State retirees on Medicare: your November 6 checklist

1. 1Know which plan you're on now

   Retirees on Medicare are on one of three State Health Plan options: the Base Medicare Advantage plan, the Enhanced Medicare Advantage plan, or the 70/30 plan. You can see yours when you log in to eBenefits through shpnc.gov.

2. 2On the 70/30 plan? Decide by November 6

   If you're on the 70/30 plan and do nothing, you're moved to the Base Medicare Advantage plan for 2027. To stay on the 70/30 plan, you have to choose it by November 6.

3. 3On a Medicare Advantage plan and happy? You can stay put

   If you're already on the Base or Enhanced plan and do nothing, you stay on the plan you have.

4. 4Check your doctors

   The 70/30 plan uses a three-tier provider network in 2027, and the tier your doctor is in can change what you pay. Atrium Health update, October 27: Atrium and the State Health Plan reached an agreement, so all Atrium doctors and hospitals, including Atrium Health Wake Forest Baptist, are in network for 2027 in the plan's middle “access” tier, at about today's costs. Not sure how your plan treats your doctors? Call the State Health Plan Medicare Support Center at 833-429-5003 before November 6.

5. 5Check what you could pay

   The medical out-of-pocket limit, the most you can pay for medical care in a year, goes from $4,000 to $4,500 on the Base plan and from $3,300 to $3,700 on the Enhanced plan. Drug costs have a separate out-of-pocket limit. There's also a new $50 copay for Part B drugs on both plans.

6. 6Make any change online by November 6

   Changes are made in eBenefits on shpnc.gov. Questions about eligibility or enrolling go to the State Health Plan at 855-859-0966. The Medicare Support Center (833-429-5003) can answer questions about the plans, but it can't enroll you in a different one.

7. 7Don't mix up the two deadlines

   November 6 is the State Health Plan's deadline. Medicare's Annual Enrollment, October 15 to December 7, is a different window, for people with their own Medicare plans.

Warning: if you join a Medicare Advantage plan or a Part D drug plan outside the State Health Plan, your State Health Plan Medicare Advantage coverage is cancelled and you are moved to the 70/30 plan.

Want the details behind each step? Read the full State Health Plan guide. Hired by the state on or after January 1, 2021? You aren't eligible for retiree medical coverage, so your Medicare choices are on the open market: start with the turning 65 guide.

Sources: State Health Plan 2027 open enrollment page for Medicare members (shpnc.gov); NC Department of State Treasurer, October 14, 2026; WFDD / NC Newsroom and North Carolina Health News, October 27, 2026; Becker's Payer Issues, June 8, 2026. Confirm anything that matters to you with the State Health Plan.