Medicare Plans in
Wayne County, NC
37 Medicare Advantage Plans Found in Wayne County. See Plans
Wayne County, NC
Medicare Information
For Wayne County’s Medicare beneficiaries, private plans like Medicare Advantage plans offer an alternative to Original Medicare, and Part D plans (PDP) can work alongside your Original Medicare benefits.
Currently, 37 private Medicare plans are available in Wayne County, and coverage is provided through Medicare-approved private companies, following rules set by Medicare.
MA plans, which are also referred to as Medicare Part C, may offer additional benefits that aren't available through Original Medicare.
Part D plans, also referred to as PDPs, cover retail prescription drugs.
Some Medicare Part C plans include coverage for prescription medications. Known as Medicare Advantage Prescription Drug plans, or MAPDs, these plans offer comprehensive coverage for seniors who want to minimize their out-of-pocket costs.
Learn more about some of the Medicare plans in Wayne County, North Carolina, including average costs, out-of-pocket expenses and what’s involved in obtaining prescription drug coverage.
The following is HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files as well as carrier-provided plan data supplied by SunFire Inc.
Average Cost of Medicare
Plans in Wayne County
| Average Cost of Medicare Advantage Plans in Wayne County, North Carolina | |
|---|---|
| Average Monthly Premium | $45.33 |
| Average in-network out-of-pocket spending limit | $6,818.92 |
| Average drug deductible in 2024 (weighted) | $337.78 |
| Percentage of plans rated 4 stars or higher | 86.5% |
| Average Cost of Medicare Advantage Plans in Wayne County, North Carolina |
|---|
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Average Monthly Premium $45.33 |
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Average in-network out-of-pocket spending limit $6,818.92 |
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Average drug deductible in 2021 (weighted) $337.78 |
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Percentage of plans rated 4 stars or higher 86.5% |
Learn More About Medicare
Prescription Drug Plans
| Plan Type | Description |
|---|---|
| HMO | HMO enrollees typically receive services through in-network providers and must obtain referrals for visits to specialists. However, most plans permit out-of-network care in emergencies or out-of-area dialysis. HMO plans often include prescription drug coverage. |
| PPO | Members of PPO plans can typically go in or out of network for care, including hospitalization, although visits to non-network providers may cost considerably more. Referrals are usually not needed for visits to specialists, and many PPO plans include prescription drug coverage. |
| PFFS | Private fee-for-service plans determine how much a doctor or facility will be paid for services, and members may seek care from any in or out-of-network provider that agrees to the plan's terms. Some PFFS plans include prescription drug coverage. Otherwise, members may seek coverage for medications through standalone Medicare drug plans, which are also known as Part D plans. |
| SNP | Special Needs Plans are designed for individuals with specific conditions or medical characteristics. Benefits such as providers and drug formularies are tailored to members' unique needs, and most care is provided by in-network physicians and facilities. SNPs are required to provide prescription drug coverage. |
| Plan Type and Description |
|---|
|
HMO enrollees typically receive services through in-network providers and must obtain referrals for visits to specialists. However, most plans permit out-of-network care in emergencies or out-of-area dialysis. HMO plans often include prescription drug coverage.
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Members of PPO plans can typically go in or out of network for care, including hospitalization, although visits to non-network providers may cost considerably more. Referrals are usually not needed for visits to specialists, and many PPO plans include prescription drug coverage.
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Private fee-for-service plans determine how much a doctor or facility will be paid for services, and members may seek care from any in or out-of-network provider that agrees to the plan's terms. Some PFFS plans include prescription drug coverage. Otherwise, members may seek coverage for medications through standalone Medicare drug plans, which are also known as Part D plans.
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Special Needs Plans are designed for individuals with specific conditions or medical characteristics. Benefits such as providers and drug formularies are tailored to members' unique needs, and most care is provided by in-network physicians and facilities. SNPs are required to provide prescription drug coverage.
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Some beneficiaries may be eligible for standalone prescription drug plans. Otherwise known as a PDP or Part D plan, a standalone prescription drug plan adds coverage for prescription medications to Original Medicare and some PFFS plans. It’s important to note that some MA plans, such as HMOs, may disenroll members who sign up for a separate drug plan.
Medicare Advantage Plans
Aetna Inc. Medicare Plans in Wayne County, NC
The following table includes cost information and other plan details for Aetna Inc. private Medicare plans available in North Carolina in 2024.
| Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
|---|---|---|---|---|---|---|
| Aetna Medicare Eagle (PPO) | H5521: 241 | $0 | N/A | $6,500 | No | 4 out of 5 |
| Aetna Medicare Assure Plan (HMO D-SNP) | H3146: 002 | $0 | $0 | $8,850 | Yes | 4 out of 5 |
| Aetna Medicare Value Plan (PPO) | H5521: 243 | $0 | $0 | $6,800 | Yes | 4 out of 5 |
| Aetna Medicare Essential Plan (PPO) | H5521: 348 | $0 | $300 | $7,500 | Yes | 4 out of 5 |
| Aetna Medicare Value Plus Plan (HMO) | H3146: 006 | $7 | $150 | $5,500 | Yes | 4 out of 5 |
Blue Cross and Blue Shield of North Carolina Medicare Plans in Wayne County, NC
The following table includes cost information and other plan details for Blue Cross and Blue Shield of North Carolina private Medicare plans available in North Carolina in 2024.
| Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
|---|---|---|---|---|---|---|
| Blue Medicare Essential (HMO) | H3449: 027 | $0 | $375 | $8,300 | Yes | 4 out of 5 |
| Blue Medicare Essential Plus (HMO-POS) | H3449: 023 | $0 | $150 | $4,900 | Yes | 4 out of 5 |
| Blue Medicare Medical Only (HMO-POS) | H3449: 012 | $0 | N/A | $3,900 | No | 4 out of 5 |
| Healthy Blue + Medicare (HMO-POS D-SNP) | H9147: 001 | $0 | $0 | $8,850 | Yes | 2.5 out of 5 |
| Blue Medicare Freedom+ (PPO) | H3404: 004 | $0 | N/A | $8,850 | No | 4.5 out of 5 |
| Blue Medicare Enhanced (HMO-POS) | H3449: 024 | $45 | $0 | $3,400 | Yes | 4 out of 5 |
| Blue Medicare PPO Enhanced (PPO) | H3404: 003 | $49 | $0 | $4,900 | Yes | 4.5 out of 5 |
Humana Inc. Medicare Plans in Wayne County, NC
The following table includes cost information and other plan details for Humana Inc. private Medicare plans available in North Carolina in 2024.
| Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
|---|---|---|---|---|---|---|
| HumanaChoice H5525-035 (PPO) | H5525: 035 | $0 | $0 | $8,000 | Yes | 4 out of 5 |
| Humana Gold Plus SNP-DE H1036-307 (HMO D-SNP) | H1036: 307 | $0 | $0 | $8,850 | Yes | 5 out of 5 |
| HumanaChoice H5525-050 (PPO) | H5525: 050 | $0 | $0 | $6,350 | Yes | 4 out of 5 |
| Humana Gold Plus H1036-291 (HMO-POS) | H1036: 291 | $0 | $0 | $3,600 | Yes | 5 out of 5 |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | H1036: 308 | $0 | $145 | $7,550 | Yes | 5 out of 5 |
| HumanaChoice H5525-071 (PPO) | H5525: 071 | $0 | $0 | $2,900 | Yes | 4 out of 5 |
| HumanaChoice SNP-DE H5525-073 (PPO D-SNP) | H5525: 073 | $0 | $0 | $8,850 | Yes | 4 out of 5 |
| HumanaChoice SNP-DE H5525-072 (PPO D-SNP) | H5525: 072 | $0 | $0 | $8,850 | Yes | 4 out of 5 |
| Humana USAA Honor (Regional PPO) | R1390: 003 | $0 | N/A | $7,550 | No | 3.5 out of 5 |
| Humana Gold Plus SNP-DE H1036-309 (HMO D-SNP) | H1036: 309 | $0 | $0 | $8,850 | Yes | 5 out of 5 |
| HumanaChoice R1390-001 (Regional PPO) | R1390: 001 | $0 | N/A | $6,350 | No | 3.5 out of 5 |
| Humana USAA Honor (PPO) | H5525: 065 | $0 | N/A | $8,850 | No | 4 out of 5 |
| HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | H5525: 036 | $0 | $0 | $8,850 | Yes | 4 out of 5 |
| Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | H1036: 167 | $0 | $0 | $8,850 | Yes | 5 out of 5 |
| HumanaChoice H5525-049 (PPO) | H5525: 049 | $41 | $0 | $5,900 | Yes | 4 out of 5 |
| HumanaChoice H5525-070 (PPO) | H5525: 070 | $47 | $545 | $7,550 | Yes | 4 out of 5 |
| HumanaChoice R1390-002 (Regional PPO) | R1390: 002 | $105 | $480 | $7,550 | Yes | 3.5 out of 5 |
UnitedHealthcare Medicare Plans in Wayne County, NC
The following table includes cost information and other plan details for UnitedHealthcare private Medicare plans available in North Carolina in 2024.
| Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
|---|---|---|---|---|---|---|
| UHC Dual Complete NC-V001 (HMO-POS D-SNP) | H5253: 116 | $0 | $0 | $3,600 | Yes | 4.5 out of 5 |
| AARP Medicare Advantage from UHC NC-0003 (PPO) | H2577: 017 | $0 | $350 | $7,500 | Yes | 3.5 out of 5 |
| AARP Medicare Advantage from UHC NC-0011 (HMO-POS) | H5253: 103 | $0 | $0 | $5,900 | Yes | 4.5 out of 5 |
| UHC Dual Complete NC-D001 (HMO-POS D-SNP) | H5253: 041 | $0 | $0 | $8,850 | Yes | 4.5 out of 5 |
| AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS) | H5253: 040 | $0 | N/A | $6,900 | No | 4.5 out of 5 |
| UHC Dual Complete NC-S001 (PPO D-SNP) | H1889: 005 | $0 | $0 | $8,850 | Yes | 4.5 out of 5 |
| UHC Nursing Home Plan NC-F001 (PPO I-SNP) | H0710: 034 | $30 | $545 | $2,300 | Yes | 5 out of 5 |
| AARP Medicare Advantage from UHC NC-0012 (HMO-POS) | H5253: 104 | $39 | $0 | $4,900 | Yes | 4.5 out of 5 |
