Medicare Plans in Wake County
North Carolina
in North Carolina
Wake County residents exploring Medicare coverage can compare Medicare options 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.
192,017 Wake County residents have Medicare, up 23% since June 2021.
About 52% 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.
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.
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.
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.
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.
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.
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.
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.
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 in Wake County: Medicare Savings Programs are part of NC Medicaid. Apply online at ePASS, by phone at 919-212-7000, or in person at Wake County Health & Human Services (220 Swinburne St, Raleigh) or a regional center in Wake Forest, Fuquay-Varina, Zebulon or Cary.
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 Wake County site and ask for "SHIIP Help":
Site | Address | Phone |
|---|---|---|
Apex Senior Center | 63 Hunter Street, Apex, NC 27502 | |
Cary Senior Center | 120 Maury O'Dell Place, Cary, NC 27512 | |
East Wake Senior Center | 323 Lake Drive, Wendell, NC 27591 | |
Five Points Center for Active Adults | 2000 Noble Road, Raleigh, NC 27608 | |
Anne Gordon Center | 1901 Spring Forest Road, Raleigh, NC 27615 | |
Garner Senior Center | 205 E. Garner Road, Garner, NC 27529 | |
Morrisville Senior Center | 4117 Davis Drive, Morrisville, NC 27560 | |
Northern Wake Senior Center | 235 E. Holding Street, Wake Forest, NC 27587 |
Source: NC Department of Insurance.
Office | What it helps with | Address | Phone |
|---|---|---|---|
Social Security, Raleigh office | Signing up for Medicare, Extra Help, replacement Medicare cards | 3315 Poole Rd, Suite 100, Raleigh, NC 27610 | |
Wake County Health & Human Services | Medicaid and Medicare Savings Programs | 220 Swinburne St, Raleigh, NC 27610 | |
Central Pines Regional Council (Area Agency on Aging) | Aging services and caregiver support | 4307 Emperor Blvd., Suite 110, Durham, NC 27703 | |
Resources for Seniors | Home and community services, information and referral | 1110 Navaho Drive, Suite 400, Raleigh, NC 27609 |
Social Security's national line is 1-800-772-1213 (TTY 1-800-325-0778).
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 | CMS star rating |
|---|---|---|---|
UNC Rex Hospital | 4420 Lake Boone Trail, Raleigh, NC 27607 | 5 stars | |
WakeMed Cary Hospital | 1900 Kildare Farm Rd, Cary, NC 27518 | 5 stars | |
WakeMed Raleigh Campus | 3000 New Bern Ave, Raleigh, NC 27610 | 4 stars | |
Holly Hill Hospital | 3019 Falstaff Rd, Raleigh, NC 27610 | Not rated | |
Raleigh Oaks Behavioral Health | 3200 Waterfield Dr, Garner, NC 27529 | Not rated | |
Triangle Springs | 10901 World Trade Blvd, Raleigh, NC 27617 | Not rated |
Star ratings are CMS's overall hospital quality ratings (1 to 5 stars) from Medicare Care Compare, October 2026. Psychiatric hospitals aren't rated.
Clinic | Address | Phone |
|---|---|---|
Advance Axcess | 3509 Capital Blvd, Raleigh, NC 27604 | |
Advance CarePlex - Holly Springs | 9764 Holly Springs Rd, Apex, NC 27539 | |
Advance CarePlex - Wake Forest | 110 Capcom Avenue, Wake Forest, NC 27587 | |
Advance Community Health - Apex | 212 South Salem Street, Apex, NC 27502 | |
Advance Community Health - Cary at Dorcas Plaza | 173 High House Road, Cary, NC 27511 | |
Advance Community Health - Fuquay-Varina | 130 N Judd Pkwy NE, Fuquay Varina, NC 27526 | |
Advance Community Health - Southeast Raleigh - South | 1011 Rock Quarry Road, Raleigh, NC 27610 | |
BDIHS Wake Forest | 620 Doctor Calvin Jones Hwy, Suite 100, Wake Forest, NC 27587 | |
CarePlex at Beacon Point | 1425 Promise Beacon Cir, Raleigh, NC 27610 | |
Horizon at Oak City Cares | 1430 S Wilmington St, Raleigh, NC 27603 | |
NeighborHealth Center Susanne Berger Clinic | 2605 Blue Ridge Rd, Suite 225, Raleigh, NC 27607 | |
Starlight Pediatrics | 500 Holly Springs Road, Holly Springs, NC 27540 |
Talk to a licensed Blue Cross NC agent who lives and works in Wake County. Consultations are free.
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
• 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
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
U4093, 12/25
