in Wake County
Apex, North Carolina residents have access to 9 Medicare plans for 2026 through Blue Cross NC, and Health Plans of NC is here to help every eligible senior compare and enroll in the right coverage, including plans accepted at local facilities like WakeMed.
Apex, North Carolina is home to approximately 6,000 Medicare-eligible residents, representing about 8.5% of the city's total population of 67,765, and all of these seniors have access to a broad range of Medicare coverage types for 2026. Local health systems including WakeMed, UNC Rex Healthcare, and Duke Raleigh Hospital serve Medicare beneficiaries throughout the area, giving Apex seniors strong in-network options regardless of the plan type they choose. Coverage categories available to Apex residents span Medicare Advantage HMO, HMO-POS, and PPO plans, a Dual Special Needs Plan, and a standalone Part D Prescription Drug Plan, ensuring that nearly every healthcare need and budget can be addressed.
Plan Name | Type | Monthly Premium |
|---|---|---|
Blue Medicare Medical Only | HMO-POS | $0.00/month |
Blue Medicare Essential | HMO | $0.00/month |
Blue Medicare Essential Plus | HMO-POS | $0.00/month |
Blue Medicare Choice | HMO | $0.00/month |
Blue Medicare Enhanced | HMO-POS | $40.00/month |
Blue Medicare PPO Enhanced | PPO | $53.00/month |
Blue Medicare Freedom+ | HMO-POS | $0.00/month |
Healthy Blue Medicare (D-SNP) | HMO-POS | $0.00/month |
Blue Medicare Rx Enhanced PDP | PDP | $163.20/month |
Medicare Advantage HMO plans in Apex, North Carolina provide coordinated care through networks that include local providers connected to WakeMed and UNC Rex Healthcare.
Medicare Advantage HMO-POS plans offer Apex, North Carolina residents the flexibility to seek care both inside and outside the primary network, including at Duke Raleigh Hospital.
Medicare Advantage PPO plans give Apex, North Carolina seniors broader provider access, allowing visits to out-of-network facilities at a higher cost-sharing level.
Medicare Supplement (Medigap) plans allow Apex, North Carolina residents to visit any provider nationwide that accepts Medicare, including specialists at Duke Raleigh Hospital and UNC Rex Healthcare.
Part D Prescription Drug Plans provide standalone drug coverage for Apex, North Carolina seniors enrolled in Original Medicare who need prescription benefits separate from a Medicare Advantage plan.
Dual Special Needs Plans (D-SNP) are available in Apex, North Carolina for residents who qualify for both Medicare and Medicaid, connecting them with coordinated care across local health systems.
Blue Cross NC offers nine Medicare plans in Apex, North Carolina for 2026, spanning HMO, HMO-POS, PPO, D-SNP, and Part D prescription drug plan types, giving local seniors a wide range of coverage structures to evaluate. Several plans carry a $0 monthly premium, making them especially attractive to Apex residents looking to maximize coverage value, while enhanced plan options offer richer benefits at a modest additional cost. Each plan interacts with local provider networks in Apex, North Carolina, including facilities affiliated with WakeMed, UNC Rex Healthcare, and Duke Raleigh Hospital, so plan selection directly affects which providers and specialists a senior can access.
Blue Medicare Medical Only, HMO-POS, $0.00 per month, provides hospital and medical coverage through an HMO-POS network that includes local Apex, North Carolina providers affiliated with WakeMed.
Blue Medicare Essential, HMO, $0.00 per month, offers fully managed care coordination through an HMO network serving Apex, North Carolina residents near WakeMed and UNC Rex Healthcare facilities.
Blue Medicare Essential Plus, HMO-POS, $0.00 per month, gives Apex, North Carolina enrollees the in-network benefits of an HMO with added flexibility to seek out-of-network care when needed.
Blue Medicare Choice, HMO, $0.00 per month, delivers comprehensive HMO coverage to Apex, North Carolina seniors through a coordinated network connected to local healthcare providers.
Blue Medicare Enhanced, HMO-POS, $40.00 per month, provides an elevated benefit package to Apex, North Carolina residents through an HMO-POS structure that may include enhanced dental, vision, or other supplemental benefits.
Blue Medicare PPO Enhanced, PPO, $53.00 per month, offers the broadest network flexibility among Blue Cross NC plans in Apex, North Carolina, allowing enrollees to visit both in-network and out-of-network providers including those at Duke Raleigh Hospital.
Blue Medicare Freedom+, HMO-POS, $0.00 per month, provides Apex, North Carolina Medicare enrollees with HMO-POS coverage and a $0 premium, making it a strong option for cost-conscious seniors.
Healthy Blue Medicare DSNP, HMO-POS, $0.00 per month, is designed specifically for Apex, North Carolina residents who qualify for both Medicare and Medicaid, offering coordinated care through local health system networks.
Blue Medicare Rx Enhanced PDP, Part D Prescription Drug Plan, $163.20 per month, provides standalone prescription drug coverage for Apex, North Carolina seniors on Original Medicare who need a comprehensive formulary.
For 2026, Apex, North Carolina residents can choose from Medicare Advantage plans ranging from $0.00 per month for options like Blue Medicare Essential and Blue Medicare Freedom+ up to $53.00 per month for the Blue Medicare PPO Enhanced, giving seniors meaningful choices across a range of price points. The standalone Blue Medicare Rx Enhanced PDP carries a monthly premium of $163.20, which is the primary out-of-pocket cost for Original Medicare enrollees who need prescription drug coverage without a bundled Advantage plan. With a median household income of $138,442 in Apex, North Carolina, most residents are unlikely to qualify for income-based premium reductions, but Health Plans of NC can still identify opportunities to minimize costs through plan selection and available assistance programs.
Part A: $0 premium for most Apex, North Carolina residents who paid Medicare taxes for 10 or more years. The Part A hospital deductible is $1,736 in 2026.
Part B: $202.90 per month standard premium in 2026, an increase from $185.00 in 2025. Higher-income residents pay more through income-related monthly adjustment amounts.
Medicare Supplement (Medigap): $80 to $300 or more per month depending on plan letter and age, covers gaps not paid by Original Medicare.
Blue Cross NC is the Medicare carrier offering all 9 available Medicare plans in Apex, North Carolina for 2026, making it the sole insurer through which local seniors can access Medicare Advantage and Part D coverage in this market. The plan types available through Blue Cross NC in Apex include HMO, HMO-POS, PPO, D-SNP, and a standalone Part D Prescription Drug Plan, covering the full spectrum of Medicare coverage structures. Blue Cross NC plan networks in Apex, North Carolina are directly connected to local healthcare providers and facilities, including those affiliated with WakeMed, UNC Rex Healthcare, and Duke Raleigh Hospital, which means the plan a senior chooses will determine which of these systems is accessible in-network. Selecting a plan type such as an HMO versus a PPO can significantly affect a senior's ability to access specialists and services at the area's major health systems without incurring out-of-network cost sharing. Health Plans of NC compares every Blue Cross NC Medicare plan side-by-side at absolutely no cost to Apex, North Carolina residents, ensuring each enrollee understands exactly how their plan choice affects local provider access.
Blue Cross NC, offering HMO, HMO-POS, PPO, D-SNP, and Part D Prescription Drug Plan types, with a total of 9 Medicare plans available in Apex, North Carolina for 2026.
Apex, North Carolina seniors who meet federal income and asset thresholds may qualify for the Extra Help program, also known as the Low Income Subsidy, which can reduce Part D prescription drug costs to near $0 per month. Medicare Savings Programs are available to qualifying residents and can cover the standard Part B premium, significantly lowering the overall cost of Medicare coverage for those who are eligible. Apex, North Carolina has an uninsured rate of 4.3% and a poverty rate of 2.6%, and while these figures are low relative to state and national averages, the seniors who do face affordability challenges can also explore the Healthy Blue Medicare DSNP for dual Medicare and Medicaid eligibility. Health Plans of NC checks eligibility for all available assistance programs at no cost to Apex, North Carolina residents, helping ensure that no eligible senior misses out on savings they have earned.
Extra Help (Low Income Subsidy) can reduce Part D prescription drug plan costs significantly for Apex, North Carolina seniors who meet federal income and asset limits.
Medicare Savings Programs may cover the Part B premium and other cost-sharing expenses for qualifying low-income Apex, North Carolina Medicare enrollees.
The Healthy Blue Medicare DSNP is available to Apex, North Carolina residents who are enrolled in both Medicare and Medicaid, providing coordinated coverage through a $0 premium plan.
NC Medicaid may provide additional healthcare cost assistance to low-income Apex, North Carolina residents who meet the state's eligibility criteria alongside their Medicare coverage.
Health Plans of NC licensed agents check eligibility for all financial assistance programs at no cost, helping Apex, North Carolina seniors apply quickly and confidently.
Health Plans of NC licensed agents serve Apex, North Carolina residents at absolutely no cost, comparing every available 2026 Medicare plan side-by-side and guiding seniors through enrollment, plan changes, and financial assistance applications. Call 800-797-0327 today to speak with a local Medicare expert who is ready to help you find the right coverage for your health needs and budget.
Call 800-797-0327 (toll free) or 704-303-8256 to speak with a licensed Medicare agent and schedule a free appointment
Email [email protected] with questions about Medicare plans available in Apex, North Carolina
Find a licensed agent and book directly at healthplansofnc.com/agents
No cost, no pressure. Walk-ins by appointment only, phone and email welcome anytime.
Enrolled in Part A and Part B? Get more with Blue Medicare Supplement Original Medicare only covers some of your medical costs. That’s why Blue Cross and Blue Shield of North Carolina (Blue Cross NC) offers reliable Medicare Supplement plans to help lessen the worries over what Medicare doesn’t cover.
• Coverage for the costs not covered by Original Medicare (Parts A and B) • The freedom to see any Medicare-participating provider nationwide that accepts Medicare • Rates as low as $31.50 per month1 • Flexibility to change plans • Fitness benefit and hearing benefit on all five plans
With some insurers, you can get locked into a plan that may not be right for you. But thanks to our exclusive Blue-to-Blue program, if your needs change over time, Blue Cross NC gives you the flexibility to switch Medicare plans:2 • Without additional medical exams • Without underwriting or additional health questions • Without any hassle
You cannot be turned down for Blue Medicare Supplement, and may not have to complete a medical questionnaire, if you meet all of the following criteria: • You are age 65 or older, or under age 65 and are eligible for Medicare due to disability3 • You enroll within six months of enrolling in Medicare Part B • You are not covered by certain Medicaid programs • You are a resident of North Carolina
If you enroll early, you may be eligible for a Medicare Supplement plan without waiting periods for pre-existing conditions. If you wait until after your deadline to enroll, you may have a waiting period for pre-existing conditions.
Fitness memberships at in-network facilities using the designated provider. Unlimited access to the vendor’s online platform. SilverSneakers is more than a traditional fitness program. It’s a way to improve your health and live the life you want.
In the gym:
• Thousands of participating locations4 nationwide with various amenities • Ability to enroll at multiple locations at any time • SilverSneakers classes5 designed for all levels and abilities
At home or on the go: • SilverSneakers LIVE online classes and workshops led by specially trained instructors, 7 days a week • SilverSneakers On-Demand videos available 24/7 • SilverSneakers GO mobile app with personalized program resources, adjustable workout plans, and more
In your community: • Group activities and classes5 offered outside the gym
Always talk with your doctor before starting an exercise program.
TruHearing covers one hearing aid per ear per year for a low copay of $499 for Standard hearing aids, $699 for Advanced hearing aids or $999 for Premium hearing aids. Also, as part of the program, a TruHearing provider will help you choose the best hearing aid for your lifestyle and unique hearing needs.
Blue Cross NC is more than a health insurance company. We’re North Carolinians serving North Carolinians. For over 90 years, we’ve been in your community, giving back and listening to how we can provide access to the quality care you deserve.
• Compare plan benefits • Get a free rate quote
Notes: • For costs and further details of the coverage, including exclusions, any reductions or limitations, and terms under which the policy may be continued in force, contact your agent or the company. • Plan A: BMS A, 1/26; Plan G: BMS G, 1/26; Plan G-HD: BMS HDG, 1/26;Plan K: BMS K, 1/26; Plan N: BMS N, 1/26. • Agent/Agency is an independent authorized Agent/Agency licensed to sell and promote products from Blue Cross NC. The content contained in this site is maintained by Agent/Agency. • Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. • Policy benefits are limited to those approved by Medicare for payment.
Disclaimers: • Blue Cross NC contracts with independent companies to provide supplemental benefits. These companies are responsible for the services they provide. They do not provide Blue Cross or Blue Shield products or services. Marks and trade names are property of their respective owners. This fitness program is not an insurance offering. • SilverSneakers is a registered trademark of Tivity Health, Inc. © 2025Tivity Health, Inc. All rights reserved. • TruHearing is a registered trademark of TruHearing, Inc. TruHearing is an independent company and does not offer Blue Cross or Blue Shield products or services. This program may change or be discontinued at any time. This is not an insurance offering.
1 Example for a female non-smoker, age 65. Premium rates can vary based on a number of factors. Contact Blue Cross NC or your Authorized Independent Agent to learn more. 2 Blue-to-Blue is only available when you switch from one Blue Cross NC medical plan (limitations apply) to a Blue Cross NC Medicare plan. You may only switch during designated times of the year. Certain other limits apply. Contact the plan or your Authorized Independent Agent for more information. 3 Guaranteed acceptance for those under age 65 who have Medicare due to disability is limited to Plan A and Plan G. 4 Participating locations (PL) are not owned or operated by Tivity Health, Inc. or its affiliates. Use of PL facilities and amenities is limited to terms and conditions of PL basic membership. Facilities and amenities vary by PL. Inclusion of specific PLs is not guaranteed and PL participation may differ by health plan. 5 Membership includes SilverSneakers instructor-led group
®, SM are marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. All other marks and names are property of their respective owners. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. U4093, 12/25
Apex, North Carolina ZIP Codes include: 27502, 27523, and 27539
