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a consumer's guide to North Carolina Medicare programs, Medicare Part D Prescription Drug Reimbursement and Coverage

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North Carolina Medicare, North Carolina Medicare Prescription Drug Coverage
Medicare Help & Information, Medicare Part D In North Carolina, Medicare help

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.
 

North Carolina Medicare; NC; Medicare Part D in North Carolina

North Carolina Medicaid: Medicaid assistance and North Carolina Medicaid help Were you looking for North Carolina Medicaid instead of North Carolina Medicare? This link provides a directory of Medicare web sites, articles, publications, brochures
 
The Medicare Coverage Gap (The Doughnut Hole) A directory of web sites, articles, and publications that helps explain what and how the Prescription Drug Coverage Gap works.
 

North Carolina Medicare Coverage, Prescription Drug Plans
North Carolina Medicare Help Articles & Resources

Information from varied resources about Medicare in North Carolina
Important advice about how to use this data: This Web Site links you to other Web Sites on the Internet. We cannot take responsibility for information found on third party Web sites outside our control. While we attempt to provide links only to Web Sites that comply with all applicable laws and regulations and appear to have responsible information, please understand that the content on these third-party Web Sites is subject to change without notice to us. We therefore cannot be responsible for, and accept no liability for, any information or opinion contained in any third-party Web Site. Nothing on this Web Site should be construed as the giving of advice or the making of a recommendation and it should not be relied on as the basis for any decision or action. Use this web page for informational purposes only.

 
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medicaid
 
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..."
.
Medicare Web Page:
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..."
.
Medicare brochure or publication:
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..."
.
Medicare Web Page:
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..."
.
Medicare Web Page:
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 Web Page:
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."

.
Medicare brochure or publication:
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...."
.
Medicare Web Page:
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
.
Medicare Web Page:
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
.
Medicaid brochure or publication:
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....."
.
Medicare brochure or publication:
State Pharmacy Listing - Aetna Medicare RxSM Plans - North Carolina

Aetna Medicare
.
Medicaid brochure or publication:
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:
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."
.
Medicare brochure or publication:
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."

How to get more information about North Carolina Medicare Prescription Drug Programs

Medicare.gov has summary information about the plans offered by the companies listed in the tables below. The data sheets are called "Landscapes".
  1. The Landscape of Local Plans is a list of all plans available in your area. You can get answers to important questions for people with Medicare based on what matters to them, including:
    • Cost (premiums, deductibles and payments)
    • Coverage (important issues around what and how drugs are covered)
    • Convenience (pharmacy and mail-order options)
  2. Medicare.gov has an important help page that explains how to read and interpret the information in both Medicare Prescription Drug Plan "Landscapes. You can access the help page through this link: How to read the Medicare Prescription Drug Plans Landscape
  3. We have provided links to the landscape documents for this state in the list of publications above. 
.
.


Medicare prescription drug coverage plans offered in North Carolina: 

Important advice about how to use this data: The data for the table below came from www.medicare.gov, "The Official U.S. Government Site for People with Medicare", in December, 2006, and is subject to change at any time. To check for changes and the newest data, you should visit www.medicare.gov. Your state insurance administrator might have different data; be sure to check with them before making any decisions. Nothing on this Web Site should be construed as the giving of advice or the making of a recommendation and it should not be relied on as the basis for any decision or action.

 
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.)
Plan Name and
ID Numbers
Company
(w. link to
plan web site)
Coverage in
the Gap
About the gap
Contact Service
Phones
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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


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
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
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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