Best Medicare Advantage Plans in North Carolina (2027)

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Updated: October 17, 2026

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Best Medicare Advantage Companies in North Carolina

Alignment Health Plan is the best Medicare Advantage insurer in North Carolina. Its plans have a 4.5-star CMS rating (Medicare’s 1-to-5 quality score) and the lowest median annual cost exposure, at $3,900. Cost exposure adds your yearly premiums to the out-of-pocket maximum, the most you’d pay for in-network care in a year.

Low cost and wide reach rarely come together. Every carrier with exposure under $5,000 sells in 35 or fewer of the state’s 100 counties. The three statewide carriers have cost exposure at least $3,250 above Alignment’s.

Check Alignment’s 20-county list first. Outside it, Aetna Medicare covers 96 counties with a 4-star rating and a $5,984 median cost exposure.

Alignment Health Plan
4.5
$3,900
4.5
20
5
Devoted Health
4.3
$7,075
4.5
52
24
Aetna Medicare
4.2
$5,984
4
96
16
Blue Cross and Blue Shield of North Carolina
4.1
$7,888
4
100
6
HealthTeam Advantage
4.1
$4,900
3.5
33
5
Humana
4
$9,850
4
100
22
UnitedHealthcare
4
$7,150
4
100
18
Troy Medicare
4
$4,950
3
35
1
Wellcare
3.9
$6,925
3
74
4
HealthSpring
3.8
$6,750
3
24
4

North Carolina Medicare Advantage Market Overview

North Carolina has 105 Medicare Advantage plans for 2027, and the typical county has 36 of them. Medicare Advantage plans are private plans that replace Original Medicare, the federal Part A and Part B coverage. Most also add drug coverage.

All 10 North Carolina carriers met our scoring criteria and appear in the rankings. Most plans (86%) charge no premium, so plans differ mainly in their out-of-pocket maximum, the most you pay for in-network care in a year.

North Carolina out-of-pocket maximums range from $3,400 to $9,850. To see any doctor who accepts Medicare, keep Original Medicare and add a Medicare Supplement plan, which pays deductibles and your share of each bill.

Medicare Advantage plans (excluding SNPs)
105

North Carolina’s 105 plans span multiple carriers and network types. The plan you pick changes your premium and what’s covered.

Carriers
10

Ten carriers compete in North Carolina. At annual enrollment, you can switch insurers entirely.

CMS contracts
24

Several carriers hold more than one North Carolina contract. Benefits and star ratings differ by contract, even within the same insurer.

Median plans per county
36

At 36 plans per county, the typical North Carolina resident has local options across price points and network types.

Plans with a $0 premium
86%

With 86% of plans at $0 premium, copays, co-insurance and out-of-pocket maximums separate one plan from another.

Median max out-of-pocket (MOOP)
$7,100

Half of North Carolina plans cap in-network costs at $7,100 or less in a high-use year

MOOP range

$3,400–9,850

The plan you choose sets your annual cost ceiling, which ranges from $3,400 to $9,850 across North Carolina plans, a $6,450 difference.

Average CMS star rating
4.00 out of 5

North Carolina plans average 4.00 out of 5 on CMS quality measures, but ratings vary by plan. Check the rating for any plan you consider.

Contracts rated 4+ stars
63%

63% of North Carolina contracts reach 4 stars or higher. Before you enroll, check where your plan’s contract falls.

Alignment Health Plan

Alignment Health Plan

MoneyGeek Rating
4.5/ 5
5/5Affordability
4.5/5Quality & Member Experience
3.7/5Benefits & Access

  • Median Max Annual Cost Exposure

    $3,900

  • Median CMS Star Rating

    4.5

  • Counties Served

    20

  • Plans Available

    5
Devoted Health

Devoted Health

MoneyGeek Rating
4.3/ 5
4/5Affordability
4.5/5Quality & Member Experience
4.3/5Benefits & Access

  • Median Max Annual Cost Exposure

    $7,075

  • Median CMS Star Rating

    4.5

  • Counties Served

    52

  • Plans Available

    24
Aetna Medicare

Aetna Medicare

MoneyGeek Rating
4.2/ 5
4.2/5Affordability
4.1/5Quality & Member Experience
4.4/5Benefits & Access

  • Median Max Annual Cost Exposure

    $5,984

  • Median CMS Star Rating

    4

  • Counties Served

    96

  • Plans Available

    16
Blue Cross Blue Shield

Blue Cross Blue Shield

MoneyGeek Rating
4.1/ 5
4/5Affordability
4.1/5Quality & Member Experience
4.2/5Benefits & Access

  • Median Max Annual Cost Exposure

    $7,888

  • Median CMS Star Rating

    4

  • Counties Served

    100

  • Plans Available

    6
HealthTeam Advantage

HealthTeam Advantage

MoneyGeek Rating
4.1/ 5
4.4/5Affordability
3.9/5Quality & Member Experience
3.7/5Benefits & Access

  • Median Max Annual Cost Exposure

    $4,900

  • Median CMS Star Rating

    3.5

  • Counties Served

    33

  • Plans Available

    5
Humana

Humana

MoneyGeek Rating
4/ 5
3.8/5Affordability
4.1/5Quality & Member Experience
4.4/5Benefits & Access

  • Median Max Annual Cost Exposure

    $9,850

  • Median CMS Star Rating

    4

  • Counties Served

    100

  • Plans Available

    22
UnitedHealthcare

UnitedHealthcare

MoneyGeek Rating
4/ 5
3.8/5Affordability
4.1/5Quality & Member Experience
4.3/5Benefits & Access

  • Median Max Annual Cost Exposure

    $7,150

  • Median CMS Star Rating

    4

  • Counties Served

    100

  • Plans Available

    18
Troy Medicare

Troy Medicare

MoneyGeek Rating
4/ 5
4.4/5Affordability
3.6/5Quality & Member Experience
3.8/5Benefits & Access

  • Median Max Annual Cost Exposure

    $4,950

  • Median CMS Star Rating

    3

  • Counties Served

    35

  • Plans Available

    1
WellCare

WellCare

MoneyGeek Rating
3.9/ 5
4.2/5Affordability
3.5/5Quality & Member Experience
4.2/5Benefits & Access

  • Median Max Annual Cost Exposure

    $6,925

  • Median CMS Star Rating

    3

  • Counties Served

    74

  • Plans Available

    4
HealthSpring

HealthSpring

MoneyGeek Rating
3.8/ 5
4.2/5Affordability
3.5/5Quality & Member Experience
3.7/5Benefits & Access

  • Median Max Annual Cost Exposure

    $6,750

  • Median CMS Star Rating

    3

  • Counties Served

    24

  • Plans Available

    4

How to Choose the Best North Carolina Medicare Advantage Plan

North Carolina Medicare Advantage plans differ most in their networks and out-of-pocket maximums, which range from $3,400 to $9,850, so check both before comparing premiums.

  1. 1
    Confirm Your Doctors and Hospitals Are In-Network

    Call your doctors and hospitals directly and ask if they accept your specific Medicare Advantage plan. The same insurer can operate different networks across plans, and each plan has its own provider list.

  2. 2
    Compare Your Full Annual Costs

    A $0 premium plan in North Carolina can still cost you $2,000 or more in a year if you need hospital care. The median North Carolina HMO charges $408 per day for a hospital stay, so five days cost $2,040 before any specialist or prescription costs. Add up copays and the out-of-pocket maximum before choosing a plan on premium alone.

  3. 3
    Check Prescription Drug Coverage

    Find your medications on each plan’s drug formulary, the list of drugs the plan covers. The same drug can cost less with one North Carolina plan than with another, so compare your prescriptions plan by plan. Check whether any of your medications need prior authorization, meaning the plan has to approve them before it pays.

  4. 4
    Compare Different Plan Types

    HMOs have a lower median out-of-pocket maximum in North Carolina ($5,900) than PPO plans ($7,150), but they require a referral from your primary care doctor to see a specialist. HMO-POS plans let you see some out-of-network doctors, though their median out-of-pocket maximum is $7,775. PPOs need no referrals, which helps if you travel or see several specialists.

  5. 5
    Review Star Ratings and Quality Metrics

    Medicare rates plans on a 1 to 5 star scale based on quality of care, member experience and chronic condition management. In North Carolina, 63% of contracts reach 4 stars or higher.

  6. 6
    Compare Extra Benefits

    Vision benefits appear in 92% of North Carolina Medicare Advantage plans, and dental benefits in 77%. Annual limits vary widely. A plan with dental coverage but a $500 annual maximum won't cover major dental work. Check dollar limits and which procedures are included before counting a benefit as a reason to choose a plan.

  7. 7
    Check Out-of-Pocket Maximums

    Out-of-pocket maximums in North Carolina range from $3,400 to $9,850, a $6,450 difference in the most you’d pay in a year for covered in-network care. A lower limit protects you most in a year with a hospital stay or ongoing treatment, even when the plan’s copays cost more.

How Much Does Medicare Advantage Cost in North Carolina?

With most North Carolina plans charging no premium, plan type matters most in a costly year. HMOs have the lowest out-of-pocket maximum, with a $5,900 median that’s $1,250 below PPOs.

Routine care costs about the same across plan types, from office visits to a hospital day (the inpatient copay, your daily cost as an admitted patient). HMO-POS plans are the exception, with a $7,775 median out-of-pocket maximum that’s $625 above PPOs. Nine of Humana’s 10 HMO-POS plans set $9,850, which pulls that median up.

Choose an HMO if your doctors are in its network. For out-of-network care, a PPO has a lower median out-of-pocket maximum than an HMO-POS.

Median Monthly Premium
$0
$0
$0
$0
Median Max Out-of-Pocket
$5,900
$7,775
$7,150
$9,850
Median Inpatient Copay
$408
$412
$400
$375
Median PCP Copay
$15
$15
$15
$15
Median Specialist Copay
$35
$28
$35
$25

*Median cost figures across all 105 North Carolina Medicare Advantage plans, excluding Special Needs Plans (SNPs), which are limited to people who meet specific eligibility rules. Grouped by plan type. All dollar figures rounded to nearest dollar. Source: CMS 2027 data, MoneyGeek analysis.

North Carolina Medicare Advantage Resources

North Carolina residents can get free plan counseling, compare coverage and apply for cost assistance through these state and federal resources.

  • NC SHIIP (Seniors' Health Insurance Information Program): North Carolina’s free Medicare counseling program, operated by the North Carolina Department of Insurance. Trained volunteers help you compare Medicare Advantage plans, review costs and clarify enrollment rules.
  • Medicare Plan Finder: The federal comparison tool. Enter your ZIP code to see all Medicare Advantage plans in your county, including premiums, out-of-pocket limits, drug coverage and quality ratings.
  • NC Department of Insurance: The state agency that licenses insurance carriers in North Carolina. Use it to verify a carrier’s standing, check complaints or report a dispute.
  • NC Medicare Savings Programs: State programs that help eligible residents pay Part B premiums and reduce cost sharing. Eligibility is based on income and assets.
  • Social Security Administration: Handles Medicare enrollment for most North Carolina residents. Apply for Medicare, check your enrollment status or set up Part B premium payments.
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Frequently Asked Questions

Our Methodology

To rank North Carolina Medicare Advantage companies for the 2027 plan year, MoneyGeek used five CMS data sources: the Medicare Plan Landscape File, Plan Benefit Package files, CMS Star Ratings, the CAHPS Report Card Master Table and the Contract/Plan Enrollment file.   

Our analysis covers 105 Medicare Advantage plans from 10 carriers across North Carolina’s 100 counties. Special Needs Plans aren’t included. To get a score, a carrier had to offer plans in at least five North Carolina counties and have data for all three scoring categories.   

How We Score Carriers

Every carrier we scored in North Carolina gets an overall MoneyGeek score out of five. This score is a weighted average of three category scores:   

  • Affordability (40%): Maximum annual cost exposure, which adds annual premiums to the in-network out-of-pocket maximum, makes up half of this category. Median inpatient hospital, specialist and primary care copays make up the rest.
  • Quality and Member Experience (40%): CMS Star Ratings account for 60% of this category, and CAHPS Rating of Health Plan scores account for the other 40%. We measure both at the contract level.
  • Benefits and Access (20%): Supplemental benefits, including dental, OTC, vision and hearing, account for 50% of this category. County coverage accounts for 30%, and the number of plans offered in each county accounts for 20%.

About Mark Fitzpatrick

Mark Fitzpatrick, Licensed P&C Insurance Expert, MoneyGeek

Mark Fitzpatrick is a licensed Property and Casualty (P&C) Insurance Producer and MoneyGeek's resident expert in insurance and economics. In nearly a decade covering the insurance market at LendingTree and MoneyGeek, he's analyzed hundreds of carriers and millions of rates across auto, home, renters, health and life insurance.

His work has appeared in The Washington Post, The New York Times and NPR. He draws on independent cost and consumer experience data, and no insurance company partnerships affect his recommendations.

Mark studied at Boston College and later earned a master's in economics and international relations from Johns Hopkins University. He worked in financial risk management at State Street before joining MoneyGeek. He's also a five-time “Jeopardy!” champion.

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