Medicare Supplement

Choosing a Medigap plan in Cary: how North Carolina's standardized letters work

If you live in Cary and are pairing Original Medicare with a Medicare Supplement policy, the good news is that shopping is simpler than it looks. Every Medigap plan sold in North Carolina follows the same federal blueprint — a letter, like A, G, or N — and every insurer selling that letter must offer the same core benefits. What changes from carrier to carrier is price and service, not the coverage itself.

Choosing a Medigap plan in Cary: how North Carolina's standardized letters work

Cary is in Wake County, and the same set of Medigap letters is available across the state. Below is a plain-English guide to how the letters work, how they fit with Part D, and where to get help before you sign anything.

What the plan letters actually mean

Medigap policies are standardized by the federal government. That means a Plan G sold by one insurer covers the same Medicare-approved costs as a Plan G sold by another. Only three states — Massachusetts, Minnesota and Wisconsin — do this differently. North Carolina follows the federal letters.

The letters you can shop today if you're newly eligible are A, B, D, G, G-HD (a high-deductible version of G), K, L, M and N. Plans C and F are still on the market, but only people who became eligible for Medicare before January 1, 2020 can buy them. If you qualify under that older rule, you'll see C and F listed by some carriers in the table below.

Each letter covers a different mix of things like the Part A hospital coinsurance, the Part B coinsurance, and skilled nursing facility costs. Some letters cover more; some, like K and L, share costs with you up to a yearly limit. Medicare.gov has a side-by-side chart that shows exactly which gaps each letter fills.

How Medigap fits with Original Medicare and Part D

Medigap is designed for people who have Original Medicare (Part A and Part B). It pays some of what Medicare doesn't — things like coinsurance and, depending on the letter, the Part A deductible. It does not replace Medicare; it sits on top of it.

Two important pairing rules:

• Medigap does not include drug coverage. If you want prescription coverage, you enroll in a stand-alone Part D plan. In 2026, Part D has a $2,100 annual out-of-pocket cap, a maximum deductible of $615, and no more coverage gap ("donut hole") — there are now three payment phases instead of four. There is also an optional Medicare Prescription Payment Plan that lets you spread drug costs across the calendar year.
• You can't use Medigap with a Medicare Advantage plan. Medigap only works with Original Medicare. If you're currently on Advantage and thinking about switching to Original Medicare plus a Medigap policy, timing and medical underwriting can matter — check with SHIIP before you make a move.

Who sells Medigap in North Carolina

Roughly thirty insurers are licensed to sell Medigap in the state, from familiar national names to smaller regional companies. The table below lists every insurer and every plan letter each one offers, so you can see at a glance who sells the letter you're considering.

A few examples of the range: AARP - UnitedHealthcare Insurance Company offers Plans A, B, C, D, F, G, K, L and N; Aetna Health Insurance Company offers A, B, F, G, G-HD and N; BlueCross BlueShield of North Carolina offers A, G, G-HD, K and N; Mutual of Omaha (Omaha Insurance Company) offers A, F, G, G-HD and N; and State Farm Mutual Automobile Insurance Company offers A, C, D, F, G and N. Because benefits are standardized, once you pick a letter, the shopping question becomes price, customer service, and how the insurer handles future rate changes — not what the plan covers.

The rules that shape your choice

A few state and federal rules are worth knowing before you shop:

• Your Medigap Open Enrollment Period. This is a one-time, six-month window that starts the month you're 65 or older AND enrolled in Part B. During this window, insurers can't turn you down or charge you more for health reasons. Missing it can make it harder — or more expensive — to switch later.
• Guaranteed issue rights. Federal law gives you the right to buy certain Medigap plans without medical underwriting in specific situations, like when an employer plan ends or an Advantage plan leaves your area. North Carolina may have additional protections; SHIIP can walk you through what applies to your case.
• IRMAA on Part B and Part D. If your income is above $109,000 as a single filer for 2026, you'll pay a higher Part B and Part D premium (IRMAA). This doesn't affect your Medigap premium directly, but it's part of your total monthly Medicare cost.

We don't quote Medigap premiums here because they vary by age, tobacco use, ZIP code and insurer, and they can change. The North Carolina Department of Insurance publishes rate guides that let you compare current pricing.

How to think about the decision

A reasonable order of operations for someone in Cary:

1. Decide which letter fits your budget and how much cost-sharing you want to handle yourself. Medicare.gov's benefits chart is the fastest way to compare letters. 2. Once you've chosen a letter, use Medicare.gov's Medigap policy search — or call SHIIP — to see which insurers sell that letter and at what price for your ZIP code and age. 3. Pick your Part D plan separately, using Medicare's Plan Finder. Drug plans should be reviewed every year during the Annual Enrollment Period (October 15 – December 7), because formularies and pricing change. 4. Confirm your enrollment windows. Your Medigap Open Enrollment window is the friendliest time to buy; after that, insurers in most cases can use medical underwriting.

Where to get unbiased help

• Medicare.gov — official plan and policy comparison tools.
• 1-800-MEDICARE (TTY 1-877-486-2048) — 24/7.
• SHIIP (Seniors' Health Insurance Information Program) — North Carolina's SHIP, run free of charge by the state Department of Insurance. Counselors don't sell anything; they help you compare.
• North Carolina Department of Insurance — publishes state Medigap rate guides.