Triad, North Carolina
What Is Medigap? Medicare Supplement in NC
Educational information only, not personalized tax, legal, or investment advice. Christian is a licensed insurance agent (NC Life & Health), not a CPA or registered investment adviser. Discuss your own situation with a qualified professional.
What Medigap pays
Original Medicare leaves you with real bills. The Part A hospital deductible is $1,736 per benefit period in 2026. Part B pays 80 percent of most outpatient care and leaves you the other 20 percent, with no yearly limit. A skilled nursing stay costs $217 a day for days 21 through 100 in 2026. Medigap pays some or all of these gaps, depending on the plan letter: the Part A deductible, Part A and Part B coinsurance, the first three pints of blood, hospice coinsurance, and skilled nursing coinsurance. Some plans also pay Part B excess charges and 80 percent of emergency care abroad, after a $250 deductible, up to a $50,000 lifetime limit.
The ten standardized letters
Federal law standardizes ten Medigap plans: A, B, C, D, F, G, K, L, M, and N. A Plan G from one company covers exactly what a Plan G from another company covers. Only the premium and the service differ. Every plan covers Part A coinsurance and 365 extra hospital days. Plans C and F are closed to anyone who became eligible for Medicare on or after January 1, 2020, because they cover the Part B deductible. Plan G is the most complete plan open to new enrollees: it covers everything Plan F did except the Part B deductible. Plan N covers most of what G covers, with copays of up to $20 for some office visits and up to $50 for an emergency room visit that does not lead to admission, and no excess-charge coverage. Plans K and L pay 50 percent and 75 percent of most benefits, with an annual out-of-pocket limit.
What Medigap does not cover
No Medigap plan covers prescription drugs. Policies sold since 2006 have no drug coverage, so nearly everyone with Medigap also buys a separate Part D plan. No plan covers routine dental or vision care, eyeglasses, hearing aids, private-duty nursing, or long-term custodial care. Medigap also cannot be paired with a Medicare Advantage plan. The two are mutually exclusive: you either have Original Medicare plus Medigap, or you have a Medicare Advantage plan, not both.
When to buy in North Carolina
Your best window is the six-month Medigap Open Enrollment Period that starts the month you turn 65 and enroll in Part B. During it, insurers must sell you any plan they offer, with no health questions and no higher premium for health reasons. Outside that window, North Carolina insurers can ask health questions, charge higher premiums, and turn you down. That is why the decision belongs in the months around 65, not years later. People under 65 on disability face different rules in North Carolina, so check with the state's free SHIIP counselors before assuming a plan is available.
What it costs
A Medigap premium is separate from the Part B premium, and it is separate from any Part D premium. Nationally, Medigap policyholders paid an average of $244 a month in 2025, according to KFF, up 7 percent from the year before. Your premium depends on your age, your ZIP code, the plan letter, and how the insurer sets rates. Some insurers raise premiums as you age. Others set the rate by your age at purchase. No page can quote your price, and this one does not try. Compare the same letter across companies, and ask how the premium has changed over the past five years.
| Choice | What you get |
|---|---|
| Original Medicare plus Medigap | Any doctor who takes Medicare, predictable costs, separate drug plan |
| Medicare Advantage | One plan with network rules, a yearly out-of-pocket limit, drug coverage often built in |
| Original Medicare alone | No yearly limit on your 20 percent share of Part B |
Your records checklist
- Enroll in Parts A and B first. Medigap needs both.
- Buy inside the six-month window at 65, when no health questions apply.
- Compare the same letter across companies, not different letters.
- Add a separate Part D plan for prescriptions.
- Ask how the premium is rated and how it has changed.
Common questions
- Does Medigap cover prescription drugs?
- No. No Medigap policy sold since 2006 includes drug coverage. You need a separate Part D plan for outpatient prescriptions, and the Part D deductible and $2,400 cap for 2027 apply to that plan.
- Can I have Medigap and a Medicare Advantage plan?
- No. Medigap works only with Original Medicare. If you join a Medicare Advantage plan, you cannot use a Medigap policy to pay its copays, and you cannot buy one to go with it.
- When is the best time to buy Medigap?
- During the six-month Medigap Open Enrollment Period that starts the month you turn 65 and enroll in Part B. Insurers must sell you any plan they offer, with no health questions. Outside that window, insurers in North Carolina can use underwriting.
- Is Plan G the same from every company?
- Yes, in benefits. Federal law standardizes the plans, so a Plan G from one company covers exactly what a Plan G from another covers. Premiums, rate history, and service differ, so compare those.
- Does my Medigap policy follow me if I move?
- Yes. A Medigap policy travels with you anywhere in the United States, as long as you keep Original Medicare. Tell your insurer your new address. Your premium may change with the move.
Sources and current instructions
Check the tax year and any later updates before acting. These are the primary sources used for this guide.