North Carolina Medicare insurance provides coverage to individuals who are over the age of 65. In some cases, workers with disabilities are also eligible for the said program. While funding for Medicare comes from the federal government, the state government of North Carolina also provides assistance to Medicare beneficiaries living here through various public programs.
Medicare coverage is crucial in North Carolina, as the state ranks only 40th among the states in terms of median household income. With the average premiums costing $526 in North Carolina, many prefer the more affordable health insurance option offered by Medicare.
Medicare starts with Original Medicare, which refers to the coverage offered by Medicare Part A and Part B. Medicare Part A is for hospital insurance, which covers hospital inpatient care and services in similar facilities. Medicare Part B is for medical insurance, including medical treatments, durable supplies, and preventive screenings.
The cost of Medicare is not high compared to private insurance plans, as Medicare Part A is normally free of premiums. Medicare Part B requires a premium, but this only costs $134 for those who earn no more than $85,000 a year. Part A and Part B come with deductibles, coinsurance, and 20% copayments.
Original Medicare coverage may not be comprehensive enough for some Medicare beneficiaries, and these can obtain supplemental Medicare plans to add to the coverage of Original Medicare. These plans are available from Medicare-approved private health insurance companies, and they will require an additional premium aside from the premium for Medicare Part B.
These plans do offer the option of covering services that are not covered by Medicare Part A and Part B. They may even help defray the costs of out-of-pocket expenses such as the deductibles and coinsurance. A more common supplemental plan covers the cost of Medicare prescription medication, and this is called Medicare Plan D.
Instead of obtaining Original Medicare and then purchasing supplemental plans to add to the coverage, some Medicare beneficiaries opt to merely purchase a plan that combines the benefits of Medicare Part A and Part B with the benefits of supplemental plans. These are called Medicare Advantage Plans, but they are also known as Medicare Part C.
These plans are also available from private carriers that have been approved by Medicare, and different plans are available with varying extra benefits. Many of them cover additional health care services and they may cover Medicare prescription drugs as well.
North Carolina Medicaid offers a free program called Medicare-Aid that helps Medicare beneficiaries with limited income and resources. This program has several levels that can assist in covering the various expenses associated with Medicare.
The first of three Medicare-Aid programs is the Comprehensive Medicare-Aid (MQB-Q) program. It pays for the premiums for Medicare Part A and Part B, plus the deductibles and the 20% copayment. It may even cover the cost of the first 20 days of staying in a nursing home.
To qualify for this program, an individual’s monthly income should be less than $1,032. Married couples have an income limit of $1,392.
The next program is the Limited Medicare-Aid (MQB-B), which only covers the premium for Medicare Part B. The monthly income limit is $1,234 for an individual and $1,666 for a married couple.
The third program is the Limited Medicare-Aid Capped Enrollment (MQB-E) and also only pays for the Medicare Part B premium. However, applications and benefits are granted on a “first come, first served” basis as the funding for this particular level of Medicare-Aid is limited. The monthly income limit for an individual is $1,386 and $1.872 for a married couple.
All of these three levels also place a cap on the resources of qualified beneficiaries. For individuals, resources cannot exceed $7,560 in value while the limit is $11,340 for individuals. The program also enables beneficiaries to apply for Low-Income Subsidy (Extra Help), which can pay for all or part of the Medicare Part D premium depending on the income and resources of the beneficiary.
Medicare-Aid also has a level for Working Individuals with a Disability. This program pays for the premium for Medicare Part A. Individuals can qualify with an income of less than $4,132 a month and resources limited to $4,000. For married couples, the limit is $5,572 a month for income and $6,000 for resources.
North Carolina has a Seniors’ Health Insurance Information Program that answers all questions regarding Medicare. Residents of the state can call 855-408-1212 (toll-free) Monday thru Friday from 8 am to 5 pm.
Speak to a licensed agent today