Top Medicare Advantage Health Insurance Plans in North Carolina
These top plans were chosen for factors such as plan costs (including coinsurance and co-payments ) and out-of-pocket maximums, overall benefits, and whether the plan received a 5-star rating from Medicare. For more information on our ranking procedure, see our methodology page.
Best Medicare Advantage Plans In North Carolina
1. Humana Gold Plus - Score: 76.76
2. FirstMedicare Direct smartHMO - Score: 75.05
3. Cigna Preferred Plus Medicare - Score: 74.68
4. Cigna Preferred Medicare - Score: 74.68
5. Erickson Advantage Signature with Drugs - Score: 74.31
6. AARP Medicare Advantage Plan 1 - Score: 73.43
7. Erickson Advantage Liberty with Drugs - Score: 72.22
8. Erickson Advantage Freedom - Score: 72.22
A complete description of benefits documents for each plan and for other medical insurance plans are available on the North Carolina Department of Insurance website. These documents also specify which plans offer Medicare prescription drug coverage for enrollees and include a formulary explaining drug coverage costs.
#1: Humana Gold Plus
Insurify Composite Score: 76.76
This low cost plan comes with a lot of advantages indeed. We want to be sure to poin out the low out-of-pocket maximum first. That’s set at just $4,400 annually.
Additionally, you’ll get low copays for Tier 1 and Tier 2 prescriptions. Plus $0 copays for preventive and primary care visits, preventive dental, and routine vision. For most other care, including hearing and mental health, copays are well below average.
The best news is that costs may be even lower depending on your county.
#2: FirstMedicare Direct smartHMO
Insurify Composite Score: 75.05
Though this plan is only available to residents of Wake county, those who can get it should certainly consider it. No monthly premium, a $0 drug deductible, and a very-advantageous $3,400 out-of-pocket maximum limit makes this plan an incredible contender.
And the cost of use is low too. Low copays for Tier 1 and Tier 2 prescriptions. Plus, $0 copays for urgent care, preventive, and primary care visits. You’ll also get low cost preventive dental, comprehensive dental, and routine vision care.
The only drawback is that you’ll need stand-alone hearing coverage. Exams are covered, but not hearings aids or fittings.
#3: Cigna Preferred Plus Medicare Plan
Insurify Composite Score: 74.68
Unlike the first Cigna plan, this HMO plan has a premium of $29. The plan includes Part D drug coverage and a $0 medical deductible, along with $0 co-pays for primary care, specialist visits, and many hearing, dental, and vision benefits.
Its out-of-pocket maximum is a bit higher at $4,050 for covered in-network services, but it offers lower costs for some provided benefits, such as diagnostic services, and higher allowances for benefits like over-the-counter items.
#4: Cigna Preferred Medicare Plan
Insurify Composite Score: 74.68
Here’s another health plan option that offers users both Part D drug coverage and a $0 monthly premium. This HMO plan has a $0 medical deductible, and it caps out at $3,650 on out-of-pocket costs for covered in-network services.
Like other top plans, there’s also a $0 co-pay for primary care services and preventive care, but it takes the savings a step further with a $0 co-pay for specialist visits as well. Lastly, many hearing, dental, and vision benefits also have $0 co-pays.
#5: Erickson Advantage Signature Plan with Drugs
Insurify Composite Score: 74.31
Erickson Living describes this HMO option as its “most complete plan,” with coverage including a prescription drug plan, $0 co-pays for preventive care, in-network primary care, and lab visits, and only a $20 co-pay for in-network specialist visits.
The plan also features $0 co-pays for some dental, vision, and transportation benefits, as well as fitness and respite care coverage, but those benefits and more come with a $199 monthly premium. It also offers a lower $2,600 out-of-pocket maximum for covered in-network services.
#6: AARP Medicare Advantage Plan 1
Insurify Composite Score: 73.43
While this is another plan where you’ll pay a monthly premium, you’ll be happy with the many low costs across the plan. And don’t forget that $27 a month for a premium is still quite low. You get a low prescription deductible at just $50, with no deductible for the health plan. Plus, a low out-of-pocket maximum set at $3,600..
Beyond that, you’ll see low or no copayment for low-tier prescriptions, preventive care visits, primary care visits, and diagnostic services. Plus no or no cost hearing, dental, and vision coverage. Add to that the ability to access out-of-network coverage and you can see why this plan made the list.
#7: Erickson Advantage Liberty with Drugs
Insurify Composite Score: 72.22
This 5-star HMO plan is great for those who want extra coverage regarding co-payments and other regular care-related costs. In addition to prescription drug plan coverage, it offers a $0 premium and a $6,700 out-of-pocket maximum for covered in-network care.
The plan also offers $0 co-pay costs for preventive care, primary care for providers in the Erickson Health Medical Group, and lab services, with just a $50 cost for specialist visits.
Like other Erickson Advantage plans, there’s a list of additional benefits for dental, transportation, hearing aids, fitness, and vision.
#8: Erickson Advantage Freedom Plan
Insurify Composite Score: 72.22
Also a 5-star HMO health plan, this plan is a mid-level option for those looking for extra coverage around any out-of-pocket expenses. The plan benefits include prescription drug coverage along with a $70 monthly premium (lower than the Champion plan), and it includes a $4,300 out-of-pocket maximum for covered in-network care.
The plan also offers $0 co-pays for preventive care, primary care doctor visits within Erickson Health Medical Group, and lab services, in addition to a $50 co-pay for in-network specialist visits.
Like the Champion plan, it also provides $0 co-pays for some preventive dental care, transportation to approved locations, and annual vision exams in addition to other benefits, such as those for hearing aids and fitness.
Now that you know what the top plans have to offer, discover which plans are available in your service area with the Insurify Medicare comparison tool.