Medicare Supplement · North Carolina
Medicare Supplement (Medigap) Plans — Is It Right for You?
Medigap works alongside Original Medicare to help pay certain cost-sharing amounts. Original Medicare generally lets you use providers nationwide who accept Medicare for covered services. Coverage rules and limits still apply.
Two paths through Medicare
Medicare Advantage vs. Medicare Supplement — side by side
- Generally, any U.S. provider who accepts Medicare for covered services
- Original Medicare generally does not require specialist referrals
- Medigap may pay specified Medicare cost-sharing amounts
- Your costs depend on plan benefits, premiums, and covered care
- No plan-specific provider network; Original Medicare coverage rules still apply
- Monthly premium applies; Medicare Advantage premiums and other costs vary by plan
- Does not include drug coverage (need separate Part D)
- No dental, vision, or hearing extras
- Underwriting may apply if you enroll after your OEP
- Some plans have a $0 plan premium; Part B premium still applies
- Usually includes Part D drug coverage
- May include dental, vision, hearing, OTC benefits
- A yearly out-of-pocket limit applies to covered Part A and B services; the amount and plan rules vary
- Networks and referral rules vary by plan type
- Plans may require prior authorization for some services
- Benefits, costs, and provider networks may change annually
- Out-of-network coverage depends on plan rules and circumstances
Neither path is universally better. The right choice depends on your health, your providers, your travel patterns, and your budget. We can review plans we represent for your situation. A consultation has no fee; premiums and other coverage costs may apply.
Compare Medigap options in North Carolina
Plan G vs. Plan N — what each covers
Both Plan G and Plan N are standardized by the federal government — which means the coverage is identical across all insurers offering the same plan. The difference is the premium and what you pay at the point of service.
What it covers
- Part A hospital coinsurance for up to 365 additional days after Medicare hospital benefits are exhausted
- Part A deductible ($1,736 per benefit period in 2026)
- Part A hospice care coinsurance/copay
- Part B coinsurance or copay (20% after deductible)
- Part B excess charges
- Blood (first 3 pints)
- Skilled nursing facility coinsurance
- Foreign travel emergency (80%, up to plan limits)
What you still pay
- Annual Part B deductible ($283 in 2026)
What it covers
- Part A hospital coinsurance for up to 365 additional days after Medicare hospital benefits are exhausted
- Part A deductible ($1,736 per benefit period in 2026)
- Part A hospice care coinsurance/copay
- Part B coinsurance (after deductible — with copays)
- Blood (first 3 pints)
- Skilled nursing facility coinsurance
- Foreign travel emergency (80%, up to plan limits)
What you still pay
- Annual Part B deductible ($283 in 2026)
- Part B excess charges (balance billing)
- Copay up to $20/visit for some office visits
- Copay up to $50/ER visit (waived if admitted)
Plan F is generally unavailable to people who became eligible for Medicare on or after January 1, 2020. If you were eligible before that date but have not enrolled, you may still be able to buy it. Plan G is a common alternative; it does not cover the Part B deductible. Source: Medicare.gov Medigap.
Timing is everything
Your Medigap Open Enrollment Period — a one-time window
Your federal Medigap Open Enrollment Period is a one-time six-month period that starts the first month you are both 65 or older and enrolled in Medicare Part B. During this 6-month window:
- Guaranteed acceptance for policies offered. During this period, insurers generally cannot deny you a Medigap policy they sell or use health problems to decide acceptance.
- Health-based pricing protections apply. Insurers generally cannot charge you more because of pre-existing health problems, but premiums still vary by policy, insurer, location, discounts, and pricing method.
After your OEP closes, medical underwriting may apply unless you qualify for a guaranteed-issue right or another state protection. North Carolina also provides Medigap purchase protections to some beneficiaries under age 65. There is no annual Medigap open season like the Medicare Advantage and Part D Annual Enrollment Period. Check your situation with NC SHIIP / Department of Insurance.
Medigap questions, answered
What is a Medicare Supplement (Medigap) plan?
A Medicare Supplement plan — also called Medigap — is private insurance that works alongside Original Medicare (Parts A and B) to help pay certain Medicare cost-sharing amounts. With Original Medicare, you can generally use any provider in the U.S. that accepts Medicare for Medicare-covered services. Coverage rules, medical necessity, and other limits still apply.
What does Medigap Plan G cover?
Plan G helps pay many Original Medicare cost-sharing amounts after you pay the annual Part B deductible ($283 in 2026). Plans that cover the Part B deductible are generally unavailable to people first eligible for Medicare on or after January 1, 2020. Plan N has different cost sharing, including limited office and emergency-room copayments. Benefits are standardized, but premiums vary by insurer. See Medicare.gov or compare official plan materials.
What is the Medigap Open Enrollment Period?
Your federal Medigap Open Enrollment Period is a six-month window that begins when you are both 65 or older and enrolled in Medicare Part B. During it, insurers generally cannot deny a policy or charge more because of health problems. After it ends, guaranteed-issue rights may still apply in certain situations; otherwise, medical underwriting may affect acceptance or price. North Carolina also has protections for some Medicare beneficiaries under 65. Check your circumstances with NC SHIIP or the Department of Insurance.
Can I switch from Medicare Advantage to Medigap later?
Possibly. Outside your Medigap Open Enrollment Period, you may need to answer health questions unless a guaranteed-issue right or other state protection applies. Switching from Medicare Advantage to Original Medicare does not by itself guarantee Medigap acceptance; specific trial-right or other protections may apply in some situations. Check with NC SHIIP before changing coverage.
Does Medigap include prescription drug coverage?
No. Medigap policies sold after 2005 generally do not include outpatient prescription drug coverage; you can consider a separate Part D plan. For 2027, the standard Part D deductible is $700 and the annual out-of-pocket threshold for covered Part D drugs is $2,400. Plan premiums, deductibles, formularies, and cost-sharing vary. Verify current options and drug coverage with Medicare.gov.
How much does Medigap cost in North Carolina?
Medigap premiums vary by plan type, insurer, age, location, tobacco status, discounts, and rating method. Plan N may cost less than Plan G, but premiums differ among insurers. We can review rates for the carriers and plans Price Services Group represents; we do not compare every insurer. Contact NC SHIIP or multiple insurers for a broader comparison.
Not sure which path is right for you?
We can review plans we represent based on your doctors, prescriptions, and budget. A consultation has no fee; premiums and other coverage costs may apply. We do not offer every plan available in your area.
Related Medicare resources
- Enrollment periods →
Your Medigap OEP and other Medicare windows.
- Medicare FAQ →
Common supplement and plan questions answered.
- Medicare 101 →
Parts A, B, C, and D explained.
- Find help by county →
Local Medicare plan data for your area.
Official source: Medicare.gov — Medigap plans. For the most current information, visit Medicare.gov directly.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, 24 hours a day, 7 days a week, to get information on all of your options. Not affiliated with or endorsed by the U.S. government or the federal Medicare program. For informational purposes only — not insurance, legal, or financial advice. Medicare Supplement plan availability and premium information are illustrative examples and vary by insurer, age, gender, tobacco status, and zip code. Contact us for a personalized quote. NPN: 18530055. Agency NPN: 20387435.