Medicare Supplement

Medigap in Raleigh: which plan letters you can actually buy in North Carolina

If you live in Raleigh and are weighing a Medicare Supplement policy — better known as Medigap — the first thing worth knowing is that you are not really choosing from an endless menu. You are choosing from a short list of standardized plans named by letter, and the same letter means the same core benefits no matter which insurer sells it.

That makes shopping less about the plan design and more about price, service and how the insurer prices policies over time.

The plan letters you can buy in North Carolina

North Carolina follows the federal standardized Medigap framework (three states — Massachusetts, Minnesota and Wisconsin — do it differently). If you are turning 65 today or newly eligible for Medicare in Raleigh, these are the letters you can buy:

• Plan A
• Plan B
• Plan D
• Plan G
• High-deductible Plan G
• Plan K
• Plan L
• Plan M
• Plan N

Plans C and F still exist, but only for people who became eligible for Medicare before January 1, 2020. If that is you, those two remain on the table.

Each letter has a fixed set of benefits set by federal law. A Plan G sold by one company covers the same Medicare-approved gaps as a Plan G sold by another. What differs between insurers is price, customer service, how the company handles rate increases over the years, and small extras that are not part of the standardized benefits.

How Medigap fits with Original Medicare and Part D

Medigap is designed to work only with Original Medicare. It helps pay some of the out-of-pocket costs Parts A and B leave behind — things like coinsurance, copays and, depending on the letter, the Part A or Part B deductible.

A few ground rules to remember:

• You must be enrolled in Part A and Part B to have a Medigap policy.
• Medigap does not work with Medicare Advantage. If you join an Advantage plan, a Medigap policy cannot pay your Advantage cost-sharing.
• Medigap policies sold today do not include prescription drug coverage. To get drug coverage, you add a stand-alone Part D plan.

Part D has its own program-level rules for 2026 that are worth knowing while you shop. The Part D out-of-pocket cap is $2,100, the maximum deductible any Part D plan can charge is $615, and the old coverage gap ("donut hole") has been eliminated — Part D now has three phases. There is also the Medicare Prescription Payment Plan, an optional way to spread your drug costs across the calendar year in monthly amounts. Higher-income enrollees may pay an IRMAA surcharge on top of the Part D premium; the surcharge starts above $109,000 in income for a single filer in 2026.

When you can buy — and when it gets harder

The best moment to buy a Medigap policy is your Medigap Open Enrollment Period: the six months that begin the first month you are 65 or older and enrolled in Part B. During that window, insurers in North Carolina must sell you any Medigap policy they offer at their best available rate for your age group, and they cannot turn you down or charge you more because of health history.

Outside that window, things change. North Carolina does not have a state "birthday rule" or the kind of broad annual switching right that a few other states have added. So if you want to move to a different Medigap policy later, insurers can generally use medical underwriting — meaning they can ask health questions and decide whether to accept you and at what price.

There are federal guaranteed-issue situations where you keep the right to buy certain Medigap plans without underwriting, such as when a Medicare Advantage plan leaves your area or you move out of its service area. Your local SHIP counselor can walk you through whether one of those rights applies to you.

What actually differs between insurers

Since the benefits inside each lettered plan are fixed, price and pricing method are where insurers separate themselves. In North Carolina, companies can use different approaches to set premiums — for example, attained-age (rises as you get older), issue-age (based on your age when you buy), or community-rated (same for everyone regardless of age). Two companies selling the same Plan G can look similar at 65 and quite different at 80.

That is why it pays to look past the sticker price and ask how the insurer has raised rates in recent years, how it prices new customers vs. long-term policyholders, and what discounts (household, electronic payment, non-tobacco) it offers.

Where to compare Raleigh options

Raleigh is in Wake County, and Medigap policies are regulated at the state level, so any insurer approved in North Carolina can sell in Wake County. The table on this page shows the standardized letters available to newly eligible enrollees. To see which companies are offering those letters at your ZIP code, use these sources:

• Medicare.gov Medigap policy search — enter your ZIP code to see which insurers offer each letter in Raleigh and a general price range.
• North Carolina Department of Insurance — publishes a Medigap rate guide and can answer questions about your rights as a policyholder in the state.
• North Carolina SHIIP (Seniors' Health Insurance Information Program) — the state's SHIP offers free, unbiased one-on-one counseling.
• 1-800-MEDICARE — for general Medicare questions any time.