Medicare Advantage Plans in North Carolina 2026
Last reviewed: June 2026 · Data sourced from CMS.gov
North Carolina has strong Medicare Advantage growth, now covering roughly half of beneficiaries. Charlotte, Raleigh-Durham, and Greensboro all have competitive markets. Blue Cross Blue Shield of North Carolina has a very large statewide presence, though national carriers compete strongly in the major metros.
Plan availability varies by county. Enter your ZIP code to see the exact plans, premiums, and coverage available where you live in North Carolina.
Rural Coverage Note
Parts of North Carolina have limited Medicare Advantage plan availability. If you live in a rural county, you may find fewer plans or smaller provider networks. Comparing your options alongside Medicare Supplement plans is worth doing before you decide.
What to Look for in a North Carolina Medicare Advantage Plan
- ✓ Whether your current doctors and specialists are in-network
- ✓ Drug formulary — does it cover your prescriptions at a reasonable cost?
- ✓ Monthly premium and annual out-of-pocket maximum
- ✓ Extra benefits: dental, vision, hearing, fitness programs
- ✓ Star rating — CMS rates plans from 1 to 5 stars based on quality and member experience
- ✓ HMO vs. PPO — HMOs require referrals and restrict out-of-network care; PPOs are more flexible
2026 Medicare Advantage Costs in North Carolina
| Cost | Typical Range |
|---|---|
| Monthly premium | $0 to $50 (many plans at $0) |
| Annual out-of-pocket maximum | Up to $9,350 in-network (2026 CMS limit) |
| Primary care visit copay | $0 to $20 typical |
| Specialist visit copay | $20 to $50 typical |
| Inpatient hospital stay | $250 to $350/day for first few days (varies by plan) |
| Part B premium (always required) | $202.90/month standard (2026) |
Medicare Advantage vs. Medigap in North Carolina
North Carolina's Medigap market is active in the metro areas. Residents in the western mountain counties and rural eastern regions sometimes prefer Medigap, where Medicare Advantage network options are more limited.