Medigap in Guilford County, NC — 2026
Medigap (Medicare Supplement) plans in Guilford County fill the cost-sharing gaps that Original Medicare leaves behind — deductibles, coinsurance, and copays. Unlike Medicare Advantage (including Cone Health’s own HealthTeam Advantage HMO), Medigap carries no network restrictions. You can see any Medicare-accepting provider in the country — all Cone Health facilities in Guilford County, plus Duke University Medical Center, UNC Health, Wake Forest Baptist, or any specialist anywhere — without referrals or prior authorizations. Plan G is the most popular Medigap plan in NC. It covers all Original Medicare cost-sharing except the 2026 Part B deductible of $288. Plan G premiums in Guilford County typically range from $100–$220/month. Every carrier’s Plan G is identical — comparing carriers is a pure price comparison. Call (828) 761-3326 to compare every carrier available in Guilford County.
(Plan G’s only gap)
Deductible per Benefit Period
Range — Guilford County
Every Carrier
The Cone Health / HealthTeam Advantage Problem — What Guilford County Beneficiaries Should Know
Cone Health is the dominant integrated health system in Guilford County, serving Greensboro, High Point, and surrounding communities. It operates Moses Cone Hospital, Wesley Long Hospital, MedCenter High Point, Annie Penn Hospital, and a wide network of outpatient facilities and physician practices across the Piedmont Triad.
Cone Health also operates its own Medicare Advantage plan: HealthTeam Advantage. This creates a uniquely local dynamic in Guilford County — the county’s dominant health system is also its dominant Medicare insurer. On the surface, HealthTeam Advantage offers convenient, familiar Cone Health access. But the structure comes with significant restrictions that many Guilford County beneficiaries don’t fully understand until they need care outside the Cone network.
HealthTeam Advantage Is an HMO — Not Freedom to See Any Doctor
HealthTeam Advantage is a Health Maintenance Organization (HMO). As an HMO, it typically requires you to designate a primary care physician, obtain referrals to see specialists, and get prior authorizations for many procedures, imaging orders, and hospital admissions. Non-emergency care at providers outside the Cone Health network is generally not covered.
This matters for Guilford County beneficiaries who need care beyond what Cone Health offers locally. Referrals to Duke University Medical Center, UNC Health Chapel Hill, Wake Forest Baptist Comprehensive Cancer Center, or any out-of-system specialist typically require advance approval — and may not be covered at all under an HMO structure. For patients with complex conditions requiring sub-specialty expertise at academic medical centers, these restrictions can create real delays and real costs.
Medigap eliminates every one of these restrictions. With Original Medicare and a Medigap supplement, you can see any Medicare-accepting provider in the country — all Cone Health facilities, Duke, UNC, Wake Forest Baptist, or any specialist anywhere — without a referral, without a prior authorization, and without any network check. Call (828) 761-3326 for a full comparison of your options.
Cone Health Facilities Covered Under Medigap
With Medigap, every Cone Health facility that accepts Original Medicare is covered — no HealthTeam Advantage enrollment required, no HMO restrictions, no referrals:
Moses Cone Hospital
Greensboro · Primary acute care · Level II Trauma Center · Cardiac, orthopedic, neurology programs
Wesley Long Hospital
Greensboro · Medical-surgical inpatient · Cone Health orthopedics · Rehabilitation services
MedCenter High Point
High Point · Full-service acute care hospital · Cone Health cardiac and surgical programs
Annie Penn Hospital
Reidsville · Community hospital serving northern Guilford and Rockingham County patients
Cone Health Medical Group
Primary care and specialist physician practices throughout Greensboro and High Point · All Medicare-accepting
Outpatient & Ambulatory Centers
Multiple Cone Health outpatient surgery, imaging, and specialty care locations across Guilford County · All covered with Medigap
Medigap vs. HealthTeam Advantage vs. Other MA Plans — Guilford County
| Coverage Factor | HealthTeam Advantage (HMO) | Other MA Plans | Medigap Plan G |
|---|---|---|---|
| All Cone Health facilities | ✓ In-network | ⚠ Varies by plan & year | ✓ Always covered |
| Duke University Medical Center | ✗ Generally not covered (HMO) | ⚠ Varies by plan contract | ✓ Always covered |
| UNC Health Chapel Hill | ✗ Generally not covered (HMO) | ⚠ Varies by plan contract | ✓ Always covered |
| Wake Forest Baptist / NCI Cancer Center | ✗ Generally not covered (HMO) | ⚠ Varies by plan contract | ✓ Always covered |
| Specialist referral required | ✗ Yes — PCP referral required | ⚠ Often yes (HMO/PPO varies) | ✓ Never needed |
| Prior authorization required | ✗ Yes — many procedures | ⚠ Common for surgery, imaging | ✓ Never — Original Medicare only |
| Out-of-network non-emergency care | ✗ Not covered (HMO) | ⚠ Limited in most HMOs | ✓ Full coverage, any Medicare provider |
| Annual OOP maximum (2026) | Up to $9,350 | Up to $9,350 | $288 deductible, then $0 |
| Network changes at AEP | ⚠ Cone may change contracts | ⚠ Contract changes annually | ✓ Unaffected by any contract |
Guilford County has a specific dynamic I walk through with every beneficiary here: Cone Health is excellent and widely used — but HealthTeam Advantage is an HMO with real restrictions. If you need a second opinion at Duke, a specialist at UNC, or care at Wake Forest Baptist’s cancer center, the HMO structure creates barriers that don’t exist under Original Medicare with Medigap.
Many Guilford County clients don’t discover this until they’re already mid-treatment and trying to get a referral approved for an out-of-network academic center. With Plan G, you pay the $288 Part B deductible once in 2026, then every Medicare-approved service is covered — Cone Health, Duke, UNC, or anywhere else — with no one to ask permission from. Call (828) 761-3326 and I’ll compare every carrier in Guilford County and find the lowest premium for identical Plan G coverage.
Medigap Plan Options in Guilford County, NC
All Medigap plans are standardized by the federal government. Every carrier’s Plan G in Guilford County provides identical coverage — the same benefits, the same provider access, the same cost-sharing rules. The only variable between carriers is the monthly premium. Here are the most relevant plans for 2026:
- Part A hospital deductible — $1,676/benefit period
- Part A coinsurance & extended hospital stay
- Part B coinsurance & copays (all outpatient)
- Part B excess charges
- Skilled nursing facility coinsurance
- Foreign travel emergency (80%, up to limits)
- Part B deductible ($288 in 2026 — you pay once)
- Part A hospital deductible & coinsurance
- Part B coinsurance (after $288 deductible)
- Skilled nursing facility coinsurance
- Foreign travel emergency (80%)
- Part B deductible ($288 in 2026 — you pay)
- Office visits — up to $20 copay per visit
- ER visits — up to $50 copay (if not admitted)
- Part B excess charges (not covered)
- Everything Plan G covers, plus:
- Part B deductible ($288 in 2026) also covered
- True $0 out-of-pocket for Medicare-approved costs
- Available only if Medicare-eligible before January 1, 2020. Compare Plan F vs. Plan G premiums — the difference often exceeds the $288 deductible savings.
- Full Plan G coverage after deductible is met
- Must meet $2,870 deductible first (2026)
- Covers all Cone Health & other providers once met
- Best for relatively healthy enrollees who want catastrophic protection at minimum monthly cost. Not recommended for frequent Cone Health or specialist users.
Open Enrollment & NC Medigap Underwriting Rules
Your Medigap Open Enrollment Period (OEP) is the one window in which North Carolina carriers must sell you any Medigap plan, at standard rates, regardless of health history. Outside this window — including for beneficiaries considering a switch from HealthTeam Advantage or another Medicare Advantage plan — NC carriers can apply full medical underwriting.
When It Begins
Your 6-month Medigap OEP begins the month you are both age 65 or older and enrolled in Medicare Part B. During this window, no NC Medigap carrier can deny you any plan, charge more based on health conditions, or apply a pre-existing condition waiting period.
Underwriting Applies in NC
Once your 6-month OEP ends, NC Medigap carriers can apply medical underwriting. They may deny coverage, charge higher premiums, or apply waiting periods based on health history including diabetes, COPD, heart disease, or prior cancer treatment at Moses Cone or elsewhere.
Other Protected Windows
Certain qualifying events give you guaranteed issue rights outside the OEP — carriers cannot underwrite. Events include your MA plan leaving the service area, exercising a 12-month trial right, or losing employer-based supplemental coverage.
Leaving HTA for Medigap
Guilford County beneficiaries on HealthTeam Advantage who want to switch to Medigap outside a guaranteed issue right may face full medical underwriting — and could be denied. Confirm GI rights before disenrolling from HealthTeam Advantage. Call (828) 761-3326 first.
Guaranteed Issue Rights in North Carolina
These qualifying events grant you guaranteed Medigap access without NC carrier underwriting:
Leaving HealthTeam Advantage for Medigap: Don’t Disenroll First
If you are currently on HealthTeam Advantage or another Medicare Advantage plan in Guilford County and want to switch to Medigap, do not disenroll from your MA plan until you have confirmed your guaranteed issue rights and received Medigap approval. In North Carolina, leaving a Medicare Advantage plan outside a guaranteed issue window means Medigap carriers can apply medical underwriting — and can deny you based on conditions like diabetes, COPD, prior cardiac events, or cancer history. Disenrolling first and then being denied Medigap coverage leaves you with only Original Medicare and no supplement. Call (828) 761-3326 before making any changes to your current coverage.
Does Medigap Include Drug Coverage?
No. Medigap plans do not include prescription drug coverage. If you choose Medigap in Guilford County, you will need a separate Medicare Part D Prescription Drug Plan. Rob can help you select both — a Medigap plan at the lowest carrier premium available in Guilford County, and the right Part D plan for your specific medications. See our Guilford County Part D guide for details on the 2026 $2,100 OOP cap and Cone Health pharmacy preferred-network status.
Which Guilford County Medigap Plan Fits Your Situation?
Three questions to identify your best starting point for Medigap in Guilford County.
Free Medigap Carrier Comparison — Guilford County
HealthTeam Advantage HMO tradeoffs explained · Every carrier compared · NC underwriting rules reviewed · GI rights checked if switching from MA · $0 cost
Compare Plans Online
See every Medigap carrier available in Guilford County with real premium comparisons. Same Plan G coverage — significantly different prices by carrier.
Start Free Carrier ComparisonTalk to Rob Before You Enroll
HealthTeam Advantage HMO restrictions vs. Medigap explained. NC underwriting rules reviewed. GI rights confirmed before any MA disenrollment. Open enrollment timing verified. No call centers — direct with Rob.
📞 Call (828) 761-3326Mon–Fri 9am–7pm · Sat 12pm–4pm 💬 Text Us Your Questions 📅 Book a Free CallAll Cone Health — No HMO Required
Medigap covers Moses Cone Hospital, Wesley Long, MedCenter High Point, Annie Penn, and all Cone Health Medical Group locations — with no HealthTeam Advantage HMO enrollment, no referrals, no prior auths.
NC Underwriting Rules Navigated
Rob confirms your open enrollment status and guaranteed issue rights before any coverage change — especially for Guilford County beneficiaries on HealthTeam Advantage considering a switch to Medigap.
Same Coverage, Lowest Premium
Every carrier's Plan G is identical. Rob compares every carrier in Guilford County and finds the lowest premium for the same benefits. $0 cost to compare.
What Medigap plans are available in Guilford County NC in 2026?
Available Medigap plans in Guilford County include Plans A, B, D, G, K, L, M, N, and High-Deductible G. Plan F is available only to beneficiaries who became eligible for Medicare before January 1, 2020. Plan G is the most popular and most comprehensive option for new enrollees. Call (828) 761-3326 to compare every carrier available in Guilford County.
Does Medigap cover Cone Health in Guilford County?
Yes — Medigap covers any provider that accepts Original Medicare. All Cone Health facilities in Guilford County accept Original Medicare, including Moses Cone Hospital, Wesley Long Hospital, MedCenter High Point, Annie Penn Hospital, and Cone Health Medical Group physician practices. With Medigap, you can receive care at any Cone Health location — or at Duke, UNC Health, Wake Forest Baptist, or any other Medicare-accepting provider nationwide — with no referrals, no prior authorizations, and no network restrictions. You are not limited to the HealthTeam Advantage HMO network. Call (828) 761-3326 for a full comparison.
What is the difference between Medigap and HealthTeam Advantage in Guilford County?
HealthTeam Advantage is Cone Health's Medicare Advantage HMO. As an HMO, it typically requires a primary care physician, referrals for specialists, and prior authorizations for many procedures. Non-emergency care outside the Cone Health network is generally not covered. Medigap works alongside Original Medicare with no network restrictions — you can see any Medicare-accepting provider without a referral or prior authorization, including all Cone Health facilities and any specialist outside the Cone network. Call (828) 761-3326 to compare the full tradeoffs for your specific situation.
What is the Part B deductible for Medigap Plan G in 2026?
The 2026 Medicare Part B deductible is $288 per year — up from $257 in 2025. Medigap Plan G covers all Original Medicare cost-sharing except this $288 annual deductible. Once you pay the $288 (typically on your first Part B service of the calendar year), Plan G covers 100% of Medicare-approved costs for the rest of the year. Call (828) 761-3326 to compare Plan G premiums across every carrier in Guilford County.
How much does Medigap Plan G cost in Guilford County?
Medigap Plan G premiums in Guilford County typically range from approximately $100 to $220 per month, depending on carrier, age, and tobacco use. Every carrier's Plan G provides identical coverage — the only difference is the premium. Some Guilford County beneficiaries are overpaying by $50–$80 per month by staying with their original carrier without comparing alternatives. Call (828) 761-3326 for a free carrier comparison.
What is the NC Medigap underwriting rule for HealthTeam Advantage members?
In North Carolina, Medigap carriers can apply medical underwriting outside your 6-month Open Enrollment Period or a qualifying Guaranteed Issue window. For Guilford County residents on HealthTeam Advantage who want to switch to Medigap, this means NC carriers can review your health history — and deny coverage or charge higher premiums based on conditions including diabetes, COPD, heart disease, or cancer. Always confirm your guaranteed issue rights and receive Medigap approval before disenrolling from HealthTeam Advantage. Call (828) 761-3326 to review your situation before making any coverage change.
Does Medigap include prescription drug coverage?
No. Medigap plans do not include prescription drug coverage. If you choose Medigap in Guilford County, you will need a separate Medicare Part D Prescription Drug Plan. Rob can help you select both — a Medigap plan at the lowest available carrier premium in Guilford County and the right Part D plan for your specific drugs. See the Guilford County Part D guide at generationhealth.me/medicare-part-d-plans-in-guilford-county-nc or call (828) 761-3326.