Do I Qualify for Financial Assistance with Medigap Premiums, As a Low-Income Senior Residing, in Greensboro and Receiving Care From Cone Health?
Real numbers. Real Guilford County context.
I track every Medigap rate filing in North Carolina. Medicare.gov shows you today’s price — it can’t tell you which carrier has raised rates three years running.
What does the data actually show for this Medicare question?
| Household size | Full Extra Help income limit (2026) | Partial Extra Help (up to 150% FPL) |
|---|---|---|
| 1 person | $23,475/yr | $23,475/yr |
| 2 people | $31,725/yr | $31,725/yr |
| 3 people | $39,975/yr | $39,975/yr |
| 4 people | $48,225/yr | $48,225/yr |
Resource (asset) limit: $17,600 single / $35,130 married. Extra Help reduces or eliminates Part D premiums, deductible, and copays. Apply at ssa.gov/medicare/part-d-extra-help.
What are the 2026 Medicare numbers for Guilford County residents?
What is Plan Match?
Three are specific to Guilford County. Two apply to every NC resident. All five are fixable — if you catch them before enrollment.
What's the difference between doing it alone and working with an independent NC broker?
| What you need | Doing it alone | Robert Simm — NC #10447418 |
|---|---|---|
| Plans you can compare | Whatever Medicare.gov lists, no NC context | Every major NC carrier, filtered to your situation |
| Guilford County network knowledge | Generic federal directories, often 6 months stale | Direct contract verification with each carrier |
| 2026 numbers applied to your budget | Generic rules — no IRMAA math, no spousal coordination | Run with your real income and household |
| Part D formulary check | Manual entry per drug, per plan | I pre-check every prescription on every eligible plan |
| Same person next year | Different agent every call | Same broker, same answer, every AEP |
| Cost | $0 (just your time and risk) | $0 — paid by carrier |
Which Cone Health facilities serve Guilford County?
Cone Health is the health system on record for Guilford County, and 3 facilities in the county carry its name — which does not mean they all sit on the same plan contracts.
Cone Health’s published Medicare contract list names Aetna, Blue Cross Blue Shield NC, Cigna, Devoted Health, HealthTeam Advantage, Humana, Liberty Advantage, Longevity Health Plan of North Carolina, Provider Partners Health Plan of North Carolina, PruittHealth Premier, United Healthcare and WellCare, plus Align Senior Care and Virginia Premier for cross-border care. Verified 2026-09-02.
Cone Health owns one of the Medicare Advantage plans on its own accepted list. In April 2025 it bought out Novant Health’s stake and now owns 100% of HTA Holdings, which owns Care N’ Care Insurance Company of North Carolina — the company trading as HealthTeam Advantage, with more than 22,000 members across six Medicare Advantage plans. If a Cone provider recommends HealthTeam Advantage, that is Cone recommending its own insurer. Worth knowing before you compare it against the others. Verified 2026-09-02.
The 2025 ownership change did not cut HealthTeam Advantage members off from Novant Health. HealthTeam Advantage’s president stated that members would continue to access the same Novant Health providers they used before, and Novant Health’s own plan list still shows it participating in all HealthTeam Advantage products. HealthTeam Advantage also grew from 7 Triad counties to 33 North Carolina counties over the two and a half years of co-ownership. Verified 2026-09-02.
One protection cuts against the worry, and it is worth knowing before you panic about it. Under the federal No Surprises Act, when you are treated at an in-network hospital or ambulatory surgical centre by a provider who is out of network, the most they may bill you is your plan’s in-network cost-sharing — and that specifically covers emergency medicine, anaesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist and intensivist services. Those providers cannot balance bill you and cannot ask you to waive the protection. North Carolina law adds that you do not pay more for an out-of-network provider where no in-network one was reasonably available. What is NOT protected: the hospital itself being out of network, ground ambulance, and non-emergency care where you sign a consent giving the protection up. So the question that actually costs you money is whether the FACILITY is in network — not whether every doctor inside it is. Verified 2026-09-02.
Two entries on Cone Health’s contract list carry limits written into them: Virginia Premier Health Plan is restricted to professional services at Reidsville Endocrinology Associates, and Primary PhysicianCare is limited to physician services only. On the exchange side, Blue Home with Cone Health became effective 1 January 2026. Read the qualifier next to the plan name, not just the name. Verified 2026-09-02.
Frequently asked questions
Does this answer change if I live in Guilford County specifically?
How do I verify any Medicare agent is licensed in NC?
Is there a fee to talk to a Medicare broker?
What happens after I call?
Where is Robert Simm based?
Does it matter which Medicare carrier you choose?
It doesn’t — because I get paid by the insurance carrier to manage your plan. Most call centers get paid more to steer your business toward certain carriers based on volume and contracts. The only thing I’m optimizing for is making sure you’re covered correctly when you actually need it. That’s what keeps people coming back. And referring their neighbors.