Medicare Supplement

Does Your Medigap Letter Matter More Than the Insurer?

If you live in Winston-Salem and are shopping for a Medicare Supplement policy, the most important thing to understand is this: Medigap plans are standardized by the federal government. That means a Plan G sold in Forsyth County by one insurer covers the exact same set of gaps as a Plan G sold by any other insurer licensed here. The letter tells you what the policy pays. The company name on the card does not change the benefits.

The letter on your Medigap card matters more than the logo

That single fact shapes almost every other decision, from which letter to pick to how to compare quotes.

How Medigap fits with the rest of Medicare

Original Medicare — Part A (hospital) and Part B (medical) — pays most of your covered care, but it leaves deductibles, coinsurance and some copays for you. A Medigap policy is private insurance that fills in some or all of those gaps.

A few ground rules to keep in mind in Winston-Salem:

• Medigap only works alongside Original Medicare. You cannot use it with a Medicare Advantage plan.
• Medigap does not include prescription drug coverage. If you want drug coverage, you pair Medigap with a stand-alone Part D plan.
• You pay your Part B premium as usual, plus the Medigap premium to the private insurer.

Part D has its own 2026 numbers worth knowing: the maximum deductible is $615, and there is a new $2,100 annual out-of-pocket cap on covered drugs. The old coverage gap ("donut hole") was eliminated in 2025, and Medicare now offers an optional Prescription Payment Plan that lets you spread drug costs over the year.

The plan letters you can buy in North Carolina today

North Carolina follows the federal standardized Medigap framework (three states — Massachusetts, Minnesota and Wisconsin — do it differently). For people newly eligible for Medicare, the letters available are:

• 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.

Each letter is a fixed benefit package. For example, every Plan G covers the same list of gaps, whether you buy it from a small regional company or a national brand. The "HD" versions of Plan G (and Plan F, where available) are high-deductible variants — you pay more out of pocket before the coverage kicks in, in exchange for a lower premium.

Because the benefits are locked in by law, the real differences between insurers come down to premium, how they set rates over time, customer service, and any extras (like fitness or wellness programs) they layer on top.

Who sells Medigap in North Carolina

Winston-Salem is in Forsyth County, and the same list of state-licensed Medigap insurers is available across North Carolina. The table below lists every insurer selling Medigap in the state and the letters each one offers. It's a long list — well over two dozen companies — so it pays to compare more than one.

You'll see familiar national names on the roster, including AARP - UnitedHealthcare Insurance Company, Aetna Health Insurance Company, AFLAC, BlueCross BlueShield of North Carolina, Humana (Humana Benefit Plan of Illinois, Inc.), Mutual of Omaha (Omaha Insurance Company), State Farm Mutual Automobile Insurance Company and USAA Life Insurance Company. You'll also see smaller and more specialized carriers such as American Benefit Life Insurance Company, Heartland National Life Insurance Company and WoodmenLife.

Not every insurer sells every letter. Some carry the full menu; others focus on a few of the most popular letters (often A, G, G-HD and N). The table shows exactly which letters each company offers.

How North Carolina rules shape the choice

Federal law gives you a six-month Medigap Open Enrollment Period that begins the month you're 65 or older and enrolled in Part B. During that window, insurers must sell you any Medigap policy they offer at their best available rate, regardless of your health history. This is usually the easiest time to buy.

Outside that window, insurers in most cases can use medical underwriting — they can ask health questions and may charge more or decline coverage. There are limited federal "guaranteed issue" situations (for example, if your Medicare Advantage plan leaves the area or you lose certain other coverage) when you keep the right to buy specific Medigap plans without underwriting.

Because state rules on things like switching plans, birthday-rule rights and additional protections can change, confirm your current rights with the North Carolina Department of Insurance or the state's Seniors' Health Insurance Information Program (SHIIP), which is North Carolina's SHIP. Both offer free, unbiased help.

Smart ways to compare in Winston-Salem

A few tips that apply no matter which insurer you consider:

1. Pick the letter first, then compare prices. Because benefits are identical within a letter, you're really comparing premiums and the company behind them. 2. Ask how the rates are set. Insurers price Medigap using different methods (community-rated, issue-age or attained-age), which affects how the premium may change as you get older. 3. Don't forget Part D. Medigap is medical only. If you take prescriptions, price a stand-alone Part D plan at the same time. 4. Watch the calendar. The Medicare Advantage and Part D Annual Enrollment Period runs October 15 – December 7, and Medicare Advantage Open Enrollment runs January 1 – March 31. Medigap has its own separate enrollment rules, but AEP is a good yearly reminder to review the whole picture.