in Wake County and Durham County
Raleigh, North Carolina residents have access to 9 Medicare plans for 2026 through Blue Cross NC, and Health Plans of NC connects local seniors with licensed agents who compare every available option at absolutely no cost. Whether you receive care at WakeMed, UNC Rex Healthcare, or Duke Raleigh Hospital, finding the right plan starts with a free side-by-side comparison.
Raleigh, North Carolina is home to approximately 55,000 Medicare-eligible residents, representing 11.7% of the city's total population of 470,763, and these seniors have access to a full range of Medicare coverage types for 2026. Local health systems including WakeMed, UNC Rex Healthcare, and Duke Raleigh Hospital accept Medicare and participate in plan networks that serve beneficiaries across the greater Raleigh area. From Medicare Advantage HMO and PPO plans to Medicare Supplement and standalone Part D drug coverage, Raleigh residents can choose the structure that best fits their providers, health needs, and budget.
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 Raleigh, North Carolina provide coordinated care through a defined network of local doctors and hospitals, including providers at WakeMed and UNC Rex Healthcare.
Medicare Advantage HMO-POS plans offer Raleigh beneficiaries the structure of an HMO with limited point-of-service flexibility for accessing care outside the primary network.
Medicare Advantage PPO plans give Raleigh, North Carolina seniors in-network access to local facilities like Duke Raleigh Hospital plus the option to see out-of-network providers at higher cost-sharing.
Medicare Supplement (Medigap) plans pair with Original Medicare to cover out-of-pocket costs at any provider nationwide that accepts Medicare, including specialists throughout the Raleigh area.
Part D Prescription Drug Plans provide standalone drug coverage for Raleigh, North Carolina residents who are enrolled in Original Medicare or a Medicare Medical Only plan.
Dual Special Needs Plans (D-SNP) are designed for Raleigh residents who qualify for both Medicare and Medicaid, coordinating benefits across local health systems and community providers.
For 2026, Blue Cross NC offers nine Medicare plans in Raleigh, North Carolina, spanning HMO, HMO-POS, PPO, PDP, and D-SNP structures, each connecting beneficiaries to local provider networks across the greater Raleigh area. Plans range from $0 monthly premium options to plans with modest premiums that include enhanced benefits, and the standalone Part D plan provides prescription drug coverage for those who prefer Original Medicare. Health Plans of NC agents help Raleigh residents match each plan's network and benefit structure to their preferred providers at no cost.
Blue Medicare Medical Only, HMO-POS, $0.00 per month, provides medical-only coverage and connects Raleigh beneficiaries to a local HMO-POS provider network including facilities in the Wake County area.
Blue Medicare Essential, HMO, $0.00 per month, offers comprehensive Medicare Advantage benefits through a defined HMO network serving Raleigh, North Carolina and surrounding communities.
Blue Medicare Essential Plus, HMO-POS, $0.00 per month, builds on essential HMO benefits with point-of-service flexibility for Raleigh residents who occasionally need care outside the primary network.
Blue Medicare Choice, HMO, $0.00 per month, provides Raleigh seniors with a zero-premium Medicare Advantage HMO option tied to a local network of physicians and hospitals.
Blue Medicare Enhanced, HMO-POS, $40.00 per month, offers upgraded benefits beyond the zero-premium options and is available to Raleigh, North Carolina residents through the Blue Cross NC HMO-POS network.
Blue Medicare PPO Enhanced, PPO, $53.00 per month, gives Raleigh beneficiaries in-network access to providers at local health systems as well as out-of-network access at a higher cost-share.
Blue Medicare Freedom+, HMO-POS, $0.00 per month, provides Raleigh, North Carolina seniors with a flexible HMO-POS structure at no monthly premium beyond the standard Part B cost.
Healthy Blue Medicare DSNP, HMO-POS, $0.00 per month, is a Dual Special Needs Plan designed for Raleigh residents who are enrolled in both Medicare and Medicaid, coordinating care across local providers.
Blue Medicare Rx Enhanced PDP, standalone Prescription Drug Plan, $163.20 per month, provides comprehensive drug coverage for Raleigh, North Carolina beneficiaries who remain on Original Medicare.
In Raleigh, North Carolina for 2026, Medicare Advantage plan premiums through Blue Cross NC range from $0.00 per month for plans like Blue Medicare Essential and Blue Medicare Freedom+ to $40.00 per month for Blue Medicare Enhanced and $53.00 per month for Blue Medicare PPO Enhanced, giving residents a wide range of premium levels to consider. The standalone Blue Medicare Rx Enhanced PDP carries a monthly premium of $163.20 for Raleigh beneficiaries who need prescription drug coverage alongside Original Medicare. With a median household income of $82,424 in Raleigh, many residents can manage these costs comfortably, though those with lower incomes may qualify for programs that reduce premiums and out-of-pocket expenses significantly, and Health Plans of NC agents identify every available cost-reduction option at no charge.
Part A: $0 premium for most Raleigh, 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.
For 2026, Blue Cross NC is the Medicare carrier serving Raleigh, North Carolina, offering a total of 9 Medicare plans to eligible residents in the area. These plans span five distinct structures: HMO, HMO-POS, PPO, Prescription Drug Plan (PDP), and Dual Special Needs Plan (D-SNP), giving Raleigh beneficiaries meaningful choice in how their coverage is organized. Blue Cross NC plan networks connect directly to Raleigh's local healthcare landscape, including providers and facilities affiliated with WakeMed, UNC Rex Healthcare, Duke Raleigh Hospital, and retirement and skilled nursing communities such as Springmoor Life Care Retirement Community, The Oaks at Whitaker Glen, and Elmcroft of Northridge. The plan type a Raleigh resident selects will directly determine which local doctors, specialists, and hospitals they can access under their Medicare coverage, making careful plan comparison essential before enrolling. Health Plans of NC licensed agents compare every available Blue Cross NC Medicare plan in Raleigh side-by-side at absolutely no cost, ensuring seniors understand exactly what each plan covers and which local providers participate.
Blue Cross NC, offering HMO, HMO-POS, PPO, PDP, and D-SNP plan types, with 9 total Medicare plans available to residents of Raleigh, North Carolina for 2026.
Raleigh, North Carolina residents who have limited income and resources may qualify for the Extra Help program, also known as the Low Income Subsidy, which can reduce Part D prescription drug costs to near zero for eligible Medicare beneficiaries. Medicare Savings Programs can help qualifying Raleigh seniors by covering some or all of the standard Part B premium, reducing monthly costs for those whose income falls below federal thresholds. With an uninsured rate of 10.1% and a poverty rate of 11.4% in Raleigh, North Carolina, a meaningful share of Medicare-age residents may be eligible for these programs and for Medicaid-coordinated coverage through the Healthy Blue Medicare D-SNP. Health Plans of NC agents check eligibility for every available assistance program at no cost to Raleigh beneficiaries, helping ensure no senior pays more than necessary for their Medicare coverage.
Extra Help (Low Income Subsidy) can reduce Part D prescription drug premiums, deductibles, and copayments to near zero for qualifying Raleigh, North Carolina Medicare beneficiaries.
Medicare Savings Programs may cover Part B premiums and other cost-sharing for Raleigh residents whose income and assets fall within qualifying federal limits.
The Healthy Blue Medicare D-SNP coordinates Medicare and Medicaid benefits for Raleigh, North Carolina residents who are dual-eligible, helping manage care across local health providers.
NC Medicaid provides additional coverage for low-income Raleigh residents and can work alongside Medicare to reduce out-of-pocket costs for eligible seniors.
Health Plans of NC agents screen Raleigh, North Carolina beneficiaries for all available assistance programs at no cost, simplifying the application and enrollment process.
Health Plans of NC licensed agents serve Raleigh, North Carolina residents at absolutely no cost, comparing every available 2026 Medicare plan side-by-side to help you find the right coverage for your providers, prescriptions, and budget. Call 800-797-0327 today to speak with a local agent who can guide you through enrollment, plan changes, and every financial assistance program you may qualify for.
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 Raleigh, 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
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