Top Medicare Advantage Plans in North Carolina 2026

Searching for the top Medicare Advantage plans in North Carolina 2026? This article lists the best plans, with key details on premiums, coverage, and benefits to help you choose the right option.

 

Key Takeaways

 

  • In 2026, North Carolina offers 134 Medicare Advantage plans, with average premiums around $12.86, providing comprehensive coverage options for beneficiaries.

 

  • Top-rated providers such as UnitedHealthcare, Humana, and Aetna stand out for their high-quality plans, extensive networks, and customer satisfaction.

 

  • Supplemental benefits are crucial in enhancing Medicare Advantage plans, with providers like SCAN Health Plan and Devoted Health offering tailored services to improve the quality of life for seniors.

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Overview of Medicare Advantage Plans in North Carolina

Medicare Advantage Plans in North Carolina 2026 - Top Medicare Advantage Plans in North Carolina 2026

 

Medicare Advantage plans, also known as Part C, are offered by private companies that adhere to guidelines set by the federal Medicare program. In 2026, North Carolina boasts 134 different Medicare Advantage plans, providing a wide array of options for its Medicare beneficiaries. These plans often include prescription drug coverage, making them a comprehensive alternative to Original Medicare. Additionally, most plans come with an annual cap on out-of-pocket costs, which can be a significant financial relief for beneficiaries. Medicare parts and Part D plans are also considered when evaluating coverage options, including various medicare plans.

The average monthly premium for these plans is expected to be $12.86, with some plans available at no additional premium beyond the standard Part B premium.

The main advantages of HMO Medicare Advantage plans include:

  • Low premiums
  • Manageable out-of-pocket limits
  • Broad provider networks
  • Robust extras such as vision, dental, and wellness programs

With such benefits, it’s clear why these plans are a popular choice among North Carolina’s Medicare beneficiaries, especially considering the hearing benefits they offer.

 

Types of Medicare Advantage Plans Available

 

Types of Medicare Advantage Plans Available - Top Medicare Advantage Plans in North Carolina 2026

 

Medicare Advantage plans come in various types, each catering to different healthcare needs and preferences. The most common types in North Carolina are:

  • Health Maintenance Organization (HMO) plans: Generally require members to use in-network providers for most services, apart from emergencies.
  • Preferred Provider Organization (PPO) plans
  • Special Needs Plans (SNPs)

In Henderson County, for example, the majority of Medicare Advantage plans are HMOs, including popular options like Aetna Medicare Value Plus and AARP Medicare Advantage from UHC.

PPO plans, on the other hand, offer more flexibility, allowing members to choose between in-network and out-of-network providers, although at a higher cost. This can be particularly appealing to those who value greater freedom in their healthcare choices within the plan’s network.

Lastly, SNPs are tailored for individuals with specific health needs, often coming with higher premiums but offering targeted benefits for managing chronic conditions.

 

Top-Rated Medicare Advantage Providers in North Carolina

When it comes to selecting a Medicare Advantage plan, the provider’s reputation and quality ratings are crucial. In North Carolina, several insurers stand out for their high-quality offerings. Evaluating CMS star ratings from the Centers for Medicare & Medicaid Services can help you make an informed choice.

Among the top-rated providers for 2026 are UnitedHealthcare, Humana, and Aetna. These private insurance companies are known for their comprehensive plans, high-quality ratings, and robust customer satisfaction scores.

 

UnitedHealthcare (AARP/UnitedHealthcare)

UnitedHealthcare offers a wide range of Medicare Advantage plans, including PPO options, making it a versatile choice for many beneficiaries. Key features include:

  • Plans available in nearly every U.S. state, including North Carolina
  • Extensive network coverage
  • Access to a large number of doctors and healthcare facilities
  • A broad provider network that ensures beneficiaries can receive care from a wide array of providers, enhancing their healthcare experience.

Members of UnitedHealthcare’s Medicare Advantage plans benefit from additional perks such as wellness programs, preventive care services, and prescription drug coverage. These extras make UnitedHealthcare a compelling option for those seeking comprehensive healthcare coverage with added benefits.

 

Humana

Humana is another top provider, known for its focus on wellness and preventive care. Serving over 8 million Medicare members, Humana offers a variety of plans, many of which come with $0 premiums. This emphasis on affordability makes it an attractive option for cost-conscious beneficiaries. Humana’s overall Medicare Star Rating of 3.5 and member experience rating of 3.65 reflect its dedication to customer satisfaction and quality care.

Humana’s plans often include wellness programs that promote healthy living among its members. These programs can range from fitness memberships to preventive health screenings, ensuring that beneficiaries receive comprehensive care that goes beyond basic medical services.

 

Aetna (CVS Health)

Aetna, owned by CVS Health, offers Medicare Advantage plans in 44 states, including North Carolina. Key features of Aetna’s plans include:

  • Emphasis on wellness support
  • Plans catering to a variety of health needs
  • Access to preventive and wellness services
  • Network flexibility allowing members to choose from a wide range of healthcare providers

Some Aetna customers have reported challenges with consistency. Additionally, they have faced issues with customer service. Despite these issues, Aetna remains a strong contender due to its comprehensive offerings and commitment to enhancing member health.

 

Best Medicare Advantage Plans for Low Costs in North Carolina

For those prioritizing affordability, certain Medicare Advantage plans in North Carolina stand out. The average monthly premium for these plans is projected to be around $12.86 in 2026.

Providers like Alignment Health and HealthSpring (formerly Cigna) offer competitively priced plans that make quality healthcare accessible to more beneficiaries.

 

Alignment Health

Alignment Health offers some of the most affordable Medicare Advantage plans in North Carolina, with the following features:

  • Average monthly premium of $8 for combined Part C and Part D coverage
  • Additional services such as dental, vision, and wellness programs
  • Average out-of-pocket maximum for standard plans: $4,244
  • Higher out-of-pocket maximum for special needs plans: $6,801, including considerations for cost sharing.

These low-cost plans do not compromise on quality, making them highly attractive with lower premiums.

Despite its affordable premiums, Alignment Health’s availability is limited to just five states. For those who can access them, however, these plans offer strong performance and comprehensive existing coverage.

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HealthSpring (formerly Cigna)

HealthSpring, now operating under the Cigna name, is another provider offering competitively priced Medicare Advantage plans. The average premium for HealthSpring’s plans is around $4.26, making it the second-lowest among all insurers. About 63% of HealthSpring’s plans are structured as HMOs, providing coordinated care and ensuring that beneficiaries receive high-quality services.

HealthSpring has received high ratings in member experience, reflecting its commitment to customer satisfaction. However, plan availability can be limited based on ZIP codes, so it’s essential to check for local availability before making a decision.

Medicare Advantage Plans with Best Drug Coverage in North Carolina

Prescription drug coverage is a crucial component of many Medicare Advantage plans. In North Carolina, providers like Kaiser Permanente and Blue Cross Blue Shield (BCBS) are noted for their extensive prescription drugs plans and high member satisfaction.

These providers offer plans that ensure beneficiaries have access to the medications they need at affordable prices.

 

Kaiser Permanente

Kaiser Permanente is known for its strong drug coverage and integrated care model. With the second-highest overall Medicare Star Rating, Kaiser Permanente serves approximately 1.9 million Medicare beneficiaries. This integrated care model ensures better coordination and performance, making it a preferred choice for many beneficiaries.

The comprehensive drug coverage offered by Kaiser Permanente is complemented by its preventive care services and wellness programs. This holistic approach to healthcare helps members manage their health more effectively and ensures they have access to necessary medications.

 

Blue Cross Blue Shield (BCBS / Anthem / Highmark)

Blue Cross Blue Shield (BCBS) is well-regarded for its extensive drug plans and high member satisfaction. The variety of drug plans offered by BCBS ensures that beneficiaries can find a plan that meets their specific medication needs. This extensive network and commitment to member satisfaction make BCBS a trusted provider.

The strong brand trust associated with BCBS is a key factor for beneficiaries when choosing their Medicare Advantage plans. This trust, combined with comprehensive drug coverage, makes BCBS a reliable choice for many Medicare beneficiaries in North Carolina.

 

Medicare Advantage Plans Offering Supplemental Benefits

Supplemental benefits can significantly enhance the value of Medicare Advantage plans, including special supplemental benefits such as vision, dental, and wellness programs, which are not typically covered by Original Medicare.

Providers like SCAN Health Plan and Devoted Health offer plans with tailored supplemental benefits, addressing specific health needs and improving overall quality of life for beneficiaries.

 

SCAN Health Plan

SCAN Health Plan is designed to offer tailored supplemental benefits aimed specifically at seniors. These benefits include free transportation to medical appointments and discounts on fitness memberships, making it easier for seniors to maintain their health and well-being. SCAN Health Plan’s focus on senior-specific needs makes it a valuable option for those looking for comprehensive coverage.

In addition to transportation and fitness discounts, SCAN Health Plan also offers other perks that cater to the unique needs of seniors. These supplemental benefits can significantly enhance the quality of life for beneficiaries, ensuring they have access to necessary services and support.

 

Devoted Health

Devoted Health emphasizes a focus on comprehensive care, integrating supplemental benefits to enhance health outcomes. Their offerings may include services tailored to support members with specific health challenges, such as chronic conditions or cardiovascular disorders. This focus on maintaining continuity of care ensures that members receive personalized services that meet their unique health needs.

Devoted Health’s plans often include benefits like the Food & Home Card, which provides a monthly allowance for grocery expenses targeted at members with specific health conditions. This comprehensive approach to healthcare ensures that beneficiaries receive the support they need to manage their health effectively.

 

Enrollment Periods for Medicare Advantage Plans

 

Annual Enrollment Periods for Medicare Advantage Plans - Top Medicare Advantage Plans in North Carolina 2026

 

Understanding the enrollment periods for Medicare Advantage plans is crucial for beneficiaries looking to switch or enroll in a new plan. The Annual Election Period runs from October 15 to December 7 each year, allowing beneficiaries to switch from Original Medicare to a Medicare Advantage plan or change their existing Medicare Advantage plan.

Additionally, the Medicare Advantage Open Enrollment Period occurs from January 1 to March 31, providing another opportunity for beneficiaries to change plans or revert to Original Medicare. Special Enrollment Periods (SEPs) are also available for those experiencing certain life events, such as moving or losing coverage, ensuring that beneficiaries have the flexibility to make changes as needed.

 

How to Compare Medicare Advantage Plans in North Carolina

Comparing Medicare Advantage plans can be overwhelming, but using online tools and consulting licensed insurance agents can simplify the process. Websites like Medicare.gov offer tools that allow users to compare plans and different Medicare Advantage options based on their personal health needs and preferences. These tools can help beneficiaries find the right plan that fits their budget and health requirements.

In addition to online tools, consulting with a licensed insurance agent can provide tailored advice and help navigate the complexities of different plans. These agents can offer insights into plan differences, costs, and coverage options, ensuring that beneficiaries make informed decisions about their healthcare.

 

Local Resources for Medicare Beneficiaries in North Carolina

North Carolina offers several local resources to assist Medicare beneficiaries. The Seniors’ Health Insurance Information Program (SHIIP) provides counselors in all counties to help with Medicare inquiries and decisions. These counselors are non-licensed and do not sell or promote any insurance products, ensuring unbiased assistance.

Another valuable resource is the Medicare Patrol Program, which educates beneficiaries about preventing and reporting Medicare fraud. For those struggling with costs, SHIIP’s programs can also provide assistance with Medicare expenses, ensuring that beneficiaries have access to necessary healthcare and additional medicare resources.

Summary

Navigating the landscape of Medicare Advantage plans in North Carolina for 2026 can be complex, but understanding the options available can help you make an informed decision. From top-rated providers like UnitedHealthcare, Humana, and Aetna, to cost-effective plans from Alignment Health and HealthSpring, there’s a wide array of choices catering to different needs and budgets. Additionally, plans with robust drug coverage like those from Kaiser Permanente and Blue Cross Blue Shield ensure that beneficiaries have access to essential medications.

Supplemental benefits offered by providers such as SCAN Health Plan and Devoted Health can significantly enhance the quality of life for beneficiaries by providing additional services like transportation, fitness discounts, and grocery allowances. By understanding the enrollment periods and utilizing local resources like SHIIP, beneficiaries can find the best Medicare Advantage plan to meet their unique health needs. With the right plan, you can enjoy comprehensive coverage, manage healthcare costs, and enhance your overall well-being.

Frequently Asked Questions

 

What are the key benefits of choosing a Medicare Advantage plan over Original Medicare?

Choosing a Medicare Advantage plan can be advantageous due to its inclusion of additional benefits like vision, dental, and wellness programs, alongside annual caps on out-of-pocket costs, which enhance financial predictability in healthcare expenses. These features can make a significant difference in coverage and cost management.

 

How can I compare different Medicare Advantage plans in North Carolina?

To effectively compare different Medicare Advantage plans in North Carolina, utilize online resources such as Medicare.gov and seek assistance from licensed insurance agents to find plans that align with your health needs and preferences.

 

When can I enroll in a Medicare Advantage plan?

You can enroll in a Medicare Advantage plan during the Annual Election Period from October 15 to December 7, or during the Medicare Advantage Open Enrollment Period from January 1 to March 31. Additionally, Special Enrollment Periods may be available for specific life events.

 

What should I consider when choosing a Medicare Advantage plan?

When choosing a Medicare Advantage plan, it is essential to evaluate plan premiums, out-of-pocket expenses, provider networks, prescription drug coverage, and additional benefits such as dental and vision care. This comprehensive assessment will help you select a plan that best meets your healthcare needs.

 

Are there local resources available to help me understand my Medicare options in North Carolina?

Yes, in North Carolina, the Seniors’ Health Insurance Information Program (SHIIP) offers counselors in every county to assist with Medicare inquiries, while the Medicare Patrol Program provides education on preventing and reporting Medicare fraud.

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 ZRN Health & Financial Services, LLC, a Texas limited liability company

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Speak with a licensed insurance agent

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Russell Noga
( Medicare Expert )

Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.