In 2025, the number of North Carolinians enrolled in Medicare surpassed 2 million. That said, the monthly premium costs for Medicare Advantage plans in the state have risen.

When you turn age 65, you’re eligible for health insurance from the federal government through Medicare. Some Medicare options are sold by private insurance companies as well.

Read on to learn more about Medicare options in North Carolina and tips to help you choose the plan that’s right for you.

The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in North Carolina according to the latest statistics leading up to 2025:

  • In North Carolina, 2,206,673 individuals enrolled in Medicare, a slight increase from the 2,154,130 residents enrolled in the lead-up to 2024.
  • The average monthly Medicare Advantage plan premium changed from $16.27 in 2024 to $18.81 in 2025.
  • There are 163 Medicare Advantage plans available in North Carolina for 2025, down from 180 plans in 2024.
  • All North Carolina residents enrolled in Medicare have the option to buy a Medicare Advantage plan, including plans with $0 premiums.
  • For those who want prescription drug coverage, 16 stand-alone Part D plans are available, with some premiums as low as $0.

Medicare includes many options for coverage. The federal government offers Original Medicare and includes both hospitalization and medical coverage. You can purchase other options to help cover your prescription drugs and other medical and health services.

Here is an overview of the parts of Medicare and what they may cover.

  • Original Medicare’s Parts A: Part A is for people 65 and older, those with certain conditions, or who receive specific government benefits. It covers inpatient hospital care, limited care in skilled nursing facilities, home healthcare, and hospice care. You won’t pay a premium unless you don’t meet the qualifications.
  • Original Medicare’s Parts B: Part B is available to those eligible with a monthly premium. It covers doctor’s visits, preventive care, lab and imaging services, outpatient treatments, and durable medical equipment.
  • Part D: Original Medicare doesn’t cover prescription medications. You may purchase prescription drug coverage from private companies in the form of Medicare Part D or as a part of a Medicare Advantage plan.
  • Medicare Advantage (Part C): These are private insurance plans combining coverage for Parts A, B, and often Part D into one policy. You must enroll in Part A to sign up, and there is an out-of-pocket spending limit. Plan offerings differ by county, so use your ZIP code when searching in North Carolina. Available carriers include Cigna, Humana, and WellCare.
  • Medigap: Medigap plans help pay deductibles, copays, coinsurance, and other out-of-pocket costs. These plans are also offered through private insurance companies. Coverage and premiums vary, so use the Medicare Find a Plan tool to discover the plans in your area.

Unless you meet the qualifications for automatic enrollment, you need to sign up for Medicare during an enrollment period. These enrollment periods include:

You can enroll in parts A and B online, by calling 800-772-1213, or by visiting a Social Security office.

  • Initial enrollment period (IEP): This 7-month window begins 3 months before your 65th birthday and continues through the month of your 65th birthday and three months after you turn 65. If you enroll before your birthday, coverage begins in your birthday month. If you enroll during the month of your birthday or the three months following, there is a two- to three-month delay before coverage begins.
  • General enrollment (January 1–March 31): If you missed your IEP, you can enroll at the beginning of each calendar year during the general enrollment period. Your coverage begins on July 1.
  • Medicare Advantage open enrollment (January 1–March 31): You can make changes to your Medicare Advantage plan during the Medicare Advantage open enrollment if you were already enrolled in one of these plans.
  • Medicare open enrollment (October 15-–December 31): During Medicare’s annual open enrollment period, you can switch between original Medicare and Medicare Advantage plans, and add, drop, or switch your Part D coverage.
  • Special enrollment period: If you lose coverage, like after leaving a job or moving to an area that your previous plan doesn’t cover, you can enroll in Medicare during a special enrollment period. How long you have to enroll varies based on the reason you lost coverage.

You can enroll in Part D during your IEP. If you don’t enroll in Part D during your IEP, and you don’t have other prescription drug coverage, you’ll pay a penalty fee if you decide to enroll at a later time.

Tips for enrolling in Medicare in North Carolina

Before you decide on a plan, consider whether:

  • you want to enroll in original Medicare (Part A and Part B)
  • you want additional coverage or convenience from a Medicare Advantage plan
  • you need a Medigap plan to help with deductibles, copays, and coinsurance costs
  • you need to add Part D prescription drug coverage to original Medicare or a Medicare Advantage plan

There are specific times when you can sign up, so pay close attention to the enrollment windows to avoid missing them.

If you have questions about Medicare North Carolina enrollment and available plans, you can contact:

If you need help paying for Medicare, you can also reach out to:

What should I do next?

To take the next steps to enroll in Medicare, take care to:

  • Review available plan types and decide whether original Medicare or a Medicare Advantage plan is right for you.
  • Contact SHIIP to get any questions you have answered.
  • Mark enrollment dates on your calendar so you don’t miss the deadline.

Over 2 million people in North Carolina were enrolled in Medicare for 2025. Overall, monthly premium costs for 2025 Medicare Advantage plans in North Carolina have increased.