Medicare Advantage

What’s Changing in North Carolina Medicare Advantage for 2027: 29 Leaving, 41 Changing

RALEIGH, N.C. — North Carolina's Medicare Advantage lineup is shifting again heading into 2027, and most households with a current plan will see at least some paperwork land in the mailbox this fall. According to the federal Medicare Advantage Landscape Source Files published by the Centers for Medicare & Medicaid Services (CMS), the state will have 179 Medicare Advantage plans available for 2027, compared with 175 for 2026. The year-over-year file comparison shows 29 plans leaving the state, 41 continuing but changing in at least one county, 33 arriving as new offerings, and 105 renewing without the kinds of changes CMS flags in its file. One carrier, Experience Health, is listed with no North Carolina plans for 2027.

The changes reach everywhere: all 100 of North Carolina's 100 counties will see at least one plan either leave or change.

What the statewide numbers mean

CMS publishes a Landscape Source File for each plan year. When analysts line up the 2026 file next to the 2027 file, each plan is counted once statewide, no matter how many counties it serves. A plan is marked as "leaving" when it is offered somewhere in North Carolina for 2026 but nowhere in the state for 2027. A plan is marked as "changing" when it is offered in both years but differs in at least one county on premium, drug deductible, plan type, or plan name as those fields appear in the CMS file. A plan is "new" when it appears for 2027 but did not appear in the 2026 file, and "continuing unchanged" when those tracked fields match in every county it serves.

For North Carolina, that comparison yields 29 leaving, 41 changing, 33 new, and 105 continuing unchanged, out of 179 plans available for 2027. Experience Health is the carrier the file shows with no North Carolina plans for 2027.

If your plan is leaving

If your current Medicare Advantage plan is one of the 29 not being offered in North Carolina for 2027, your carrier is required to send you a non-renewal notice. You have two separate windows to act.

The first is the Annual Enrollment Period, which runs October 15 through December 7, 2026. A choice you make in that window takes effect January 1, 2027.

The second is a Special Enrollment Period (SEP) that applies specifically to members whose plan is not being renewed. That SEP runs through the end of February 2027 and gives you additional time to enroll in a different Medicare Advantage plan or move to Original Medicare with a stand-alone drug plan.

If you do nothing and your plan is leaving, you will not be automatically moved into another Medicare Advantage plan by default; you would return to Original Medicare. That is why opening the non-renewal letter matters.

If your plan is changing

If your plan is one of the 41 that is continuing but changing, you should receive an Annual Notice of Change (ANOC) from your carrier before the Annual Enrollment Period opens. The ANOC is the document that lays out, in detail, exactly what is different about your plan for the coming year compared with the current year.

CMS flags a plan as "changing" when at least one of a handful of tracked fields — premium, drug deductible, plan type, or plan name — differs in at least one county the plan serves. The Landscape file does not tell you which one, or by how much. Your ANOC does. Read it alongside your current member materials and compare line by line.

If you do nothing, you stay enrolled in your renewing plan with the changes described in that ANOC.

The counties with the most change

Every one of North Carolina's 100 counties has at least one plan leaving or changing for 2027. A few counties stand out in the file for the sheer number of plans affected:

• Davidson County: 14 leaving, 26 changing
• Forsyth County: 15 leaving, 25 changing
• Guilford County: 15 leaving, 25 changing
• Johnston County: 19 leaving, 21 changing
• Avery County: 17 leaving, 22 changing
• Wake County: 19 leaving, 20 changing
• Buncombe County: 16 leaving, 22 changing
• Mitchell County: 18 leaving, 20 changing

These are counts, not rankings. A county with a high "leaving" number simply means more of the plans available there this year will not be on the shelf next year.

What to do before December 7

A simple sequence works for most households:

1. Watch the mail in September and early October for either a non-renewal letter or an ANOC from your current carrier. 2. Make a short list of what matters to you — your doctors, your hospital system, the specific prescriptions you take, and the pharmacies you use. 3. During the Annual Enrollment Period, October 15 through December 7, 2026, compare your current plan's 2027 version to the other plans offered in your county. 4. If you decide to switch, enroll by December 7, 2026, for a January 1, 2027 start date. 5. If your plan is not being renewed and December passes without a decision, use the Special Enrollment Period that runs through the end of February 2027.

Where to get free help

You do not have to figure this out alone, and you do not have to pay anyone to help you.

• Medicare.gov has the official Plan Finder, where you can enter your ZIP code and prescriptions and compare the plans offered in your county for 2027.
• 1-800-MEDICARE (1-800-633-4227) is staffed 24 hours a day, seven days a week.
• North Carolina's State Health Insurance Assistance Program (SHIP), known locally as the Seniors' Health Insurance Information Program (SHIIP), offers free, one-on-one counseling from trained volunteers who do not sell insurance.