Orlando Harmon
Medicare is the federal health insurance program for people aged 65 and over in the United States. If you are under 65, you may still be eligible for Medicare if you have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's Disease). In North Carolina, you can apply for Medicare online, by phone, or in person at your local Department of Social Services. If you are already receiving Social Security benefits, Railroad Retirement benefits, or Federal Retiree benefits, your enrollment in Medicare Parts A and B is automatic. If not, you can contact the Social Security Administration by phone or enroll online or in person. You can also contact SHIIP for information about Medicare Supplement Plans, Medicare Advantage Plans, and Medicare Prescription Drug Plan options available in North Carolina.
| Characteristics | Values |
|---|---|
| Eligibility | Any U.S. citizen aged 65 or older who lives in North Carolina; some individuals under 65 with disabilities may also qualify |
| Enrollment options | Online, by phone, or in person at a local Social Security office |
| Enrollment timing | Specific times, including an Initial Enrollment Period (IEP); if missed, a Special Enrollment Period (SEP) may be available without penalty |
| Enrollment assistance | Local North Carolina Medicare agents, SHIIP Counselors, and experienced elder law attorneys |
| Medicare parts | Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (prescription drug coverage) |
| Medicare Advantage plans | 163 available in North Carolina for 2025, with an average monthly premium of $18.81 |
| Medicare Advantage carriers | Cigna, Humana, and WellCare |
| Supplemental coverage | Medicare Supplement Plan and Medigap |
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What You'll Learn
Automatic enrolment
If you are not automatically enrolled in premium-free Part A, you can sign up when your Initial Enrollment Period begins. This period lasts for seven months, starting three months before your 65th birthday and ending three months after. Your Part A coverage will begin six months before the date of your application, but no earlier than the first month you were eligible for Medicare.
Medicare Part A and Part B automatically renew each year, provided you are paying your premiums. Medicare Part D also automatically renews, but your prescription benefits may vary annually, so it is important to review your coverage regularly.
If you are still working when you turn 65, you can still enrol in Medicare. If your employer has fewer than 20 employees, it is advisable to enrol during your Initial Enrollment Period to avoid late penalties. If your employer has more than 20 employees, your Medicare coverage will be secondary, and you can choose to enrol in Part B or defer until you finish working.
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Signing up for Part A and Part B
Signing up for Medicare Part A and Part B in North Carolina can be done in several ways. Firstly, you can apply online at Social Security, which is the easiest and fastest way to sign up and receive any financial assistance for which you qualify. You will need to create a secure my Social Security account to sign up for Medicare or apply for Social Security benefits online. You can also apply over the phone by calling 800-772-1213 or by visiting a Social Security office in person.
If you already have Part A and want to sign up for Part B, you can apply online, but your employer will need to fill out form CMS-L564, which should be sent to your local Social Security office by fax or mail. If your employer cannot fill out the form, you should complete Section B of the CMS-L564 form as best you can, but do not sign it, and submit proof of job-based health insurance. If you are signing up for Part A and have to pay a premium for it, you can only sign up at certain times.
If you are still working when you turn 65, you can still enroll in Medicare. If you work for a company with more than 20 employees, your Medicare will be secondary to your employer coverage, and you can choose to enroll in Part B when you turn 65 or defer enrollment until you finish working without penalties. If your employer has fewer than 20 employees, it is important to enroll during your Initial Enrollment Period to avoid late penalties.
Medicare Part A covers hospital stays, while Part B covers doctor visits. Part A is typically available without a monthly premium for those who have worked at least 10 years, while Part B has a standard monthly premium of $185 for 2025.
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Medicare Supplement Plans
In North Carolina, there are several Medigap plans available:
- Medigap Plan C: This plan covers everything except for Medicare excess charges. It includes deductibles and the 20% you would typically pay towards outpatient costs.
- Medigap Plan D: This plan covers most items but does not include the Part B deductible or excess charges. It is important to distinguish Medigap Plan D from Medicare Part D, which covers prescription drugs.
- Medigap Plan F: This plan is a popular choice as it covers all expenses, resulting in zero out-of-pocket costs for covered services. There is also a High-Deductible Plan F with lower monthly premiums.
- Medigap Plan G: This plan is similar to Plan F and is also a popular choice.
- Blue Medicare Supplement Plans: Offered by Blue Cross and Blue Shield of North Carolina, these plans include options such as Plan A, Plan G, Plan HI DED G, Plan K, and Plan N. Plan N, for example, covers 100% of Part B coinsurance, except for copayments for certain office and emergency room visits.
When choosing a Medicare Supplement Plan, it is important to compare the plans and their pricing. Health Plans of NC offers free advice from North Carolina-based experts to help you make an informed decision. Additionally, Blue Cross NC provides a Plan Finder tool to explore and compare their Medicare plans, including premiums and copay amounts.
To apply for Medicare Supplement Plans in North Carolina, you can contact the respective insurance providers, such as Blue Cross NC or State Farm, which currently offers Medicare Supplement Insurance in the state. You can also reach out to local Medicare agents or your local Social Security office for guidance on enrollment and choosing the right plan for your needs.
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Medicare Advantage Plans
Most Medicare Advantage Plans offer additional coverage for things like vision, hearing, dental, and wellness programs. Plans can also offer extra benefits such as transportation to doctor visits, over-the-counter drugs, adult day-care services, and other health-related services.
In North Carolina, there are 163 Medicare Advantage Plans available for 2025, offered by carriers including Cigna, Humana, and WellCare. Blue Cross and Blue Shield of North Carolina is another provider of Medicare Advantage Plans in the state.
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Applying online
Applying for Medicare in North Carolina can be done online. Medicare is a federal health insurance program for people aged 65 and over. However, those under 65 may be eligible if they have a disability, End-Stage Renal Disease (ESRD), or Lou Gehrig's Disease (ALS).
The Initial Enrollment Period to sign up for Medicare begins 3 months before you turn 65 and ends 3 months after the month you turn 65. You may have to pay a penalty if you miss this period. You can apply online for Medicare only if you are still working and not ready to receive Social Security benefits at 65.
To apply online, you can visit the official website of the Social Security Administration, SSA.gov, or Medicare.gov. Here, you can enrol in Medicare Parts A and B, or Part A only. Part A covers hospital stays, while Part B covers medical insurance for doctor visits. You can delay Part B if you already have coverage through an employer's group health plan.
If you already have Part A and want to sign up for Part B, you can do so by visiting the same websites. Additionally, if you have ESRD, you can call 800-772-1213 to apply for Medicare due to your condition.
If you are deaf or hard of hearing, you can contact TTY +1 800-325-0778 for assistance.
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Frequently asked questions
You can apply for Medicare online at Social Security or by calling the Social Security Administration at 800-772-1213. You will need to create a secure my Social Security account to apply online. You can also contact your local county Department of Social Services or SHIIP to apply.
Medicare is available for people who are 65 and over. If you are under 65, you may be eligible for Medicare if you have a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's Disease).
Medicare Part A is insurance for hospitalization, home or skilled nursing, and hospice. You get Part A automatically once you start receiving benefits. Medicare Part B is medical insurance, and you need to sign up for it.
The Initial Enrollment Period to sign up for Medicare begins 3 months before you turn 65 and ends 3 months after the month you turn 65. You may have to pay a penalty if you miss this 7-month window.
Medicare Supplement Plans, also known as Medigap, are standardized plans that fill the gaps in coverage left by Original Medicare (Parts A and B). These plans are sold by private insurance companies and regulated by the Department of Insurance.
