Live Worry-Free. Find the Right Medicare Plan in NC. in Wake County
North Carolina
in North Carolina
Wake County residents exploring Medicare coverage for 2026 can compare all available plans through Health Plans of NC, a local resource connecting beneficiaries with the right coverage across major health systems including WakeMed Health and Hospitals, UNC Rex Healthcare, and Duke Raleigh Hospital.
Wake County is home to approximately 144,000 Medicare-eligible residents, representing 12.5% of the county's total population of 1,151,009, all of whom have access to one of North Carolina's most comprehensive healthcare landscapes. Major health systems including WakeMed Health and Hospitals, UNC Rex Healthcare, and Duke Raleigh Hospital accept Medicare across multiple Wake County locations, giving beneficiaries a wide range of in-network provider options depending on the plan type they choose. Coverage options available in Wake County for 2026 span Medicare Advantage HMO, HMO-POS, and PPO plans, a Dual Special Needs Plan, a standalone Part D prescription drug plan, and Medicare Supplement policies that work alongside 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 | $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 are available through Blue Cross NC and may include access to primary and specialty care at Rex Hospital and WakeMed campuses within the plan network.
Medicare Advantage HMO-POS plans offer some out-of-network flexibility, which can be useful for Wake County residents who occasionally need care at facilities outside their primary network.
Medicare Advantage PPO plans allow beneficiaries greater freedom to see specialists at facilities such as Duke Raleigh Hospital or WakeMed Raleigh Campus, often without a referral.
Medicare Supplement (Medigap) plans pair with Original Medicare and allow Wake County residents to visit any Medicare-accepting provider nationwide, including all WakeMed campuses and UNC Rex Healthcare, without network restrictions.
Part D Prescription Drug Plans provide standalone drug coverage for Wake County residents who remain on Original Medicare and need help covering prescription costs at local and chain pharmacies throughout the county.
Dual Special Needs Plans (D-SNP) are available for Wake County residents who qualify for both Medicare and Medicaid, coordinating benefits across both programs and connecting members to local behavioral health and specialty providers.
Blue Cross NC offers nine Medicare plans in Wake County for 2026, ranging from $0-premium Medicare Advantage options to a standalone Part D drug plan, each connecting beneficiaries to provider networks that include WakeMed Health and Hospitals, UNC Rex Healthcare, and Duke Raleigh Hospital. Plan types include HMO, HMO-POS, and PPO structures under the Medicare Advantage umbrella, a Dual Special Needs Plan for dual-eligible residents, and a Part D Prescription Drug Plan for those who prefer Original Medicare with separate drug coverage. Beneficiaries should review each plan's specific network tier to confirm that their preferred specialists, facilities such as Holly Hill Hospital or WakeMed Cary Hospital, and local pharmacies are included before enrolling.
Blue Medicare Medical Only, HMO-POS, $0.00 per month, designed for beneficiaries who want medical-only Advantage coverage connected to Blue Cross NC's Wake County provider network.
Blue Medicare Essential, HMO, $0.00 per month, a zero-premium plan offering comprehensive Medicare Advantage benefits through an HMO network that includes major Wake County hospitals and clinics.
Blue Medicare Essential Plus, HMO-POS, $0.00 per month, adds point-of-service flexibility to the Essential plan structure, allowing some access to providers outside the core HMO network.
Blue Medicare Choice, HMO, $0.00 per month, another zero-premium HMO option available in Wake County with access to Blue Cross NC's network of local hospitals, primary care, and specialty providers.
Blue Medicare Enhanced, HMO-POS, $40.00 per month, a step-up plan with an HMO-POS structure that may offer enhanced benefits such as expanded dental, vision, or hearing coverage for Wake County enrollees.
Blue Medicare PPO Enhanced, PPO, $53.00 per month, Wake County's only PPO Advantage option for 2026, giving beneficiaries the broadest in-network and out-of-network flexibility across facilities like Duke Raleigh Hospital and Rex Hospital.
Blue Medicare Freedom+, HMO-POS, $0.00 per month, a zero-premium HMO-POS plan connecting Wake County members to local providers while allowing some out-of-network access when needed.
Healthy Blue Medicare DSNP, HMO-POS, $0.00 per month, a Dual Special Needs Plan for Wake County residents enrolled in both Medicare and Medicaid, coordinating care across behavioral health providers including Holly Hill Hospital and WakeBrook Recovery Center.
Blue Medicare Rx Enhanced PDP, Part D Prescription Drug Plan, $163.20 per month, a standalone drug plan for Wake County residents on Original Medicare who need prescription coverage at local and chain pharmacies across the county.
Wake County Medicare Advantage plan premiums for 2026 range from $0.00 per month for plans like Blue Medicare Essential and Blue Medicare Freedom+ to $53.00 per month for Blue Medicare PPO Enhanced, with the standalone Blue Medicare Rx Enhanced PDP priced at $163.20 per month for drug-only coverage. Wake County's median household income of $101,763 places many residents above automatic eligibility thresholds for federal cost-reduction programs, though income-based adjustments to Part B premiums and Extra Help for drug costs may still apply to a meaningful portion of the county's Medicare population. Health Plans of NC agents can walk beneficiaries through a full cost comparison, including out-of-pocket maximums, copays, and drug formulary tiers, to identify the most affordable plan for each individual's healthcare usage and budget.
Part A: $0 premium for most Wake County 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 plans in Wake County for 2026, with a total of nine plans available to eligible residents across multiple plan types. Those plan types include Medicare Advantage HMO, HMO-POS, and PPO structures, a Dual Special Needs Plan, and a standalone Part D Prescription Drug Plan, giving beneficiaries a broad range of coverage configurations to evaluate. Blue Cross NC's provider networks in Wake County interact directly with major local health systems including WakeMed Health and Hospitals, UNC Rex Healthcare, and Duke Raleigh Hospital, meaning the specific plan a beneficiary selects determines which hospitals and specialists they can access at in-network cost-sharing rates. Plan choice is especially consequential in a county with 14 area hospitals and dozens of specialty clinics, where access to neurosciences and trauma care at WakeMed Raleigh Campus, cancer and orthopedic services at Rex Hospital, and palliative and spine pain management through Duke Raleigh Hospital's affiliated clinics may depend on plan network inclusion. Health Plans of NC compares every Blue Cross NC Medicare plan available in Wake County side by side at no cost, helping beneficiaries evaluate their options against their specific providers, prescriptions, and budget.
Blue Cross NC, offering Medicare Advantage HMO, HMO-POS, and PPO plans, a D-SNP, and a Part D Prescription Drug Plan, with 9 total plans available in Wake County for 2026.
Wake County residents with limited income and resources may qualify for Extra Help, 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 are available through North Carolina Medicaid to help lower-income Wake County residents pay Part B premiums, deductibles, and cost-sharing, with eligibility determined based on income and asset guidelines. Wake County's uninsured rate of 8.2% and poverty rate of 7.9% indicate that a meaningful share of the county's population may benefit from these programs, particularly residents who are newly aging into Medicare from uninsured or underinsured status. Health Plans of NC agents can review eligibility for all assistance programs at no cost and help qualifying residents enroll in the Healthy Blue Medicare DSNP or other cost-reduction options that align with their financial situation.
Extra Help (Low Income Subsidy) can significantly reduce or eliminate monthly Part D drug plan premiums and copays for qualifying Wake County Medicare beneficiaries.
Medicare Savings Programs through NC Medicaid may cover Part B premiums and other cost-sharing for Wake County residents who meet income and resource limits.
The Healthy Blue Medicare DSNP is available at $0.00 per month for Wake County residents who qualify for both Medicare and Medicaid, coordinating benefits across both programs.
NC Medicaid may provide additional coverage for low-income Wake County residents who do not yet qualify for Medicare or who need supplemental assistance alongside their Medicare benefits.
Health Plans of NC agents can screen Wake County residents for all available financial assistance programs at no cost and assist with enrollment in the appropriate plan or savings program.
Health Plans of NC licensed agents serve Wake County residents at no cost, comparing every available Medicare Advantage, Medicare Supplement, and Part D plan side by side to help beneficiaries find the right coverage for their providers, prescriptions, and budget. Call 800-797-0327 today to speak with a local agent who can guide you through enrollment, plan changes, and assistance program eligibility with no sales pressure.
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 County
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.
Hospital | Address | Phone |
|---|---|---|
Central Regional Hospital | 300 Veazey Dr, Butner, NC 27509 | (919) 764-2000 |
Duke Raleigh Hospital | 3400 Wake Forest Rd, Raleigh, NC 27609 | (919) 954-3000 |
Granville Health System | 1010 College St, Oxford, NC 27565 | (919) 690-3000 |
Holly Hill Hospital | 3019 Falstaff Rd, Raleigh, NC 27610 | (919) 250-7000 |
Nash General Hospital | 2460 Curtis Ellis Dr, Rocky Mount, NC 27804 | (252) 962-8000 |
PAM Specialty Hosp Of Rocky Mt | 1051 Noell Ln, Rocky Mount, NC 27804 | (252) 451-2300 |
Rex Hospital | 4420 Lake Boone Trl, Raleigh, NC 27607 | (919) 784-3100 |
Strategic Behavioral Ctr Rlgh | 3200 Waterfield Dr, Garner, NC 27529 | (919) 800-4400 |
UNC Health Johnston | 509 N Brightleaf Blvd, Smithfield, NC 27577 | (919) 934-8171 |
UNC Hospitals At Wakebrook | 111 Sunnybrook Rd, Raleigh, NC 27610 | (984) 974-4800 |
WakeMed Cary Hospital | 1900 Kildaire Farm Rd, Cary, NC 27518 | (919) 350-8000 |
WakeMed North Hospital | 10000 Falls Of Neuse Rd, Raleigh, NC 27614 | (919) 350-8000 |
WakeMed Raleigh Campus | 3000 New Bern Ave, Raleigh, NC 27610 | (919) 350-8000 |
Wilson Medical Ctr | 1705 Tarboro St SW, Wilson, NC 27893 | (252) 399-8040 |
Clinic | Address | Phone |
|---|---|---|
Angier Pediatric & Adult Med | 441 Lakestone Commons Ave, Fuquay Varina, NC 27526 | (919) 577-0481 |
Benson Area Medical Ctr Inc | 11801 Vogel St, Raleigh, NC 27617 | (919) 207-4403 |
Beverly Medical Ctr | 6008 Creedmoor Rd, Raleigh, NC 27612 | (919) 844-4552 |
Brier Creek Medical Pavilion | 10207 Cerny St, Raleigh, NC 27617 | (919) 634-6269 |
Carolina Neuropsychology Svc | 3900 Barrett Dr # 102, Raleigh, NC 27609 | (919) 859-9040 |
Carolinas Center For Med | 3600 Glenwood Ave # 120, Raleigh, NC 27612 | (919) 461-5500 |
Clayton Dialysis Ctr | 86 Healthpark Way, Clayton, NC 27520 | (919) 550-7456 |
Clinton Dialysis Unit | 545 E Market St, Smithfield, NC 27577 | (919) 934-2826 |
Duke Raleigh Hosp Palliative | 3404 Wake Forest Rd, Raleigh, NC 27609 | (919) 862-5400 |
Duke Raleigh Hosp Pre | 3300 Executive Dr, Raleigh, NC 27609 | (919) 954-3940 |
Duke Raleigh Hosp | 3404 Wake Forest Rd, Raleigh, NC 27609 | (919) 862-5718 |
Duke Rheumatology Raleigh | 3480 Wake Forest Rd # 414, Raleigh, NC 27609 | (919) 613-2243 |
Duke Spine-Pain Mgmt-Raleigh | 3480 Wake Forest Rd, Raleigh, NC 27609 | (919) 862-5367 |
Duke Women's Health Heritage | 3000 Rogers Rd, Wake Forest, NC 27587 | (919) 385-2940 |
Eastern Carolina Pathology | 2693 Forest Hills Rd SW # B, Wilson, NC 27893 | (252) 234-2841 |
ECU Health Family Medicine | 1704 Glendale Dr. SW, Wilson, NC 27893 | (252) 246-8960 |
Fastmed Family Medicine | 11491 US 70 Business Hwy W, Clayton, NC 27520 | (919) 550-2484 |
Fastmed Family Medicine | 5156 N Carolina 42, Garner, NC 27529 | (919) 329-5000 |
Goshen Medical Ctr Inc | 1624 White Oak Church Rd, Apex, NC 27523 | (941) 267-2042 |
Granville Medical Ctr | 1010 College St, Oxford, NC 27565 | (919) 690-3000 |
Karissa Binkley | 1021 W Williams St # 105, Apex, NC 27502 | (919) 961-9885 |
Meso & Beyond Medical Ctr | 1000 N Main St # 100, Fuquay Varina, NC 27526 | (919) 285-4373 |
Pai Wellness Group | 9380 Falls Of Neuse Rd # 101, Raleigh, NC 27615 | (919) 529-3355 |
Rocky Mt Medical Park | 901 N Winstead Ave, Rocky Mount, NC 27804 | (252) 937-8507 |
Siemens Medical Solutions | 209 Gregson Dr, Cary, NC 27511 | (919) 461-0132 |
Smithfield Pulmonology | 706 Wilkins St # A, Smithfield, NC 27577 | (919) 989-1800 |
Southern Wake Medical Ctr | 415 Wake Chapel Rd, Fuquay Varina, NC 27526 | (919) 552-9143 |
Synchrony Energetics Incl | 3201 Nash St NW # A, Wilson, NC 27896 | (252) 373-4722 |
UNC Fertility | 7920 Acc Blvd # 300, Raleigh, NC 27617 | (919) 908-0000 |
Voyage Anesthesia PC | 101 Forest Dr # D, Knightdale, NC 27545 | (919) 341-0188 |
Wake Health Svc | , Franklinton, NC 27525 | (919) 494-5246 |
WakeMed Brier Creek Healthplex | 8001 T W Alexander Dr, Raleigh, NC 27617 | (919) 350-8000 |
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
Wake County ZIP Codes include: 27502, 27511, 27512, 27513, 27518, 27519, 27523, 27526, 27529, 27539, 27540, 27545, 27560, 27571, 27587, 27588, 27591, 27592, 27597, 27601, 27602, 27603, 27604, 27605, 27606, 27607, 27608, 27609, 27610, 27611, 27612, 27613, 27614, 27615, 27616, 27617, 27619, 27620, 27621, 27622, 27623, 27624, 27625, 27626, 27627, 27628, 27629, 27634, 27635, 27636, 27640, 27650, 27656, 27658, 27661, 27668, 27675, 27676, 27690, 27695, 27697, 27698, and 27699
