TSM Life & Health is a licensed, independent insurance agency serving North Carolina. For 2026, three anchor counties — Mecklenburg (Charlotte), Wake (Raleigh) and Guilford (Greensboro) — together list 129 Medicare Advantage plans with drug coverage (MA-PD), 89 of them at a $0 monthly premium, with CMS Overall Star Ratings up to 5 stars. On the ACA Marketplace, a single 40-year-old earning $40,000 sees 44–83 plans and monthly premium tax credits of roughly $256–$304 depending on county. We help North Carolina neighbors compare these options in plain language, at no cost.
Medicare Advantage availability is set county by county, so we profile three representative North Carolina metros as anchors. Your exact options depend on your ZIP code, doctors and prescriptions.
Every stat below is a live pull of the CMS Medicare Advantage / Part D Landscape for contract year 2026, covering non-SNP MA-PD plans in each county. Averages are computed across all MA-PD plans listed for that county.
| County (metro / ZIP) | MA-PD plans | $0 premium | Avg premium/mo | Avg in-network MOOP | Avg Part D deductible | Plans 4 stars+ |
|---|---|---|---|---|---|---|
| Mecklenburg (Charlotte, 28202) | 43 | 29 | $21.88 | $6,254 | $465 | 28 |
| Wake (Raleigh, 27601) | 38 | 26 | $18.16 | $6,118 | $450 | 25 |
| Guilford (Greensboro, 27401) | 48 | 34 | $16.57 | $5,828 | $441 | 33 |
Prefer to start with the basics of Part C, Supplements and Part D? See our Medicare coverage overview.
North Carolina uses the federal HealthCare.gov Marketplace. The table below shows total 2026 plan availability and an example advance premium tax credit (APTC) for a single adult age 40 earning $40,000 per year — your own subsidy depends on household size, income and age.
| County (metro / ZIP) | Marketplace plans (2026) | Example monthly APTC | Example lowest net premium/mo |
|---|---|---|---|
| Mecklenburg (Charlotte, 28202) | 81 | $296 | $150.85 |
| Wake (Raleigh, 27601) | 44 | $304 | $141.74 |
| Guilford (Greensboro, 27401) | 83 | $256 | $165.96 |
Example figures are for illustration only, not a quote or an offer of coverage. We help you check your own subsidy and compare plans that keep your doctors in network.
TSM Life & Health is an independent, licensed insurance agency (National Producer Number 3481853) authorized to serve residents of North Carolina, along with Connecticut, Florida, Virginia, Washington DC, Arizona, Massachusetts and Delaware. We are not a government agency and are not connected with or endorsed by the U.S. government, the federal Medicare program, CMS or the SSA. You always work directly with a licensed advisor — by phone, video or in plain email — at no cost and with no pressure.
Yes. TSM Life & Health is an independent, licensed insurance agency (NPN 3481853) authorized to help residents in North Carolina, along with CT, FL, VA, DC, AZ, MA and DE.
Availability is set by county. In three anchor North Carolina counties for 2026, CMS lists 43 MA-PD plans in Mecklenburg (Charlotte), 38 in Wake (Raleigh) and 48 in Guilford (Greensboro) — 129 plans in all, 89 of them at a $0 monthly premium.
Yes. For 2026, 29 of 43 MA-PD plans in Mecklenburg County, 26 of 38 in Wake County and 34 of 48 in Guilford County carry a $0 monthly plan premium. A $0 premium does not mean $0 cost — you still pay your Medicare Part B premium and any plan copays or coinsurance.
Many households qualify. For 2026, a single adult age 40 earning $40,000 sees monthly advance premium tax credits (APTC) of about $296 in Mecklenburg, $304 in Wake and $256 in Guilford County, with 44 to 83 Marketplace plans to choose from depending on county. Your own subsidy depends on household size, income and age.
Beyond Medicare and ACA coverage, we help with life insurance, final expense coverage, annuities and lifetime income, indexed universal life, and Social Security timing guidance.
Sources. Medicare Advantage plan counts, $0-premium counts, average monthly consolidated (Part C and D) premiums, in-network out-of-pocket maximums, Part D deductibles and CMS Overall Star Ratings come from the CMS Medicare Advantage / Part D Landscape files for contract year 2026 (cms.gov), queried for Mecklenburg, Wake and Guilford counties, NC, covering non-SNP MA-PD plans. ACA Marketplace plan counts and example advance premium tax credit (APTC) amounts come from the HealthCare.gov Marketplace API for 2026, for a single adult age 40 earning $40,000 per year. County lookups by ZIP use the CMS Marketplace county-FIPS service. Averages are computed across the MA-PD plans listed in each county. Data accessed July 31, 2026.
TSM Life & Health is an independent, licensed insurance agency. We do not offer every plan available in your area. Any information we provide is limited to the plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Assistance Program (SHIP) to get information on all of your options. For ACA coverage, see HealthCare.gov. We are not connected with or endorsed by the U.S. government, the federal Medicare program, CMS or the SSA. Example figures are illustrations, not quotes or guarantees of coverage or savings. Verify current plan details with a licensed agent before enrolling.
Most North Carolina residents choose between three building blocks. There is no single "best" path — the right fit depends on your doctors, prescriptions and budget. We do not offer every plan available in your area.
| Coverage path | What it is | Good to know |
|---|---|---|
| Original Medicare | Federal Part A (hospital) + Part B (medical). | Covers essentials, but not everything — no built-in drug coverage and no annual out-of-pocket cap. |
| Medicare Advantage (Part C) | Bundles Part A and B, and usually Part D, through a private plan. | Often adds extra benefits and a yearly out-of-pocket cap; uses a provider network. |
| Medicare Part D | Prescription drug coverage from a private plan. | Pairs with Original Medicare, or is built into most Medicare Advantage plans. |
Timing matters — enrolling in the right window helps you avoid gaps and late penalties.
| Enrollment period | When it runs | What it is for |
|---|---|---|
| Initial Enrollment Period (IEP) | The 7 months around your 65th birthday — the 3 months before, your birthday month, and the 3 months after. | Your first chance to sign up for Medicare. |
| General Enrollment Period (GEP) | January 1 – March 31. | For those who missed their IEP; coverage starts the first of the month after you sign up. |
| Annual Enrollment Period (AEP) | October 15 – December 7. | Switch, join or drop Medicare Advantage or Part D; changes take effect January 1. |
| Medicare Advantage Open Enrollment | January 1 – March 31. | If already in a Medicare Advantage plan, make one change. |
A Special Enrollment Period (SEP) may also apply after a qualifying life event — for example, losing employer coverage or moving to a new area.
You may be eligible for Medicare if any of the following apply:
Sources: CMS Medicare Monthly Enrollment (data.cms.gov), 2025 annual figures for North Carolina; stand-alone Part D plan count from the CMS Medicare Advantage / Part D Landscape, contract year 2026. Medicare Advantage plan counts and premiums vary by county — see the county tables above. Accessed 2026-07-31.
No pressure and no cost — just clear help understanding your choices:
These free, official resources can help you research every option — not just the plans any one agency offers:
Medicare is usually the reason people call, but it’s rarely the only thing on the kitchen table. We’re an independent agency, so we compare across carriers rather than representing one — and a fair number of these conversations end with us telling someone that what they already have is the right fit.
Not sure which of these applies to you? That’s a normal place to start. Book a free consultation or call 203-951-0339 and ask one question — that is allowed.
You will probably recognize yourself in one of these. Each one starts in a different place, so each one gets a different first conversation.
There are three shopping bags of mail on the table, every plan claims to be free, and you’d like to keep your cardiologist. We start with your doctors and your prescriptions, then look at the plans — not the other way around.
Start with MedicareYou’re the one reading small print at 11pm, wondering whether the postcard that looks like a Medicare card is a scam. Bring us the mail. We’ll tell you what’s real, and you can put us on speakerphone with your mother.
See how we workCOBRA quoted more than the mortgage payment and you’ve got a few years to get to Medicare. We help you think through the income estimate the Marketplace runs on, and set the calendar so you land on Medicare at 65 without a gap or a penalty.
Read the ACA guideSize it before you shop it — debt, income to replace, mortgage, education, minus what you already have. Then match the tool: term for the years with a mortgage and children in the house, a smaller permanent policy for what never expires.
See life insuranceNone of these are dramatic enough to notice in the mail. All three show up later — at the pharmacy counter, at the front desk, or in a monthly check that can’t be changed.
Working past 65 does not always let you delay Medicare. Whether you can wait depends on the size of your employer and whether the coverage counts as creditable. Nothing that arrives in the mail tells you which case you’re in, and the penalties for guessing wrong are added to your premium for as long as you hold the coverage. Here is how the enrollment windows actually work.
The higher earner’s Social Security decision is really the survivor’s decision. When one spouse dies, the survivor keeps the larger of the two checks — not both. So the higher earner’s claiming age sets the income the widow or widower lives on, potentially for decades. It’s the single most expensive thing to get wrong, and the easiest to miss. We walk through 62 versus 67 versus 70 here.
“Keep what I have” is one of the options being compared, not the default. Plans change every year — premiums, formularies, networks, the out-of-pocket maximum — and so does your life. Once a year we re-run your drug list and your doctors against the plans we offer in your area. If the plan you have is still the right one, that’s what we tell you, and it costs nothing either way. That yearly review is the part of the relationship that matters most.
Happy to look at any of this with you, at your pace. Our office is at 479 New Haven Avenue in Milford, Connecticut, and a real person answers the phone Monday to Friday 9–6 and Saturday 10–2. Get in touch.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP), to get information on all of your options. TSM Life & Health is a licensed independent insurance agency and is not connected with, affiliated with, or endorsed by the U.S. government, the federal Medicare program, the Social Security Administration, or the Centers for Medicare & Medicaid Services (CMS). This is a solicitation for insurance; a licensed insurance agent may contact you. Product availability and benefits vary by state and carrier, and all guarantees are backed solely by the claims-paying ability of the issuing insurance company. This page is general educational information only and is not insurance, tax, legal, or investment advice.
Tell us your ZIP, doctors and prescriptions and we will help you match a plan, at no cost and no pressure.