How to Find the Best North Carolina Medicare Advantage Plans

The best Medicare Advantage Plan in North Carolina for you is one that meets your needs while remaining within your budget. MoneyGeek summarizes the best Medicare Advantage Plans in North Carolina that provide comprehensive benefits and are widely available. We discovered that the Aetna Medicare Premier Plan is the best PPO plan and the AARP Medicare Advantage Plan 2 is the best HMO plan.

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Last Updated: 9/23/2022
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Based on the Centers for Medicare & Medicaid Services (CMS) five-star rating system, MoneyGeek found the best Medicare Advantage Plans that are widely available in North Carolina. When determining the best health insurance plan for you, MoneyGeek examined a variety of factors, including the type of plan you want, whether you need drug coverage and how much you're willing to pay out of pocket.

Note that these are just guidelines. The only way to pick the ideal plan for your needs is to do some research. It is essential to confirm if the hospitals and providers you want to use are included in the insurance plan that you intend to buy.

MoneyGeek also analyzed the best medicare supplement plans in North Carolina for those focused on covering out-of-pocket expenses.

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Best Medicare Advantage Plans in North Carolina

Best Medicare Advantage Plan in North Carolina - Overall

The best Medicare Advantage plan for you will be based on your individual requirements. The six core benefits and a high star rating from the Centers for Medicare & Medicaid Services (CMS) are important considerations for a North Carolina Medicare Advantage plan buyer. When it comes to Medicare Advantage Plans, MoneyGeek rated the Aetna Medicare Premier Plan (PPO) from Aetna Medicare as the best option in North Carolina.

Preferred Provider Organization (PPO) plans offer several benefits, including more flexibility, no referral requirement to visit a specialist plus a larger network.

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Aetna Medicare

MoneyGeek discovered that Aetna Medicare Premier Plan (PPO) is the best choice in North Carolina for those looking for a PPO. However, the best option for you will depend on your unique requirements.

Here are the plan details:

  • Monthly premium: $0
  • Drug coverage: $150
  • An in-network max-out-of-pocket payment: $5,900
  • Overall star rating of 4.5 out of 5 from the CMS

Vision, dental, hearing, fitness, worldwide emergency and telehealth services are included in the Aetna Medicare Premier Plan (PPO). Because of the worldwide emergency coverage, this plan is an excellent option for travelers. It also has a high CMS rating and offers Part D drug coverage.

Best HMO Medicare Advantage Plan in North Carolina

The best HMO Medicare Advantage Plan in North Carolina for you will be determined by your healthcare requirements. For example, AARP Medicare Advantage Plan 2 (HMO-POS) from UnitedHealthcare is MoneyGeek’s top choice for a buyer in North Carolina seeking an HMO plan that includes drug coverage, six core benefits and a high CMS star rating.

HMOs are more likely to be less expensive than other plan types. However, to get coverage, you must remain within your network. The only exception is in the case of an emergency. To visit a specialist, you'll also need a referral.

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AARP

What is best for one person may not be the best option for another. However, AARP Medicare Advantage Plan 2 (HMO-POS) is the best option for North Carolinians who want to buy an HMO in the state.

Here are the plan details:

  • No monthly premium
  • Drug Coverage: $95
  • An in-network Max-Out-of-Pocket Payment: $4,500
  • Overall star rating of 5 out of 5 from the CMS

This HMO plan offers Part D drug coverage as well as the six most common additional benefits, including vision, dental, hearing, fitness, worldwide emergency and telehealth. CMS also gives it excellent ratings, and it offers Part D coverage.

Best Medicare Advantage Plan in North Carolina Without Drug Coverage

If you don't require Part D prescription drug coverage, you'll have more healthcare plan options.

According to MoneyGeek’s research, the AARP Medicare Advantage Patriot (HMO-POS) plan from UnitedHealthcare could be the best option for North Carolinians looking for a Medicare Advantage plan without drug coverage, six core benefits and an excellent CMS star rating.

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AARP

Based on MoneyGeek's research, AARP Medicare Advantage Patriot (HMO-POS) from UnitedHealthcare is the best choice for buyers in North Carolina, regardless of whether or not they want drug coverage. Keep in mind that this plan does not offer drug coverage.

The plan details include:

  • Monthly premium: $0
  • An in-network max-out-of-pocket payment: $3,600
  • Overall star rating 5 out of 5 from the CMS

The six most common additional benefits are included in the Medicare Advantage Patriot (HMO-POS) plan, including vision, dental, hearing, fitness, worldwide emergency and telehealth. The plan also has an excellent rating from CMS.

Best Medicare Advantage Plan in North Carolina for Low Max Out-of-Pocket Costs

Despite the fact that many Medicare Advantage plans offer low or no premiums, paying out-of-pocket may lead to higher costs in certain cases. To prevent this, look for a plan with a low in-network maximum out-of-pocket expense limit.

MoneyGeek found that North Carolina residents shopping for a Medicare Advantage plan with a low maximum out-of-pocket limit, drug coverage, six core benefits and a high star rating from the Centers for Medicare and Medicaid Services (CMS) should consider Aetna Medicare Premier Plan (PPO) from Aetna Medicare.

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Aetna Medicare

The Aetna Medicare Premier Plan (PPO) is the best option for North Carolinians, regardless of whether they choose drug coverage or not, excluding plans with high maximum out-of-pocket caps. This plan does offer drug coverage.

The plan details include:

  • No monthly premium
  • An in-network max-out-of-pocket payment of $5,900
  • Overall star rating of 4.5 out of 5 from the CMS

If you have a lot of medical needs in a year, a plan with a low maximum out-of-pocket saves you from enormous costs. As soon as you've exhausted your $5,900 deductible with Aetna Medicare Premier Plan (PPO), the insurance company begins to pay for in-network benefits. As a PPO plan, out-of-network coverage has a separate maximum out-of-pocket limit. The total cost is $11,300 for this particular plan.

Medicare Advantage Plan in North Carolina - Statistics

In North Carolina, Medicare Advantage plans are offered by fifteen different healthcare organizations. The following information includes plan types, common benefits and uncommon benefits.

1

North Carolina Medicare Advantage Plans are a mix of HMO, PFFS, MSA and PPO, with 63% offering drug coverage

North Carolina's Medicare Advantage Plans include Preferred Provider Organization plans (48.8%), Health Maintenance Organization plans (33.8%), Private Fee-For-Service (PFFS) plans (.5%) and Medical Savings Accounts (16.8%). Drugs are covered by 63% of these plans.

2

62% of Medicare Advantage Plans in North Carolina have a $0 premium

In North Carolina, you may choose from 50 different plans that cost nothing. About 62% of all Medicare Advantage Plans on the market are covered by these plans. Plans that charge a monthly payment cost $51.70 on average.

3

Hearing, fitness and telehealth benefits are common in North Carolina, with most plans offering them

The three most popular Medicare Advantage Plan benefits are hearing, fitness and telehealth. In contrast, the most uncommon are home safety devices & modifications, in-home support and emergency response devices.

Methodology

MoneyGeek collected data from the Centers for Medicare & Medicaid Services 2022 MA Landscape Source Files released in October 2021. Plans in North Carolina were filtered down to those that offer drug coverage (unless otherwise noted), offer six of the most common Medicare Advantage coverage benefits and are available to at least 50% of the population of North Carolina based on county availability.

About the Author


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Mark Fitzpatrick is a senior content manager with MoneyGeek specializing in insurance. Mark has years of experience analyzing the insurance market and creating original research and content. He graduated from Boston College with a Bachelor of Arts and Johns Hopkins University with a Master of Arts.