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Medicare in Raleigh

Over 12% of the population of Wake County is on Medicare. That totals over 117,000 residents throughout the county, the majority seniors. Medicare isn’t always easy to understand, and if you’re looking for answers to questions you or a loved one have about the program, there are resources in your area that can help. Commonly, people wonder about their benefits and how they work or are looking for a healthcare provider, nursing home facility, or a hospital that take their insurance. There are locations you can visit, and reputable websites you can search that will give you the information you need.

The fundamentals of Medicare coverage

Medicare is an insurance program for seniors ages 65 and above who are American citizens living in the US. The federal program is also available to adults under the qualifying age who have very specific medical diagnosis, like end-stage renal disease. There are four parts to the program that, as a whole, create comprehensive coverage: Parts A, B, C, and D.

Part A allows for hospital-based care, certain types of skilled nursing and home health care in approved situations, and hospice care.

Part B allows for medical care provided by a doctor, approved rehabilitation and outpatient services, lab tests, mental health care, x-rays, and medical equipment.

Part C is administered through an insurance company who has developed a plan that offers, at a minimum, everything that Medicare Parts A and B cover, and often times includes additional coverage like prescription benefits, dental, or vision. The insurance is privately administered, optional, and the plan is approved by Medicare. Part D allows for coverage for prescription medications. This is an optional add-on to traditional Medicare.

Raleigh numbers on Medicare beneficiaries

117,785 Wake County residents had Medicare in 2014. In 2014, the average age of someone receiving Medicare in Wake County was 71 years. Of the total amount Medicare claims paid in 2014 in Wake County, 34% were on inpatient care. Of the total amount Medicare claims paid in 2014 in Wake County, 5 percent were on home health care. Of the total amount Medicare claims paid in 2014 in Wake County, 8 percent were on skilled nursing care.

Where to go in Raleigh for help with Medicare

For Medicare questions about things like your benefits, how to apply, or replacing a lost card you can visit your local Social Security Administration office at:

Address: 4701 Old Wake Forest Rd, Raleigh, NC 27609 Phone: (877) 803-6311

This website has a feature that allows you to search by zip code to locate the Social Security office that is nearest to your location.

Another place to find help in the area is the Health Insurance Smart NC. They run the North Carolina Consumer Assistance Program as part of the state’s Department of Insurance. You can find them at:

NC Department of Insurance 430 N. Salisbury Street Suite 1018 Raleigh, NC 27603 Toll-free: (855)-408-1212

Locating Raleigh Medicare providers on the internet

Finding medical providers who accept patients with Medicare is easy when you log onto the Medicare website and use their search tools. You can look for doctors, nursing homes, or other types of providers like home health care or dialysis centers in your area by searching by zip code. You can also narrow your criteria by selecting a doctor specialty, like geriatric or family medicine, and search for providers who accept the Medicare fee-for-service plan.

The website also allows for side-by-side comparisons among doctors in the same practice and includes detailed listing information on the doctors like their location, contact information, and where they have hospital privileges.

Learn more about Financial Assistance for Raleigh Seniors here:

Medicaid in Raleigh

Raleigh Veterans Benefits

Social Security for Raleigh Seniors

Top Raleigh Senior Discounts

Raleigh Family Caregiver Benefits

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