Medicare by State
Medicare Advantage Plans North Carolina 2027: 179 Plans and What Could Cost More
CMS counts 179 Medicare Advantage plans in North Carolina for 2027, up from 175, and the average premium falls from $12.49 to $6.19. But the Insurance Commissioner warns many plans intend increases, so check every cost, not just the premium.
- North Carolina has 179 Medicare Advantage plans for 2027, up from 175 in 2026, per CMS.
- The average North Carolina Medicare Advantage premium falls from $12.49 to $6.19 a month.
- Under N.C.G.S. 58-54-45, people under 65 on Medicare due to disability can buy Medigap Plan A, D or G.
- SHIIP gives free, unbiased Medicare counseling at 1-855-408-1212.
Table of Contents
Medicare Advantage plans North Carolina residents can join for 2027 send two different signals. CMS counts 179 plans, up from 175, and the average premium is cut almost in half, from $12.49 to $6.19 a month. Yet North Carolina’s Insurance Commissioner warned on October 14 that many plans intend to raise costs, some significantly. This guide explains both, along with North Carolina’s Medigap law for people under 65 and the free SHIIP counseling program.
Medicare Advantage plans North Carolina: the 2027 numbers
CMS published a North Carolina fact sheet on September 28, 2026. It says 2,322,851 people in North Carolina are enrolled in Medicare. Here are its figures:
| Measure (North Carolina) | 2026 | 2027 |
|---|---|---|
| Medicare Advantage plans available | 175 | 179 |
| Average monthly Medicare Advantage premium | $12.49 | $6.19 |
| Lowest monthly Medicare Advantage premium | — | $0 |
| People with access to a $0-premium plan | — | 100% |
| Stand-alone Part D drug plans | — | 11 |
| Lowest stand-alone Part D premium | — | $5.30 |
| Stand-alone Part D enrollees who get Extra Help | — | 22.87% |
A dash means the fact sheet gives no 2026 figure. Figures are from the CMS North Carolina fact sheet as of September 28, 2026, and are shown for illustration only. They are not quotes or offers, and they can change. Confirm current numbers with Medicare Plan Finder, SHIIP or a licensed agent.
The fact sheet is statewide. It does not show how many Medicare Advantage plans North Carolina offers in each county, and your county’s list may be much shorter than 179. Plan Finder is the only way to see your own list, with each plan’s premium, drug costs and out-of-pocket limit side by side.
What changed for Medicare Advantage plans North Carolina carriers offer
- More plans. Four more statewide (175 to 179), while CMS projects the national count to slip from 5,553 to about 5,532.
- A lower average premium. Down $6.30 a month ($12.49 minus $6.19), or about 50%. CMS projects the national average to fall from $14.37 to $12.00, per its 2027 press release.
- $0 plans everywhere. CMS says 100% of people with Medicare in North Carolina can get a $0-premium plan.
- Drug plans. Eleven stand-alone drug plans, and 52.96% of current members can find a lower premium than in 2026.
The Commissioner’s warning
An average premium is only one number. In an October 14, 2026 news release, Commissioner Mike Causey said, “Many plans have indicated that they intend to have increases, some significantly.” The Department urged people to compare before staying put, noting that a different plan in your area may cost less even if you are happy with yours. Costs can rise through copays, deductibles and drug tiers, not just premiums, so read your Annual Notice of Change line by line.
If your North Carolina plan is not renewing for 2027
Even with more plans statewide, some Medicare Advantage plans North Carolina members had in 2026 may have sent non-renewal letters. Medicare.gov says that when a plan’s contract isn’t renewed, you can switch between December 8 and the last day of February. If you don’t choose, you go to Original Medicare when the plan ends. Our guide on what to do when a Medicare Advantage plan is not renewing covers the steps.
You also get a federal Medigap right. When a Medicare Advantage plan leaves Medicare or your area, Medicare.gov says you can buy any Medigap policy sold in your state, applying from 60 days before coverage ends to 63 days after. The Department’s release says changes must be made by December 7 to make sure coverage starts January 1 without interruption.
Leaving Medicare Advantage in North Carolina: Medigap rules
The Department’s Medigap page describes open enrollment as a one-time, six-month period that begins the first month you are both 65 or older and enrolled in Part B. During it, you can buy any plan from any company that sells them, and insurers cannot deny you or charge more for health problems. A preexisting-condition wait, if any, cannot be longer than six months.
Outside that window, the page warns that insurers can use medical underwriting to decide whether to accept you. That makes the choice among Medicare Advantage plans North Carolina sells a bigger decision than it looks: once your window passes, getting back to Medigap may depend on your health or a guaranteed issue right. Our underwriting guide explains the questions. The Department’s page describes no birthday or anniversary rule; our birthday rule guide lists the states that have one.
Medigap North Carolina under 65
Federal rules don’t guarantee Medigap to people under 65. North Carolina does, under N.C.G.S. 58-54-45, the Department says. Since January 1, 2020, people under 65 with Medicare because of a disability can buy Plan A, D or G. Premiums may be higher than for people 65 and older, and at 65 you get a new six-month window to buy any standardized plan. The Department’s page addresses disability; ask SHIIP about ESRD. Our North Carolina life insurance guide also covers Medigap North Carolina under 65.
Hypothetical example: an under-65 choice in North Carolina
Hypothetical example. Ray, 58, lives in Asheville and qualifies for Medicare because of a disability. His Part B starts January 1, 2027, so his Medigap window runs January through June 2027.
- Option 1: a Medicare Advantage plan at North Carolina’s 2027 average premium of $6.19, or $6.19 x 12 = $74.28 a year. At the 2026 average of $12.49 it would have been $12.49 x 12 = $149.88, so the average falls by $75.60 a year.
- Option 2: Medigap Plan A, D or G during his window, plus a drug plan from $5.30 x 12 = $63.60 a year.
Both options add Part B ($202.90 x 12 = $2,434.80 at the 2026 rate). Option 2 needs a Medigap quote; Ray can check the Department’s online Medicare Supplement Premium Comparison Database. If he picks Option 1 and lets June pass, his next guaranteed Medigap window comes at 65. This is an illustration, not a quote.
How to compare Medicare Advantage plans North Carolina offers
North Carolina Medicare open enrollment runs October 15 to December 7, 2026, with coverage starting January 1, 2027, per CMS. Then:
- Read your Annual Notice of Change. Look for higher copays, deductibles and drug tiers, given the Commissioner’s warning.
- List your care. Doctors, hospitals, pharmacy and every drug with its dose.
- Use Medicare Plan Finder. Sort by estimated yearly cost, not premium.
- Call your doctors. Confirm they are in the plan’s 2027 network.
- Compare out-of-pocket limits and star ratings. CMS posted 2027 star ratings on or around October 8, 2026.
Our Medicare enrollment calculator maps your windows, and our IRMAA calculator estimates income-based surcharges. For plan types, see our Medicare Part C guide. After North Carolina Medicare open enrollment ends, the Medicare Advantage Open Enrollment Period, January 1 to March 31, lets people already in a plan make one change. With 22.87% of stand-alone drug plan members getting Extra Help, check that too.
NC SHIIP Medicare help and other free resources
North Carolina’s State Health Insurance Assistance Program is the Seniors’ Health Insurance Information Program (SHIIP), part of the Department of Insurance. It provides free, unbiased information and counseling to Medicare beneficiaries and caregivers. The Department says SHIIP counselors are not licensed insurance agents and do not sell, endorse or oppose any product, plan or company. NC SHIIP Medicare help also includes screening for cost-savings programs.
- SHIIP: 1-855-408-1212, weekdays 8 a.m. to 5 p.m.
- Medicare: 1-800-633-4227, 24 hours a day, 7 days a week (TTY 1-877-486-2048).
- Social Security: 1-800-772-1213.
A licensed agent can enroll you and is paid by the insurance company. Using NC SHIIP Medicare help alongside an agent gives you a neutral check on any of the Medicare Advantage plans North Carolina agents show you.
Checklist before you choose for 2027
Use this list during North Carolina Medicare open enrollment with any of the Medicare Advantage plans North Carolina carriers sell:
- Read your Annual Notice of Change for cost increases, not just the premium.
- If your plan is ending, choose by December 7 for a January 1 start.
- Confirm doctors and hospitals for 2027, by phone.
- Check your drugs on the 2027 formulary.
- Compare out-of-pocket limits.
- If you are under 65, note the end of your six-month Medigap window.
- Ask SHIIP whether you qualify for cost-savings programs.
- Keep your enrollment confirmation and new ID card.
Medicare Advantage plans North Carolina: frequently asked questions
How many Medicare Advantage plans are there in North Carolina for 2027?
CMS counts 179 plans for 2027, up from 175 in 2026. Your county has fewer; Plan Finder shows the list by ZIP code.
If average premiums fell, why is the Commissioner warning about increases?
The CMS average covers premiums only. The Commissioner said many plans intend increases, some significant, so check every cost in your Annual Notice of Change.
Can I get a $0-premium plan in North Carolina?
Yes. CMS says 100% of people with Medicare in North Carolina have access to one in 2027. Part B and copays still apply.
Can I buy Medigap in North Carolina if I’m under 65?
Yes. Under N.C.G.S. 58-54-45, people under 65 on Medicare due to disability can buy Plan A, D or G, possibly at higher premiums.
Does North Carolina have a Medigap birthday rule?
The Department’s Medigap page describes none. Use open enrollment or a guaranteed issue right.
Who gives free Medicare help in North Carolina?
SHIIP, part of the Department of Insurance. Call 1-855-408-1212.
Compare your options with a licensed agent
Octans Insurance is an independent agency based in Massachusetts. Our licensed agents work with 120+ carriers and can compare the Medicare Advantage plans North Carolina carriers offer in your county with Medigap options, at no fee to you. Call (617) 935-9220. For free, unbiased counseling, you can also call SHIIP at 1-855-408-1212 or 1-800-MEDICARE.
Keep Reading: Related Guides
- Life insurance in North Carolina
- Medicare Part C
- Medicare Advantage plan not renewing
- Medicare enrollment calculator
- Free Medicare help in North Carolina
- North Carolina Medicaid burial rules
- Unclaimed life insurance in North Carolina
We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
This article is for general information and is not tax, legal, or medical advice.
About examples and tools: Hypothetical examples, sample rates, calculators and quizzes on this site are for general educational and illustrative purposes only. They are not quotes, offers of coverage, or guarantees of eligibility, approval, price or benefits, and they are not legal, tax, financial or medical advice. The insurance company decides eligibility and price; Medicare rules are set by CMS and the Social Security Administration. Octans Insurance is not connected with or endorsed by the U.S. government or the federal Medicare program.
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