Updated: June 16, 2026
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North Carolina offers 23 Medicare Advantage plans from 11 providers, including HMO, HMO-POS, PPO, PFFS and Regional PPO options. Nine plans have $0 monthly premiums, while costs reach $117 depending on the provider and plan type.
Humana offers top HMO-POS plans at $3 monthly with 4.24 stars, while Wellcare leads PPO options at $31 per month, providing greater flexibility in choosing doctors.
Choosing the right Medicare Advantage plan in North Carolina depends on your health care needs. Consider which doctors and specialists you want to see, the medications you take regularly, and how much you're comfortable spending on monthly premiums and out-of-pocket costs.
Based on CMS star ratings, premiums, MOOP costs and coverage features, we identified the best Medicare Advantage plans in North Carolina. Alignment Health Plan offers the top HMO option with a perfect 5.0 CMS star rating, $0 monthly premium and $3,900 maximum out-of-pocket limit.
Humana leads for HMO-POS plans with a 4.24 star rating, while Wellcare offers PPO coverage with a 3.5 star rating. These providers deliver affordable premiums with comprehensive coverage across the state.
| HMO | Alignment Health Plan | 5.00 | $0 | $3,900 | Alignment Health Platinum (HMO) |
| HMO-POS | Humana | 4.24 | $3 | $6,925 | Humana Gold Plus H1036-335 (HMO-POS) |
| PPO | Wellcare | 3.50 | $31 | $4,201 | Wellcare Assist Open (PPO) |
Medicare Advantage plans cover hospital stays, doctor visits and prescription drugs in one comprehensive package. These private insurance alternatives to Original Medicare must provide the same basic coverage while adding dental, vision and hearing benefits.
Best HMO
CMS Star Rating
Plan Types
Best HMO-POS
CMS Star Rating
Plan Types
Best PPO
CMS Star Rating
Plan Types
North Carolina's HMO Medicare Advantage market has strong quality providers, with star ratings ranging from 3.0 to 5.0 stars and 17 of the 19 available plans earn 4 stars or higher. You'll find 15 plans charging $0 monthly premiums across 7 providers, keeping the median premium at $0. Maximum out-of-pocket costs average $5,338 annually and range from $3,200 to $9,250, giving residents affordable options with strong quality ratings.
| Alignment Health Plan | 5.00 | $0 | $3,900 | 3 | 4.79 |
| Devoted Health | 5.00 | $0 | $6,543 | 3 | 4.42 |
| Cigna HealthCare | 4.00 | $6 | $3,346 | 4 | 4.33 |
| Troy Medicare | 3.00 | $0 | $3,950 | 1 | 4.24 |
| Blue Cross Blue Shield | 4.00 | $0 | $8,876 | 2 | 4 |
| Aetna | 4.00 | $24 | $5,631 | 5 | 3.83 |
| Experience Health | 3.50 | $7 | $6,500 | 1 | 3.72 |
HMO plans connect you with a defined network of local doctors and route your care through a primary care physician in North Carolina. You'll need referrals for specialist visits, but premiums and out-of-pocket costs are lower than most other plan types. These plans work well if you want one doctor managing your overall health and prefer keeping health care costs predictable
North Carolina has 27 HMO-POS Medicare Advantage plans, and 14 carry 4-star CMS ratings with none falling to 3 stars. Four providers offer these options, and 19 plans charge no monthly premium. Out-of-pocket maximums average $6,701 but range from $2,900 to $9,250.
| Humana | 4.24 | $3 | $6,925 | 9 | 4.4 |
| Wellcare | 3.50 | $0 | $4,200 | 1 | 4.25 |
| UnitedHealthcare | 4.01 | $11 | $5,781 | 15 | 4.1 |
| Blue Cross Blue Shield | 4.00 | $21 | $5,311 | 2 | 3.8 |
HMO-POS plans cost less monthly than PPO plans and give you more flexibility than standard HMOs. You can see out-of-network specialists when needed, though those visits cost more than in-network care. These plans are a good fit for seniors who mostly use network providers but occasionally need specialized care that isn't available locally. Out-of-network visits don't require referrals.
North Carolina's 26 PPO Medicare Advantage plans give you more provider choice than HMO options, though that flexibility comes at a higher cost. Monthly premiums range from $0 to $255, with a median of $0. Out-of-pocket maximums average $6,656 and top out at $9,250. Fourteen plans carry 4 or more CMS stars: eight have 4.5-star ratings, six have 4-star ratings, 11 have 3.5-star ratings, and one has 3-star ratings.
| Wellcare | 3.50 | $31 | $4,201 | 3 | 5 |
| Aetna | 4.50 | $2 | $6,817 | 4 | 4.63 |
| HealthTeam Advantage | 4.00 | $8 | $4,032 | 3 | 4.49 |
| Blue Cross Blue Shield | 4.50 | $48 | $6,300 | 1 | 4.34 |
| UnitedHealthcare | 4.32 | $105 | $4,928 | 6 | 4.32 |
| Cigna HealthCare | 3.00 | $0 | $5,078 | 1 | 4.26 |
| Humana | 3.50 | $13 | $9,250 | 8 | 4 |
While PPO plans come with higher premiums, they're best for people who want complete provider freedom without referral requirements. You can see any specialist directly and access out-of-network doctors when needed, though staying in-network saves money. These plans work well if you travel frequently or prioritize unrestricted access to specialized care over lower monthly costs.
Your medical needs, budget and doctor preferences all matter when choosing Medicare Advantage coverage in North Carolina.
Call your doctors and hospitals directly and ask if they accept your specific Medicare Advantage plan. The same insurer can run different networks across plans, and each plan has its own provider list.
A $0 premium plan may still cost you $3,000 yearly in copays and deductibles. Calculate your real annual costs by adding medication expenses and specialist visit fees. Some plans charge $50 monthly but save you money through lower out-of-pocket costs.
Search your medications on each plan's formulary before enrolling. Tier 1 drugs cost $5 to $10 per prescription; Tier 4 drugs can run $100 or more. Some medications require prior authorization, which delays access by several days.
HMOs cost less but require primary care referrals. HMO-POS plan types let you see out-of-network doctors occasionally without locking you into a single network. PPOs skip referral requirements entirely, which works better if you travel or see multiple specialists.
Medicare rates plans on a 1 to 5 star scale. Plans with 4 or 5 stars process claims faster and score higher on customer service. Members also report better outcomes with top-rated plans.
Many North Carolina Medicare Advantage plans include dental, vision, hearing, fitness memberships and over-the-counter allowances. Compare extras based on what you need most.
Out-of-pocket maximums cap your annual medical spending. Lower caps give you more cost certainty. Higher caps often come with lower monthly premiums but leave you exposed to larger bills if you need surgery or hospitalization.
Plan type determines Medicare Advantage costs across the Tar Heel State. HMO plans offer the most affordable option with $0 median premiums and $6 average monthly costs, plus they carry the lowest out-of-pocket maximums at $5,338 annually. HMO-POS plans cost more at $19 average monthly but have higher $6,701 MOOP limits, while PPO plans top the spectrum at $28 average monthly premiums with $6,656 out-of-pocket maximums. PPOs charge more because they let you see out-of-network providers and access specialists without referrals.
| HMO | $0 | $6 | $5,338 |
| HMO-POS | $0 | $19 | $6,701 |
| PFFS | $7 | $7 | $7,550 |
| PPO | $0 | $28 | $6,656 |
| Regional PPO | $117 | $117 | $9,250 |
Get answers about how to enroll, what's covered and enrollment timing for Medicare Advantage plans across North Carolina.
Enroll with Medicare Part A and B first, then compare plans on Medicare.gov during Annual Enrollment (Oct. 15 to Dec. 7) or other qualifying periods.
Medicare Advantage plans cover everything Original Medicare does, plus most include prescription drugs and extras like dental, vision and fitness benefits.
Medicare Advantage replaces Original Medicare with bundled coverage from private insurers, while Medicare Supplement (Medigap) works alongside Original Medicare to cover deductibles and copays.
North Carolina follows the same Medicare Advantage enrollment windows as the rest of the country. The main open enrollment period runs October 15 to December 7 each year. Current enrollees can switch plans January 1 to March 31. If you're turning 65, you have a seven-month window that starts three months before your birthday month.
Our scores weight three factors: affordability (50%), star ratings (40%) and availability (10%).
About Mark Fitzpatrick
Mark Fitzpatrick, a Licensed Property and Casualty (P&C) Insurance Producer in Connecticut, is MoneyGeek's resident insurance expert. He has spent nearly a decade analyzing the market, first at LendingTree and now at MoneyGeek, where he produces original research on hundreds of carriers and millions of rates across auto, home, renters, health and life insurance.
He covers economics and insurance at MoneyGeek, and his work has been featured in The Washington Post, The New York Times and NPR, among other outlets.
Like all MoneyGeek analysts, he draws on independent cost and consumer experience data. No insurance company partnership influences his recommendations.
Fitzpatrick earned his degrees from Johns Hopkins University (M.A. Economics and International Relations) and Boston College (B.A.). His career began in financial risk management at State Street. He's also a five-time “Jeopardy!” champion.
