2,229,392
Total Medicare beneficiaries
55.3%
On Medicare Advantage
44.7%
On Original Medicare
$202.90
Standard Part B premium (2026)
Medicare Enrollment by County in North Carolina
The 15 most-populous counties by Medicare beneficiaries. Click any column heading to sort. Medicare Advantage percentage is the share of each county’s beneficiaries enrolled in an MA or other health plan.
| Wake County | 178,568 | 51.1% |
| Mecklenburg County | 159,648 | 53.6% |
| Guilford County | 107,657 | 68.8% |
| Forsyth County | 82,196 | 66.3% |
| Buncombe County | 66,282 | 47.0% |
| Brunswick County | 62,623 | 41.7% |
| Cumberland County | 59,292 | 53.1% |
| Durham County | 53,947 | 50.3% |
| New Hanover County | 53,022 | 42.3% |
| Gaston County | 48,021 | 61.2% |
| Union County | 40,021 | 51.6% |
| Iredell County | 39,629 | 57.2% |
| Davidson County | 38,543 | 70.7% |
| Johnston County | 38,532 | 55.7% |
| Cabarrus County | 38,376 | 60.5% |
Key Findings: Medicare in North Carolina
- 1North Carolina has about 2.23 million Medicare beneficiaries across 100 counties.
- 255.3% of North Carolina beneficiaries are on Medicare Advantage, above the national average.
- 3Piedmont Triad counties have the highest MA penetration in the state — Davidson (70.7%) and Guilford (68.8%).
- 4Coastal retirement counties lean toward Original Medicare — Brunswick (41.7%) and New Hanover (42.3%).
- 5North Carolina expanded Medicaid in December 2023, opening new dual-eligibility options for lower-income beneficiaries.
How North Carolina Compares to National Averages
Medicare Advantage penetration
North Carolina is at 55.3%, 1.3 points above the national average of about 54%.
Plans available
Nationally, the average beneficiary can choose from about 32 Medicare Advantage prescription-drug plans for 2026. The exact number available depends on your county.
Medicare Supplement (Medigap)
Nationally, about 41.9% of Original Medicare beneficiaries carry a Medigap policy (AHIP, 2023). State-by-state Medigap rates are not published in an open dataset, so this figure is national. In North Carolina, 44.7% of beneficiaries are in Original Medicare and therefore eligible to buy Medigap.
Find the Best Medicare Plan in Your North Carolina County
The right plan depends on where you live. Get a free, personalized review of the Medicare options available in your North Carolina county from a licensed advisor.
Get My Free Medicare ReviewMethodology & Sources
Enrollment and county data: Centers for Medicare & Medicaid Services, Medicare Monthly Enrollment, 2024 (data.cms.gov). Figures are 2024 annual counts. Medicare Advantage percentage = (beneficiaries in Medicare Advantage & Other Health Plans ÷ total beneficiaries) × 100. The county table shows the 15 most-populous counties of 100 total.
Part B premium: CMS, 2026 Medicare Parts A & B Premiums and Deductibles. The standard premium is set federally and is the same in every state; higher-income beneficiaries pay an income-related adjustment (IRMAA).
Plan counts and Medigap: KFF, Medicare Advantage 2026 Spotlight (CMS Landscape files); AHIP, The State of Medicare Supplement Coverage, 2023. These are reported as national figures only.
Limitations: Medicare Supplement (Medigap) enrollment and per-county plan counts are not available in an open dataset at the state or county level, so they are not shown per county. Percentages are rounded. Last updated 2026-06-11.
This page is for educational purposes. HealthPlan Connect is not affiliated with or endorsed by CMS or any government agency. Contact a licensed advisor for current plan options in your area.