Original Medicare, which is Medicare Part A and Part B combined, can help to cover many healthcare costs. However, you’ll still be responsible for some expenses like copayments, coinsurance, and deductibles.1 Medigap policies, also known as Medicare Supplement insurance, can help to cover those healthcare expenses. That way you pay less out of pocket for the healthcare that you need.
In North Carolina, you can choose from 10 Medigap policies, plus two extra high-deductible options. Private companies sell these policies, and you’ll pay a premium to the insurance provider in addition to your Original Medicare premiums.
When you need healthcare, your Original Medicare will cover the amount that’s approved in your policy. Then, your Medigap policy will pay toward the remaining costs, reducing or eliminating the expenses that you’ll need to pay for. If you frequently need healthcare services, having the extra coverage of a Medigap policy can save you money.
What You Need to Know
With Original Medicare, you’re still responsible for some healthcare expenses. Medigap policies help to pay for some of these expenses, getting you extra coverage for copayments, deductibles, and more.2
You can buy a Medigap policy from a private insurance company, but you need to be enrolled in Medicare Part A and Part B to qualify.3
In North Carolina, you can choose from 10 different Medigap policies. There are also high-deductible versions of two of these policies.4
When Can You Enroll in Medigap?
Like most health insurance policies, Medigap has an Open Enrollment Period, but you can potentially enroll outside of that period, too.5 The Medigap Open Enrollment Period begins the month that you turn 65 and enroll in Medicare Part B, and goes on for six months. While you’re within the Open Enrollment Period, you can buy any Medigap policy available in your state. You may have access to more policies at better prices than you’d have when buying outside of Open Enrollment. You can also buy any policy, even if you have pre-existing conditions.
Buying a Medigap policy becomes more complicated when you’re outside of that enrollment period. Insurance companies can deny you if you have pre-existing conditions and health problems. Alternatively, they can decide not to cover your pre-existing condition, and they may implement a six-month waiting period before your Medicare policy takes effect.
Depending on your situation, you may qualify for guaranteed issue rights, which require insurance providers to allow you to buy a Medigap policy even though you’re outside of the Medigap Open Enrollment Period.6 If you have guaranteed issue rights, the provider needs to cover your pre-existing health conditions and can’t increase the price of your policy because of health issues. Many situations qualify as guaranteed issue rights, including:
- Your Medigap policy is ending through no fault of your own
- You drop a Medigap policy because the company misled you
- You’re moving out of your Medicare Advantage Plan’s service area
In some situations, you may qualify for a Special Enrollment Period (SEP).7 During a SEP, you will be able to change your coverage, but each type of SEP comes with restrictions on the specific changes you can make. Events like moving, losing your current coverage, and having the chance to apply for coverage through your employer may qualify for SEP.
Want to compare policies? Check out MedicareGuide.com.
What Are the Most Popular Medicare Supplement Plans?
| Plan Type | Total Enrolled (Rounded) | Percent of Total Enrolled |
| Plan F | 274,000 | 54% |
| Plan G | 160,000 | 31% |
| Plan N | 34,000 | 7% |
The 10 available standardized Medigap policies offer slightly different coverage, but they all help to cover healthcare expenses like hospital costs, blood transfusion, and Medicare Part B copays and coinsurance.8 Plans F, G, and N are some of the most popular options.
Plan F
Plan F offers the most comprehensive coverage, including:
- Part A coinsurance and hospital costs
- Part B copays/coinsurance
- Blood (first 3 pints)
- Part A hospice
- Skilled nursing facility
- Part A deductible
- Part B deductible
- Part B excess charges
- Foreign travel emergency – 80%
Plan G
Plan G offers most of the same coverage as Plan F, but it excludes the Part B deductible:
- Part A coinsurance and hospital costs
- Part B copays/coinsurance
- Blood (first 3 pints)
- Part A hospice
- Skilled nursing facility
- Part A deductible
- Part B excess charges
- Foreign travel emergency – 80%
Plan N
Plan N also has most of the same coverage as Plan F. Plan N excludes the Part B deductible and Part B excess charges:
- Part A coinsurance and hospital costs
- Part B copays/coinsurance
- Blood (first 3 pints)
- Part A hospice
- Skilled nursing facility
- Part A deductible
- Foreign travel emergency – 80%
In North Carolina, Plan F and Plan G are both available with high deductible options.9 If you choose a high deductible plan, you’ll pay a lower monthly premium but will be responsible for covering costs until you reach the plan’s deductible. If you suspect you may not frequently need the coverage each plan offers, then a high deductible plan could help to save you money. If you anticipate having healthcare costs that the plan would cover, then choosing a plan with a standard deductible might be a better option.
How to Choose a Medicare Supplement Plan?
Medigap policies offer slightly different coverage, available at different premiums and with different deductibles. Consider using a third-party comparison tool like HealthCare.com to easily see the differences between each plan. When deciding which plan is right for you, you’ll want to think about the types of healthcare that you most commonly need and the premiums that you can afford.
Ready to shop? Compare Medigap policies with HealthCare.com
How Much Do Medigap Policies Cost?
Medigap policy cost will vary depending on the policy and other factors like your age and whether or not you smoke. The following prices reflect quotes for a 65-year-old female in North Carolina who doesn’t use tobacco.10 They can give you an idea of what you might pay for a Medigap policy:
65-Year-Old Woman, No Tobacco Use
| Plan Type | Premium Range |
| Plan F | $108-$308 |
| Plan G | $87-$290 |
| Plan N | $68-$274 |
65-Year-Old Man, No Tobacco Use
| Plan Type | Premium Range |
| Plan F | $120-$348 |
| Plan G | $98-$328 |
| Plan N | $77-$310 |
What Companies Sell Medigap in North Carolina?
What If You Want to Change Your Medigap Policy?
Once you choose a Medigap policy, you’ll only be able to change that policy at certain times.11 You can change your policy if you’re still within the open enrollment period. Certain special circumstances or guaranteed issue rights can also qualify you to change your policy, such as if you move to another state. But because there are limited opportunities to change policies, it’s important to thoroughly research each policy’s coverage to make sure you’re choosing the policy that’s right for you.
What Are Alternatives to Medicare Supplement?
If a Medigap policy isn’t right for your needs, a Medicare Advantage Plan can still give you extra coverage.12 These plans are provided by private health insurance companies and they help to cover your Medicare Part A and Part B expenses. While Medigap policies don’t offer prescription drug coverage, many Medicare Advantage Plans do, making these plans a practical option if you regularly take prescription medications.
What Are Medicare Resources in North Carolina?
- The North Carolina Medicare and Seniors’ Health Insurance Information Program (SHIIP) can help you to understand Medicare and related insurances. SHIIP can also connect you to Extra Help, a program that helps you to cover Medicare prescription drug costs.
- The North Carolina Department of Insurance helps state residents to resolve issues with insurance providers, like filing a complaint or appealing a claim denial.
- The North Carolina Medicaid Division of Health Benefits can help you apply for Medicaid and also oversees community programs for children and disabled adults, people who are transitioning from nursing homes back into the community, and other people in need of physical and behavioral healthcare and services.
You can also use MedicareGuide.com to view and compare available Medicare policies in North Carolina.
Medigap Chart
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Next Steps
Medicare covers many healthcare expenses, but you might still face bills for expenses that Medicare doesn’t cover. If you know that you’ll regularly need healthcare services that Medicare won’t cover, investing in a Medigap policy can help you to save money. All Medigap policies provide slightly different coverage, so for more guidance, check out How to Choose a Medicare Supplement Plan.
