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Out-Of-Pocket Maximums Rose In Nearly 4 In 5 Continuing North Carolina Medicare Plans

Updated October 28, 2026.

What changed in North Carolina Medicare Advantage plans for 2027, and how to compare the plans offered in your county. Open enrollment runs October 15 through December 7.

These figures come from Medicare's public plan data, published by the Centers for Medicare & Medicaid Services (CMS). Insurers can change plan details after filing them with Medicare. Before you enroll, confirm a plan's costs, covered drugs, doctors and hospitals with the insurer, on Medicare's Plan Finder, or by calling 1-800-MEDICARE (1-800-633-4227). How To Use This Website And Its Limits.

The Changes In North Carolina

Most Continuing Plans Now Cost More For Those Who Get Sick

Of the 101 North Carolina Medicare Advantage plans that continue into 2027, 79 raised the most a person can pay out of pocket in a year for in-network care, and 1 lowered it. For people who stay in their plan, the typical increase was 6.5%, almost twice the 3.7% inflation rate. About 769,000 North Carolinians are in plans that continue and should review them.

More Than 30,000 North Carolinians Must Choose A New Plan By December 7

More than 30,000 North Carolinians, about 1 in 26 people in Medicare Advantage plans, are in plans that end on December 31 and must choose new coverage. No insurer leaves the state, but HealthSpring leaves 13 counties.

Compare Plans In Your North Carolina County

The full guide shows every plan offered in each North Carolina county for 2027, what each could cost you in a year if you get sick, and what it covers, and lets you compare plans side by side.

Open the North Carolina guide

Or go straight to your county:

If You Choose Original Medicare Instead

Original Medicare has no out-of-pocket maximum: there is no cap on what you can pay in a year. Most people add a Medigap supplement and a stand-alone drug plan. North Carolina uses the standard lettered Medigap plans (such as Plan G and Plan N). Prices vary by company, age and area; SHIIP can help you compare them.

Stand-alone drug plans in North Carolina went from 12 to 11 for 2027, with monthly premiums from $5.30 to $239.20.

In 2027, what you pay out of pocket for covered drugs is capped at $2,400 a year in every Medicare drug plan, including drug coverage inside Medicare Advantage.

The Warning Most People Never Hear

If you choose Medicare Advantage and later want to switch back to Original Medicare, you may not be able to buy a Medigap supplement. After your first chance to buy one, Medigap insurers can deny you or charge you more because of your health.

There are exceptions. If your Medicare Advantage plan is ending or leaving your area, as many are for 2027, federal law gives you the right to buy certain Medigap policies without health questions. This right applies only if you switch to Original Medicare, not to another Medicare Advantage plan. You can apply as early as 60 days before your plan ends and no later than 63 days after. Original Medicare does not cover prescription drugs, so you will also need a separate drug plan. You also have this right if you joined Medicare Advantage when you first got Medicare at 65 and switch to Original Medicare within the first year. If you dropped a Medigap policy to join Medicare Advantage for the first time, you have one year to get that policy back if the same company still sells it.

Some Plans Can Fill Up Before December 7

For 2027, Medicare lets insurers cap how many people can join some Medicare Advantage plans. Once a plan reaches its cap, it closes to new members, even before open enrollment ends. People already in a plan keep it. If you have picked a plan, enroll soon and confirm with the plan that it is still open.

Get Free Help

Check your own doctors and prescriptions in Medicare's Plan Finder at medicare.gov, or call 1-800-MEDICARE (1-800-633-4227). If your income is limited, ask about Medicare Savings Programs and Extra Help with drug costs.

Free, unbiased counseling: North Carolina Seniors' Health Insurance Information Program (SHIIP), 1-855-408-1212.

If you are deaf, hard of hearing or have a speech disability, dial 711 to reach any of these numbers through a free relay service.

What's Coming In 2032 And 2033

This year's changes come as two larger deadlines approach. The government's own trustees reported in June 2026:

Congress can still act; it has before. But it has less room than in 1981, the last time Social Security came this close. The national debt then was just under $1 trillion. On October 8, 2026, it was more than $40 trillion.

Sources: 2026 Annual Reports of the Social Security and Medicare Boards of Trustees (June 9, 2026); Committee for a Responsible Federal Budget (July 24, 2025, and June 9, 2026); U.S. Treasury, Debt to the Penny (Oct. 8, 2026); Washington Post, Oct. 23, 1981 (debt passes $1 trillion).

Sources: Centers for Medicare & Medicaid Services, CY2026 and CY2027 Landscape files (Sept. 2026), CY2027 Plan Benefit Package files, CY2027 Plan Crosswalk (Oct. 1, 2026); U.S. Census Bureau, American Community Survey 2020-2024, Table B19049. Shows plans open to everyone with Medicare in the county; special needs plans are not listed. Premiums are plan premiums and do not include the Part B premium. See How We Did This.