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Medicare Coverage In North Carolina: Costs and Eligibility

October 19, 2023

Medicare Coverage In North Carolina: Costs and Eligibility

Medicare can be confusing because there are a variety of parts that all provide coverage for different medical needs. This page will help you understand how Medicare works and how you can choose the coverage that works best for you.

Medicare NC Eligibility

Who is eligible for Medicare in NC? The program is intended to help those 65 and older, along with people who have specific health conditions, get coverage for their medical needs.

To be eligible for Medicare, you need to be a citizen or permanent resident of the U.S. who has lived in the country for at least five years. Also, one of the following must apply to you:

  • You’re age 65 or older
  • You’re under 65 but disabled and receiving disability benefits from Social Security or the Railroad Retirement Board
  • You have end-stage renal disease (ESRD)
  • You have Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease

How to Apply for Medicare in NC

Are you wondering how to apply for Medicare in North Carolina? Many state residents will automatically receive Medicare Part A and Part B when they are eligible. The initial eligibility period, generally around your 65th birthday, is the most important. You’ll have more options available and will have guaranteed acceptance into Medigap (Part F) plans.

If you don’t automatically get Medicare when you’re eligible, you’ll have to enroll. There are several ways to do this:

  • Contacting your local Social Security office
  • Calling 1-800-772-1213 to enroll over the phone
  • If you retired from a railroad, calling the Railroad Retirement Board at 1-877-772-5772
  • Signing up for Part A online at and Part B using Form CMS-40B

Curious where your local social security office is? The field office locator at can help.

What Does Medicare Cover in NC?

Medicare has several parts, and each one provides different benefits.

  • Medicare Part A is known as hospital insurance and helps pay for inpatient hospital stays and related needs.
  • Medicare Part B helps with other medical insurance needs, like doctor’s visits and medical equipment.
  • Medicare Part D provides coverage for prescription medications that you may need.
  • Medicare Part C is known as Medicare Advantage and is an alternative to Original www. Part C plans include at least as much coverage as Part A and B, and most include Part D coverage as well. You may also get additional benefits like vision or dental coverage. However, you will need to stay within the medical network of the plan.

No Medicare plan pays 100% of your medical costs. You’ll have a monthly premium to pay along with a deductible and coinsurance or copayment amounts. For example, if you use Medicare Part B you’ll pay your deductible and then 20% of your costs.

If you have Original Medicare, you may be able to get a Medicare Supplement Plan, known as Medigap, to help pay for these out-of-pocket costs.

Does Medicare Pay for Assisted Living in North Carolina?

Assisted living and other long-term care can be very expensive, and it’s natural to wonder if Medicare pays for assisted living in North Carolina.

Medicare will pay for some skilled nursing services for a limited amount of time but does not cover long-term assisted living or nursing home care. If you are lower-income, you might be able to get assistance through Medicaid, however.

What is the Best Medicare Supplement Plan in North Carolina?

Medicare supplement plans are known as Medigap. They can help you pay for the out-of-pocket costs associated with Original www.

You’ll have to pay a separate monthly premium for your supplement plan. There are several options for Medigap, lettered A-N. It’s important to compare each plan to determine which is best for your needs.

While private insurers offer Medigap plans, each plan with a specific letter will be the same no matter who offers it. The only difference is the price you pay each month.

Cost of Medicare in North Carolina?

Many Medicare beneficiaries wonder, “How much does Medicare cost in NC?” There are different costs for each Medicare part you enroll in.

Medicare Part A is free for most recipients, based on the amount of time you worked and paid Medicare taxes. If you didn’t pay Medicare taxes for enough time, your spouse’s history may qualify you. Otherwise, you will have to pay a monthly premium of either $259 or $471 in 2021.

The Part A deductible in 2021 is $1,484 each year, and then you pay coinsurance depending on the length of your hospital stay.

For 2021, Medicare Part B has a monthly premium of $148.50 per month for most people. Higher-income individuals may pay more. There’s a deductible of $203, and then you pay 20% of your costs afterward.

Medicare Part C and Part D are offered by private insurance companies, so the costs will vary. Be sure you compare plans to ensure that the medication and doctors you need are included in the coverage.

Learn More About Original Medicare and Medicare Advantage in North Carolina

As you can see, there are a lot of options available when choosing Medicare coverage. It can be hard to properly compare Medicare Advantage plans on your own. If you’d like to talk to a licensed agent that can help you understand your needs and choose the right plan, contact us today!

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