Learn about Medigap Plan B coverage, costs, and benefits for 2026. Compare what's covered vs. not covered, see how it compares to other plans, and get expert help from NC Medicare specialists.
Medicare Supplement Plan B (also called Medigap Plan B) is one of 10 standardized Medicare Supplement plans available in North Carolina. It provides basic coverage to help fill some of the gaps left by Original Medicare, but offers fewer benefits than more comprehensive plans like Plan G or Plan N.
Important Clarification: Medigap Plan B and Medicare Part B are NOT the same thing. Medicare Part B is the medical insurance portion of Original Medicare that covers doctor visits, outpatient care, and preventive services. Medigap Plan B is a supplemental insurance policy you purchase to help pay for costs that Medicare Part B doesn't cover.
Plan B provides coverage for core Medicare costs but leaves several significant gaps. Here's exactly what's included:
Medicare Part A Coverage (Hospital Insurance):
✓ Part A Deductible: Plan B covers the $1,736 Part A hospital deductible (2026). This is a key benefit that Plan A doesn't include.
✓ Part A Coinsurance and Hospital Costs: Covers your share of hospital costs for days 61-90 ($434/day in 2026) and lifetime reserve days ($868/day).
✓ 365 Additional Hospital Days: After you exhaust your Medicare hospital benefits, Plan B provides coverage for an additional 365 days of hospitalization during your lifetime.
✓ Hospice Care Coinsurance/Copayment: Covers your share of costs for hospice care, including respite care and prescription drugs for pain and symptom management.
Medicare Part B Coverage (Medical Insurance):
✓ Part B Coinsurance/Copayment: Covers the 20% coinsurance you'd typically pay for doctor visits, outpatient services, and other Part B services after you meet the Part B deductible.
Other Coverage:
✓ Blood (First 3 Pints): Covers the first three pints of blood you receive each year, whether as a hospital inpatient or outpatient.
Plan B has several significant coverage gaps compared to more comprehensive Medigap plans. Understanding these gaps is essential when comparing your options.
✗ Medicare Part B Deductible ($283 in 2026): You pay this annual deductible before Plan B's Part B coinsurance coverage begins. Only Medigap Plans C and F (for those eligible before 2020) cover this deductible.
✗ Part B Excess Charges: If a doctor doesn't accept Medicare assignment, they can charge up to 15% more than the Medicare-approved amount. Plan B doesn't cover these excess charges. This could add high costs if you see non-participating providers.
✗ Skilled Nursing Facility Coinsurance: Medicare covers the first 20 days of skilled nursing care. Days 21-100 cost $217.50/day in 2026. Plan B doesn't cover this—you'd pay up to $17,400 for an 80-day stay.
✗ Foreign Travel Emergency Care: If you travel outside the United States and need emergency medical care, Plan B provides no coverage. Plans C, D, F, G, M, and N include foreign travel emergency benefits.
The Bottom Line: Plan B leaves you exposed to skilled nursing facility costs, excess charges, foreign travel emergencies, and the Part B deductible. For many North Carolina residents, these gaps make more comprehensive plans like Plan G or Plan N a better value.
Understanding how Plan B stacks up against other options helps you make an informed decision.
Plan B vs. Plan A (Less Coverage):
Plan B covers everything Plan A covers, PLUS the Part A deductible ($1,736 in 2026). For a slightly higher premium, Plan B provides significantly more value than Plan A.
Plan B vs. Plan G (More Coverage):
Plan G covers everything Plan B covers PLUS:
• Skilled nursing facility coinsurance (saves up to $17,400)
• Part B excess charges (up to 15% above Medicare rates)
• Foreign travel emergency coverage (80% after $250 deductible)
Plan G is the most popular Medigap plan in North Carolina because it provides nearly complete coverage at a reasonable premium. The difference in premiums between Plan B and Plan G is often small compared to the additional protection.
Plan B vs. Plan N (Popular Alternative):
Plan N covers everything Plan B covers, PLUS skilled nursing facility coinsurance and foreign travel emergency, but requires small copays for doctor visits ($20) and ER visits ($50), and doesn't cover Part B excess charges.
Why Plan B Is Rarely Recommended:
Plan B sits in an awkward middle ground—it costs more than Plan A but provides far less coverage than Plans G or N. The premium savings compared to Plan G are often minimal, yet the coverage gaps can result in thousands of dollars in out-of-pocket costs if you need skilled nursing care or travel abroad.
Plan B premiums vary by insurance carrier, your age, location within North Carolina, gender, and tobacco use. Because Medigap plans are standardized, every Plan B offers identical coverage—only the price differs between carriers.
Typical Plan B Premium Range:
• Monthly Premiums: $100-180/month (varies by carrier and age)
• Annual Premiums: $1,200-2,160/year
Total Potential Annual Out-of-Pocket Costs with Plan B:
• Plan B Premiums: ~$1,500/year (average)
• Part B Deductible: $283
• Part B Premium: $2,435/year ($202.90/month)
• Potential SNF Costs: Up to $17,400 (not covered)
• Potential Excess Charges: Variable (not covered)
Pricing Methods Used by Carriers:
Issue-Age Rated: Premium based on your age when you buy the policy. Premiums don't increase due to age (though they may increase due to inflation).
Attained-Age Rated: Premium increases as you get older. Starts lower but can become expensive over time.
Community Rated: Same premium for everyone regardless of age. May start higher but provides predictable costs.
Medigap policies are guaranteed renewable, meaning your insurance company cannot cancel your coverage as long as you pay your premiums on time. However, there are a few exceptions:
Your Coverage Can Be Cancelled If:
• Non-Payment: You fail to pay your premiums on time
• Fraud or Misrepresentation: You provided false information on your application
• Insurer Insolvency: The insurance company goes bankrupt (rare)
• Plan Discontinuation: The insurer stops offering Plan B in your area (you'd be offered an alternative)
Your Coverage CANNOT Be Cancelled Because:
• Your health declines or you develop new conditions
• You file too many claims
• You reach a certain age
Medigap Open Enrollment Period (Best Time to Enroll):
Your Medigap Open Enrollment Period lasts 6 months and begins the month you turn 65 AND are enrolled in Medicare Part B. During this window, you have guaranteed issue rights:
• Insurance companies cannot deny you coverage for any reason
• You cannot be charged higher premiums due to health conditions
• No waiting periods for pre-existing conditions
• You can choose any Medigap plan sold in North Carolina
Enrolling Outside Open Enrollment:
If you apply for Plan B outside your Medigap Open Enrollment Period, insurance companies can:
• Require medical underwriting (health questions)
• Deny coverage based on your health history
• Charge higher premiums for pre-existing conditions
• Impose waiting periods before covering certain conditions
Exceptions (Guaranteed Issue Rights):
Certain situations give you guaranteed issue rights outside Open Enrollment:
• Your Medicare Advantage plan leaves your area or stops providing coverage
• You move out of your Medicare Advantage plan's service area
• Your employer group coverage ends
• Your Medigap insurer goes bankrupt or commits fraud
While Plan B is rarely the best option for most people, it might make sense in limited circumstances:
Plan B May Be Appropriate If:
• You want coverage for the Part A deductible, but have an extremely tight budget
• You never travel outside the United States
• You're very healthy and consider skilled nursing facility care unlikely
• Your doctors all accept Medicare assignment (no excess charges)
Better Alternatives for Most People:
Plan G: The most popular plan in North Carolina. Covers everything except the Part B deductible ($283). Provides complete protection against skilled nursing costs, excess charges, and foreign travel emergencies.
Plan N: Lower premiums than Plan G with small copays ($20 for doctor visits, $50 for ER). Covers skilled nursing and foreign travel but not excess charges—best value for many budget-conscious seniors.
High-Deductible Plan G: Very low premiums ($60-100/month) with a $2,950 deductible. Same comprehensive coverage as Plan G after the deductible is met. Good for healthy seniors who want catastrophic protection.
Choosing the right Medicare Supplement plan requires careful comparison of coverage, costs, and your personal healthcare needs. At Health Plans of NC, our licensed Medigap specialists help North Carolina residents compare all available options—including why Plan B may or may not be right for you.
How Our Agents Help:
• Compare Plan B premiums from multiple insurance carriers
• Show you how Plan B stacks up against Plans G, N, and other options
• Calculate your potential out-of-pocket costs under different plans
• Review your healthcare needs to recommend the best coverage
• Explain enrollment periods and guaranteed issue rights
• Provide ongoing support after you enroll
Serving All of North Carolina:
Our experienced Medicare Supplement agents work with residents throughout North Carolina, including Charlotte, Raleigh, Durham, Greensboro, Winston-Salem, Asheville, Wilmington, Fayetteville, and all surrounding areas.
Our services are completely free. We're paid by insurance carriers, never by you. Contact Health Plans of NC today for personalized quotes and expert guidance on choosing the right Medigap plan for your needs and budget.
What's Covered:
✓ Part A deductible ($1,736)
✓ Part A coinsurance and hospital costs
✓ 365 additional hospital days
✓ Hospice care coinsurance
✓ Part B coinsurance (20%)
✓ First 3 pints of blood
What's NOT Covered:
✗ Part B deductible ($283)
✗ Part B excess charges (up to 15%)
✗ Skilled nursing facility coinsurance ($217.50/day)
✗ Foreign travel emergency
Typical Premium: $100-180/month
Best For: Limited situations—consider Plan G or N instead
Recommendation: Compare Plan G, Plan N, or the High-Deductible Plan G for better value