Company vs company · Mecklenburg County, NC · 2027 plan year
Humana vs Blue Cross and Blue Shield of North Carolina Medicare Advantage plans
Medicare.gov compares Medicare Advantage plans with each other. This page also shows Original Medicare, so you can see the full trade-off: premiums, copays, the yearly limit, extra benefits, and the rules about doctors and approvals.
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In most states, including North Carolina, you cannot count on getting Medigap later
You can buy any Medigap plan with no health questions in the 6 months that start when you are 65 or older and have Part B. After that, a Medigap company in North Carolina can ask about your health. It can say no, or it can charge you more. So if you join a Medicare Advantage plan now, you may not be able to get Medigap later.
One exception is the trial right. If you joined Medicare Advantage when you first got Medicare at 65, or you left a Medigap plan to try Medicare Advantage for the first time, you can switch back within 12 months. Then you can buy a Medigap plan with no health questions.
Read about Medigap rights on Medicare.govYour yearly cost, side by side
Move the controls to match your year. Totals include premiums, the Part B premium, copays, and drug costs.
Want to check your exact drugs? Medicare.gov lets you enter each drug and shows what each plan charges for it. Enter your drugs on Medicare.gov
Medicare.gov lists $114 to $505 a month for a 65-year-old woman who does not use tobacco. We start at the lowest price. Health questions can raise the price after your first 6 months with Part B.
Original Medicare
With Medigap Plan G at $114 a month and Wellcare Value Script (PDP)
$6,413 a year
- Premiums
- $3,946
- Medical costs
- $292
- Drugs
- $2,175
Most you can pay in a bad year, before drugs: $4,238.
Humana Gold Plus Giveback H1036-318 (HMO-POS)
HMO-POS from Humana
$4,614 a year
- Premiums
- $1,098
- Medical costs
- $1,813
- Drugs
- $1,703
Most you can pay in a bad year, before drugs: $10,948.
Blue Medicare Essential (HMO)
HMO from Blue Cross and Blue Shield of North Carolina
$5,633 a year
- Premiums
- $2,082
- Medical costs
- $1,612
- Drugs
- $1,939
Most you can pay in a bad year, before drugs: $11,932.
With these settings, Humana Gold Plus Giveback H1036-318 (HMO-POS) costs about $1,019 less a year than Blue Medicare Essential (HMO).
Tipping point for Humana Gold Plus Giveback H1036-318 (HMO-POS): with this drug use, if your medical copays and coinsurance in this plan pass $3,612 in a year, Original Medicare with Plan G costs less. The plan caps those costs at $9,850.
Tipping point for Blue Medicare Essential (HMO): with this drug use, if your medical copays and coinsurance in this plan pass $2,392 in a year, Original Medicare with Plan G costs less. The plan caps those costs at $9,850.
These are estimates, not quotes. Check every number with Medicare (Medicare.gov or 1-800-MEDICARE) and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Drug costs use typical prices for generic and brand-name drugs. Original Medicare amounts are 2027 projections from the 2026 Medicare Trustees Report. CMS sets the final amounts in November.
Text us about this comparisonWhat you pay each time you get care
In-network costs for one visit or one stay. The Original Medicare amounts follow your Medigap choice above: Plan G.
Primary doctor visit
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Humana Gold Plus H1036-335 (HMO-POS)
$0
HumanaChoice Giveback H5525-035 (PPO)
$0
Blue Medicare Essential Plus (HMO-POS)
$0
Blue Medicare PPO Enhanced (PPO)
$0
Specialist visit
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Humana Gold Plus H1036-335 (HMO-POS)
$10
Prior authorizationHumanaChoice Giveback H5525-035 (PPO)
$45
Prior authorizationBlue Medicare Essential Plus (HMO-POS)
$30
Blue Medicare PPO Enhanced (PPO)
$20
Lab tests
Original Medicare + Medigap Plan G
$0
most Medicare-covered tests
Humana Gold Plus H1036-335 (HMO-POS)
$0
Prior authorizationHumanaChoice Giveback H5525-035 (PPO)
$0
Prior authorizationBlue Medicare Essential Plus (HMO-POS)
$0-$35
Prior authorizationBlue Medicare PPO Enhanced (PPO)
$0-$25
Prior authorization
MRI or CT scan
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Humana Gold Plus H1036-335 (HMO-POS)
$0-$345
Prior authorizationHumanaChoice Giveback H5525-035 (PPO)
$0-$345
Prior authorizationBlue Medicare Essential Plus (HMO-POS)
$0-$300 or 20%
Prior authorizationBlue Medicare PPO Enhanced (PPO)
$0-$300 or 20%
Prior authorization
Emergency room
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Humana Gold Plus H1036-335 (HMO-POS)
$150
HumanaChoice Giveback H5525-035 (PPO)
$115
Blue Medicare Essential Plus (HMO-POS)
$130
Blue Medicare PPO Enhanced (PPO)
$130
Urgent care
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Humana Gold Plus H1036-335 (HMO-POS)
$65
HumanaChoice Giveback H5525-035 (PPO)
$40
Blue Medicare Essential Plus (HMO-POS)
$50
Blue Medicare PPO Enhanced (PPO)
$50
Outpatient surgery
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Humana Gold Plus H1036-335 (HMO-POS)
$0-$400
Prior authorizationHumanaChoice Giveback H5525-035 (PPO)
$0-$400
Prior authorizationBlue Medicare Essential Plus (HMO-POS)
$0-$350
Prior authorizationBlue Medicare PPO Enhanced (PPO)
$0-$300
Prior authorization
Ground ambulance
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Humana Gold Plus H1036-335 (HMO-POS)
$325
Prior authorizationHumanaChoice Giveback H5525-035 (PPO)
$325
Prior authorizationBlue Medicare Essential Plus (HMO-POS)
$300
Prior authorizationBlue Medicare PPO Enhanced (PPO)
$250
Prior authorization
Hospital stay, 5 days
Original Medicare + Medigap Plan G
$0
Plan G pays the $1,788 Part A deductible
Humana Gold Plus H1036-335 (HMO-POS)
$1,475
for a 5-day stay
Prior authorizationHumanaChoice Giveback H5525-035 (PPO)
$1,875
for a 5-day stay
Prior authorizationBlue Medicare Essential Plus (HMO-POS)
$2,250
for a 5-day stay
Prior authorizationBlue Medicare PPO Enhanced (PPO)
$1,995
for a 5-day stay
Prior authorization
See every cost in one table
| What you pay in network | Original Medicare + Medigap Plan G | Humana Gold Plus H1036-335 (HMO-POS) | HumanaChoice Giveback H5525-035 (PPO) | Blue Medicare Essential Plus (HMO-POS) | Blue Medicare PPO Enhanced (PPO) |
|---|---|---|---|---|---|
| Monthly premium | Part B $209.50 + Medigap Plan G $114 + drug plan $5.30 | $0 (pays back $1 a month of your Part B premium) + Part B $209.50 | $0 (pays back $110 a month of your Part B premium) + Part B $209.50 | $0 + Part B $209.50 | $45 + Part B $209.50 |
| Yearly limit on what you pay | You pay the $292 Part B deductible. Plan G pays the rest. | $3,950 in network | $9,850 in network; $14,800 in and out of network | $5,900 in network | $6,900 in network; $6,900 in and out of network |
| Medical deductible | $292 Part B. Plan G pays the $1,788 Part A deductible. | $0 | $600 | $130 | $210 |
| Primary doctor visit | $0, after the $292 yearly Part B deductible | $0 copay | $0 copay | $0 copay | $0 copay |
| Specialist visit | $0, after the $292 yearly Part B deductible | $10 copayPrior authorization | $45 copayPrior authorization | $30 copay | $20 copay |
| Lab tests | $0, most Medicare-covered tests | $0 copayPrior authorization | $0 copayPrior authorization | $0-$35 copayPrior authorization | $0-$25 copayPrior authorization |
| MRI or CT scan | $0, after the $292 yearly Part B deductible | $0-$345 copayPrior authorization | $0-$345 copayPrior authorization | $0-$300 copay, 20% coinsurancePrior authorization | $0-$300 copay, 20% coinsurancePrior authorization |
| X-rays | $0, after the $292 yearly Part B deductible | $0-$145 copayPrior authorization | $0-$145 copayPrior authorization | $0-$30 copayPrior authorization | $0-$30 copayPrior authorization |
| Emergency room | $0, after the $292 yearly Part B deductible | $150 copay | $115 copay | $130 copay | $130 copay |
| Urgent care | $0, after the $292 yearly Part B deductible | $65 copay | $40 copay | $50 copay | $50 copay |
| Outpatient hospital | $0, after the $292 yearly Part B deductible | $0-$475 copayPrior authorization | $0-$475 copayPrior authorization | $0-$575 copayPrior authorization | $0-$410 copayPrior authorization |
| Surgery center | $0, after the $292 yearly Part B deductible | $0-$400 copayPrior authorization | $0-$400 copayPrior authorization | $0-$350 copayPrior authorization | $0-$300 copayPrior authorization |
| Ground ambulance | $0, after the $292 yearly Part B deductible | $325 copayPrior authorization | $325 copayPrior authorization | $300 copayPrior authorization | $250 copayPrior authorization |
| Hospital stay | $0, Plan G pays the $1,788 Part A deductible | $295 per day for days 1-5; $0 per day for days 6-90Prior authorization | $375 per day for days 1-7; $0 per day for days 8-90Prior authorization | $450 per day for days 1-6; $0 per day for days 7-90Prior authorization | $399 per day for days 1-6; $0 per day for days 7-90Prior authorization |
| Skilled nursing facility | $0, Plan G pays days 21-100 | $20 per day for days 1-20; $221 per day for days 21-100Prior authorization | $0 per day for days 1-20; $221 per day for days 21-100Prior authorization | $10 per day for days 1-20; $221 per day for days 21-100Prior authorization | $10 per day for days 1-20; $221 per day for days 21-100Prior authorization |
| Mental health visit | $0, after the $292 yearly Part B deductible | $35 copayPrior authorization | $35 copayPrior authorization | $30 copay | $20 copay |
| Physical therapy | $0, after the $292 yearly Part B deductible | $25 copayPrior authorization | $25 copayPrior authorization | $40 copay | $25 copay |
| Home health care | $0, Medicare-covered home health | $0 copayPrior authorization | $0 copayPrior authorization | $0 copayPrior authorization | $0 copayPrior authorization |
| Medical equipment | $0, after the $292 yearly Part B deductible | 20% coinsurancePrior authorization | 13% coinsurancePrior authorization | 20% coinsurancePrior authorization | 20% coinsurancePrior authorization |
| Part B drugs | $0 after the $292 Part B deductible | 0%-20% coinsurancePrior authorization | 0%-20% coinsurancePrior authorization | 0%-20% coinsurancePrior authorization | 0%-20% coinsurancePrior authorization |
| Drug deductible (Part D) | $700 with Wellcare Value Script (PDP) | $700 | $700 | $700 | $700 |
| Drug tiers (one month, retail) | Generic: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 45% coinsuranceInjectable Drugs: 15% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $11 copay | Preferred Generic: $0 copayGeneric: $5 copayPreferred Brand: 17% coinsuranceNon-Preferred Drug: 44% coinsuranceSpecialty Tier: 25% coinsurance | Preferred Generic: $0 copayGeneric: $4 copayPreferred Brand: 19% coinsuranceNon-Preferred Drug: 30% coinsuranceSpecialty Tier: 25% coinsurance | Preferred Generic: $0 copayGeneric: $4 copayPreferred Brand: 21% coinsuranceNon-Preferred Drug: 26% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $0 copay | Preferred Generic: $0 copayGeneric: $4 copayPreferred Brand: 21% coinsuranceNon-Preferred Drug: 26% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $0 copay |
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A higher drug plan premium is not, by itself, a reason to switch
With Original Medicare, you buy a separate drug plan. In North Carolina, 11 drug plans are for sale for 2027, from $5.30 to $239.20 a month. Half of them cost $130.20 a month or less.
- Every 2027 drug plan limits what you pay for covered drugs to $2,400 a year. The drug coverage in Medicare Advantage plans has the same limit.
- The premium is one part of your yearly cost. The calculator above adds premiums, medical costs, and drug costs, so you can see the whole year.
- A Medicare Advantage plan can cost less in a light year. But you also take on its network and prior authorization rules, and you may not be able to get Medigap later.
- If your income is limited, Extra Help can pay most of your drug plan premium and drug costs. Check Extra Help at SSA.gov
The two companies in Mecklenburg County
Humana
- 14 plans for 2027 (not counting special needs plans)
- 10 with a $0 premium; 8 pay back part of your Part B premium
- Yearly limits from $3,950 to $9,850
- Star ratings 3.5 to 4.5
- Humana Gold Plus H1036-335 (HMO-POS) · $0 a month · limit $3,950
- HumanaChoice Giveback H5525-035 (PPO) · $0 a month · limit $9,850
- Humana USAA Honor Giveback (PPO) · $0 a month · limit $9,850
- Humana Gold Plus Giveback H1036-318 (HMO-POS) · $0 a month · limit $9,850
- Humana Gold Plus H1036-137 (HMO-POS) · $0 a month · limit $9,850
- Humana Full Access (Regional PPO) · $158 a month · limit $9,850
- Humana USAA Honor Giveback (Regional PPO) · $0 a month · limit $9,850
- HumanaChoice H5525-070 (PPO) · $13.30 a month · limit $9,850
- HumanaChoice H5216-211 (PPO) · $67 a month · limit $9,850
- HumanaChoice Giveback H5216-017 (PPO) · $0 a month · limit $9,850
- HumanaChoice R0110-004 (Regional PPO) · $0 a month · limit $9,850
- Humana USAA Honor Giveback (PPO) · $0 a month · limit $9,850
- Humana Gold Plus Giveback H1036-343 (HMO-POS) · $0 a month · limit $9,850
- HumanaChoice H7617-122 (PPO) · $13 a month · limit $9,850
Blue Cross and Blue Shield of North Carolina
- 6 plans for 2027 (not counting special needs plans)
- 4 with a $0 premium; 3 pay back part of your Part B premium
- Yearly limits from $3,900 to $9,850
- Star ratings 4 to 4.5
- Blue Medicare Essential Plus (HMO-POS) · $0 a month · limit $5,900
- Blue Medicare PPO Enhanced (PPO) · $45 a month · limit $6,900
- Blue Medicare Enhanced (HMO-POS) · $41 a month · limit $4,900
- Blue Medicare Essential (HMO) · $0 a month · limit $9,850
- Blue Medicare Medical Only (HMO-POS) · $0 a month · limit $3,900
- Blue Medicare Freedom+ (PPO) · $0 a month · limit $9,850
Doctors, referrals, and prior authorization
Cost is one side. The other side is how you get care. These rules come from the CMS plan files. Prior authorization means the plan must approve a service before you get it.
Original Medicare
- Any doctor or hospital in the U.S. that takes Medicare
- No referrals
- Prior authorization only for a short list of services
Humana Gold Plus H1036-335 (HMO-POS)
HMO-POS
- You use the plan network. Some care outside the network is covered at a higher cost.
- No referral needed to see a specialist.
Prior authorization for 24 services
Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs
HumanaChoice Giveback H5525-035 (PPO)
PPO
- The plan has a network. You can go outside it, but you pay more.
- No referral needed to see a specialist.
Prior authorization for 24 services
Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs
Blue Medicare Essential Plus (HMO-POS)
HMO-POS
- You use the plan network. Some care outside the network is covered at a higher cost.
- No referral needed to see a specialist.
Prior authorization for 14 services
Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Surgery center, Ambulance, Home health, Partial hospitalization, Medical equipment, Prosthetics, Diabetic supplies, Hospital stay, Skilled nursing, Part B drugs
Blue Medicare PPO Enhanced (PPO)
PPO
- The plan has a network. You can go outside it, but you pay more.
- No referral needed to see a specialist.
Prior authorization for 14 services
Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Surgery center, Ambulance, Home health, Partial hospitalization, Medical equipment, Prosthetics, Diabetic supplies, Hospital stay, Skilled nursing, Part B drugs
Extra benefits
| Extra benefit | Original Medicare | Humana Gold Plus H1036-335 (HMO-POS) | HumanaChoice Giveback H5525-035 (PPO) | Blue Medicare Essential Plus (HMO-POS) | Blue Medicare PPO Enhanced (PPO) |
|---|---|---|---|---|---|
| Dental | No | Comprehensive, up to $4,000 a year | Preventive only | Preventive only | Comprehensive, up to $1,500 a year |
| Eye exam | No | Yes | Yes | Yes | Yes |
| Glasses or contacts | No | Yes, $450 allowance | Yes, $150 allowance | Yes | Yes |
| Hearing aids | No | Yes, copays from $0 | Yes, copays from $575 | Yes, copays from $499 | No |
| Over-the-counter allowance | No | No | No | Yes, limited | $136 a year |
| Fitness benefit | No | Yes | Yes | Yes | No |
| Rides to care | No | No | No | No | No |
| Meals after a hospital stay | No | Yes | Yes | Yes | No |
| Emergency care abroad | Plan G and Plan N pay 80% after a $250 deductible | Yes | Yes | Yes | Yes |
| Part B premium giveback | No | $1 a month | $110 a month | No | No |
What changed for 2027
Humana Gold Plus H1036-335 (HMO-POS)
Renewal Plan with SAR · 2026 plan H1036-335-2
- Drug deductible up from $250 to $700
- Part B giveback down from $2 to $1
- Diagnostic radiology (MRI, CT): $0-$335 copay to $0-$345 copay
- Outpatient hospital: $0-$395 copay to $0-$475 copay
- Ground ambulance: $335 copay to $325 copay
- Skilled nursing facility: $20 per day for days 1-20; $218 per day for days 21-100 to $20 per day for days 1-20; $221 per day for days 21-100
- Dental maximum up from $2,500 to $4,000
- Eyewear allowance up from $250 to $450
- OTC allowance removed
HumanaChoice Giveback H5525-035 (PPO)
Renewal Plan with SAR · 2026 plan H5525-035-0
- In-network out-of-pocket maximum up from $9,250 to $9,850
- Medical deductible up from $400 to $600
- Drug deductible up from $450 to $700
- Part B giveback down from $117 to $110
- Specialist visit: $35 copay to $45 copay
- Diagnostic radiology (MRI, CT): $0-$335 copay to $0-$345 copay
- Outpatient hospital: $0-$450 copay to $0-$475 copay
- Ground ambulance: $335 copay to $325 copay
- Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
- Overall star rating up from 3.5 to 4
Blue Medicare Essential Plus (HMO-POS)
Consolidated Renewal Plan · 2026 plan H3449-023-1
- In-network out-of-pocket maximum up from $4,900 to $5,900
- Medical deductible up from $0 to $130
- Drug deductible up from $615 to $700
- Specialist visit: $20 copay to $30 copay
- Outpatient hospital: $0-$400 copay to $0-$575 copay
- Inpatient hospital: $400 per day for days 1-6; $0 per day for days 7-90 to $450 per day for days 1-6; $0 per day for days 7-90
- Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-100 to $10 per day for days 1-20; $221 per day for days 21-100
- Comprehensive dental removed
- Rides to care removed
Blue Medicare PPO Enhanced (PPO)
Renewal Plan · 2026 plan H3404-003-1
- Monthly premium up from $35 to $45
- In-network out-of-pocket maximum up from $6,300 to $6,900
- Medical deductible up from $0 to $210
- Drug deductible up from $100 to $700
- Outpatient hospital: $0-$335 copay to $0-$410 copay
- Inpatient hospital: $350 per day for days 1-6; $0 per day for days 7-90 to $399 per day for days 1-6; $0 per day for days 7-90
- Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-100 to $10 per day for days 1-20; $221 per day for days 21-100
- Dental maximum down from $2,000 to $1,500
- Yearly OTC allowance down from $160 to $136
- Hearing aids removed
- Rides to care removed
- Fitness benefit removed
- Meals after a hospital stay removed
More 2027 plans in Mecklenburg County
- AARP Medicare Advantage from UHC NC-15 (HMO-POS), H5253-117
- AARP Medicare Advantage from UHC NC-0021 (HMO-POS), H5253-037
- Aetna Medicare Signature (PPO), H5521-081
- AARP Medicare Advantage from UHC NC-0022 (HMO-POS), H5253-038
- AARP Medicare Advantage Patriot No Rx NC-MA02 (HMO-POS), H5253-040
- HealthSpring Preferred (HMO), H9725-009
- Aetna Medicare Signature Giveback (PPO), H5521-348
- HealthSpring Preferred Savings (HMO), H9725-015
County guide: 2027 plans in Mecklenburg CountyState guide: North Carolina
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Sources and method
Plan data comes from the CMS 2027 Plan Benefit Package and landscape files. The data is from 2026-10-10. We checked a sample of plans field by field against Medicare.gov. Original Medicare amounts are the 2027 projections in the 2026 Medicare Trustees Report (Tables V.E1 and V.E2). CMS sets the final amounts in November. Medigap prices are the range Medicare.gov showed for ZIP 28202 on 2026-10-09. Totals use typical Medicare-allowed amounts for each service and typical drug prices.
- Humana Gold Plus H1036-335 (HMO-POS) on Medicare.gov · plan website · drug list · doctor directory
- HumanaChoice Giveback H5525-035 (PPO) on Medicare.gov · plan website · drug list · doctor directory
- Blue Medicare Essential Plus (HMO-POS) on Medicare.gov · plan website · drug list · doctor directory
- Blue Medicare PPO Enhanced (PPO) on Medicare.gov · plan website · drug list · doctor directory
- Medigap prices for ZIP 28202 on Medicare.gov
- CMS Plan Benefit Package files, 2027
- CMS 2027 landscape files (premiums and limits)
- CMS 2027 plan crosswalk
- CMS 2027 Star Ratings
- 2026 Medicare Trustees Report: projected 2027 Part A and Part B amounts (Tables V.E1 and V.E2)
- CMS 2026 Part A and Part B amounts
- Medicare.gov: Medigap guaranteed issue rights
These are estimates, not quotes, and they are for education only. Check every number with Medicare and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Plans can change their benefits, premiums, drug lists, and networks each year.
Pinnie is not an insurance agent or broker and does not sell Medicare plans. Pinnie is not connected with or endorsed by the U.S. government or the federal Medicare program. For all your options, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.