Important news for HMO and PPO members: see what’s changing and what’s staying the same for 2027. When you’re ready, talk with a licensed North Carolina agent to find the plan that fits you.
What’s Changing for 2027
Each year, Medicare Advantage plans can update their premiums, benefits, prescription drug coverage, and provider networks. The 2027 highlights arrive ahead of the Annual Enrollment Period each fall, and a short conversation with an agent is the fastest way to see how any changes affect your current coverage.
Key Medicare Dates for 2027 Coverage
Three dates matter as you review your options: your Annual Notice of Change arrives by September 30, 2026; the Annual Enrollment Period runs October 15 to December 7, 2026, with changes effective January 1, 2027; and the Medicare Advantage Open Enrollment Period runs January 1 to March 31, 2027, for anyone who needs to adjust after the year begins.
2027 Blue Medicare Advantage Plans
For 2027, Blue Cross NC offers seven Medicare Advantage plans across HMO, HMO-POS, PPO, and Dual-Eligible (D-SNP) options. Premiums, benefits, and availability vary by county, so the plan that fits you depends on where you live and how you use care. Explore the lineup below, then request a personalized quote to confirm what is offered in your area.
New to Medicare Advantage or comparing your options? Start with our overview of BCBSNC Medicare Advantage plans and Medicare Advantage plans in North Carolina.
| Plan | Type | Monthly premium | In-network max out-of-pocket | Prescription coverage | Stands out for |
|---|---|---|---|---|---|
| Blue Medicare Essential | HMO | $0 | $9,850 | Yes | Part B giveback of $40 to $55 per month |
| Blue Medicare Essential Plus | HMO-POS | $0 | $5,800 to $9,150 (by county) | Yes | Lower out-of-pocket max in most counties, OTC allowance |
| Blue Medicare Enhanced | HMO-POS | $30 to $47 | $4,900 | Yes | Lowest out-of-pocket max, $1,500 dental |
| Blue Medicare Medical Only | HMO-POS | $0 | $3,900 | No | Members with separate drug coverage; $2,000 dental, $35/mo giveback |
| Blue Medicare PPO Enhanced | PPO | $35 to $53 | $6,900 | Yes | See any Medicare provider; visitor/traveler program |
| Blue Medicare Freedom+ | PPO | $0 | $6,000 to $9,850 | Yes (with federal retiree benefits) | Pairs with federal retiree benefits; giveback up to $912/yr |
| Healthy Blue + Medicare | HMO-POS D-SNP | $0 | $9,850 | Yes | Members with both Medicare and Medicaid; $0 cost shares, $250/mo OTC and food |
Premiums and benefits vary by county and plan segment. You continue to pay your Medicare Part B premium.
Blue Medicare Essential (HMO) HMO · $0 premium · Part B giveback
HMO plan, contract H3449-027. Available in two county segments across North Carolina; some costs vary by segment.
| Benefit | Segment 1 | Segment 2 |
|---|---|---|
| Monthly premium | $0 | $0 |
| In-network max out-of-pocket | $9,850 | $9,850 |
| Primary care provider | $5 | $10 |
| Specialist | $50 | $50 |
| Hospital, days 1 to 6 (per day) | $407 | $407 |
| Outpatient hospital | $0 to $475 | $0 to $475 |
| Ambulatory surgical center | $0 to $300 | $0 to $300 |
| Skilled nursing, days 1 to 20 | $0 | $0 |
| Skilled nursing, days 21 to 100 | $221 | $221 |
| Diagnostic services, labs, imaging | $0 to $300 | $0 to $300 |
| Ground and air ambulance | $275 | $275 |
| Emergency room | $115 | $115 |
| Urgent care | $40 | $40 |
| Medicare-covered eye exam | $25 | $25 |
| Part B insulin (30-day) | $35 | $35 |
| Chemotherapy and other Part B drugs | 0 to 20% | 0 to 20% |
| Benefit | Segment 1 | Segment 2 |
|---|---|---|
| Fitness (SilverSneakers) | $0 | $0 |
| Hearing aids (1 per ear per year) | $499 to $999 | $499 to $999 |
| Vision allowance | $100 per year | $100 per year |
| Glaucoma and diabetic eye exam | $0 | $0 |
| Meals (post-discharge) | 2 per day for 7 days | 2 per day for 7 days |
| Part B Premium Reduction (giveback) | $40 per month | $55 per month |
| Tier | Your cost |
|---|---|
| Deductible | $700 (applies to Tiers 3, 4, and 5) |
| Tier 1, preferred generic | $0 |
| Tier 2, generic | $4 |
| Tier 3, preferred brand | 21% |
| Tier 4, non-preferred | 26% |
| Tier 5, specialty | 25% |
| Tier 6, select care | $0 |
Mail order: Tiers 1 and 2 up to a 90-day supply for $0; Tier 6 up to a 100-day supply for $0. Some services may require prior authorization.
Blue Medicare Essential Plus (HMO-POS) HMO-POS · $0 premium · lower out-of-pocket max
HMO-POS plan, contract H3449-023. Available in four county segments; premium and several costs vary by segment.
| Benefit | Segment 1 | Segment 2 | Segment 4 | Segment 5 |
|---|---|---|---|---|
| Monthly premium | $0 | $0 | $0 | $0 |
| In-network max out-of-pocket | $5,800 | $6,300 | $7,150 | $9,150 |
| Primary care provider | $0 | $0 | $5 | $5 |
| Specialist | $30 | $40 | $50 | $60 |
| Hospital, days 1 to 6 (per day) | $450 | $450 | $450 | $400 |
| Outpatient hospital | $0 to $475 | $0 to $475 | $0 to $475 | $0 to $475 |
| Ambulatory surgical center | $0 to $350 | $0 to $350 | $0 to $350 | $0 to $350 |
| Skilled nursing, days 1 to 20 | $10 | $10 | $10 | $0 |
| Skilled nursing, days 21 to 100 | $221 | $221 | $221 | $221 |
| Diagnostic services, labs, imaging | $0 to $300 | $0 to $300 | $0 to $300 | $0 to $300 |
| Ground and air ambulance | $300 | $300 | $300 | $300 |
| Emergency room | $130 | $130 | $130 | $115 |
| Urgent care | $50 | $50 | $50 | $40 |
| Medicare-covered eye exam | $20 | $25 | $30 | $30 |
| Part B insulin (30-day) | $35 | $35 | $35 | $35 |
| Chemotherapy and other Part B drugs | 0 to 20% | 0 to 20% | 0 to 20% | 0 to 20% |
| Benefit | Segment 1 | Segment 2 | Segment 4 | Segment 5 |
|---|---|---|---|---|
| Fitness (SilverSneakers) | $0 | $0 | $0 | $0 |
| Hearing aids (1 per ear per year) | $499 to $999 | $499 to $999 | $499 to $999 | $499 to $999 |
| Vision allowance | $200 per year | $200 per year | $200 per year | $200 per year |
| Glaucoma and diabetic eye exam | $0 | $0 | $0 | $0 |
| Dental services | $0; out-of-network at 40% | $0; out-of-network at 40% | $0; out-of-network at 40% | $0; out-of-network at 40% |
| Meals (post-discharge) | 2 per day for 7 days | 2 per day for 7 days | 2 per day for 7 days | 2 per day for 7 days |
| Tier | Your cost |
|---|---|
| Deductible | $700 (applies to Tiers 3, 4, and 5) |
| Tier 1, preferred generic | $0 |
| Tier 2, generic | $4 |
| Tier 3, preferred brand | 21% |
| Tier 4, non-preferred | 26% |
| Tier 5, specialty | 25% |
| Tier 6, select care | $0 |
Mail order: Tiers 1 and 2 up to a 90-day supply for $0; Tier 6 up to a 100-day supply for $0. Some services may require prior authorization.
Blue Medicare Enhanced (HMO-POS) HMO-POS · lowest out-of-pocket max · $1,500 dental
HMO-POS plan, contract H3449-024. Available in three county segments; premium and a few costs vary by segment.
| Benefit | Segment 1 | Segment 2 | Segment 3 |
|---|---|---|---|
| Monthly premium | $30 | $40 | $47 |
| In-network max out-of-pocket | $4,900 | $4,900 | $4,900 |
| Primary care provider | $0 | $0 | $0 |
| Specialist | $30 | $30 | $30 |
| Hospital, days 1 to 6 (per day) | $399 | $399 | $399 |
| Outpatient hospital | $0 to $410 | $0 to $410 | $0 to $410 |
| Ambulatory surgical center | $0 to $200 | $0 to $200 | $0 to $200 |
| Skilled nursing, days 1 to 20 | $10 | $10 | $10 |
| Skilled nursing, days 21 to 100 | $221 | $221 | $221 |
| Diagnostic services, labs, imaging | $0 to $300 | $0 to $300 | $0 to $300 |
| Ground and air ambulance | $250 | $250 | $250 |
| Emergency room | $130 | $130 | $130 |
| Urgent care | $50 | $50 | $50 |
| Medicare-covered eye exam | $30 | $30 | $30 |
| Part B insulin (30-day) | $35 | $35 | $35 |
| Chemotherapy and other Part B drugs | 0 to 20% | 0 to 20% | 0 to 20% |
| Benefit | Segment 1 | Segment 2 | Segment 3 |
|---|---|---|---|
| Fitness (SilverSneakers) | $0 | $0 | $0 |
| Hearing aids (1 per ear per year) | $499 to $999 | $499 to $999 | $499 to $999 |
| Vision allowance | $300 per year | $300 per year | $250 per year |
| Glaucoma and diabetic eye exam | $0 | $0 | $0 |
| Dental allowance (preventive and comprehensive) | $1,500 combined; out-of-network at 20% and 40% | $1,500 combined; out-of-network at 20% and 40% | $1,500 combined; out-of-network at 20% and 40% |
| Meals (post-discharge) | 2 per day for 7 days | 2 per day for 7 days | 2 per day for 7 days |
| OTC allowance (no rollover) | $40 per quarter | $30 per quarter | $20 per quarter |
| Tier | Your cost |
|---|---|
| Deductible | $700 (applies to Tiers 3, 4, and 5) |
| Tier 1, preferred generic | $0 |
| Tier 2, generic | $4 |
| Tier 3, preferred brand | 21% |
| Tier 4, non-preferred | 25% |
| Tier 5, specialty | 25% |
| Tier 6, select care | $0 |
Mail order: Tiers 1 and 2 up to a 90-day supply for $0; Tier 6 up to a 100-day supply for $0. Some services may require prior authorization.
Blue Medicare Medical Only (HMO-POS) HMO-POS · $0 premium · no drug coverage
HMO-POS plan, contract H3449-012. Available statewide. This plan does not include prescription drug coverage, so it suits members who already have separate Part D or creditable drug coverage.
| Benefit | Your cost |
|---|---|
| Monthly premium | $0 |
| In-network max out-of-pocket | $3,900 |
| Primary care provider | $0 |
| Specialist | $25 |
| Hospital, days 1 to 6 (per day) | $295 |
| Outpatient hospital | $0 to $275 |
| Ambulatory surgical center | $0 to $225 |
| Skilled nursing, days 1 to 20 | $0 |
| Skilled nursing, days 21 to 100 | $221 |
| Diagnostic services, labs, imaging | $0 to $300 |
| Ground and air ambulance | $250 |
| Emergency room | $150 |
| Urgent care | $65 |
| Medicare-covered eye exam | $25 |
| Part B insulin (30-day) | $35 |
| Chemotherapy and other Part B drugs | 0 to 20% |
| Benefit | Your cost |
|---|---|
| Fitness (SilverSneakers) | $0 |
| Routine hearing exam | $0 |
| Hearing aids (1 per ear per year) | $499 to $999 |
| Vision allowance | $300 per year |
| Glaucoma and diabetic eye exam | $0 |
| Dental allowance (preventive and comprehensive) | $2,000 combined; out-of-network at 20% and 40% |
| Meals (post-discharge) | 2 per day for 7 days |
| OTC allowance (no rollover) | $100 per quarter |
| Part B Premium Reduction (giveback) | $35 per month |
No prescription drug coverage is offered with this plan. Some services may require prior authorization.
Blue Medicare PPO Enhanced (PPO) PPO · see any Medicare provider
PPO plan, contract H3404-003. Available in two county segments. As a PPO, you can see any provider who accepts Medicare, in or out of network. Unless noted, costs shown are in-network.
| Benefit | Segment 1 | Segment 2 |
|---|---|---|
| Monthly premium | $35 | $53 |
| Max out-of-pocket, in-network | $6,900 | $6,900 |
| Max out-of-pocket, out-of-network | $6,900 | $6,900 |
| Primary care provider | $0 | $0 |
| Specialist | $20 | $30 |
| Hospital, days 1 to 6 (per day) | $399 | $399 |
| Outpatient hospital | $0 to $410 | $0 to $410 |
| Ambulatory surgical center | $0 to $300 | $0 to $300 |
| Skilled nursing, days 1 to 20 | $10 | $10 |
| Skilled nursing, days 21 to 100 | $221 | $221 |
| Diagnostic services, labs, imaging | $0 to $300 | $0 to $300 |
| Ground and air ambulance | $250 | $250 |
| Emergency room | $130 | $130 |
| Urgent care | $50 | $50 |
| Medicare-covered eye exam | $20 | $30 |
| Visitor/traveler program | Included | Included |
| Part B insulin (30-day) | $35 | $35 |
| Chemotherapy and other Part B drugs | 0 to 20% | 0 to 20% |
| Benefit | Segment 1 | Segment 2 |
|---|---|---|
| Vision allowance | $300 per year | $300 per year |
| Dental allowance (preventive and comprehensive) | $1,500 combined; out-of-network at 20% and 40% | $1,500 combined; out-of-network at 20% and 40% |
| OTC allowance (no rollover) | $40 per quarter | $30 per quarter |
Fitness, hearing, and other supplemental benefits are described in the Supplemental benefits section below. See Evidence of Coverage for out-of-network details.
| Tier | Your cost |
|---|---|
| Deductible | $700 (applies to Tiers 3, 4, and 5) |
| Tier 1, preferred generic | $0 |
| Tier 2, generic | $4 |
| Tier 3, preferred brand | 21% |
| Tier 4, non-preferred | 26% |
| Tier 5, specialty | 25% |
| Tier 6, select care | $0 |
Mail order: Tiers 1 and 2 up to a 90-day supply for $0; Tier 6 up to a 100-day supply for $0. Some services may require prior authorization.
Blue Medicare Freedom+ (PPO) PPO · pairs with federal retiree benefits
PPO plan, contract H3404-004. Available statewide. Designed to pair with federal retiree benefits, with Medicare Advantage paying primary. You continue to pay your Medicare Part B premium.
| Benefit | With federal retiree benefits | Without federal retiree benefits |
|---|---|---|
| Monthly premium | $0 | $0 |
| Part B Premium Reduction (giveback) | Up to $912 per year | Up to $912 per year |
| Annual max out-of-pocket | $6,000 to $9,850 | $9,850 |
| Primary doctor visit | $0 | 20% |
| Specialist doctor visit | $0 | 20% |
| Inpatient hospital | $0 | $2,241 per stay (up to 90 days) |
| Outpatient hospital facility | $0 | 20% |
| Ambulatory surgical center | $0 | 20% |
| Diagnostic services, labs, imaging | $0 | 20% |
| Diabetes supplies | $0 | 20% |
| Emergency room | $0 | $115 |
| Prescription drug coverage | Covered | Not covered |
| Routine vision services | Not covered | Not covered |
| Part B insulin (30-day) | $0 | $35 |
| Chemotherapy | $0 | 0 to 20% |
Figures for members with federal retiree benefits are illustrative and depend on your federal retiree plan, with Medicare Advantage paying primary. Members pay 40% for most out-of-network services. Some services may require prior authorization. If you also receive a Part B giveback from your federal retiree benefits, you can receive both, up to but not exceeding your total Part B premium.
Healthy Blue + Medicare (HMO-POS D-SNP) HMO-POS D-SNP · for Medicare and Medicaid · $0 cost shares
Dual-Eligible Special Needs Plan (D-SNP), contract H9147-001. Available statewide for members who have both Medicare and Medicaid. Most cost shares are $0.
| Benefit | Your cost |
|---|---|
| Monthly premium | $0 |
| Annual max out-of-pocket | $9,850 |
| Primary care provider | $0 |
| Specialist | $0 |
| Hospital, days 1 to 90 | $0 |
| Outpatient hospital | $0 |
| Ambulatory surgical center | $0 |
| Skilled nursing, days 1 to 100 | $0 |
| Diagnostic services, labs, imaging | $0 |
| Ground and air ambulance | $0 |
| Emergency room | $0 |
| Urgent care | $0 |
| Routine eye exam | $0, one per year |
| Vision allowance | $400 per year |
| Part B insulin (30-day) | $0 |
| Chemotherapy and other Part B drugs | $0 |
| Benefit | Your cost |
|---|---|
| Fitness (SilverSneakers) | $0 |
| Advanced hearing aids (1 per ear, every 3 years) | $0 |
| Dental allowance (preventive and comprehensive) | $0; up to $3,000 combined out-of-network on covered dental services |
| Meals (post-discharge) | 2 per day for 14 days |
| OTC and healthy food allowance (no rollover) | $250 per month |
| Transportation (48 one-way rides) | $0 |
| Tier | Your cost |
|---|---|
| Deductible | $0 with Extra Help. Without Extra Help, a $700 deductible and 25% coinsurance apply to Tiers 3, 4, and 5. |
| Tier 1, preferred generic | $0 |
| Tier 2, generic | $0 |
| Tier 3, preferred brand | $0 to $14.40 |
| Tier 4, non-preferred | $0 to $14.40 |
| Tier 5, specialty | $0 to $14.40 |
| Tier 6, select care | $0 |
Your drug costs depend on your level of Extra Help (the Low-Income Subsidy). Many members with full Medicaid pay $0. You may also qualify for Special Supplemental Benefits for the Chronically Ill (SSBCI); contact the plan for eligibility. Some services may require prior authorization.
Supplemental benefits
Beyond what Original Medicare covers, Blue Medicare Advantage plans add benefits that support your total health. Availability varies by plan.
| Benefit | What it includes |
|---|---|
| Part B Premium Reduction (giveback) | Contributes toward your Part B premium each month. Amounts by plan: Medical Only $35, Essential up to $55, Freedom+ $76 (up to $912 per year). You must pay your own Part B premium to qualify. |
| Over-the-counter (OTC) allowance | A quarterly allowance for OTC health and wellness items, loaded onto the Blue FlexCard. No rollover. |
| Meals | Mom's Meals post-discharge program: two meals per day for 7 days (14 days on the D-SNP plan). |
| Personal Emergency Response System (PERS) | A wearable device from Connect America that links you to a call center at the push of a button, with fall detection and caregiver alerts on most devices. |
| Support for caregivers | Carallel provides live and online support for family caregivers making decisions about senior living, in-home care, and more. |
| Vision | Coverage for eye exams plus a vision allowance on most plans. |
| Hearing | TruHearing savings on hearing aids and routine hearing exams. |
| Dental | Coverage including exams and X-rays on most plans. |
| Fitness | SilverSneakers membership at no additional cost, with access to participating gyms and an online platform. |
Not available on all plans. Blue Cross NC contracts with independent companies to provide these supplemental benefits.
Blue FlexCard
The Blue FlexCard puts your plan allowances on one convenient debit card:
| Allowance | How you use it |
|---|---|
| Over-the-counter allowance | Buy health and wellness items from the OTC catalog, or shop in-store at in-network retailers including Harris Teeter and Walmart. |
| Vision allowance | Buy prescription glasses and contact lenses at any eyewear store, including your eye doctor or a favorite online retailer. |
| Rewards | Earn reward dollars for completing healthy activities, then spend them at select stores. |
The Blue FlexCard is issued by Stride Bank, N.A., Member FDIC, under license by Mastercard. Not available on all plans; in-network stores are subject to change. Learn more at BlueCrossNC.com/Members/Medicare/Blue-Flex-Card.
Find the right 2027 plan for you
The best plan depends on your county, your doctors, and how you use care. A licensed North Carolina agent can compare your options side by side and confirm what is available where you live. You can also review Medicare enrollment periods so you know when changes can be made.
Prefer to learn in a group setting? Attend a Medicare seminar or browse our Medicare Advantage plans in North Carolina.
Blue Cross and Blue Shield of North Carolina is an HMO and HMO-POS plan with a Medicare contract. It is also a PPO plan with a Medicare contract, and an HMO-POS D-SNP plan with a Medicare contract and a North Carolina State Medicaid Agency Contract (SMAC). Enrollment in Blue Cross and Blue Shield of North Carolina depends on contract renewal. Every year, Medicare evaluates plans based on a 5-star rating system. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Marks are the property of their respective owners. Premiums, benefits, and cost shares vary by county and plan segment and may change for the plan year. Please see the Evidence of Coverage for full details.
Speak to an agent to learn more about what plan is right for you
FAQs
When can I change my Blue Medicare Advantage plan for 2027?
The Medicare Annual Enrollment Period runs October 15 to December 7, 2026, and any changes take effect January 1, 2027. A separate Medicare Advantage Open Enrollment Period runs January 1 to March 31, 2027 if you need to switch after the year starts.
What is the Annual Notice of Change, and why does it matter?
Your plan mails an Annual Notice of Change by September 30 each year. It summarizes updates to your premium, benefits, drug coverage, and network for the coming year, which makes it the easiest way to confirm your plan still fits for 2027.
Will my current Blue Medicare plan stay the same in 2027?
Medicare Advantage plans can adjust premiums, copays, covered benefits, drug formularies, and networks from one year to the next. Check your Annual Notice of Change and compare your options before the enrollment window closes.
What extra benefits can Medicare Advantage plans include?
Beyond Original Medicare, many plans add benefits such as dental, vision, hearing, fitness memberships, and over-the-counter allowances. Specific benefits vary by plan, so review the details for the plan you are considering.
Do I need to do anything to keep my current plan?
In most cases your plan renews automatically if it is still offered. Reviewing your Annual Notice of Change still helps you catch any cost or coverage changes for 2027.
When will the 2027 Blue Medicare plan details be available?
Full plan details are released ahead of the Annual Enrollment Period each fall. Watch the update videos above and speak with a licensed North Carolina agent to walk through the specifics for your situation.
What is the Medicare Prescription Payment Plan?
It is an optional program that lets you spread your out-of-pocket costs for Part D prescription drugs across the calendar year in monthly amounts, instead of paying a large sum at the pharmacy at once. It does not lower what your drugs cost in total, it changes the timing so the cost is easier to manage. There is no fee, and you opt in through your plan.
Is there a limit on what I pay for prescriptions each year?
Yes. Medicare caps what you pay out of pocket for covered Part D drugs in a year. Once you reach that annual limit, you pay nothing more for covered drugs for the rest of the year. The cap is set by Medicare and has risen a little each year, so confirm the current amount for 2027.
What is a Medicare flex card, and what does it really cover?
A flex card is a prepaid allowance card that some Medicare Advantage plans include, usually for over-the-counter health items and sometimes vision or other benefits. Despite what some television ads suggest, it is not free government money, and both the amount and what it covers vary by plan and county. The Blue Cross NC version is called the Blue FlexCard.
What is a Part B giveback?
A Part B giveback, also called a premium reduction, is a benefit some Medicare Advantage plans offer that pays part of your monthly Medicare Part B premium. You still pay your Part B premium, and the giveback amount depends on the plan and where you live.
What is an over-the-counter (OTC) allowance and how do I use it?
An OTC allowance is a set amount some plans give you to buy approved health items such as pain relievers, first-aid supplies, and vitamins, often loaded onto a benefit card. The amount and the eligible items vary by plan, and any unused balance usually does not roll over.
Will my Medicare Advantage plan include dental, vision, and hearing in 2027?
Many Medicare Advantage plans include dental, vision, and hearing benefits that Original Medicare does not, and these can change from one year to the next. Review your plan’s 2027 details, since allowances and covered services vary by plan and county.
Is SilverSneakers included in 2027 plans?
Many Medicare Advantage plans include a SilverSneakers fitness membership at no extra cost, which gives access to participating gyms and online classes. Whether it is included depends on the plan, so confirm it before you enroll.
I have both Medicare and Medicaid. Is there a plan for me?
Yes. A Dual-Eligible Special Needs Plan, or D-SNP, is built for people who have both Medicare and Medicaid, and it often includes extra support with low or zero cost shares. The Blue Cross NC D-SNP is called Healthy Blue + Medicare, and eligibility depends on your Medicaid status.