Medicare Supplement

Why North Carolina Has No Medigap Birthday Rule

If you live in Fayetteville and are shopping for a Medicare Supplement policy — the coverage most people call Medigap — the first thing to know is that you are choosing from a short list of federally standardized plans. Fayetteville is in Cumberland County, but Medigap is regulated at the state level, so the same plan letters and the same rules apply whether you live off Raeford Road, out toward Hope Mills, or anywhere else in North Carolina.

Medicare SupplementFayetteville, NC

That standardization is good news. A Plan G is a Plan G, no matter which company sells it. What changes from insurer to insurer is the price and the customer service — not the medical benefits inside that letter.

The plan letters you can buy in North Carolina

Medigap plans are labeled with letters. For anyone who became eligible for Medicare on or after January 1, 2020, these letters are available in North Carolina:

• Plans A, B, D, G, G-HD, K, L, M and N.

Plans C and F are still sold, but only to people who were eligible for Medicare before January 1, 2020. If that is you and you never enrolled, you may still be able to buy them.

Every lettered plan covers the same core benefits across companies. Plan G, for example, includes the same hospital and doctor cost-sharing help at one insurer as it does at another. The differences are the monthly premium, how the company handles rate changes over time, and its service.

How Medigap pairs with Original Medicare and Part D

Medigap is designed to sit alongside Original Medicare. Medicare pays its share first, then your Medigap policy picks up some or all of what is left, depending on the letter you chose.

A few ground rules to keep straight:

• You must be enrolled in both Part A and Part B to buy Medigap.
• Medigap does not work with a Medicare Advantage plan. You choose one path or the other.
• Medigap does not include prescription drug coverage. If you want help paying for medications, you enroll in a separate Part D plan.

For 2026, Part D has some numbers worth knowing: a $2,100 annual out-of-pocket cap on covered drugs, a maximum deductible of $615, and no more coverage gap (the "donut hole" was eliminated in 2025). Medicare also offers the Medicare Prescription Payment Plan, which lets you spread your drug costs across the year in monthly installments instead of paying at the pharmacy counter.

The enrollment window that matters most

The single most important date for a Medigap shopper is your Medigap Open Enrollment Period. It lasts six months and begins the month you are 65 or older and enrolled in Part B. During that window, an insurer in North Carolina must sell you any Medigap plan it offers, at its best available rate for your situation, without asking health questions.

Miss that window and, in most cases, you can still apply — but the insurer may use medical underwriting and can decline you or charge more based on your health. There are some federal guaranteed-issue rights that protect you in specific situations, such as losing other coverage or moving out of a plan's service area.

North Carolina does not have a state "birthday rule" like California or Oregon that lets you switch Medigap plans each year without underwriting. That makes your first Medigap decision an important one.

The insurers selling Medigap in Fayetteville

Many national and regional companies file Medigap policies in North Carolina, and residents of Cumberland County can shop from that full list. The table below lists every insurer approved to sell Medigap in the state, along with the specific letters each one offers.

You will see familiar names such as AARP - UnitedHealthcare Insurance Company, Aetna Health Insurance Company, BlueCross BlueShield of North Carolina, Humana (Humana Benefit Plan of Illinois, Inc.), Mutual of Omaha (Omaha Insurance Company) and State Farm Mutual Automobile Insurance Company, along with smaller carriers such as Heartland National Life Insurance Company and WoodmenLife. Not every insurer sells every letter — for instance, some offer only a handful of letters, while others such as United American Insurance Company file most of the menu.

Because the benefits inside a lettered plan are identical, comparison shopping in Fayetteville comes down to price and service for the exact same letter across companies.

Enrollment periods to keep on your calendar

A few dates apply to everyone on Medicare, not just Medigap shoppers:

• Annual Enrollment Period: October 15 – December 7. This is the window to join, drop or switch a Part D drug plan or Medicare Advantage plan.
• Medicare Advantage Open Enrollment Period: January 1 – March 31. For people already in a Medicare Advantage plan.

Medigap itself does not follow these dates. You can apply for a Medigap policy any time of year, but outside of a guaranteed-issue situation, approval depends on the insurer's underwriting.

One more figure to note for 2026: Part B and Part D IRMAA surcharges begin above $109,000 in income for a single filer. That does not affect Medigap premiums, but it does affect the other pieces of your Medicare bill.