How to file with NCDOI
- Write down what happened. The agent's name and NPN if you have it, the company, dates, what was said and anything you signed.
- Gather documents. Enrollment forms, letters, plan cards, texts and the caller's number.
- File the complaint. Use the online form on NCDOI's Assistance or File a Complaint page, or the printable or Spanish form there. You can also mail it to NC Department of Insurance, 1201 Mail Service Center, Raleigh, NC 27699-1201.
- Watch for NCDOI's reply. It may forward the complaint to the company and ask for an explanation.
Which office handles what
| Problem | Where it goes |
|---|---|
| Misleading sales, pressure, or a license problem | NCDOI complaint form |
| Forged signatures, taking money, or other insurance fraud | NCDOI Criminal Investigations Division: 919-807-6840, or 888-680-7684 from within North Carolina, or online |
| Enrolled in a Medicare Advantage or Part D plan without agreeing, or a sales practice that breaks Medicare's rules | 1-800-MEDICARE (TTY 1-877-486-2048) |
| A problem with a Medigap insurer | NCDOI complaint form; NCDOI regulates Medigap in North Carolina (G.S. 58, Article 54) |
| Robocalls and scam calls | NC Department of Justice, 1-877-5-NO-SCAM (1-877-566-7226) |
The rules agents must follow
Medicare's marketing rules bar agents and plans from unsolicited calls and door-to-door visits, require a Scope of Appointment before a sales meeting, and require recording of sales calls. Agents must be licensed in North Carolina and appointed by the company whose plan they sell. If an agent broke these rules, say so in your complaint. NCDOI's licensing actions search shows past disciplinary actions against agents.
Tip: If a sales problem left you in the wrong plan, you may have a special enrollment period to fix it. Open Enrollment also runs through December 7, 2026. See Medicare Open Enrollment in North Carolina.
Related questions
How do I find a licensed agent in North Carolina?
Checking a license and NPN.
How do I report Medicare fraud in North Carolina?
Where each report goes.
Medicare phone numbers in North Carolina
Official numbers.
Sources
- NC Department of Insurance — Assistance or file a complaint
- NC Department of Insurance — Report insurance fraud
- NC Department of Insurance — Licensing actions search
- eCFR — 42 CFR Part 422, Subpart V (marketing rules)
- Medicare.gov — Talk to someone
- NC Department of Justice (consumer complaint line)
More questions in this guide
- How can I help a parent with Medicare in North Carolina?
- How do I appeal a hospital discharge in North Carolina if I'm not ready to go home?
- How do I appeal a Medicare denial in North Carolina?
- How do I find a licensed Medicare agent in North Carolina?
- How do I find my area agency on aging in North Carolina?
- How do I report Medicare fraud in North Carolina?
- Medicare phone numbers in North Carolina
Part of the guide: North Carolina Medicare contacts · All questions
Frequently asked questions
What can NCDOI do about my complaint?
NCDOI says it can forward your complaint to the insurance company and require a response, review that response for compliance with North Carolina law, and require corrective action if the company's position doesn't comply. It can't act as your lawyer or decide who is at fault in a dispute.
I was enrolled in a Medicare plan I didn't choose. What do I do?
Call 1-800-MEDICARE (1-800-633-4227) right away. Medicare can look into an enrollment you didn't agree to. Then file a complaint about the agent with NCDOI.
Can I complain to the insurance company too?
Yes. Medicare Advantage and Part D plans must have a grievance process, explained in the Evidence of Coverage, and you can file a grievance about how a plan's agent treated you. Keep a copy of everything you send.
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 →
