Medicare Plans in Wake Forest, North Carolina

Blue Cross and Blue Shield of North Carolina, Authorized Independent Agency
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Wake Forest, North Carolina

in Franklin County, Granville County, and Wake County

Health Plans of NC is a licensed insurance agency authorized by Blue Cross NC. Our Medicare agents help people in Wake Forest, North Carolina compare Medicare Supplement, Medicare Advantage and Part D plans at no cost to you.

Wake Forest, North Carolina residents have access to a range of Medicare options, and Health Plans of NC is here to help every eligible senior in Wake Forest compare and enroll in the right coverage at absolutely no cost.


Medicare in the Wake Forest area at a glance

  • Wake Forest is mostly in Wake County and extends into Franklin County and Granville County. In Wake County, 192,017 residents have Medicare, up 23% since June 2021.

  • About 52% of Wake County residents with Medicare are enrolled in Medicare Advantage or other Medicare health plans and 48% have Original Medicare. Statewide, 58% are in Medicare Advantage or other plans.

  • 18,685 Wake County residents have both Medicare and Medicaid.

Source: CMS Medicare Monthly Enrollment, June 2026. CMS reports Medicare enrollment by county, not by city.


How much does Medicare cost in Wake Forest, North Carolina?

Wake Forest's median household income of $120,777 means that many residents may not qualify for income-based assistance programs, but Health Plans of NC agents can review each household's specific situation to identify any available savings on premiums or out-of-pocket costs.

  • Part A: $0 premium for most Wake Forest, 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.

  • Part D: Plans set their own premiums. The most you pay out of pocket for covered drugs is $2,100 in 2026, rising to $2,400 in 2027.

  • Medicare Advantage: Plans set their own premiums and costs, but in-network out-of-pocket spending can't exceed $9,250 in 2026, rising to $9,850 in 2027.

  • Medicare Supplement (Medigap): Premiums depend on the plan letter, your age and the insurer. Original Medicare has no yearly out-of-pocket limit on its own.


What are your Medicare coverage options in Wake Forest?

Once you have Part A and Part B, most people choose one of two paths:

  • Original Medicare: Any doctor or hospital in the country that accepts Medicare. Many people add a Medicare Supplement (Medigap) policy to help with deductibles and coinsurance, and a Part D plan for prescriptions.

  • Medicare Advantage (Part C): Private plans approved by Medicare that combine hospital, medical and usually drug coverage, with a yearly out-of-pocket limit. Most use provider networks, so check that your doctors and hospitals are included.

The right choice depends on your doctors, prescriptions, budget and how much you travel. Plans, premiums and networks change every year, so it's worth reviewing your coverage during Open Enrollment.


Important Medicare dates for Wake Forest residents

  • Initial Enrollment Period: A 7-month window around your 65th birthday: the 3 months before, your birthday month and the 3 months after.

  • Medicare Open Enrollment: October 15 to December 7 each year. Changes made by December 7, 2026 take effect January 1, 2027.

  • Medicare Advantage Open Enrollment: January 1 to March 31. If you're in a Medicare Advantage plan, you can switch plans or return to Original Medicare once.

  • Medigap Open Enrollment: The 6 months starting the month you're 65 or older and enrolled in Part B. During this time, insurers can't turn you down or charge more because of your health.

  • Special Enrollment Periods: Moving, losing other coverage and certain other life events can let you make changes at other times.


Who qualifies for Medicare financial assistance in Wake Forest, North Carolina?

Medicare Savings Programs are available to help qualifying Wake Forest seniors cover their Part B premiums and other cost-sharing obligations, providing meaningful relief for those on fixed incomes. With an uninsured rate of 5.7% and a poverty rate of 2.9% in Wake Forest, North Carolina, Health Plans of NC agents are available to check every resident's eligibility for financial assistance programs at no cost.

  • Medicare Savings Programs can cover Part B premiums and cost-sharing for eligible Wake Forest, North Carolina residents, significantly lowering monthly out-of-pocket Medicare expenses.

  • NC Medicaid provides additional healthcare coverage for low-income Wake Forest, North Carolina residents who may not yet be Medicare-eligible or who need supplemental assistance beyond Medicare benefits.

2026 income and resource limits

Program

Monthly income: individual

Monthly income: couple

Resources: individual / couple

Qualified Medicare Beneficiary (QMB)

$1,350

$1,824

$9,950 / $14,910

Specified Low-Income Medicare Beneficiary (SLMB)

$1,616

$2,184

$9,950 / $14,910

Qualifying Individual (QI)

$1,816

$2,455

$9,950 / $14,910

Income limits include the $20 general income disregard. Sources: SSA POMS HI 00815.023 and NC DHHS Medicaid eligibility chart. Limits change each year.

Extra Help with drug costs: In 2026, people with yearly income under $23,940 (single) or $32,460 (married couple) and resources under $16,590 (single) or $33,100 (couple) may qualify for Extra Help, which lowers Part D premiums and copays. Apply through Social Security. Source: SSA POMS HI 03001.020 and HI 03030.025.

Where to apply: Medicare Savings Programs are part of NC Medicaid. Apply online at ePASS, or contact your county's social services office. In Wake County, that's Wake County Division of Social Services at (919) 212-7000 (220 Swinburne St., Raleigh, NC 27610).


Free local Medicare help in Wake Forest

SHIIP counseling

SHIIP, the NC Department of Insurance's Seniors' Health Insurance Information Program, offers free, unbiased one-on-one Medicare counseling. Call 1-855-408-1212 (Monday to Friday, 8am to 5pm), or make an appointment at a local site and ask for "SHIIP Help":

SHIIP counseling sites in Wake County:

Site

Address

Phone

Apex Senior Center

63 Hunter Street, Apex, NC 27502

(919) 249-3354

East Wake Senior Center

323 Lake Drive, Wendell, NC 27591

(919) 910-2790

Five Points Center for Active Adults

2000 Noble Road, Raleigh, NC 27608

(919) 996-4730

SHIIP

3200 Beechleaf Court, Raleigh, NC 27604

(919) 807-6900

Cary Senior Center

120 Maury O'Dell Place, Cary, NC 27512

(919) 469-4081

Garner Senior Center

205 E. Garner Road, Garner, NC 27529

(919) 661-6894

Northern Wake Senior Center

235 E Holding Street, Wake Forest, NC 27587

(919) 554-4111

Anne Gordon Center

1901 Spring Forest Road, Raleigh, NC 27615

(919) 996-4720

Morrisville Senior Center

4117 Davis Drive, Morrisville, NC 27560

(919) 463-7140

Source: NC Department of Insurance.

Other local offices

Office

What it helps with

Address

Phone

Social Security Office (Raleigh)

Signing up for Medicare, Extra Help, replacement Medicare cards

3315 Poole Rd, Suite 100, Raleigh, NC 27610

1-877-803-6311

Wake County Division of Social Services

Medicaid and Medicare Savings Programs

220 Swinburne St., Raleigh, NC 27610

(919) 212-7000

Central Pines Regional Council Area Agency on Aging (Region J)

Aging services and caregiver support

4307 Emperor Blvd., Suite 110, Durham, NC 27703

1-800-310-9777

Social Security's national line is 1-800-772-1213 (TTY 1-800-325-0778).


Talk with a licensed Health Plans of NC agent

Health Plans of NC licensed agents serve Wake Forest, North Carolina residents at no cost, comparing available Medicare options side-by-side and guiding seniors through enrollment, plan changes, and benefit questions from start to finish. Call 800-797-0327 today to speak with a local agent who can help you find the right Medicare plan for your needs in Wake Forest, North Carolina.

  • 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 Wake Forest, 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.


Wake Forest, North Carolina — FAQ Over 65

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Blue Medicare Supplement℠

Blue Medicare Supplement from Blue Cross and Blue Shield of North Carolina

Blue Medicare Supplement℠ from Blue Cross and Blue Shield of North Carolina

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.

With Blue Medicare Supplement, you’ll enjoy:

• 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

Blue-to-Blue℠: Flexibility to change

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

Guaranteed acceptance

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

No waiting periods

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.

SilverSneakers®

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® 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.

About Blue Cross NC

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.

Ready to get started? Contact me today to:

• Compare plan benefits • Get a free rate quote

Learn more:

• Blue Medicare Supplement Outline of Coverage (pdf)

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. • Health Plans of North Carolina, Inc. is an independent authorized agency licensed to sell and promote products from Blue Cross NC. The content contained in this site is maintained by Health Plans of North Carolina, Inc. • 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. © 2025 Tivity 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 Medicare plan to another 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 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 fitness classes. Some locations offer members additional classes. Classes vary by location.

®, 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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Wake Forest, North Carolina ZIP Codes include: 27587 and 27588

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U4093, 12/25