Plans · Medigap
Medicare Supplement (Medigap) plans in North Carolina
A Medigap policy works alongside Original Medicare to pay much of what it leaves to you, and lets you use any provider in the country that accepts Medicare — Duke, UNC, Atrium, Mission, a Virginia specialist from the Outer Banks, or the clinic in your county seat.
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Medicare Supplement insurance — usually called Medigap — is private coverage that pairs with Original Medicare (Parts A and B). Instead of replacing Medicare, it fills the gaps: the deductibles, copayments and coinsurance you’d otherwise pay yourself. You then add a standalone Part D drug plan for prescriptions. The North Carolina Department of Insurance regulates the policies; the benefits inside each plan letter are set federally.
How Medigap is different from Advantage
| Medicare Supplement (Medigap) | Medicare Advantage | |
|---|---|---|
| Provider access | Any provider in the U.S. that accepts Medicare — no networks, no county lines, no hospital-contract surprises | Plan network (HMO/PPO), sold by county |
| Drug coverage | Add a separate Part D plan | Usually built in |
| Monthly premium | A monthly premium for the policy | Often $0 plan premium |
| Out-of-pocket | Very predictable; little to pay at the point of care on Plan G | Copays/coinsurance up to an annual cap |
| Extras (dental/vision) | Not included | Often included |
| Travel and second homes | Covered anywhere in the U.S. | Emergencies only on most plans out of area |
The plans North Carolinians actually buy
Plan G covers everything Original Medicare leaves behind except the Part B deductible ($283 in 2026). Plan N costs less in exchange for small office and emergency copays and no coverage of Part B excess charges. High-deductible Plan G has a much lower premium and a deductible you pay first. Plan F still exists for people who were eligible before 2020 but cannot be sold to anyone newer. Because benefits are standardized, we compare companies on price and on how fast they have raised it — and in North Carolina nearly every policy is attained-age rated, meaning the premium rises as you get older regardless of when you bought it, so the rate history matters more than the first-year price.
When you can buy one without health questions
- Your six-month open enrollment. It starts the month you are 65 or older and enrolled in Part B. During it, every plan a company sells is guaranteed available regardless of health.
- Under 65 on disability. North Carolina law (G.S. 58-54-45) guarantees people under 65 on Medicare the right to buy Plan A, D or G during a six-month window that starts when Part B begins. Insurers may charge more than the over-65 rate and may impose a pre-existing-condition wait of up to six months, waived if you had prior creditable coverage. A second, full open enrollment arrives at 65.
- Guaranteed-issue events. Losing an Advantage plan or employer coverage through no fault of your own gives you a window (generally 63 days) to buy certain plans without underwriting. So does the federal trial right: leaving an Advantage plan within twelve months of joining it for the first time.
- Outside those windows, North Carolina insurers can use medical underwriting, and North Carolina has no birthday rule, anniversary rule or annual Medigap window. Switching later usually means answering health questions.
Timing matters. A condition that would be irrelevant at 65 can mean a decline at 72. If you are approaching 65, moving here from a state with a birthday rule, or your Advantage plan just sent a non-renewal notice, talk to us before the window closes. A hospital leaving your plan’s network — as UNC Health did for Humana, WellCare and Cigna members in 2026 — is not a guaranteed-issue event on its own.
Compare the rate history, not just the first-year price
Because the benefits are standardized, the only real differences between North Carolina Medigap companies are what they charge and how steeply they raise it later. That second part is public: every carrier files its rate increases with the North Carolina Department of Insurance, and a policy that looks cheap at 65 can be the expensive one by 75. We publish that filing history on our research site, North Carolina Medigap rate history, with each figure tied to the filing it came from. If your premium has already gone up and you want to know why, why Medigap premiums increase covers the three causes.
Who Medigap tends to suit
People who want maximum freedom to choose doctors and hospitals — Duke and UNC without a network question, Mission from a far-western county, a Norfolk specialist from the Outer Banks — predictable costs, and coverage that travels. That last point is why so many people who move to North Carolina keep the supplement they arrived with. The cost is a monthly premium that rises with age and with the carrier’s filings. Free, unbiased counseling on all of it is available from NC SHIIP at 855-408-1212.
Good to know
Frequently asked questions
Do I need a separate drug plan with Medigap?
Yes. Medigap does not include prescription coverage, so most people add a standalone Part D plan. We help you pick one around your specific medications.
Can I be turned down for Medigap in North Carolina?
Not during your six-month open enrollment, and not during a guaranteed-issue event such as your Advantage plan leaving your county. Outside those windows, North Carolina insurers can use medical underwriting, and North Carolina has no birthday rule or annual switching window.
Is Plan F still available in North Carolina?
Only to people who became eligible for Medicare before January 1, 2020. Everyone newer chooses from Plans G, N, high-deductible G and the others. We walk through which fits you.
I am under 65 on disability. Can I buy Medigap in North Carolina?
Yes. G.S. 58-54-45 guarantees you Plan A, D or G during a six-month window that starts when Part B begins. Premiums may be higher than at 65 and a pre-existing-condition wait of up to six months can apply unless you had creditable coverage. You get a fresh open enrollment for every plan at 65.
How much does a North Carolina Medigap policy cost?
It depends on the plan letter, your age, ZIP code, tobacco use and the carrier, and every carrier raises rates on its own schedule. We compare current premiums and each company’s filed rate history with you; we do not publish a number here without the filing behind it.
Ready when you are
Let’s see whether Plan G, Plan N or something else fits you.
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Sources we used on this page
- Medicare.gov: Medigap (Medicare Supplement Insurance)
- NC Department of Insurance / SHIIP: Medicare Supplement (Medigap) plans
- NC Department of Insurance: Medicare supplement insurance for beneficiaries under age 65 (G.S. 58-54-45)
- healthinsurance.org: Medicare in North Carolina (enrollment figures from KFF, January 2026; Medigap rating practices)
- MyMedigapRate: North Carolina Medigap rate history, filing by filing
- NC Department of Insurance: Medicare and the Seniors’ Health Insurance Information Program (SHIIP), 855-408-1212
- CMS: 2026 Medicare Parts A & B Premiums and Deductibles (Nov 14, 2025)
Figures are checked against the source at the review date in the byline below. If a source has changed since, the source wins.
Written and reviewed by Darin Weidauer — licensed insurance agent (NPN 18580338, NC License #18580338), Gerontologist (USC Leonard Davis School of Gerontology), MBA, Registered Social Security Analyst, and 22-year U.S. Air Force veteran.Last reviewed September 13, 2026. Plan availability, benefits and costs change every plan year — verify current details at Medicare.gov, 1-800-MEDICARE, or NC SHIIP at 855-408-1212.