Medicare Plans in
Transylvania County, NC

65 Medicare Advantage Plans Found in Transylvania County. See Plans

Transylvania County, NC
Medicare Information

For Transylvania County’s Medicare beneficiaries, Medicare Advantage plans offer an alternative to Original Medicare. Currently, 65 MA plans are available in Transylvania 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.

For Transylvania County’s Medicare beneficiaries, Medicare Advantage plans offer an alternative to Original Medicare. Currently, 65 MA plans are available in Transylvania 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.

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 Medicare Advantage plans in Transylvania County, North Carolina, including average costs, out-of-pocket expenses and what’s involved in obtaining prescription drug coverage.

Average Cost of Medicare Advantage
Plans in Transylvania County

Average Cost of Medicare Advantage Plans in Transylvania County, North Carolina
Average Monthly Premium $52.75
Average in-network out-of-pocket spending limit $5,853.85
Average drug deductible in 2023 (weighted) $324.48
Percentage of plans rated 4 stars or higher 46.2%
Average Cost of Medicare Advantage Plans in Transylvania County, North Carolina
Average Monthly Premium
$52.75
Average in-network out-of-pocket spending limit
$5,853.85
Average drug deductible in 2021 (weighted)
$324.48
Percentage of plans rated 4 stars or higher
46.2%

Learn More About Medicare Advantage
Prescription Drug Plans

Transylvania County Medicare beneficiaries who are interested in a Part C policy may choose among the following types of plans, depending on their needs and circumstances:
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.
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.
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.
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.

In addition to these primary types of plans, some members 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.

Aetna Inc. Medicare Advantage Plans in Transylvania County, NC

The following table includes cost information and other plan details for Aetna Inc. Medicare Advantage plans available in North Carolina in 2023.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Aetna Medicare Premier Plan (PPO) H5521: 236 $0 $150 $4,500 Yes
3.5 out of 5
Aetna Medicare Eagle Plan (PPO) H5521: 241 $0 N/A $6,500 No
3.5 out of 5
Aetna Medicare Essential Plan (PPO) H5521: 354 $0 $200 $7,500 Yes
3.5 out of 5
Aetna Medicare Assure Plan (HMO D-SNP) H3146: 009 $0 $0 $8,300 Yes
4 out of 5
Aetna Medicare Value Plus Plan (HMO) H3146: 006 $7 $95 $5,500 Yes
4 out of 5
SilverScript Choice (PDP) S5601: 016 $36 $505 N/A Yes
3.5 out of 5
SilverScript Plus (PDP) S5601: 017 $72 $0 N/A Yes
3.5 out of 5

Alignment Health Plan

Alignment Health Plan Medicare Advantage Plans in Transylvania County, NC

The following table includes cost information and other plan details for Alignment Health Plan Medicare Advantage plans available in North Carolina in 2023.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Alignment Health Platinum (HMO-POS) H5296: 003 $0 $0 $2,499 Yes
5 out of 5
Alignment Health AVA (PPO) H7074: 001 $0 $0 $3,900 Yes
Plan too new to be measured
Blue Cross and Blue Shield of North Carolina

Blue Cross and Blue Shield of North Carolina Medicare Advantage Plans in Transylvania County, NC

The following table includes cost information and other plan details for Blue Cross and Blue Shield of North Carolina Medicare Advantage plans available in North Carolina in 2023.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Blue Medicare Freedom+ (PPO) H3404: 004 $0 N/A $8,300 No
4.5 out of 5
Blue Medicare Medical Only (HMO-POS) H3449: 012 $0 N/A $3,900 No
4.5 out of 5
Blue Medicare Essential Plus (HMO-POS) H3449: 023 $0 $150 $5,900 Yes
4.5 out of 5
Blue Medicare Essential (HMO) H3449: 027 $0 $375 $8,300 Yes
4.5 out of 5
Healthy Blue + Medicare (HMO D-SNP) H9147: 001 $0 $0 $0 Yes
Not enough data available
Blue Medicare Enhanced (HMO-POS) H3449: 024 $19 $0 $3,900 Yes
4.5 out of 5
Blue Medicare PPO Enhanced (PPO) H3404: 003 $49 $0 $5,900 Yes
4.5 out of 5
Blue Medicare Rx Standard (PDP) S5540: 002 $102 $475 N/A Yes
3 out of 5
Blue Medicare Rx Enhanced (PDP) S5540: 004 $133 $0 N/A Yes
3 out of 5
Cigna

Cigna Medicare Advantage Plans in Transylvania County, NC

The following table includes cost information and other plan details for Cigna Medicare Advantage plans available in North Carolina in 2023.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Cigna True Choice Medicare (PPO) H7849: 046 $0 $0 $6,001 Yes
3 out of 5
Cigna TotalCare (HMO D-SNP) H9725: 003 $0 $0 $0 Yes
4 out of 5
Cigna Courage Medicare (HMO) H9725: 005 $0 N/A $3,600 No
4 out of 5
Cigna Preferred Medicare (HMO) H9725: 009 $0 $0 $3,900 Yes
4 out of 5
Cigna Preferred Savings Medicare (HMO) H9725: 012 $0 $280 $7,200 Yes
4 out of 5
Cigna TotalCare Plus (HMO D-SNP) H9725: 013 $0 $0 $0 Yes
4 out of 5
Cigna Preferred Plus Medicare (HMO) H9725: 006 $27 $0 $3,900 Yes
4 out of 5
Cigna Extra Rx (PDP) S5617: 253 $68 $100 N/A Yes
3 out of 5
Humana Inc.

Humana Inc. Medicare Advantage Plans in Transylvania County, NC

The following table includes cost information and other plan details for Humana Inc. Medicare Advantage plans available in North Carolina in 2023.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
HumanaChoice H5216-343 (PPO) H5216: 343 $0 N/A $5,900 No
4.5 out of 5
HumanaChoice H5216-017 (PPO) H5216: 017 $0 $265 $8,300 Yes
4.5 out of 5
Humana Gold Plus H6622-025 (HMO-POS) H6622: 025 $0 $0 $4,900 Yes
4.5 out of 5
Humana Gold Plus SNP-DE H6622-027 (HMO-POS D-SNP) H6622: 027 $0 $0 $0 Yes
4.5 out of 5
HumanaChoice R1390-001 (Regional PPO) R1390: 001 $0 N/A $6,950 No
3.5 out of 5
Humana Honor (Regional PPO) R1390: 003 $0 N/A $7,550 No
3.5 out of 5
Humana Gold Plus H6622-026 (HMO-POS) H6622: 026 $30 $0 $4,200 Yes
4.5 out of 5
Humana Walmart Value Rx Plan (PDP) S5884: 187 $36 $505 N/A Yes
3 out of 5
HumanaChoice H5216-211 (PPO) H5216: 211 $47 $160 $6,700 Yes
4.5 out of 5
Humana Premier Rx Plan (PDP) S5884: 154 $82 $300 N/A Yes
3 out of 5
HumanaChoice R1390-002 (Regional PPO) R1390: 002 $98 $480 $7,550 Yes
3.5 out of 5

Mutual of Omaha

Mutual of Omaha Medicare Advantage Plans in Transylvania County, NC

The following table includes cost information and other plan details for Mutual of Omaha Medicare Advantage plans available in North Carolina in 2023.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Mutual of Omaha Rx Essential (PDP) S7126: 110 $20 $505 N/A Yes
2 out of 5
Mutual of Omaha Rx Premier (PDP) S7126: 077 $63 $505 N/A Yes
2 out of 5
Mutual of Omaha Rx Plus (PDP) S7126: 007 $78 $505 N/A Yes
2 out of 5

The Carle Foundation

The Carle Foundation Medicare Advantage Plans in Transylvania County, NC

The following table includes cost information and other plan details for The Carle Foundation Medicare Advantage plans available in North Carolina in 2023.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
FirstMedicare Direct POS Standard (HMO-POS) H6306: 012 $0 $150 $5,700 Yes
4 out of 5
FirstMedicare Direct POS Plus (HMO-POS) H6306: 011 $39 $0 $3,450 Yes
4 out of 5
UnitedHealthcare

UnitedHealthcare Medicare Advantage Plans in Transylvania County, NC

The following table includes cost information and other plan details for UnitedHealthcare Medicare Advantage plans available in North Carolina in 2023.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
AARP Medicare Advantage Rebate (HMO-POS) H5253: 105 $0 $435 $6,700 Yes
4.5 out of 5
UnitedHealthcare Dual Complete Select (HMO-POS D-SNP) H5253: 116 $0 $0 $0 Yes
4.5 out of 5
UnitedHealthcare Dual Complete Choice (PPO D-SNP) H1889: 005 $0 $0 $0 Yes
4 out of 5
AARP Medicare Advantage Choice (PPO) H2577: 016 $0 $250 $6,700 Yes
3 out of 5
AARP Medicare Advantage Patriot (HMO-POS) H5253: 040 $0 N/A $3,600 No
4.5 out of 5
UnitedHealthcare Dual Complete (HMO-POS D-SNP) H5253: 041 $0 $0 $0 Yes
4.5 out of 5
AARP Medicare Advantage Plan 2 (HMO-POS) H5253: 079 $0 $0 $5,900 Yes
4.5 out of 5
AARP MedicareRx Walgreens (PDP) S5921: 390 $28 $350 N/A Yes
3 out of 5
AARP Medicare Advantage Plan 1 (HMO-POS) H5253: 080 $34 $0 $4,700 Yes
4.5 out of 5
AARP MedicareRx Saver Plus (PDP) S5921: 353 $44 $505 N/A Yes
3 out of 5
AARP MedicareRx Preferred (PDP) S5820: 007 $110 $0 N/A Yes
3.5 out of 5
WellCare Health Plans, Inc.

WellCare Health Plans, Inc. Medicare Advantage Plans in Transylvania County, NC

The following table includes cost information and other plan details for WellCare Health Plans, Inc. Medicare Advantage plans available in North Carolina in 2023.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Wellcare No Premium (HMO) H4073: 001 $0 $150 $4,500 Yes
Plan too new to be measured
Wellcare Dual Access (HMO D-SNP) H4073: 002 $0 $0 $0 Yes
Plan too new to be measured
Wellcare No Premium Open (PPO) H7175: 001 $0 $150 $5,900 Yes
2.5 out of 5
Wellcare Dual Liberty Open (PPO D-SNP) H7175: 002 $0 $0 $0 Yes
2.5 out of 5
Wellcare Giveback Open (PPO) H7175: 004 $0 $250 $8,300 Yes
2.5 out of 5
Wellcare Patriot No Premium Open (PPO) H7175: 005 $0 N/A $6,500 No
2.5 out of 5
Wellcare Value Script (PDP) S4802: 143 $11 $505 N/A Yes
3 out of 5
Wellcare Assist Open (PPO) H7175: 003 $14 $505 $8,300 Yes
2.5 out of 5
Wellcare Classic (PDP) S4802: 081 $35 $505 N/A Yes
3 out of 5
Wellcare Premium Enhanced Open (PPO) H7175: 006 $55 $100 $6,500 Yes
2.5 out of 5
Wellcare Medicare Rx Value Plus (PDP) S4802: 237 $71 $0 N/A Yes
3 out of 5
Wellcare Medicare Rx Value Plus (PDP) S4802: 211 $71 $0 N/A Yes
3 out of 5