in Forsyth County
Winston-Salem, North Carolina residents have access to 9 Medicare plans for 2026, and Health Plans of NC licensed agents are available to compare every option side-by-side at no cost, helping seniors connect with coverage that works alongside providers like Atrium Health Wake Forest Baptist and Novant Health Forsyth Medical Center.
Winston-Salem, North Carolina is home to approximately 37,000 Medicare-eligible residents, representing 14.8% of the city's total population of 250,887, all of whom can choose from multiple coverage structures designed to meet a wide range of health and financial needs. Both Atrium Health Wake Forest Baptist and Novant Health Forsyth Medical Center accept Medicare, giving local seniors access to major academic and community health systems depending on which plan type they select. Coverage options in Winston-Salem span Medicare Advantage HMO, HMO-POS, and PPO plans, a standalone Part D prescription drug plan, a Dual Special Needs Plan, and Medicare Supplement policies that pair with Original Medicare.
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 | $30.00/month |
Blue Medicare PPO Enhanced | PPO | $35.00/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 Winston-Salem, North Carolina provide coordinated care through defined provider networks that may include Novant Health Forsyth Medical Center for hospital and specialist services.
Medicare Advantage HMO-POS plans offer Winston-Salem seniors the flexibility to receive some out-of-network care while still anchoring coverage to local providers like Atrium Health Wake Forest Baptist.
Medicare Advantage PPO plans allow Winston-Salem residents to visit both in-network and out-of-network providers, including specialists at major health systems, often without a referral.
Medicare Supplement plans pair with Original Medicare and allow Winston-Salem seniors to use any provider nationwide that accepts Medicare, including local retirement and skilled nursing communities like Salemtowne and Arbor Acres United Methodist Retirement Community.
Part D Prescription Drug Plans provide standalone prescription coverage for Winston-Salem residents enrolled in Original Medicare who need help managing medication costs at local pharmacies.
Dual Special Needs Plans are available in Winston-Salem, North Carolina for residents who qualify for both Medicare and Medicaid, offering coordinated benefits that connect to local health systems and community support services.
Blue Cross NC offers nine Medicare plans in Winston-Salem, North Carolina for 2026, spanning HMO, HMO-POS, PPO, PDP, and D-SNP structures, each connecting enrollees to different tiers of local provider access and benefit levels. Plans range from zero-premium Advantage options designed for budget-conscious seniors to a standalone prescription drug plan for those who prefer Original Medicare with added drug coverage. Health Plans of NC agents walk Winston-Salem residents through each plan's network, formulary, and benefits to ensure the right fit for their health routines and preferred providers.
Blue Medicare Medical Only, HMO-POS, $0.00 per month, provides hospital and medical coverage through a flexible point-of-service network that may include local Winston-Salem health system facilities.
Blue Medicare Essential, HMO, $0.00 per month, offers coordinated care through an HMO network connecting Winston-Salem seniors to primary care and specialist providers within the Blue Cross NC network.
Blue Medicare Essential Plus, HMO-POS, $0.00 per month, adds point-of-service flexibility to the Essential plan structure, allowing some access to out-of-network providers beyond the core Winston-Salem network.
Blue Medicare Choice, HMO, $0.00 per month, is a zero-premium option for Winston-Salem seniors seeking structured HMO coverage with access to participating local physicians and facilities.
Blue Medicare Enhanced, HMO-POS, $30.00 per month, provides an elevated benefit package with point-of-service flexibility for Winston-Salem residents who want additional coverage features beyond base HMO plans.
Blue Medicare PPO Enhanced, PPO, $35.00 per month, gives Winston-Salem seniors broad provider access including both in-network and out-of-network options, making it well-suited for those who see specialists at multiple facilities.
Blue Medicare Freedom+, HMO-POS, $0.00 per month, combines zero-premium affordability with point-of-service access, connecting Winston-Salem residents to a broad set of covered providers across the region.
Healthy Blue Medicare DSNP, HMO-POS, $0.00 per month, serves Winston-Salem residents who are dual-eligible for Medicare and Medicaid, coordinating benefits across both programs through a single integrated plan.
Blue Medicare Rx Enhanced PDP, standalone Part D prescription drug plan, $163.20 per month, provides prescription coverage for Winston-Salem seniors enrolled in Original Medicare who want dedicated drug benefits at local and mail-order pharmacies.
For 2026, Winston-Salem, North Carolina residents can access multiple Medicare Advantage plans at $0.00 per month in addition to their standard Part B premium, while enhanced plan options like Blue Medicare Enhanced and Blue Medicare PPO Enhanced carry premiums of $30.00 and $35.00 per month respectively, and the Blue Medicare Rx Enhanced PDP standalone drug plan is priced at $163.20 per month. Winston-Salem's median household income of $57,673 means that many residents may qualify for federal cost-reduction programs that lower premiums, deductibles, and prescription costs beyond what standard plan pricing reflects. Health Plans of NC agents help Winston-Salem seniors identify every available savings opportunity and select the plan structure that best fits their total monthly budget.
Part A: $0 premium for most Winston-Salem, 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 serving Winston-Salem, North Carolina for 2026, offering a total of 9 plans across the area for eligible residents. These 9 plans span HMO, HMO-POS, PPO, standalone Part D prescription drug, and Dual Special Needs Plan structures, giving Winston-Salem seniors a meaningful range of coverage configurations to evaluate. Blue Cross NC networks in Winston-Salem connect enrollees to major local health systems including Atrium Health Wake Forest Baptist and Novant Health Forsyth Medical Center, meaning plan selection directly determines which hospitals, specialists, and care teams a senior can access under their coverage. Choosing a plan that aligns with a preferred health system is especially important in Winston-Salem, where the two major health networks may have different participation levels across HMO, HMO-POS, and PPO plan types. Health Plans of NC agents compare every available Medicare plan in Winston-Salem side-by-side at no cost, helping residents confirm their preferred providers are in-network before enrolling.
Blue Cross NC offers HMO, HMO-POS, PPO, Part D PDP, and D-SNP plan types, with a total of 9 Medicare plans available to Winston-Salem, North Carolina residents for 2026.
Winston-Salem, North Carolina residents with limited income and resources may qualify for the federal Extra Help program, also known as the Low Income Subsidy, which can reduce Part D prescription drug costs to near zero each month. Medicare Savings Programs administered through North Carolina Medicaid can cover some or all of the standard Part B premium for qualifying Winston-Salem seniors, providing significant monthly relief. Residents who qualify for both Medicare and Medicaid may be eligible for a Dual Special Needs Plan, which coordinates benefits across both programs and is available in Winston-Salem through Blue Cross NC. With an uninsured rate of 11.9% and a poverty rate of 17.9% in Winston-Salem, a meaningful portion of residents aging into Medicare may be eligible for these programs without realizing it, and Health Plans of NC checks eligibility at no cost.
Extra Help and the Low Income Subsidy can dramatically reduce monthly Part D prescription drug premiums and cost-sharing for qualifying Winston-Salem, North Carolina seniors.
Medicare Savings Programs through North Carolina Medicaid may cover Part B premiums, deductibles, and coinsurance for Winston-Salem residents who meet income and resource limits.
The Dual Special Needs Plan available in Winston-Salem coordinates Medicare and Medicaid benefits into a single plan, simplifying coverage for residents who qualify for both programs.
NC Medicaid provides additional support for low-income Winston-Salem residents who may not yet be enrolled in Medicare or who need supplemental coverage beyond their Medicare plan.
Health Plans of NC agents help Winston-Salem residents apply for Extra Help, Medicare Savings Programs, and D-SNP enrollment at no cost, ensuring no eligible senior misses available financial relief.
Health Plans of NC licensed agents serve Winston-Salem, North Carolina residents at no cost, comparing every available 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 agent who can match your coverage to your preferred providers, prescriptions, 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 Winston-Salem, 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
Winston-Salem, North Carolina ZIP Codes include: 27101, 27102, 27103, 27104, 27105, 27106, 27107, 27108, 27109, 27110, 27111, 27113, 27114, 27101, 27102, 27103, 27104, 27105, 27106, 27107, 27108, 27109, 27110, 27111, 27113, 27114, 27115, 27116, 27117, 27120, 27127, 27130, 27150, 27151, 27152, 27155, 27156, 27157, 27198, 27199, 27116, 27117, 27120, 27127, 27130, 27150, 27151, 27152, 27155, 27156, 27157, 27198, and 27199
