Best North Carolina Medicare Advantage Health Insurance Companies for 2023
Based on our evaluation of government quality score ratings
To help people compare and choose Medicare Advantage plans, each year the federal government rates the quality of these plans with a 5-star quality rating system. North Carolina has 14 health insurance companies offering Medicare Advantage health plans in 2023.
In this article we rank North Carolina Medicare Advantage plans based on our evaluation of government 5-star quality scores.
2023 Rankings of North Carolina Medicare Advantage Health Insurance Companies
Alignment Health Plan(2 plans)
CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA(2 plans)
Blue Cross and Blue Shield of North Carolina(14 plans)
What Are Medicare Advantage Plans (Part C)?
Medicare Advantage plans are one way beneficiaries can choose to enhance their healthcare benefits under Parts A and B. If you enroll in a Medicare Advantage plan, your coverage will be provided by a private insurance company, not the federal government. A Part C plan takes your benefits from Parts A and B, adds in extra coverage, and provides all of it under one convenient plan.
Beneficiaries who choose Medicare Advantage enjoy many benefits you won’t find in Original Medicare. Plans might include dental, vision, and hearing coverage, gym memberships, meal delivery, transportation, and much more. Plans vary, and many insurance companies offer more than one option. Be sure to understand how your plan works and which benefits are included before you enroll.
When Can I Enroll In a Medicare Advantage Plan?
Several enrollment periods pertain to Medicare Advantage plans. To be eligible to enroll, you must be enrolled in both Part A and Part B. Your first opportunity to do this is during your unique Initial Enrollment Period (IEP). Your IEP is a 7-month window around your 65th birthday. You can enroll in Parts A and B and choose to enroll in Medicare Advantage during this time. Coverage will begin no earlier than the month you turn 65.
If you decide to postpone your transition into Medicare until past the age of 65, you’ll be able to enroll when your current coverage terminates. This often happens to those who decide to continue working and are already covered by an employer’s group health policy. As long as that coverage has been deemed credible by Medicare, you’ll be able to enroll in Medicare when that coverage ends.
Possibly the most important time of year for Medicare beneficiaries is the Annual Enrollment Period (AEP), which begins on October 15 and lasts through December 7. During this time, you can choose to enroll in Medicare Advantage for the first time, or you can change your current Medicare Advantage plan. Changes go into effect on January 1.
Medicare Advantage members also have an Open Enrollment Period (MA OEP) from January 1 through March 31. You may make a one-time change to your current Part C plan during this period. Changes go into effect the following month.
How to Choose the Right Medicare Advantage Plan for Me?
Choosing a Medicare Advantage plan is no easy task. It’s also not a decision you want to make quickly and without doing your homework. Depending on where you live, you may have many plans to choose from. So, how do you know which one is right for you? Start by researching the following aspects of each plan.
Networks. Medicare Advantage plans rely on provider networks. If you see a non-contracted provider, you’ll pay more for services. You may even be responsible for the entire bill! Check the plan’s network to see if your current doctors and other providers are listed. If they aren’t, are you comfortable switching providers?
Prescriptions. Compare your current medications to those listed on the plan’s drug formulary. You’ll want to ensure all your prescriptions are covered, so you aren’t surprised the next time you pick up your refills at the pharmacy.
Ratings. Medicare Advantage plans have star ratings. Five-star plans are considered “excellent” plans based on their benefits, cost-sharing amounts, claims processing, and customer satisfaction.
Expected Costs. This is an important one. Many people are attracted to Medicare Advantage plans because of their low monthly premiums. What they don't always realize is that there are still other out-of-pocket costs. Check the plan’s deductible, inpatient hospital expenses, and other coinsurance amounts. You should also look at the maximum out-of-pocket (MOOP). A MOOP is the maximum amount you’ll pay for covered services during the calendar year.
More About Government Medicare 5-star Quality Score Ratings
Each October the government releases updated 5-star quality ratings for Medicare Advantage health insurance plans. The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.
Sub components of Health Plan Star Ratings:
- Staying healthy: screenings, tests, vaccines - evaluation of whether members of the health plan receive screening tests, check-ups, and vaccines which help them stay healthy.
- Managing chronic (long term) conditions - evaluation of whether members with certain long term conditions received the proper tests and treatments to manage their health conditions.
- Member experience with health plan - based on surveys and member feedback regarding experiences using their Medicare health plan.
- Member complaints & changes in the health plan’s performance - based on the government’s evaluation of how often members of the plan had problems and filed complaints. Scoring also factors in whether the plan’s performance improved over time.
- Health plan customer service - evaluation of how the health insurance carrier handled members’ phone calls, requests, questions, and other interactions.
Other Notes on Our Rankings and Calculations
Government 5-star quality ratings are available on medicare.gov. Our rankings are based on calculations of the average Overall Star Rating of Medicare Advantage plans for each insurance carrier within a particular State. Only regular Medicare Advantage plans are considered for our calculations. We do not consider special needs plans (SNP) or special eligibility cost savings plans. We also do not consider new plans which do not yet have a 5-star quality rating.