Top Medicare Advantage Plans in NC [2024]

Millions of Americans get their healthcare needs met through Medicare. While many people find Original Medicare (or Parts A and B) enough to cover their needs, many Americans need more health insurance.

This is especially true with the rising cost of healthcare. If you get your needs met through Medicare, you can purchase additional coverage through a Medicare Advantage plan.

Residents of North Carolina can find many affordable options for a Medicare Advantage plan. From big-name insurance companies to smaller providers, coverage is available for everyone.

If you’re looking for Medicare Advantage plans in NC, comparing quotes from different companies will help you save money. Enter your ZIP code into our free tool to see what quotes might look like for you.

What are Medicare Advantage plans?

Almost two million North Carolina residents depend on Original Medicare. However, there are gaps in Medicare coverage that can leave seniors with large medical bills.

That’s where Medicare Advantage comes in.

A Medicare Advantage plan gives you the same coverage as Original Medicare Parts A and B. Medicare Advantage plans have to provide at least the same amount of coverage that comes in Parts A and B.

Medicare Advantage (also known as Medicare Part C) is sold through private companies that follow set rules. Generally, Medicare Advantage includes the prescription medication coverage found in Part D.

Medicare Advantage plans work similarly to private health insurance in that you’ll need to visit in-network doctors. Some plans might allow you to choose out-of-network physicians, but you’ll probably pay extra.

One of the advantages to a Medicare Advantage plan is that you can add coverage Parts A and B don’t cover. Every plan is different, but you can probably find dental and vision coverage.

Types of Medicare Advantage Plans

There are four types of Medicare Advantage plans available in North Carolina:

• Health Maintenance Organization (HMO)
• Preferred Provider Organization (PPO)
• Private Fee-for-Service (PFFS)
• Special Needs Plan (SNP)

Each of these handles their physician network differently, and some are more expensive than others. However, you can rest assured that every type of Medicare Advantage plan covers what Original Medicare does.

Health Maintenance Organization Plans

HMOs usually require all services you receive be through in-network providers. You’ll need a primary care physician (PCP), visits to specialists will require a referral, and you’ll need authorization for certain treatments and prescription medications.

With an HMO, drug coverage is typically included, and you won’t be able to purchase stand-alone coverage.

You’ll get the lowest cost for your healthcare services if you stay in-network.

Preferred Provider Organization Plans

You can remember the main aspect of a PPO by the name: this plan has a preferred network of providers. However, you can choose outside the network and visit a doctor of your choice for a higher price.

With a PPO, you don’t need a dedicated PCP or a referral to see a specialist. Like an HMO, drug coverage is usually included, and you can’t buy additional stand-alone coverage.

Private Fee-for-Service Plans

There is no PCP requirement with a PFFS and your don’t need a referral to see a specialist. In fact, you have a lot of freedom with this plan. As long as the facility of your choice is Medicare-approved and accepts your plan, you can go where you like.

PFFS plans sometimes include drug coverage, but you can purchase a stand-alone medication plan if you want.

Special Needs Plan

An SNP is a unique plan made for people with specific medical conditions. SNPs come with extra benefits, like care coordination and benefits crafted specifically for your needs.

You’ll need a dedicated PCP and referrals to see a specialist. However, drug coverage is always included in an SNP. Additionally, you don’t have to wait to enroll in an SNP. As long as you’re eligible, you can join any time you wish.

What are the best rated Medicare Advantage Plans in NC?

After reviewing the types of plans available, you’ll be ready to look at the best Medicare Advantage plans in NC for 2021.

While many companies sell plans, Medicare Advantage plans in NC reviews show that four providers stand above the rest: Aetna, Humana, UnitedHealthcare, and Cigna.

However, you can’t look at nothing but professional ratings to decide which company is best for you. To get the best plan in North Carolina, you’ll need a little more information.

Aetna Medicare Advantage Plans

Aetna Part C plans have a lot of great options for residents of North Carolina. These include:

• Vision
• Prescription drugs coverage
• Hearing
• Wellness benefits like gym memberships
• Dental
• Medical transportation (with specific plans)
• Over-the-counter medications for wellness (with specific plans)

With Aetna, you’ll find the coverage you need for just about any medical condition. In fact, Aetna has SPNs for chronic diseases like cancer or Alzheimer’s.

Aetna also offers Medigap plans, which fills in gaps in your Medicare Part A and B insurance. It helps pay for your deductibles and copays. (For more information, read our “Top Medicare Part A and B Coverage: What You Need to Know“).

You can also purchase Part D coverage through Medicare.

Aside from an SPN, Aetna offers HMOs and PPOs. The HMO has lower copays and you’ll save on out-of-pocket costs since you’ll have to stay in-network. PPOs are more expensive, but you’ll have more freedom to choose your doctor.

Humana Medicare Advantage Plans

Humana doesn’t have quite as large a selection of coverage options as Aetna, you can still get excellent health insurance options. Humana offers:

• Vision
• Hearing
• Dental

You’ll also have access to Humana Health and Wellness programs which encourage members to live healthier lives. The Wellness programs include benefits like gym memberships and dietician services.

Humana offers all four types of Medicare Advantage plans, though you’ll need to speak to an agent to make sure they are available in your county. There is a specific list of conditions eligible for an SNP, which your agent can also help you with.

One exciting advantage of Humana is its telemedicine services. With Covid-19 on the rise again, Humana customers appreciate that they can visit their doctors in the safety of their homes.

As with other companies, the HMO is probably your most affordable option. However, you can find affordable health services with the HMO, PFFS, and SNPs. PPOs are usually a little more expensive.

UnitedHealthcare Medicare Advantage Plans

While UnitedHealthcare isn’t quite as well known as the other companies, you can find great health insurance coverage through this company. UnitedHealthcare offers:

• Vision
• Hearing
• Dental
• Prescription drug coverage
• Wellness benefits
• Over-the-counter medications (with specific plans)
• Medical transportation (with some plans)

Like Aetna, UnitedHealthcare offers SNPs for certain conditions. UnitedHealthcare offers HMOs, PPOs, and SNPs, mostly through AARP.

There are over a million physicians in UnitedHealthcare’s network throughout the US. UnitedHealthcare’s HMO usually has no-cost rates and copays, but you must stay in-network. If you go out of network, you’ll pay full price for your care.

You can make telehealth visits with HMOs and PPOs, usually at no cost.

Cigna Medicare Advantage Plans

Finally, Cigna is a trusted health insurance and provider throughout the country. With Cigna, you can get:

• Vision
• Dental
• Hearing
• Wellness benefits
• Prescription drug coverage

There are three major plans for Medicare Advantage with Cigna. These are two HMOs and one PPO.

Cigna Preferred is an HMO with the lowest out-of-pocket costs. You need to choose a PCP and stay in the network, though.

Cigna Premier Medicare has the same coverage as Cigna Preferred, but you have more freedom to choose a specialist doctor outside the network.

Cigna True Choice Medicare is the PPO plan. It costs the most, but you have the most freedom to choose your provider.

As of 2021, Cigna has been approved to offer SNPs. They haven’t reached every area yet, so check with an agent to see if you qualify.

How to Find the Best Medicare Advantage Plans in North Carolina

Medicare Advantage is a great option for seniors that want vision, hearing, or dental coverage on top of the Original Medicare health insurance options.

If you want to see Medicare Advantage plans in NC, shopping for quotes will help you pick the best option. Enter your ZIP code into our free tool to see what quotes might look like for you.