CVS Health is terminating SilverScript Choice plans, affecting ~950,000 members. NC residents must enroll in a new Medicare plan by December 7, 2026.
Written by the licensed agents at Health Plans of NC, an insurance agency authorized by Blue Cross and Blue Shield of North Carolina (Blue Cross NC).
CVS Health is terminating SilverScript Choice and SilverScript Plus plans at the end of 2026, affecting roughly 950,000 members nationwide.
North Carolina SilverScript members must act before December 7, 2026 — the close of Medicare's Annual Enrollment Period (AEP) — to secure new coverage starting January 1, 2027.
You can compare replacement Medicare Part D drug plans or Medicare Advantage plans at Medicare.gov or with a licensed insurance agent.
If you do nothing, you could lose your prescription drug coverage on January 1, 2027, so reviewing your options now is critical.
North Carolinians have a wide range of Medicare Advantage and standalone Part D plans to choose from, and switching during AEP is straightforward.
CVS Health has announced it is terminating its SilverScript Choice and SilverScript Plus Medicare Part D plans at the end of 2026. According to a KFF analysis of CMS enrollment data, this affects about 950,000 enrollees nationwide, including thousands of North Carolina residents who rely on these plans for prescription drug coverage.
If you are a SilverScript Choice or SilverScript Plus member in NC, your plan will not automatically renew for 2027. You should have already received a termination notice in the mail from CVS Health. Read that notice carefully — it details your current coverage end date and your rights during the Medicare Annual Enrollment Period.
CVS Health's remaining standalone Part D product, SilverScript SmartRx, may still be available depending on your county. However, eligibility and formularies vary by location across North Carolina, so do not assume you can simply roll into that plan without confirming it covers your medications and is offered in your area.
The Medicare Annual Enrollment Period runs from October 15 through December 7 every year — and December 7, 2026 is your firm deadline. Any plan you enroll in during this window takes effect January 1, 2027.
If you miss December 7, you generally cannot change your Part D drug coverage again until the next AEP, unless you qualify for a Special Enrollment Period (SEP). A plan termination notice triggers a SEP, but acting during AEP is simpler and gives you the most plan choices.
Missing the deadline without a valid SEP could leave you without creditable drug coverage, which can also lead to a late-enrollment penalty if you go more than 63 consecutive days without it.
Medicare in North Carolina follows the same federal framework as the rest of the country, administered primarily through the Centers for Medicare & Medicaid Services (CMS). Original Medicare consists of Part A (hospital) and Part B (outpatient and medical services).
Most NC residents add either a standalone Part D plan for prescription drugs or a Medicare Advantage (Part C) plan that bundles hospital, medical, and often drug coverage together. Medicare supplement (Medigap) plans are also widely available in NC to help cover out-of-pocket costs under Original Medicare.
The Medicare Administrative Contractor (MAC) for North Carolina is Palmetto GBA, which processes Medicare Part A and Part B claims for providers in the state. This means NC residents work with Palmetto GBA for claims questions and appeals related to Original Medicare services.
No single plan is universally "best" — the right Medicare Advantage plan depends on your zip code, your doctors, your medications, and your budget. Several major insurance companies offer Medicare Advantage plans across NC counties, including Blue Cross and Blue Shield of NC, Humana, Aetna, UnitedHealthcare, Cigna, and others. Availability and plan details vary by county and region.
When comparing plans, look at the monthly premium, annual deductible, copays for specialist visits, the drug formulary, and whether your doctors and preferred hospitals are in-network. Use the Plan Finder tool at medicare.gov to compare options side by side using your actual drug list and location.
Whether Original Medicare or a Medicare Advantage plan is better for you depends on your personal healthcare usage. People who travel frequently or see many specialists sometimes prefer Original Medicare's broader provider access, while those who want lower out-of-pocket costs and bundled benefits may favor Medicare Advantage.
Medicare supplement (Medigap) plans in NC are standardized by the federal government, meaning a Plan G from one company covers the same benefits as a Plan G from any other company. The main differences between carriers are typically the monthly premium and customer service reputation.
Plan G is currently one of the most comprehensive Medigap options available to new Medicare beneficiaries in NC (since Plan F was closed to new enrollees after January 1, 2020). Plan N is another popular option with slightly lower premiums in exchange for modest copays on some visits.
Shopping Medigap means comparing premiums across insurance companies for the same plan letter — a licensed insurance agent can pull quotes from multiple carriers quickly, giving you the best rates available in your North Carolina county.
SilverSneakers is a fitness benefit sometimes included with Medicare Advantage plans, not typically with Medigap/supplement plans. If gym access or fitness classes are important to you, check whether a Medicare Advantage plan in your county includes SilverSneakers or a similar fitness benefit.
A few Medicare Advantage plans in NC include SilverSneakers or comparable gym memberships at no extra cost. Use the plan comparison tool at Medicare.gov and filter for fitness benefits to find options near you.
Medicare Advantage plans in NC must cover at least the same mental health benefits as Original Medicare, and many offer additional mental health resources. If you are enrolled in a plan through the ACA Marketplace rather than Medicare, mental health and substance use disorder services are considered essential health benefits and must be covered.
Most people are automatically enrolled in Medicare Part A and Part B when they turn 65 if they are already receiving Social Security benefits. If you are not yet collecting Social Security, you must sign up during your Initial Enrollment Period—the seven-month window that includes the three months before your 65th birthday month, your birthday month, and the three months after.
You can apply online at ssa.gov (the Social Security Administration's website), by calling the SSA at 1-800-772-1213, or by visiting your local Social Security Administration office in your North Carolina county. Once enrolled in Parts A and B, you can then select a Part D drug plan or Medicare Advantage plan through Medicare.gov or with a licensed insurance agent.
Step 1 — Gather your information. Have your Medicare number, a list of your prescription medications (name, dosage, frequency), and your preferred pharmacy ready.
Step 2 — Visit Medicare.gov. Use the official Plan Finder to enter your drugs and location. The tool will show you estimated annual costs for every plan available in your county, including premiums, deductibles, and drug copays.
Step 3 — Check your doctors. If you are considering Medicare Advantage, confirm your physicians are in-network before enrolling.
Step 4 — Enroll before December 7, 2026. Complete enrollment online at Medicare.gov, by calling 1-800-MEDICARE, or through a licensed insurance agent. Coverage begins January 1, 2027.
Step 5 — Confirm your enrollment. After enrolling, you should receive a confirmation and a new plan member card. Keep this for your records.
If you suspect Medicare fraud, waste, or abuse in NC, you can report it directly to the federal government at 1-800-MEDICARE or online at medicare.gov. You can also contact the NC Senior Medicare Patrol (SMP) program, which helps beneficiaries prevent, detect, and report Medicare fraud.
Seniors should be especially alert to unsolicited calls or visits offering free equipment or services in exchange for your Medicare number. Never give your Medicare login credentials or Medicare number to anyone who contacts you unexpectedly.
If a family member received a SilverScript termination notice, the most important step is to review it and start comparing plans now — before the December 7 deadline. Even if the enrollment period feels distant, plan comparisons take time, especially when evaluating drug formularies and doctor networks across North Carolina's diverse regions.
A licensed insurance agent who specializes in Medicare can compare options from multiple insurance companies at no cost to you, since agents are compensated by the plan carriers. This is a free resource worth using if you feel overwhelmed by the plan choices available across North Carolina.
Do not wait for a reminder. The deadline is firm, and coverage gaps can be expensive and difficult to fix.
This article is for general information and is not insurance or medical advice. Consult a licensed agent.