We reviewed the 21 top Medicare Part D Plans in North Carolina for 2024. Here's what we found:
- The average premium is $61.69 per month, however the lowest premium is just $0.00.
- The average drug plan deductible is $377 per year, but 4 plans have a zero-dollar deductible.
- Medicare rated 0% of all plans available in North Carolina 4 stars or higher.
- There are 8 basic benefit plans and 13 enhanced benefit plans.
- A total of 3 plans offer full low-income subsidy (LIS) for those who qualify.
- There are 6 plans that have additional coverage in the coverage gap phase (aka, "donut hole").
- 2024 Medicare Prescription Drug Plans (PDP) will be published in early October. Sign-up to be notified.
We also ranked the best Medicare Advantage plans with Part D in North Carolina for 2024.
North Carolina Medicare Part D Plans
|Plan Name||Premium||Deductible||Benefit Type||LIS||Gap
|AARP Medicare Rx Preferred from UHC||$101.80||$0||Enhanced||No||No|
|AARP Medicare Rx Saver from UHC||$63.90||$545||Basic||No||No|
|AARP Medicare Rx Walgreens from UHC||$58.20||$410||Enhanced||No||Yes|
|Blue Medicare Rx Enhanced||$131.30||$0||Enhanced||No||Yes|
|Blue Medicare Rx Standard||$102.30||$545||Basic||No||No|
|Cigna Extra Rx||$79.30||$145||Enhanced||No||Yes|
|Cigna Saver Rx||$20.40||$545||Enhanced||No||No|
|Cigna Secure Rx||$57.80||$545||Basic||No||No|
|Clear Spring Health Value Rx||$29.00||$545||Basic||Yes||No|
|Humana Basic Rx Plan||$47.10||$545||Basic||Yes||No|
|Humana Premier Rx Plan||$111.30||$0||Enhanced||No||Yes|
|Humana Walmart Value Rx Plan||$46.10||$545||Enhanced||No||Yes|
|Mutual of Omaha Rx Essential||$24.90||$545||Enhanced||No||No|
|Mutual of Omaha Rx Plus||$81.20||$545||Basic||No||No|
|Mutual of Omaha Rx Premier||$65.40||$349||Enhanced||No||No|
|Wellcare Medicare Rx Value Plus||$78.90||$0||Enhanced||No||No|
|Wellcare Value Script||$0.00||$545||Enhanced||No||No|
Please note that 2024 Medicare Part D plan information for North Carolina beneficiaries will not be available until early October.
Sign-Up for 2024 Medicare Part D Plan Notification
North Carolina Medicare Part D Plans Have Four Phases
Part D prescription drug plans help North Carolina's Medicare beneficiaries pay for their prescriptions. If you're new to Medicare, you may not be familiar with how Medicare Part D out-of-pocket costs work. So, let's start with the four cost-sharing phases.
The Deductible Phase
Prior to a plan paying any of your prescription costs, you are required to pay the annual deductible. So, if you enroll in a 2024 plan with a $400 deductible, you'll spend $400 out-of-pocket before coverage begins. Most Medicare Part D plans have a deductible, but some plans exclude Tier 1 (generics), offering immediate coverage on low-cost medications.
NOTE: $505 is the maximum deductible a plan can have in 2024.
The 2nd Phase is the Initial Coverage Limit (ICL)
The Part D ICL (Initial Coverage Limit) for 2024 is $4,660. During the ICL phase, your Part D plan will cover the majority of your prescription costs. If your prescription costs exceed $4,660 you go into the coverage gap phase ("donut hole")
The Coverage Gap is the Third Phase
After your gross drug costs have reached $4,660, you will enter the Coverage Gap phase. This is where you will pay 25% of your medication's retail cost. While the price of generic drugs might not be much different, what you pay for brand-name drugs will be higher (because you're paying 25% of the full price). This will continue until you reach $7,400 in True Out Of Pocket Costs (TrOOP).
Some plans offer additional gap coverage, so look for it on the plan information pages.
Catastrophic Coverage is the Fourth Phase
All Part D plans offer catastrophic coverage once you have paid $7,400 in true out-of-pocket costs for covered drugs. This amount includes the cost of covered drugs as well as some additional costs. In the catastrophic coverage phase, your copays or coinsurance will be significantly lower for the remainder of the year.
The out-of-pocket costs that help you get catastrophic coverage include:
- Your plan's deductible;
- What you paid during the initial coverage limit period;
- Most of the full cost of brand-name drugs (and the manufacturer’s discount) purchased in the coverage gap;
- The amount paid by others, including family members, most charities, and other persons on your behalf; and
- The amount paid by State Pharmaceutical Assistance Programs (SPAPs), AIDS Drug Assistance Programs, and the Indian Health Service.
Choose Your Part D Plan Wisely
Evaluate Part D Medicare plans wisely. If you have a regular prescription or two, we suggest that you verify that the plan you want offers your medication(s) at a good price. You find this information in the formulary. We post links to the formulary and pharmacy web pages, as well as the plan's phone number, on each of the PDP pages listed above.
VITAL: Identifying the best Medicare Part D Plans requires research. What works the best for you is all about your regular prescriptions (if any), your health, and what you can afford.
Get Your Prescriptions and More with a Medicare Advantage Plan
Medicare realizes that one type of plan does not suit everyone. That's why there are two ways to get help with your prescription drug costs. All of the Medicare prescription drug plans available in North Carolina work with Original Medicare. That's one way to get coverage. But maybe you'd like even more benefits. That's where North Carolina Medicare Advantage Plans come in. Most offer Part D coverage.
Medicare Part D and Medicare Supplements Work Together
Are you thinking about supplemental Medicare insurance that can offer you more coverage? It's a smart move. Original Medicare only covers about 80 percent of your major medical bills, leaving you to cover the rest. We make it easy to find the lowest rates on North Carolina Medicare Supplements, also known as Medigap plans. The choice is yours because all Part D plans are compatible with the full range of North Carolina Medicare Supplements.
Getting Medicare Part D with North Carolina Medicaid
In North Carolina, if you are eligible for both Medicare and Medicaid (aka, "dual eligible" or "Medi-Medi") you will automatically be enrolled in a North Carolina Medicare Prescription Drug Plan and the Social Security Extra Help program. Extra Help pays for most of the costs of your prescriptions if you meet the eligibility requirements. You may also enroll in a plan of your own choosing that better meets your needs. If you qualified for Medicaid before you were eligible for Medicare, contact your local Medicaid office.
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna Healthcare, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, UnitedHealthcare(R), and Wellcare.
Citations & References
- Medicare.gov, "How Medicare Prescription Drug Coverage Works with a Medicare Advantage Plan or Medicare Cost Plan", Last Accessed September 28, 2022
- Medicare.gov, "What Medicare Part D drug plans cover", Last Accessed August 1, 2022
- Medicare.gov, "Catastrophic coverage", Last Accessed June 13, 2022
- Medicare.gov, "Are prescription drugs covered in Medicare Advantage plans?", Last Accessed June 6, 2022
- SSA.gov, "Extra Help with Medicare Prescription Drug Plan Costs", Last Accessed June 1, 2022
- CMS.gov, "Landscape Source Files", Last Accessed January 15, 2023
- CMS.gov, "Medicare Part C & D Performance", Last Accessed January 15, 2023