| The Medicare Project a consumer's guide to North Carolina Medicare programs, Medicare Part D Prescription Drug Reimbursement and Coverage topics: Medicare Prescription Drug Help, Medicare coverage, Medicare Advantage prescription drug programs, supplement insurance, what is Medicare? help |
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Who Offers North Carolina Medicare Prescription
Drug Plans? |
The Medicare Project (Home) | North
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North Carolina Medicare, North Carolina Medicare Prescription Drug Coverage
Answers and information about Medicare, prescription drug coverage and health insurance
involves searching through hundreds of pages at government and private websites. To help seniors and caregivers
get started in their search, our editors have compiled this digest of North Carolina Medicare help and information
resources. |
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Medicare Web Page: NC Consumer’s Guide to Health Plan Selection source: North Carolina Institute of Medicine languages: English "...To help families, people with disabilities, other consumers, and employers choose the health plan that best meets their needs, the North Carolina Institute of Medicine (NC•IOM) developed this North Carolina Consumer’s Guide to Health Plan Selection..." NCRx "NCRx is Governor Easley’s new prescription drug assistance plan to help low-income seniors participate in the federal Medicare Part D prescription drug program..." The First Year for Seniors: Medicare Prescription Drug Coverage in North Carolina, 2006 source: NC Health and Wellness Trust Fund file size: 2 pg. languages: English Medicare Part D 2006 Report prepared by The Lewin Group. "...This background report provides an overview of 2006 Medicare enrollment trends in North Carolina..." Health Plan Options (state employees, teachers, retirees) source:The State Health Plan of North Carolina file size: 8 pg. languages: English "The State Health Plan offers a wide range of health benefits to all eligible state employees, teachers, retirees and other individuals identified in the North Carolina General Statutes..." Seniors' Health Insurance Information Program (SHIIP) source:North Carolina Department of Insurance languages: English From the web page: "The Seniors' Health Insurance Information Program (SHIIP) answers questions and counsels Medicare beneficiaries and caregivers about Medicare, Medicare supplements, Medicare Advantage, Medicare prescription drug plans, long-term care insurance and other health insurance concerns. ..." more from North Carolina Department of Insurance: Medicare Publication: Is a Medicare Advantage Private- Fee-For-Service Plan Right for Me? 2 pages; languages: English Medicare Web Page: Medicare Supplement Premium Comparison Database languages: English from the web page: "...This is a free tool provided by the NC Department of Insurance. It is used to find the estimated premium rates for your Medicare supplement plans. It will show you the current estimated premiums and also a history of each policy's premium rates. " Medicare Web Page: Prescription Drug Coverage, Medicare Part D languages: English Multiple publications and Medicare information brochures. from the web page: "...SHIIP Publications, Outside Publications and Resources: " Medicare -Aid for help with Medicare costs source: North Carolina Department of Health and Human Services, Division of Medical Assistance (DMA) languages: English Need Help paying your Medicare costs? Your Medicare-Aid Benefit depends on your monthly income more from North Carolina Department of Health and Human Services, Division of Medical Assistance (DMA): Medicare Web Page: Medicare-Aid for Working Individuals With a Disability languages: English from the web page: "...Lost your entitlement to free Medicare Part A benefits because you returned to work and now have earned income? Medicaid has a Medicare-Aid program that may pay your Medicare Part A premium for you." Medicare Web Page: Medicare Part D - Information for NC Medicaid Recipients who are on Medicare languages: English from the web page: "...Starting in January 1, 2006, Medicare will help pay for your prescription drugs instead of Medicaid. This is called Medicare Part D." North Carolina Medicare Drug Plan Ratings source:AARP file size:5 pg. languages: English "...This AARP rating tool contains information about “stand-alone” Medicare plans in your state that cover only prescription drugs...." North Carolina: Medicare Hospital Payments source:Kaiser Family Foundation / statehealthfacts.org languages: English Range of Medicare Payments (Low-25th Percentile/High-75th Percentile) for Top Five Elective Inpatient Hospital Procedures, FY2005 What Medicare Covers & How Much You Will Pay source:Medicare Rights Center languages: English Charts of premiums, deductables, and other information for medicare coverage under Part A, Part B, and Part D Your Medicare Rights and Protections source: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services 44pp languages: English Fairly detailed explanations and descriptions about your Medicare rights and protections. Medicaid brochure or publication: A Consumer's Guide to Getting and Keeping Health Insurance in North Carolina source:healthinsuranceinfo.net file size: 40pg. languages: English from GEORGETOWN UNIVERSITY HEALTH POLICY INSTITUTE. "...As a North Carolina resident, you have rights under federal and state law that will protect you when you seek to buy, keep, or switch your health insurance, even if you have a serious health condition. This guide describes your protections as a North Carolina resident....." State Pharmacy Listing - Aetna Medicare RxSM Plans - North Carolina Aetna Medicare Your Medicare Rights and Protections source: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services 44pp languages: English Fairly detailed explanations and descriptions about your Medicare rights and protections. Medicare & You 2007 (North Carolina specific version) source: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services 152pp languages: English and Spanish from www.medicare.gov: "Medicare & You 2007... contains important information about what’s new, health plans, prescription drug plans, and rights and protections to help people with Medicare review their coverage options and prepare to enroll in a new plan if they choose. These files are ... the printed version that people with Medicare will get in the mail this fall. Plan information contained in each book may change after printing." Lanscape: 2007 North Carolina Stand-Alone Prescription Drug Plans source:CENTERS FOR MEDICARE & MEDICAID SERVICES, U.S. Department of Health and Human Services file size:3 pg. languages: English date:2007 North Carolina 2007 Medicare Part D Stand-Alone Prescription Drug Plans. Data as of September 12, 2006. Includes all contracts/plans regardless of 2007 approval status. Employer sponsored plans (800 series) are excluded." Medicare brochure or publication: Landscape: North Carolina Medicare Advantage, Cost Plans, and Demonstrations source:CENTERS FOR MEDICARE & MEDICAID SERVICES file size:35 pg. languages: English "North Carolina 2007 Medicare Advantage, Cost, and Demonstration Plans. Data as of September 29, 2006. Includes all contracts/plans regardless of 2007 approval status. PACE, Special Needs Plans, and Employer sponsored plans (800 series) are excluded." |
| 38 Prescription Drug Plans in North Carolina This list is to familiarize you with Medicare Prescription Plans available in your state, and to provide you with contact information to specific carriers. Check with the insurance provider or medicare.gov for information about coverage options, annual deductibles, approved drugs, and other limitations. Do NOT use this web page as the basis for any decision or action. (All data is subject to change. Check with medicare.gov or the insurance provider for latest data.) | ||||||
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| Plan Name and ID Numbers |
Company (w. link to plan web site) |
Coverage in the Gap About the gap |
Contact Service Phones |
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| AARP MedicareRx Plan (S5820-007) |
UnitedHealthcare | No gap coverage | Non-Members 1-888-867-5564 TTY Users should call: 1-877-730-4192 Members 1-888-867-5575 TTY Users should call: 1-888-867-5575 |
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| Advantage Freedom Plan (S5644-053) |
RxAmerica | No gap coverage | Non-Members 1-877-279-0370 Members 1-800-429-6686 TTY Users should call: 1-800-429-6686 |
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| Advantage Star Plan (S5644-074) |
RxAmerica | No gap coverage | Non-Members 1-877-279-0370 Members 1-800-429-6686 TTY Users should call: 1-800-429-6686 |
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| AdvantraRx Premier (S5670-046) |
Coventry AdvantraRx | No gap coverage | Non-Members 1-800-882-3822 TTY Users should call: 1-800-508-9548 Members 1-866-823-5177 TTY Users should call: 1-866-823-5177 |
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| AdvantraRx Premier Plus (S5670-048) |
Coventry AdvantraRx | No gap coverage | Non-Members 1-800-882-3822 TTY Users should call: 1-800-508-9548 Members 1-866-823-5177 TTY Users should call: 1-866-823-5177 |
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| AdvantraRx Value (S5670-045) |
RxAmerica | No gap coverage | Non-Members 1-800-882-3822 TTY Users should call: 1-800-508-9548 Members 1-866-823-5177 TTY Users should call: 1-866-823-5177 |
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| Aetna Medicare Rx Essentials (S5810-042) |
Aetna Medicare | No gap coverage | Non-Members 1-800-445-1796 TTY Users should call: 1-800-628-3323 Members 1-877-238-6211 TTY Users should call: 1-877-238-6211 |
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| Aetna Medicare Rx Plus (S5810-144) |
Aetna Medicare | Generic Only | Non-Members 1-800-445-1796 TTY Users should call: 1-800-628-3323 Members 1-877-238-6211 TTY Users should call: 1-877-238-6211 |
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| Aetna Medicare Rx Premier (S5810-178) |
Aetna Medicare | Generic Only | Non-Members 1-800-445-1796 TTY Users should call: 1-800-628-3323 Members 1-877-238-6211 TTY Users should call: 1-877-238-6211 |
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| BCBSNC Plus Plan (S5540-004) |
Blue Cross Blue Shield of North Carolina | Non-Members 1-800-478-0583 TTY Users should call: 1-800-442-7028 Members 1-888-247-4142 TTY Users should call: 1-888-247-4142 |
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| BCBSNC Standard Plan (S5540-002) |
Blue Cross Blue Shield of North Carolina | No gap coverage | Non-Members 1-800-478-0583 TTY Users should call: 1-800-442-7028 Members 1-888-247-4142 TTY Users should call: 1-888-247-4142 |
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| CIGNATURE Rx Complete Plan (S5617-178) |
CIGNA HealthCare | Generic Only | Non-Members 1-800-735-1459 Members 1-800-222-6700 TTY Users should call: 1-800-222-6700 |
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| CIGNATURE Rx Plus Plan (S5617-040) |
CIGNA HealthCare | No gap coverage | Non-Members 1-800-735-1459 Members 1-800-222-6700 TTY Users should call: 1-800-222-6700 |
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| CIGNATURE Rx Value Plan (S5617-038) |
CIGNA HealthCare | No gap coverage | Non-Members 1-800-735-1459 Members 1-800-222-6700 TTY Users should call: 1-800-222-6700 |
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| Community Care Rx BASIC (S5803-077) |
MEMBERHEALTH | No gap coverage | Non-Members 1-866-684-5353 TTY Users should call: 1-866-684-5351 Members 1-866-684-5353 TTY Users should call: 1-518-449-6800 |
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| Community Care Rx CHOICE (S5803-145) |
MEMBERHEALTH | No gap coverage | Non-Members 1-866-684-5353 TTY Users should call: 1-866-684-5351 Members 1-866-684-5353 TTY Users should call: 1-518-449-6800 |
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| Community Care Rx GOLD (S5803-111) |
MEMBERHEALTH | No gap coverage | Non-Members 1-866-684-5353 TTY Users should call: 1-866-684-5351 Members 1-866-684-5353 TTY Users should call: 1-518-449-6800 |
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| Humana PDP Complete S5884-036 (S5884-036) |
Humana Insurance Company | Generic and Brand | Non-Members 1-800-706-0872 TTY Users should call: 1-877-833-4486 Members 1-800-281-6918 TTY Users should call: 1-800-281-6918 |
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| Humana PDP Enhanced S5884-007 (S5884-007) |
Humana Insurance Company | No gap coverage | Non-Members 1-800-706-0872 TTY Users should call: 1-877-833-4486 Members 1-800-281-6918 TTY Users should call: 1-800-281-6918 |
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| Humana PDP Standard S5884-066 (S5884-066) |
Humana Insurance Company | No gap coverage | Non-Members 1-800-706-0872 TTY Users should call: 1-877-833-4486 Members 1-800-281-6918 TTY Users should call: 1-800-281-6918 |
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| MedicareRx Rewards (S5960-008) |
Unicare | No gap coverage | Non-Members 1-866-892-5335 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| MedicareRx Rewards Plus (S5960-044) |
Unicare | No gap coverage | Non-Members 1-866-892-5335 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| MedicareRx Rewards Premier (S5960-078) |
Unicare | Generic Only | Non-Members 1-866-892-5335 Members 1-800-928-6201 TTY Users should call: 1-800-928-6201 |
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| PacifiCare Comprehensive Plan (S5921-113) |
UnitedHealthcare | Generic Only | Non-Members 1-800-943-0399 Members 1-800-797-9794 TTY Users should call: 1-714-825-3600 |
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| PacifiCare Saver Plan (S5921-112) |
UnitedHealthcare | No gap coverage | Non-Members 1-800-943-0399 Members 1-800-797-9794 TTY Users should call: 1-714-825-3600 |
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| PacifiCare Select Plan (S5921-111) |
UnitedHealthcare | No gap coverage | Non-Members 1-800-943-0399 Members 1-800-797-9794 TTY Users should call: 1-714-825-3600 |
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| Prescription Pathway Bronze Plan Reg 8 (S5597-073) |
Pennsylvania Life Insurance Company | No gap coverage | Non-Members 1-800-765-8900 TTY Users should call: 1-866-222-3904 Members 1-800-698-8394 TTY Users should call: 1-850-432-1700 |
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| Prescription Pathway Gold Plan Reg 8 (S5597-040) |
Pennsylvania Life Insurance Company | No gap coverage | Non-Members 1-800-765-8900 TTY Users should call: 1-866-222-3904 Members 1-800-698-8394 TTY Users should call: 1-850-432-1700 |
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| Prescription Pathway Silver Plan Reg 8 (S5597-172) |
Pennsylvania Life Insurance Company | No gap coverage | Non-Members 1-800-765-8900 TTY Users should call: 1-866-222-3904 Members 1-800-698-8394 TTY Users should call: 1-850-432-1700 |
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| SilverScript (S5601-016) |
SilverScript Insurance Company | No gap coverage | Non-Members 1-866-552-6106 TTY Users should call: 1-866-552-6288 Members 1-866-235-5660 TTY Users should call: 1-866-235-5660 |
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| SilverScript Plus (S5601-017) |
SilverScript Insurance Company | No gap coverage | Non-Members 1-866-235-4582 TTY Users should call: 1-866-552-6288 Members 1-866-235-5660 TTY Users should call: 1-866-235-5660 |
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| Sterling Prescription Drug Plan (S4802-005) |
Sterling Life Insurance Company | No gap coverage | Non-Members 1-888-909-1713 TTY Users should call: 1-888-858-8567 Members 1-866-865-0664 TTY Users should call: 1-866-865-0664 |
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| UA Medicare Part D Prescription Drug Cov (S5755-011) |
United American Insurance Company | No gap coverage | Non-Members 1-866-524-4169 TTY Users should call: 1-866-524-4170 Members 1-866-524-4169 TTY Users should call: 1-866-524-4169 |
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| United Medicare MedAdvance (S5820-111) |
UnitedHealthcare | No gap coverage | Non-Members 1-888-556-6657 TTY Users should call: 1-888-556-7065 Members 1-888-556-7047 TTY Users should call: 1-888-556-7047 |
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| WellCare Complete (S5967-076) |
WellCare | No gap coverage | Non-Members 1-888-423-5252 Members 1-888-550-5252 TTY Users should call: 1-888-550-5252 |
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| WellCare Premier (S5967-111) |
WellCare | No gap coverage | Non-Members 1-888-423-5252 Members 1-888-550-5252 TTY Users should call: 1-888-550-5252 |
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| WellCare Signature (S5967-042) |
WellCare | No gap coverage | Non-Members 1-888-423-5252 Members 1-888-550-5252 TTY Users should call: 1-888-550-5252 |
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| YOURx PLAN (S5660-007) |
Medco YOURx PLAN | No gap coverage | Non-Members 1-800-758-3605 TTY Users should call: 1-800-716-3231 Members 1-800-758-4574 TTY Users should call: 1-800-758-4574 |
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| 3 Medicare Special Needs Plans in North Carolina This list is to familiarize you with Medicare Special Needs Plans available in your state, and to provide you with contact information to specific carriers. Check with the insurance provider or medicare.gov for information about coverage options, annual deductibles, approved drugs, and other limitations. Do NOT use this web page as the basis for any decision or action. (All data is subject to change. Check with medicare.gov or the insurance provider for latest data.) | ||||||
|---|---|---|---|---|---|---|
| Evercare Plan DH-ES (H3456-016-0) |
SecureHorizons | For people who are eligible for both Medicare and Medicaid. | Non-Members 1-888-264-8761 TTY Users should call: 1-888-685-8480 Members 1-888-264-8720 TTY Users should call: 1-888-685-8480 |
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| Evercare Plan IH (H3456-010-0) |
SecureHorizons | For people in certain long-term care facilities. | Non-Members 1-866-815-5325 TTY Users should call: 1-888-685-8480 Members 1-800-393-0993 TTY Users should call: 1-888-685-8480 |
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| Fidelis SecureCare of North Carolina (H5575-001-0) |
Fidelis SecureCare of North Carolina | For people in certain long-term care facilities. | Non-Members 1-877-372-8080 TTY Users should call: 1-877-735-8261 Members 1-877-372-8085 TTY Users should call: 1-877-735-8261 |
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