Frequently Asked Questions

Q. I Have the NC State Health Insurance Plan for Teachers and State Employees. Should I consider a Medicare Supplement plan?

A. Yes. The NC State Health Insurance Plan provides health care coverage to more than 668,000 teachers, state employees, retirees, current and former lawmakers, state university and community college personnel, state hospital staff and their dependents.

The Plan is self-insured and exempt from the Employee Retirement Income Security Act as a government-sponsored plan. The Plan offers two PPO plans, using the Blue Options network. When you reach Medicare eligibility, Medicare is YOUR primary coverage. You need to realize the amounts of coinsurance exposure you will have with Medicare and the State Health Plan.

You can choose to purchase a Medicare Supplement plan to cover the gap in the NC State Health Plan and reduce your exposure to medical expenses not covered by the state plan.

Many NC state retirees see the value in purchasing a Medicare Supplement policy to cover the gaps in the state health plan and cover the gaps in regular Medicare. The best time to purchase a Medicare Supplement policy is when you are turning 65 or during your Open Enrollment period. The NC State Health Plan provides credible prescription drug coverage so NC state retirees do not need to purchase a Medicare Part D Drug Plan.

Q. I have VA benefits or TRICARE. Should I consider a Medicare Supplement plan?

A. TRICARE for Life will work as your supplement to Medicare. VA benefits are different from TRICARE benefits. If you have good VA facilities nearby, you may feel comfortable that you’re protected from major medical expenses and have good and easy access to medical services. However, there are many former service people who live a pretty good distance from a VA facility and/or hospital. If you live a long distance from a VA hospital and have a medical emergency, you will be covered at a local hospital; however, they will want to transport you to a VA hospital as soon as you’re stable. Quality of care and availability varies with each VA facility. If you are a VA recipient, you might consider purchasing a Medicare Supplement plan to provide convenient choices for your health care options.

Q. I have a Medicare Advantage Plan. Should I consider a Medicare Supplement plan?

A. If you currently have a Medicare Advantage Plan, you should not buy a Medicare Supplement plan. A Medicare Supplement plan is intended to cover the gaps in Original Medicare. Medicare Advantage Plans replace Original Medicare and all your benefits are received through a private insurance company. So, if you have a Medicare Supplement plan and are on a Medicare Advantage Plan, you’re paying for coverage that you can’t use. It is actually illegal for an insurance agent to sell you a Medicare Supplement if you are currently on a Medicare Advantage Plan (and insurance companies go through great effort to prevent this from happening) - unless you are in the process of switching from a Medicare Advantage Plan to Original Medicare in a special enrollment period or annual enrollment period (October 15-December 7 of each year).

Medicare Supplement Insurance Helpline: 1-800-290-6188

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