Best Medicare Advantage Plans in North Carolina (2026)

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Updated: September 21, 2026

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Best Medicare Advantage Companies in North Carolina

Alignment Health Plan is the best Medicare Advantage insurer in North Carolina for 2026. It is one of two carriers with a 5-star Medicare quality median rating and the only one with a median annual cost exposure below $4,000, at $3,900. Devoted Health also earns 5 stars but carries a median cost exposure of $7,350.

Alignment Health Plan, HealthTeam Advantage, HealthSpring and Wellcare all have median annual cost exposures below $4,500. At least half the plans each carrier offers cap annual costs at $4,500 or below.

Carrier and plan availability varies by county.

Alignment Health Plan
4.7
$3,900
5
16
4
HealthTeam Advantage
4.4
$4,050
4.5
33
4
Aetna Medicare
4.3
$6,350
4.5
96
15
HealthSpring
4.3
$4,200
4
37
6
Devoted Health
4.3
$7,350
5
49
12
Blue Cross and Blue Shield of North Carolina
4.2
$6,571
4
100
7
Wellcare
4.2
$4,300
3.5
74
5

North Carolina Medicare Advantage Market Overview

Medicare Advantage is a private alternative to Original Medicare, the federal program covering hospital and doctor visits, that bundles all Medicare benefits into one plan and often adds prescription drugs, dental and vision.

North Carolina has 101 Medicare Advantage plans for 2026. Because 92% charge no monthly premium, the annual out-of-pocket limit, which caps what you pay in a year for covered care, is the more useful comparison point. North Carolina's annual out-of-pocket limits range from $2,900 to $9,250, a $6,350 difference in your worst-case annual cost.

Medicare Supplement plans work alongside Original Medicare to cover costs Original Medicare leaves unpaid. Both Medicare Advantage and Medicare Supplement give you more coverage than Original Medicare alone.

Non-SNP Medicare Advantage plans
101
North Carolina has 101 non-SNP MA plans. Network access and drug coverage are the right starting filters at this scale.
Carriers
11
11 carriers offer North Carolina's 101 MA plans. Your carrier selection determines which provider networks and plans are available.
CMS contracts
24
North Carolina's 11 carriers operate under 24 CMS contracts. CMS assigns star ratings at the contract level. Two plans from the same carrier carry independent quality ratings.
Median plans per county
37
37 plans per county gives North Carolina residents a strong local comparison set without looking statewide.
Medicare Advantage enrollment in non-SNP plans
815,023
More than 815,000 North Carolina residents are enrolled in the non-SNP MA plans included in this analysis.
Plans with a $0 premium
92%
92% of North Carolina plans charge nothing beyond Part B. Benefits and out-of-pocket limits are the more useful comparison points.
Median max out-of-pocket (MOOP)
$6,700
North Carolina's $6,700 median MOOP caps annual in-network costs for half the state's plans.
MOOP range
$2,900–$9,250

MOOP low is $2,900 and high is $9,250. Plan selection carries a $6,350 annual cost difference between the two.

Average CMS star rating
4.12 out of 5
North Carolina's 4.12-star average CMS rating clears the four-star quality benchmark. Individual contract ratings vary. Check plan-level ratings before choosing.
Contracts rated 4+ stars
54%
54% of North Carolina contracts earn four or more CMS stars. In a 101-plan market, the CMS star rating is the right first filter.
Alignment Health Plan

Alignment Health Plan

MoneyGeek Rating
4.7/ 5
5/5Affordability
4.8/5Quality & Member Experience
3.9/5Benefits & Access

  • Median Max Annual Cost Exposure

    $3,900

  • Median CMS Star Rating

    5

  • Counties Served

    16

  • Plans Available

    4
HealthTeam Advantage

HealthTeam Advantage

MoneyGeek Rating
4.4/ 5
4.6/5Affordability
4.5/5Quality & Member Experience
3.9/5Benefits & Access

  • Median Max Annual Cost Exposure

    $4,050

  • Median CMS Star Rating

    4.5

  • Counties Served

    33

  • Plans Available

    4
Aetna Medicare

Aetna Medicare

MoneyGeek Rating
4.3/ 5
4.1/5Affordability
4.5/5Quality & Member Experience
4.4/5Benefits & Access

  • Median Max Annual Cost Exposure

    $6,350

  • Median CMS Star Rating

    4.5

  • Counties Served

    96

  • Plans Available

    15
HealthSpring

HealthSpring

MoneyGeek Rating
4.3/ 5
4.5/5Affordability
4.2/5Quality & Member Experience
4/5Benefits & Access

  • Median Max Annual Cost Exposure

    $4,200

  • Median CMS Star Rating

    4

  • Counties Served

    37

  • Plans Available

    6
Devoted Health

Devoted Health

MoneyGeek Rating
4.3/ 5
3.9/5Affordability
4.8/5Quality & Member Experience
4.1/5Benefits & Access

  • Median Max Annual Cost Exposure

    $7,350

  • Median CMS Star Rating

    5

  • Counties Served

    49

  • Plans Available

    12
Blue Cross Blue Shield

Blue Cross Blue Shield

MoneyGeek Rating
4.2/ 5
4.3/5Affordability
4.1/5Quality & Member Experience
4.4/5Benefits & Access

  • Median Max Annual Cost Exposure

    $6,571

  • Median CMS Star Rating

    4

  • Counties Served

    100

  • Plans Available

    7
WellCare

WellCare

MoneyGeek Rating
4.2/ 5
4.6/5Affordability
3.7/5Quality & Member Experience
4.3/5Benefits & Access

  • Median Max Annual Cost Exposure

    $4,300

  • Median CMS Star Rating

    3.5

  • Counties Served

    74

  • Plans Available

    5

How to Choose the Best North Carolina Medicare Advantage Plan

Your medical needs, budget and doctor preferences all matter when choosing Medicare Advantage coverage in North Carolina.

  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 may still cost over $3,000 in a year if you need hospital care. North Carolina HMOs average $382 per hospital day in copays. Five days at $382 per day costs $1,910, before any specialist or prescription costs. Calculate your full annual costs 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 covered drugs. Tier 1 drugs, the lowest-cost category, cost $5 to $10 per prescription. Tier 4 drugs, the highest tier, can reach $100 or more. Some medications require prior authorization, which delays access by several days.

  4. 4
    Compare Different Plan Types

    HMOs carry a lower median out-of-pocket maximum in North Carolina ($5,500) than PPO plans ($6,750), but require a referral from your primary care doctor to see a specialist. HMO-POS plans let you see out-of-network doctors occasionally. PPOs need no referrals, which gives you more flexibility if you travel or see multiple 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, 54% of contracts clear the 4-star threshold. When costs and networks are similar, the star rating is the most reliable tie-breaker.

  6. 6
    Compare Extra Benefits

    Vision benefits appear in 91% of North Carolina Medicare Advantage plans, and dental benefits in 72%. 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 $2,900 to $9,250, a $6,350 difference in the most you'd pay in a year for covered care. Plans with lower limits are worth the trade-off even when individual copays cost more.

How Much Does Medicare Advantage Cost in North Carolina?

Medicare Advantage costs in North Carolina vary more by plan type than by premium. All four plan types have a $0 median monthly premium, so the annual out-of-pocket limit, the most you pay in a year for covered care, is the decision that matters.

HMOs have the lowest median out-of-pocket limit at $5,500. Regional PPOs have the highest at $9,250, $3,750 more than the HMO median. The extra exposure is the cost of provider flexibility without referrals.

The median primary care copay is $15 across all plan types, but inpatient and specialist costs differ more by plan type.

Median Monthly Premium
$0
$0
$0
$0
Median Max Out-of-Pocket
$5,500
$6,700
$6,750
$9,250
Median Inpatient Copay
$382
$395
$375
$375
Median PCP Copay
$15
$15
$15
$15
Median Specialist Copay
$30
$25
$30
$25

*Median cost figures across all 101 non-SNP North Carolina MA plans, grouped by plan type. All dollar figures rounded to nearest dollar. Source: CMS 2026 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): NC's free Medicare counseling program, operated by the NC 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

MoneyGeek put together scores for North Carolina Medicare Advantage carriers using five CMS data sources for the 2026 plan year. The five sources are the Medicare Plan Landscape File, Plan Benefit Package files, CMS Star Ratings, the CAHPS Report Card Master Table and the Contract/Plan Enrollment file.

How We Score Carriers

North Carolina carriers each pick up a MoneyGeek score out of five from three weighted categories.   

  • Affordability (40%): Annual premiums, the out-of-pocket maximum and inpatient hospital, specialist and primary care costs make up maximum annual cost exposure.
  • Quality and Member Experience (40%): CMS Star Ratings get 60% of this category, CAHPS C26 member ratings the other 40%. MoneyGeek measures both at the contract level.
  • Benefits and Access (20%): Supplemental benefits, including dental, OTC, vision and hearing, take up 50% of this category. The remaining 50% goes to county coverage at 30% and plan choice per county at 20%.

About Mark Fitzpatrick

Mark Fitzpatrick, Licensed P&C Insurance Expert, MoneyGeek

Mark Fitzpatrick is a licensed Property and Casualty (P&C) Insurance Producer in Connecticut 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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