Original Medicare is extremely effective at assisting seniors in maintaining good health and financial security. However, it does not cover all of your medical expenses. You might find Medicare Part B’s 20% coinsurance and other out-of-pocket expenses to be extremely expensive. So, if you do, or even if you just want to save some money on medical care, you should explore North Carolina Medicare Supplement Plans.
The benefits of these plans, which are provided by private insurance companies but standardized by the government, are straightforward. In fact, the Centers for Medicare & Medicaid Services (CMS) govern Medicare Supplement Plans. The CMS requires that all plans with the same letter name provide the same benefits to enrollees regardless of where or from whom the plan is purchased.
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With that being said, though, premiums differ from insurer to insurer. So, it’s essential to shop around for the best Medicare Supplement Plan and insurance company for you. Once you’ve read our guide to North Carolina Medicare Supplement Plans, speak to an EZ agent about all of your options.
North Carolina Medicare Supplement Plans
If you need additional coverage to fill any gaps in Original Medicare a Medicare Supplement Plan is your best option.
In North Carolina, there are ten standardized Medicare Supplement Plans. Each labeled with a letter of the alphabet: A, B, C, D, F, G, K, L, M, and N. While not every insurance provider in North Carolina will offer every plan, Plan A will always be available to all. In addition, Plan C and Plan F are only available to people who became Medicare eligible before January 1, 2020.
We’ve outlined all ten plans, including their coverage and the average premium range in North Carolina, to help you get started.
Plan A
Plan A, the only plan available from all insurers, is also the most basic. It’s simple, but it addresses one of the biggest gaps in Medicare coverage. Which is the 20% of outpatient services you are required to pay with Medicare Part B. While all Medicare recipients over the age of 65 have access to Plan A, some states do not require insurers to provide this plan to Medicare disability recipients under the age of 65.
Monthly Plan A premiums in North Carolina start at $93 per month.
Plan B
Plan B is a little more comprehensive than Plan A. It covers all the basics that Plan A does, including:
- Medicare Part A coinsurance and hospital costs – Medicare Part A only fully covers your first 60 days of inpatient hospital stays in a benefit period; after that, you are required to pay coinsurance for each day after your initial 60 days. Days 61-90 have a coinsurance of $400 a day, days 91-150 (after you use your Lifetime Reserve days) have a coinsurance of $800 a day. Plan B covers 100% of these costs.
- Medicare Part B coinsurance or copay – You’ll typically have to pay Medicare Part B coinsurance for doctor visits and other outpatient care. That means Medicare Part B pays 80% of the Medicare-approved amount for covered services, leaving you to pay the remaining 20%. Plan B covers 100% of this.
- First 3 pints of blood – Original Medicare only pays for the fourth and subsequent pints of blood if you need blood during treatment. Plan B will pay for the first three pints.
- Part A hospice care and coinsurance – Hospice care is for patients who are nearing the end of their lives. These services are covered by Medicare, but copayments are required. These copayments include $5 for each symptom and pain relief medication prescription, as well as 5% of the Medicare-approved amount for inpatient assisted living. Plan B covers all expenses related to hospice care.
What makes Plan B less basic than Plan A is that it covers the Medicare Part A deductible, while Plan A does not. The Medicare Part A deductible is $1,600 per benefit period in 2023. And because it is calculated on a 60-day basis rather than on an annual basis, you may be required to pay it more than once per year. As a result, having a plan that includes this protection could be extremely beneficial.
Monthly premiums for Plan B in North Carolina can begin as low as $113.
Plan C
While it is not available to all beneficiaries, Part C is one of the most comprehensive Medicare Supplement Plans on the market, making it a popular choice. It covers all out-of-pocket expenses, with the exception of Medicare Part B excess charges. This means that, in addition to your 20% coinsurance, Plan C will cover your Parts A and B deductibles, as well as almost everything else.
Coverage includes the following:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B coinsurance and copayments
- Part B deductible
- Other Medicare-approved expenses associated with Part B coverage
Plan C is no longer available to Medicare beneficiaries who became eligible after January 1, 2020. If you had Plan C prior to that date, you can keep it, and if you were eligible for Medicare prior to January 1, 2020 but did not enroll, you may still be able to purchase it.
Medicare Supplement Plan C premiums in North Carolina start at $194 a month.
Plan D
Plan D covers the majority of out-of-pocket expenses associated with Original Medicare including:
- Part A hospital coinsurance and hospital costs up to an extra 365 days after Original Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Part B coinsurance
- First 3 pints of blood
- Skilled nursing facility (SNF) care coinsurance – After the 20th day of your stay as an inpatient in a skilled nursing facility, Medicare Part A requires you to pay coinsurance. Part A coinsurance for skilled nursing facility care is $200 per day in 2023. Part D covers this coinsurance.
- Part A deductible
- 80% of foreign travel emergency costs (up to plan limits)
The only major expenses not covered by Plan are the Medicare Part B deductible and Part B excess charges. If your doctor refuses to accept Medicare assignment and chooses to bill you for more than Medicare would cover, you will be responsible for Part B excess charges, or the difference between what your doctor charges and what Medicare will pay. While some select plans cover excess charges, Plan D does not, so if you want to see doctors who do not accept Medicare assignment, you should look into other plans.
In North Carolina, monthly Plan D premiums can begin as low as $178.
Plan F
Plan F has been the most popular Medicare Supplement Plan on the market for a long time because of its comprehensive coverage, but it is not available to all beneficiaries. You only need to pay the monthly premium for Plan F with this plan; all other out-of-pocket expenses are covered.
Plan F covers all of the following:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B 20% coinsurance and copayments
- Medicare-approved doctor’s office fees
- Part B deductible
- Medicare Part B excess charges
- Other Medicare-approved expenses associated with Part B coverage
Plan F is no longer available to Medicare beneficiaries who became eligible after January 1, 2020. If you were eligible for Medicare prior to 2020, you can purchase one of these plans; if you have Plan F and are grandfathered in, you can keep it indefinitely.
Monthly premiums for Plan F in North Carolina can start as low as $125.
Plan G
If you like the sound of Plan F, but are not eligible to purchase one of these plans, look into Plan G. This plan covers almost everything that Plan F does, including:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Part A deductible
- Part A hospice care coinsurance or copayment
- Part B coinsurance or copayment
- Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so)
- Blood transfusion (first 3 pints)
The only thing Plan G does not cover is the Medicare Part B deductible, so it is a very comprehensive plan that will save you a lot of money.
Plan G premiums typically start at $102 per month, making it more affordable than Plan F.
Plan K
Medicare Supplement Plan K reduces your out-of-pocket expenses, but it does not completely fill the gaps. Plan K only covers half of the following costs:
- Medicare Part B coinsurance – Plan K covers half of these costs, so you will be responsible for 50% of your 20% coinsurance. For example, if your doctor charges $100 for a service, Medicare Part B will cover $80, Plan K will cover $10, and you will pay the remaining $10.
- First 3 pints of blood
- Part A hospice care coinsurance or copayment – Plan K will pay for half of these costs.
- Skilled nursing facility care coinsurance – Plan K pays half of the coinsurance for medical care in skilled nursing care facilities.
- Medicare Part A deductible – Medicare Supplement Plan K will pay half of these deductibles, or $800. Plan K requires you to pay the Medicare Part B deductible, which is $226 in 2023.
But while Plan K has higher out-of-pocket costs at the time of service, it does have an out-of-pocket maximum. Which other plans (and Original Medicare) do not have. That means once you reach this out-of-pocket maximum of $6,620 (as of 2023), Medicare Supplement Plan K will cover the remaining approved costs for the year. Each calendar year, your limit will be reset.
In addition, Plan K covers the Medicare Part A coinsurance in full, despite the fact that it only covers half of many out-of-pocket expenses. That means you won’t have to pay this coinsurance out-of-pocket if you have a hospital stay of more than 60 days.
Plan K premiums in North Carolina begin at $51 per month, which is lower than most other plans because of its higher out-of-pocket costs.
Plan L
Medicare Supplement Plan L covers the majority but not all Original Medicare expenses. The good thing about Plan L is that it covers these expenses at a higher rate than Plan K does. In addition, Plan L’s out-of-pocket maximum is also lower than Plan K’s ($3,310 in 2023).
Medicare Supplement Plan L covers all coinsurance and hospitalization costs associated with Medicare Part A. In addition, it also covers:
- Medicare Part B coinsurance – Plan L covers 75% of your Part B coinsurance.
- Blood – If you require blood while in the hospital, Plan L will cover 75% of the cost of the first three pints.
- Part A hospice care copayments – Plan L pays 75% of your Part A copays for hospice care.
- Skilled nursing facility care coinsurance – Plan L pays 75% of the $200 per day (after the 20th day of your stay) coinsurance for medical care in skilled nursing care facilities.
- Part A deductible – Medicare Supplement Plan L will cover 75% of your Part A deductibles for each 60-day benefit period. You must still meet your Medicare Part B deductible, which is $226 per year in 2023, if you choose Plan L.
Medicare Supplement Plan L premiums start at $82 a month in North Carolina.
Plan M
Plan M covers the majority of your Original Medicare out-of-pocket expenses, but not all. It does, though, provide more coverage than either Plan K or Plan L do. It covers:
- Medicare Part B coinsurance – Plan M pays your Part B coinsurance and/or copayments in full.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan M will cover the first three pints of blood in full.
- Part A hospice care coinsurance or copayment – Plan M will cover all of your hospice care coinsurance and copays in full.
- Skilled nursing facility care coinsurance – Plan M covers the entire cost of Part A skilled nursing facility coinsurance.
- Part A hospital expenses and coinsurance
- Part A deductible – While Medicare Supplement Plan M covers most Part A costs, it will only cover half of your Medicare Part A deductible. If you have Plan M, you will have to pay half of the $1,600 (or $800) deductible rather than the full $1,600.
The cost of plan M premiums in North Carolina start at $72 per month.
Plan N
Medicare Supplement Plan N is another very comprehensive Medicare Supplement Plan option. Plan N excludes only two things: the Medicare Part B deductible ($226 in 2023) and any Medicare Part B excess charges. Which are any portions of medical bills that exceed the Medicare-approved amount. With that being said, Plan K does have one expense other plans do not: copayments for some Part B services.
Medicare Supplement Plan N covers the following nearly completely:
- Medicare Part B coinsurance – Plan N will cover your Part B coinsurance costs in full, with the exception of a copayment of up to $20 for some office visits. For emergency room visits that do not result in an inpatient admission, a second copayment of up to $50 may be required.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan N will cover the first three pints.
- Part A hospice care coinsurance or copayment – Plan N pays your hospice care coinsurance and copayments in full.
- Skilled nursing facility care coinsurance – Your skilled nursing facility coinsurance will be fully covered by Medicare Supplement Plan N.
- Part A deductible – Medicare Supplement Plan N pays your $1,600 deductible in full for each 60-day benefit period.
- Foreign travel emergency care – Original Medicare typically does not cover medical care received outside of the United States. If you need emergency care while traveling outside of the United States, Medicare Supplement Plan N will cover 80% of the costs of qualified emergency medical care.
The price for Plan N starts at $76 a month in North Carolina.
When to Enroll
Federal regulations require Medicare Supplement Plan insurers to provide a six-month Open Enrollment Period. Which begins when you turn 65 and enroll in Medicare Part B (you have to be enrolled in both Parts A and B to get a Medicare Supplement Plan). During this time, insurance companies have to offer you a plan on a guaranteed-issue basis, which means that they cannot deny you or charge you more based on your health.
But, because North Carolina allows Medicare Supplement Plan insurers to choose their own rating approach, nearly all of the plans available in the state use attained-age rating. This means that your premiums will rise as you age, regardless of your age when you first enrolled. The other two ways that Medicare Supplement Plan premiums can be priced are issue-age rating. In which premiums are determined by your age at the time of enrollment, and community rating (also known as “no age” rating), in which premiums are not determined by age. Some states require insurers to use one of these types of pricing, but North Carolina does not.
How To Choose
When it comes to Medicare coverage, don’t be afraid to ask questions. Speak to an EZ agent who can explain everything to you and give you all the guidance you need. EZ can assist you in enrolling in Medicare, looking for a Medicare Supplement Plan, or simply weighing your options. Our agents work with the best insurance companies in the country. They can provide you with a free comparison of all available plans in your area. We will go over your medical and financial needs with you and help you find a plan that works for you. To get started, simply enter your zip code in the bar below or give one of our licensed agents a call at 877-670-3602.
