs. Include specialists and any provider across a state line.
- Pick a path. Original Medicare with Medigap lets you see any provider in the U.S. who accepts Medicare. Medicare Advantage uses a network and usually includes drug coverage. See Medigap vs. Medicare Advantage in North Carolina.
- See what's sold in your county. Plans are approved county by county: for 2027, Carteret County has 11 Medicare Advantage plans open to everyone and Guilford County 57. Every county has standalone Part D plans (11 statewide).
- Check each plan against your list. Use the plan's 2027 provider directory and drug list, not last year's.
- Compare a typical year and a bad year. Add premiums and expected copays, then look at the worst case: a Medicare Advantage plan's yearly limit can be up to $9,850 in network in 2027, and Part D drug costs are capped at $2,400.
- Enroll by the deadline. Open Enrollment ends December 7, 2026. Keep your confirmation.
North Carolina rules that change the math
- No Medigap birthday rule. North Carolina has no yearly right to switch Medigap policies without health questions. Your best chance to buy Medigap is the 6 months after you're 65 and in Part B. See Medigap in North Carolina.
- Plans ending in 2027. At least 30,654 North Carolinians must choose new coverage. If that's you, you also get a rare Medigap guaranteed-issue right. See plans ending in 2027.
- NC Medicaid or a Medicare Savings Program. You may qualify for a D-SNP. See D-SNPs in North Carolina.
Protect yourself
Don't give your Medicare number to anyone who calls you unasked. The State Health Plan warns retirees that confirming personal information over the phone can enroll them in a plan they don't want. You can check that an agent is licensed in North Carolina with the NAIC license lookup, which the NC Department of Insurance uses.
To compare plans from the companies they work with, you can request a call from a licensed insurance agent, or see plans for your ZIP code.
Related questions
How many Medicare Advantage plans are in NC for 2027?
Statewide and county counts.
Can I be denied Medicare Advantage in North Carolina?
Who a plan must accept.
What are special needs plans in North Carolina?
Plans for Medicaid, chronic conditions and nursing-home care.
Sources
- Medicare.gov — Medicare Plan Finder
- Medicare.gov — Compare Original Medicare and Medicare Advantage
- CMS — Medicare Advantage and Part D Landscape files, contract year 2027
- N.C. General Statutes Chapter 58, Article 54 — Medicare Supplement Insurance Minimum Standards
- State Health Plan — Pre-65 retiree presentation (Medicare and the group Medicare Advantage plans)
- TRICARE — TRICARE For Life
- NAIC — Insurance license lookup
More questions in this guide
- Can I be turned down for a Medicare Advantage plan in North Carolina?
- How many Medicare Advantage plans are in North Carolina for 2027?
- Is Medicare Advantage available in every North Carolina county?
- What are Medicare special needs plans in North Carolina?
Part of the guide: Medicare Advantage in North Carolina · All questions
Frequently asked questions
When can I change my Medicare plan in North Carolina?
Open Enrollment runs October 15 to December 7, 2026, for coverage starting January 1, 2027. If you're in a Medicare Advantage plan, you can make one change from January 1 to March 31, 2027. Moving, losing coverage, getting NC Medicaid or Extra Help, and a plan ending give you special enrollment periods.
Do I have to choose a new plan every year?
No. Your plan usually renews automatically. But plans can change their costs, networks and drug lists every January 1, so read the Annual Notice of Change your plan sends each fall. If your plan is ending, you'll get a non-renewal letter instead.
Can a licensed insurance agent help me choose?
Yes. A licensed insurance agent can compare plans from the companies they work with and check your doctors and drugs. For information on all your options, use Medicare.gov's Plan Finder or call 1-800-MEDICARE.
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 →
