Yes — Rob Simm is a licensed independent Medicare broker serving Wake County, NC (NPN #10447418). He compares every carrier, verifies your WakeMed and UNC Rex providers are in-network before you enroll, and his services cost you $0. In 2026, the standard Part B premium is $202.90/month with a $283 deductible, Medicare Advantage plans cap out-of-pocket costs at $9,350, and Part D caps drug spending at $2,100/year. For your specific situation in Wake County, call Rob Simm at (828) 761-3326 — free, no obligation.

What Wake County families ask

What questions should I ask before picking a Medicare plan in Wake County?

The questions people call me about — before they realize Medicare.gov can’t answer them.

Will my WakeMed cardiologist still be in-network next year?

Provider directories are 6 months out of date. I call WakeMed directly and verify before you enroll.

Could I get a $15,000 surprise bill from an out-of-network specialist?

In-network hospital, out-of-network anesthesiologist. It happens constantly in Wake County.

What if my $15/month medication jumps to $180/month?

Plans move drugs between tiers mid-year. The 2026 Part D cap at $2,100/year helps, but the wrong plan still costs thousands more.

Am I paying a lifetime penalty and don’t even know it?

If you delayed Part B without creditable employer coverage, you owe 10% per year delayed — for life. A 3-year delay = $60.87/month extra on top of the $202.90 premium.

⚠️ The wrong plan costs Wake County families thousands every year

Picking a $0-premium Medicare Advantage plan without verifying your WakeMed providers can lead to $9,350 in out-of-pocket costs if your oncologist or cardiologist is out-of-network. Missing your Initial Enrollment Period triggers a 10% Part B penalty for every 12 months delayed — permanently. In 2026, that’s $20.29/month per year delayed, added to your $202.90 premium for life.

The difference

What can a local broker do that Medicare.gov can’t?

What do you need to know?	Medicare.gov	Rob Simm — NC #10447418
Provider coverage	Shows “WakeMed in-network” — that’s it	I verify your specific WakeMed oncologist or cardiologist is covered
Network nuance	Doesn’t know WakeMed Raleigh vs UNC Rex can be on different contracts	I know which plans cover which Wake County facilities
Drug cost analysis	Shows formulary tier — not your actual annual cost	I run your exact medications and show real 2026 out-of-pocket totals
Family health history	Doesn’t ask	I ask about cancer, heart disease, diabetes — then build coverage around future risk
Penalty prevention	Can’t check if your employer coverage was creditable	I verify creditable coverage before you face lifetime penalties
Ongoing support	You’re on your own next year	I answer my phone when your plan changes mid-year

2026 Medicare numbers

What does Medicare actually cost in Wake County in 2026?

$202.90

Part B premium per month

2026 standard rate. Higher with IRMAA surcharge based on income above $106,000.

$283

Part B annual deductible

You pay this before Medicare covers 80% of outpatient care.

$9,350

MA in-network out-of-pocket max

2026 cap on in-network Medicare Advantage spending.

$2,100

Part D out-of-pocket cap

No catastrophic Rx costs in 2026. Insulin capped at $35/month.

💡 Broker Tip — Wake County

If you’re retiring from a Wake County employer with fewer than 20 employees, Medicare was already your primary payer — even if HR told you otherwise. I see this mistake every AEP. Before you leave your job, get a Certification of Creditable Coverage from your HR department. That one document prevents a permanent 10% Part B penalty. If you’re not sure whether your employer coverage qualifies, call me at (828) 761-3326 — I’ll check for free.

— Rob Simm, Licensed Medicare Broker, NC #10447418

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Rob Simm · Licensed NC Medicare Broker · NPN #10447418

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Real scenario · Wake County

What happens when you pick the wrong Medicare plan in Wake County?

Wrong plan — no broker

$38,000

Picked a $0-premium Humana plan without verifying network. Cancer diagnosis at UNC Rex Cancer Center — oncologist was out-of-network. Found out after the first appointment.

Right plan — broker-verified

$2,500

Switched to a plan with UNC Rex Cancer Center in-network during Special Enrollment Period. Same doctors, same hospital. Total out-of-pocket for the year: $2,500.

It pays to talk to the right broker

How much does it cost to work with a Medicare broker in Wake County?

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.

Common questions

Frequently asked questions

What is the difference between a Medicare broker and an insurance agent in Wake County?

A broker like Rob Simm represents multiple insurance companies and compares all available plans objectively. An agent works for a single carrier and can only sell that company’s plans. Brokers cost you nothing — carriers pay the same commission regardless of which plan you choose. Call (828) 761-3326 for a free comparison.

Do I pay any fees to work with a Medicare broker in Wake County NC?

No. Licensed Medicare brokers are paid by insurance carriers, never by clients. Rob’s services cost you $0 whether you enroll or not. The plan premiums are identical whether you buy direct or through a broker — the only difference is you get someone who answers the phone next year.

When can I enroll in Medicare if I live in Wake County?

Your Initial Enrollment Period (IEP) is 7 months: 3 months before your 65th birthday, your birthday month, and 3 months after. If you’re leaving employer coverage, your Special Enrollment Period lasts 8 months. Annual Open Enrollment runs October 15 through December 7 every year. Missing these windows triggers lifetime penalties.

What happens if I miss my Medicare enrollment deadline in Wake County?

You’ll pay a 10% penalty on Part B premiums for every 12 months you delayed — for life. In 2026, that’s $20.29/month extra per year delayed. A 3-year delay means $60.87/month in permanent penalties on top of the $202.90 standard premium. Call Rob at (828) 761-3326 to check if you qualify for a Special Enrollment Period.

Does Rob Simm verify WakeMed provider networks before I enroll?

Yes. Rob calls WakeMed Health and UNC Rex directly to verify your specific doctors are in-network for the plan you’re considering — before you enroll. Online provider directories are often 6 months out of date. This single step prevents the most expensive mistake Wake County Medicare beneficiaries make.

Related Medicare guides

Medicare Enrollment in NC – 2026 Guide Extra Help/LIS Eligibility NC 2026 Compare Medicare Advantage Plans in NC Extra Help / LIS in NC – 2026 Eligibility Guide Working Past 65 – Medicare Enrollment Special Enrollment Periods in NC Cheap Health Insurance Without Employer Coverage Free Medicare Quotes Online

Get help in nearby NC counties

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Robert Simm

Licensed Independent Medicare Broker

Helping NC families navigate Medicare since 2014. Independent — I work with all carriers and get paid the same regardless of which plan you choose. I verify provider networks with WakeMed and UNC Rex directly and answer my own phone the next year when something changes.

📞 (828) 761-3326 📋 NC #10447418 🏥 AHIP Certified ⭐ 5.0 · 20+ reviews 📍 2731 Meridian Pkwy, Durham NC 27713 🕐 Mon–Fri 9am–7pm ET

Last Updated: 2026-05-04 | Reviewed By: Robert Simm, Licensed Medicare Broker, NC #10447418 | Next Review: October 2026

We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE (1-800-633-4227) for information on all of your options. GenerationHealth.me and Robert Simm are independent agents not affiliated with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent may contact you. Information on this page is for educational purposes only and should not be considered legal or financial advice. Plan availability, premiums, and benefits vary by location and carrier. © 2026 GenerationHealth.me