Compare & Enroll — Part C & Part D

Compare & Enroll in Medicare Plans in Clay County, NC

With 60 Medicare Advantage options from 6 insurers, Clay County, NC has plan availability roughly in line with the national average, suggesting a competitive market with meaningful insurer variety. Approximately 95% of local MA plans charge $0 beyond the standard Part B premium, reflecting strong price competition. With 3 hospitals within 25.0 miles, verifying your preferred hospital is in-network is especially important here. We've organized the CMS data below to help you cross-reference plan costs, quality ratings, and local provider access. Compare plans below, and when you're ready, enroll directly at Medicare.gov.

📊 Direct from CMS 🚫 No agents or commissions ✓ Just the data, no sales pitch
Compare Plans at Medicare.gov →

Data freshness: CMS data as of February 2026 • ACS data as of 2023 • Reviewed & approved on 2026-02-16
Reviewed by: Wes Ward, Founder & Data Lead • View our methodology

Important: We are not affiliated with Medicare or any government agency. This site displays publicly available CMS data to help you compare plans. We do not sell insurance or represent any insurance company. For official enrollment and complete plan information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).

Important: Plan availability, benefits, and CMS Star Ratings shown here come directly from CMS public files. Plan details can change—always verify with the insurer and at Medicare.gov.
Part C Plans
60
Part D Plans
12
Top MA Star
5.0
Top Drug Star
3.5
Happy senior couple reviewing Medicare plan options together

Medicare Eligibility in Clay County, NC

Approximately 3,601 residents (32.3% of the population) in Clay County, NC are 65 or older and likely Medicare-eligible. Whether you're approaching 65, already enrolled, or a caregiver comparing options, the plan data below is organized to help you evaluate Part C (Medicare Advantage) and Part D (prescription drug) coverage side by side.

The median household income in Clay County, NC is $56,488 (24.8% below the National Average), which may affect eligibility for Extra Help with Part D drug costs.

Part C: Medicare Advantage Plans

Medicare Advantage (Part C) replaces Original Medicare through private insurers who bundle hospital, medical, and often drug coverage into a single plan. Clay County, NC's 60 Medicare Advantage plans are a mix leaning toward HMO networks (33 HMO, 27 PPO). 57 plans offer $0 monthly premiums. The average local star rating is 3.9 out of 5, with the top plan earning 5.0 ★.

Top Medicare Advantage Plans in Clay County, NC

We organize CMS plan data into separate leaderboards so you can compare based on what matters most to you. Part C premiums in Clay County, NC range from $0 to $102/month. Among rated plans, 32 plans rated 4+ stars, including 5 with perfect 5-star ratings.

Highest CMS Star Ratings

Star Ratings are assigned by CMS based on quality measures including customer service, preventive care, and managing chronic conditions.

Plan NameInsurerStar RatingPremiumType
Devoted C-Snp Plus 015 Nc (HMO C-SNP)Devoted Health5.0 ★$0.00/moHMO C-SNPEnroll
Devoted Dual Plus 006 Nc (HMO D-SNP)Devoted Health5.0 ★$0.00/moHMO D-SNPEnroll
Devoted C-Snp Premium 018 Nc (HMO C-SNP)Devoted Health5.0 ★$0.00/moHMO C-SNPEnroll
Devoted Dual Full 013 Nc (HMO D-SNP)Devoted Health5.0 ★$0.00/moHMO D-SNPEnroll
Devoted Dual 009 Nc (HMO D-SNP)Devoted Health5.0 ★$0.00/moHMO D-SNPEnroll

Lowest Monthly Premium

Lower premiums can save money, but check total costs including deductibles, copays, and MOOP.

Plan NameInsurerMonthly PremiumMOOPStar Rating
Aetna Medicare Signature (PPO)Aetna Medicare$0.00/mo$6,7504.5 ★
Humanachoice Giveback H5525-035 (PPO)Humana$0.00/mo$9,2503.5 ★
Aetna Medicare Signature Giveback (PPO)Aetna Medicare$0.00/mo$7,5004.5 ★
Humana Gold Plus H1036-335 (HMO-POS)Humana$0.00/mo$3,9504.0 ★
Humanachoice Giveback H5216-017 (PPO)Humana$0.00/mo$9,2503.5 ★

Lowest Maximum Out-of-Pocket (MOOP)

MOOP caps your financial risk. Once you hit this limit, the plan covers 100% of covered services for the rest of the year.

Plan NameInsurerMOOP (In-Network)PremiumStar Rating
Aarp Medicare Advantage Access From Uhc Nc-23 (PPO)Unitedhealthcare$3,000$102.00/mo4.5 ★
Blue Medicare Medical Only (HMO-POS)Blue Cross And Blue Shield Of North Carolina$3,900$0.00/mo4.5 ★
Humana Gold Plus H1036-335 (HMO-POS)Humana$3,950$0.00/mo4.0 ★
Wellcare Simple (HMO-POS)Wellcare$4,200$0.00/mo3.5 ★
Blue Medicare Enhanced (HMO-POS)Blue Cross And Blue Shield Of North Carolina$4,200$29.60/mo4.5 ★

Plan Type Mix in Clay County, NC

HMO plans require referrals and in-network care. PPO plans offer more flexibility. SNP (Special Needs Plans) serve specific populations. MAPD plans include drug coverage.

Plan TypeCountPercentageDescription
PPO1931.7%No referrals; in and out-of-network
HMO-POS1220.0%HMO with some out-of-network options
HMO-POS D-SNP813.3%Medicare Advantage plan
HMO D-SNP711.7%Medicare Advantage plan
PPO D-SNP58.3%Medicare Advantage plan
Regional PPO35.0%Medicare Advantage plan
HMO C-SNP35.0%Medicare Advantage plan
HMO23.3%Requires referrals; in-network only
HMO-POS C-SNP11.7%Medicare Advantage plan

Choosing the Right Medicare Advantage Plan

The best Part C plan depends on your doctors, medications, and budget. Key factors to evaluate:

  • Provider network: Verify your doctors and hospitals near Clay County, NC are in-network before enrolling
  • Total cost: A $0 premium may have higher copays—calculate your annual cost
  • Star Ratings: 4+ stars indicate above-average quality and member satisfaction

Read our full guide on choosing Medicare Advantage → · Print our enrollment checklist →
Medicare Glossary: HMO, PPO, MOOP & more →

Medicare Advantage Insurers in Clay County, NC

6 insurance companies offer Medicare Advantage plans in Clay County, NC. Below, we group plans by insurer so you can compare options from each company. More insurers generally means more competition and better benefits for consumers.

Devoted Health
Avg Star Rating
5.0 ★
8 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Devoted Choice Ma Only 007 Nc (PPO)
$0.00/mo
$9,250
N/A
PPO
Devoted Choice Giveback 006 Nc (PPO)
$0.00/mo
$8,000
N/A
PPO
Devoted Choice 005 Nc (PPO)
$0.00/mo
$5,300
N/A
PPO
Devoted Dual Plus 006 Nc (HMO D-SNP)
$0.00/mo
$9,250
5.0 ★
HMO D-SNP
Devoted Dual 009 Nc (HMO D-SNP)
$0.00/mo
$6,750
5.0 ★
HMO D-SNP
Devoted Dual Full 013 Nc (HMO D-SNP)
$0.00/mo
$9,250
5.0 ★
HMO D-SNP
Devoted C-Snp Plus 015 Nc (HMO C-SNP)
$0.00/mo
$9,250
5.0 ★
HMO C-SNP
Devoted C-Snp Premium 018 Nc (HMO C-SNP)
$0.00/mo
$5,600
5.0 ★
HMO C-SNP
Blue Cross And Blue Shield Of North Carolina
Avg Star Rating
4.3 ★
6 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Healthy Blue + Medicare (HMO-POS D-SNP)
$0.00/mo
$9,250
3.5 ★
HMO-POS D-SNP
Blue Medicare Essential (HMO)
$0.00/mo
$9,250
4.5 ★
HMO
Blue Medicare Essential Plus (HMO-POS)
$0.00/mo
$6,750
4.5 ★
HMO-POS
Blue Medicare Medical Only (HMO-POS)
$0.00/mo
$3,900
4.5 ★
HMO-POS
Blue Medicare Freedom+ (PPO)
$0.00/mo
$9,250
4.5 ★
PPO
Blue Medicare Enhanced (HMO-POS)
$29.60/mo
$4,200
4.5 ★
HMO-POS
Aetna Medicare
Avg Star Rating
4.3 ★
5 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Aetna Medicare Signature Giveback (PPO)
$0.00/mo
$7,500
4.5 ★
PPO
Aetna Medicare Eagle Giveback (PPO)
$0.00/mo
$6,750
4.5 ★
PPO
Aetna Medicare Signature (PPO)
$0.00/mo
$6,750
4.5 ★
PPO
Aetna Medicare Dual (HMO D-SNP)
$0.00/mo
$9,250
4.0 ★
HMO D-SNP
Aetna Medicare Value Plus (HMO)
$0.00/mo
$5,500
4.0 ★
HMO
Unitedhealthcare
Avg Star Rating
4.0 ★
12 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Uhc Dual Complete Nc-D001 (HMO-POS D-SNP)
$0.00/mo
$9,250
4.0 ★
HMO-POS D-SNP
Aarp Medicare Advantage From Uhc Nc-0008 (HMO-POS)
$0.00/mo
$6,700
4.0 ★
HMO-POS
Aarp Medicare Advantage From Uhc Nc-0009 (HMO-POS)
$0.00/mo
$5,400
4.0 ★
HMO-POS
Aarp Medicare Advantage Giveback From Uhc Nc-13 (HMO-POS)
$0.00/mo
$8,900
4.0 ★
HMO-POS
Aarp Medicare Advantage Patriot No Rx Nc-Ma02 (HMO-POS)
$0.00/mo
$7,900
4.0 ★
HMO-POS
Uhc Dual Complete Nc-V001 (HMO-POS D-SNP)
$0.00/mo
$5,900
4.0 ★
HMO-POS D-SNP
Uhc Complete Care Nc-25 (HMO-POS C-SNP)
$0.00/mo
$5,400
4.0 ★
HMO-POS C-SNP
Uhc Dual Complete Nc-S2 (PPO D-SNP)
$0.00/mo
$9,250
4.0 ★
PPO D-SNP
Uhc Dual Complete Nc-S001 (PPO D-SNP)
$0.00/mo
$9,250
4.0 ★
PPO D-SNP
Uhc Dual Complete Nc-S3 (HMO-POS D-SNP)
$0.00/mo
$9,250
4.0 ★
HMO-POS D-SNP
Aarp Medicare Advantage From Uhc Nc-24 (HMO-POS)
$0.00/mo
$5,400
4.0 ★
HMO-POS
Aarp Medicare Advantage Access From Uhc Nc-23 (PPO)
$102.00/mo
$3,000
4.5 ★
PPO
Humana
Avg Star Rating
3.6 ★
20 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Humana Gold Plus Snp-De H1036-167 (HMO D-SNP)
$0.00/mo
$9,250
4.0 ★
HMO D-SNP
Humanachoice Giveback H5216-017 (PPO)
$0.00/mo
$9,250
3.5 ★
PPO
Humana Usaa Honor Giveback (PPO)
$0.00/mo
$9,250
3.5 ★
PPO
Humana Gold Plus H1036-335 (HMO-POS)
$0.00/mo
$3,950
4.0 ★
HMO-POS
Humana Gold Plus Snp-De H1036-331 (HMO D-SNP)
$0.00/mo
$9,250
4.0 ★
HMO D-SNP
Humana Gold Plus - Diabetes And Heart (HMO C-SNP)
$0.00/mo
$9,250
4.0 ★
HMO C-SNP
Humana Dual Select H1036-307 (HMO D-SNP)
$0.00/mo
$9,250
4.0 ★
HMO D-SNP
Humanachoice Giveback H5525-035 (PPO)
$0.00/mo
$9,250
3.5 ★
PPO
Humana Usaa Honor Giveback (REGIONAL PPO)
$0.00/mo
$9,250
3.5 ★
Regional PPO
Humanachoice R0110-004 (REGIONAL PPO)
$0.00/mo
$7,000
3.5 ★
Regional PPO
Humana Dual Select H6622-027 (HMO-POS D-SNP)
$0.00/mo
$9,250
3.5 ★
HMO-POS D-SNP
Humanachoice Snp-De H5525-036 (PPO D-SNP)
$0.00/mo
$9,250
3.5 ★
PPO D-SNP
Humanachoice H5525-050 (PPO)
$0.00/mo
$9,250
3.5 ★
PPO
Humana Usaa Honor Giveback (PPO)
$0.00/mo
$9,250
3.5 ★
PPO
Humanachoice H5525-070 (PPO)
$0.00/mo
$9,250
3.5 ★
PPO
Humana Gold Plus H6622-026 (HMO-POS)
$0.00/mo
$9,250
3.5 ★
HMO-POS
Humana Gold Plus H6622-025 (HMO-POS)
$0.00/mo
$9,250
3.5 ★
HMO-POS
Humanachoice H5525-083 (PPO)
$0.00/mo
$9,250
3.5 ★
PPO
Humana Dual Select H5525-072 (PPO D-SNP)
$0.00/mo
$9,250
3.5 ★
PPO D-SNP
Humana Full Access R0110-005 (REGIONAL PPO)
$34.80/mo
$9,250
3.5 ★
Regional PPO
Wellcare
Avg Star Rating
3.2 ★
9 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Wellcare Dual Access (HMO-POS D-SNP)
$0.00/mo
$9,250
3.5 ★
HMO-POS D-SNP
Wellcare Simple (HMO-POS)
$0.00/mo
$4,200
3.5 ★
HMO-POS
Wellcare Patriot Giveback Open (PPO)
$0.00/mo
$8,850
3.0 ★
PPO
Wellcare Giveback Open (PPO)
$0.00/mo
$8,300
3.0 ★
PPO
Wellcare Assist Open (PPO)
$0.00/mo
$4,201
3.0 ★
PPO
Wellcare Dual Liberty Open (PPO D-SNP)
$0.00/mo
$9,250
3.0 ★
PPO D-SNP
Wellcare Simple Open (PPO)
$0.00/mo
$4,300
3.0 ★
PPO
Wellcare Dual Liberty (HMO-POS D-SNP)
$0.00/mo
$9,250
3.5 ★
HMO-POS D-SNP
Wellcare Dual Reserve (HMO-POS D-SNP)
$0.00/mo
$9,250
3.5 ★
HMO-POS D-SNP

Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.

Part D: Prescription Drug Plans (PDP)

Part D covers prescription drugs through standalone plans for those on Original Medicare, or as part of a Medicare Advantage bundle. Among the 12 standalone Part D plans in Clay County, NC, some offer $0 annual deductibles while others charge up to the 2026 maximum of $590. 2 plans are at or below the regional premium benchmark, making them eligible for Low Income Subsidy auto-enrollment. The 2026 $2,000 out-of-pocket cap means drug costs are now more predictable regardless of which plan you choose, but formulary coverage still varies significantly—always verify your medications are covered before enrolling.

Part D Formulary Notice: Each Part D plan has its own formulary (list of covered drugs). The same medication may be on different tiers—or not covered at all—depending on the plan. Always check that your specific medications are covered before enrolling.
2026 Out-of-Pocket Cap: Thanks to the Inflation Reduction Act, your total out-of-pocket drug costs are capped at $2,000 per year in 2026. Once you reach this limit, you pay nothing more for covered Part D drugs for the rest of the year. This eliminates the old "donut hole" coverage gap that previously caused higher costs.
Low Income Subsidy (LIS / Extra Help): If you have limited income and resources, you may qualify for Extra Help paying Part D costs. Visit SSA.gov or call 1-800-MEDICARE.

Top Part D Drug Plans in Clay County, NC

We organize Part D plans by CMS Star Ratings, premiums, and deductibles so you can find the best fit for your prescription needs. Part D premiums in Clay County, NC range from $4 to $163/month. Remember: all Part D plans now cap your annual out-of-pocket drug costs at $2,000 thanks to the Inflation Reduction Act.

Highest CMS Star Ratings (Part D)

Part D Star Ratings measure drug pricing, customer service, member complaints, and pharmacy access.

Plan NameInsurerStar RatingPremiumDeductible
Wellcare Value Script (PDP)Wellcare3.5 ★$3.60/mo$615Enroll
Wellcare Classic (PDP)Wellcare3.5 ★$4.70/mo$615Enroll
Silverscript Choice (PDP)Aetna Medicare3.0 ★$90.20/mo$615Enroll
Humana Basic Rx Plan (PDP)Humana3.0 ★$6.80/mo$615Enroll
Humana Value Rx Plan (PDP)Humana3.0 ★$32.00/mo$601Enroll

Lowest Monthly Premium

Lower premiums help with monthly cash flow, but check drug tier costs and the deductible.

Plan NameInsurerMonthly PremiumDrug DeductibleStar Rating
Wellcare Value Script (PDP)Wellcare$3.60/mo$6153.5 ★
Wellcare Classic (PDP)Wellcare$4.70/mo$6153.5 ★
Humana Basic Rx Plan (PDP)Humana$6.80/mo$6153.0 ★
Humana Value Rx Plan (PDP)Humana$32.00/mo$6013.0 ★
Aarp Medicare Rx Saver From Uhc (PDP)Unitedhealthcare$56.90/mo$6152.0 ★

Lowest Annual Drug Deductible

The deductible is what you pay out-of-pocket before the plan starts covering drug costs. The 2026 maximum Part D deductible is $590. Many plans offer $0 deductible options.

Plan NameInsurerDrug DeductibleMonthly PremiumStar Rating
Humana Premier Rx Plan (PDP)Humana$0$110.90/mo3.0 ★
Blue Medicare Rx Enhanced (PDP)Blue Cross And Blue Shield Of North Carolina$0$163.20/mo3.0 ★
Aarp Medicare Rx Preferred From Uhc (PDP)Unitedhealthcare$130$119.80/mo2.0 ★
Humana Value Rx Plan (PDP)Humana$601$32.00/mo3.0 ★
Wellcare Value Script (PDP)Wellcare$615$3.60/mo3.5 ★
Understanding drug tiers: Part D plans organize medications into 5 cost tiers — Tier 1 (Preferred Generic) is cheapest; Tier 5 (Specialty) is most expensive. Two plans with the same premium can have very different costs for your drugs depending on tier placement. Learn more about drug tiers →

Choosing the Right Part D Drug Plan

The right Part D plan depends on your specific medications. Key factors to evaluate:

  • Formulary: Verify your drugs are covered before enrolling
  • Preferred pharmacies: Lower copays at certain locations—check your pharmacy is in-network
  • Total annual cost: Premium + deductible + copays for your drugs

Read our full guide on choosing Part D →
What is a formulary? See our Medicare Glossary →

Part D Drug Plan Insurers in Clay County, NC

6 insurance companies offer standalone Part D drug plans in Clay County, NC. Below, we group plans by insurer.

Wellcare
Avg Star Rating
3.5 ★
2 plans
From $3.60/mo
Plan
Premium
Deductible
Stars
Type
Wellcare Value Script (PDP)
$3.60/mo
$615
3.5 ★
PDP
Wellcare Classic (PDP)
$4.70/mo
$615
3.5 ★
PDP
Humana
Avg Star Rating
3.0 ★
3 plans
From $6.80/mo
Plan
Premium
Deductible
Stars
Type
Humana Basic Rx Plan (PDP)
$6.80/mo
$615
3.0 ★
PDP
Humana Value Rx Plan (PDP)
$32.00/mo
$601
3.0 ★
PDP
Humana Premier Rx Plan (PDP)
$110.90/mo
$0
3.0 ★
PDP
Blue Cross And Blue Shield Of North Carolina
Avg Star Rating
3.0 ★
2 plans
From $83.90/mo
Plan
Premium
Deductible
Stars
Type
Blue Medicare Rx Standard (PDP)
$83.90/mo
$615
3.0 ★
PDP
Blue Medicare Rx Enhanced (PDP)
$163.20/mo
$0
3.0 ★
PDP
Aetna Medicare
Avg Star Rating
3.0 ★
1 plans
From $90.20/mo
Plan
Premium
Deductible
Stars
Type
Silverscript Choice (PDP)
$90.20/mo
$615
3.0 ★
PDP
Healthspring
Avg Star Rating
2.5 ★
2 plans
From $78.00/mo
Plan
Premium
Deductible
Stars
Type
Healthspring Extra Rx (PDP)
$78.00/mo
$615
2.5 ★
PDP
Healthspring Assurance Rx (PDP)
$110.40/mo
$615
2.5 ★
PDP
Unitedhealthcare
Avg Star Rating
2.0 ★
2 plans
From $56.90/mo
Plan
Premium
Deductible
Stars
Type
Aarp Medicare Rx Saver From Uhc (PDP)
$56.90/mo
$615
2.0 ★
PDP
Aarp Medicare Rx Preferred From Uhc (PDP)
$119.80/mo
$130
2.0 ★
PDP

Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.

Ready to Enroll in Clay County, NC?

Compare plans side-by-side at Medicare.gov or speak with a licensed Medicare specialist.

Compare Plans at Medicare.gov Call 1-800-MEDICARE

📋 Print our Medicare Enrollment Checklist — gather your info before you compare.

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Pharmacy Access in Clay County, NC

Part D plans have preferred pharmacy networks where you'll pay lower copays. Here's a look at pharmacy options in and around Clay County, NC.

Total Pharmacies

2
within 5.0 miles

Chain Pharmacies

0
CVS, Walgreens, etc.

Independent Pharmacies

2
locally owned
PharmacyAddress & PhoneDistanceType
TOWN AND COUNTRY DRUG CTR INC78 SANDERSON ST HAYESVILLE, NC 289040505📞 828-838-61110.9 miIndependent
DIMAX INC250 US HIGHWAY 64 EAST HAYESVILLE, NC 28904📞 828-838-05501.0 miIndependent
CHATUGE REGIONAL HOSPITAL INC110 S MAIN ST HIAWASSEE, GA 305463408📞 706-689-71096.8 miIndependent
YOUNG HARRIS PHARMACY, INCHWY 66 & US 76 YOUNG HARRIS, GA 305820025📞 706-637-37007.5 miIndependent
TURNER DISCOUNT MEDICINE SHOPPE451 MAIN ST ANDREWS, NC 28901📞 828-832-332711.4 miChain
WALGREEN CO286 MAIN ST ANDREWS, NC 289019250📞 828-832-580111.5 miChain
MURPHY MEDICAL CENTER3990 E US 64 ALT MURPHY, NC 289066843📞 828-883-816112.3 miIndependent
WALGREEN CO1630 ANDREWS RD MURPHY, NC 289065100📞 828-883-551212.5 miChain
PARKER'S DRUG STORE, INC14 VALLEY RIVER AVE MURPHY, NC 289062955📞 828-883-231813.3 miIndependent
HYERCARE, LLC30 PEACHTREE ST MURPHY, NC 289062940📞 828-883-747413.4 miIndependent

Pharmacy data from CMS. Network participation varies by plan—always verify with your specific Part D plan.

Local Healthcare Access in Clay County, NC

Before choosing a plan, consider the healthcare infrastructure in Clay County, NC. Medicare Advantage plans restrict you to in-network hospitals, so understanding local hospital quality helps you pick the right plan — not just the cheapest one.

Note: The facilities below do not indicate which providers are in-network for any specific plan. Always verify network status with your plan before enrolling.

Hospitals Nearby

3
within 25.0 miles

Top-Rated Hospitals near Clay County, NC

If hospital access matters to your plan choice, check quality ratings before you enroll. These are the highest CMS-rated hospitals near Clay County, NC — click a hospital name to see its full profile and verify it's in your plan's network.

HospitalCMS RatingDistanceBeds
Union General Hospital4 ★14.1 mi45
Northeast Georgia Medical Center Habersham3 ★34.9 mi53
Angel Medical Center2 ★26.0 mi25
Stephens County Hospital2 ★40.2 mi99
Erlanger Murphy Medical Center1 ★13.4 mi50
Chatuge Regional HospitalNot Rated6.8 mi25
Mountain Lakes Medical CenterNot Rated25.4 mi25
Blue Ridge Medical CenterNot Rated31.7 mi50
Highlands Cashiers HospitalNot Rated35.2 mi25
Cherokee Indian Hospital AuthorityNot Rated41.0 mi26

View all 3 hospitals near Clay County, NC to check quality before you enroll →

Hospital data from CMS Hospital Compare and Provider of Services file. Distance calculated from center of Clay County, NC.

Questions to ask your doctor about Medicare coverage →

Telehealth in Clay County, NC: Is Your Internet Ready?

Many Medicare Advantage and some Part D plans now include telehealth benefits, making routine check-ins and prescription refills easier from home. But telehealth requires reliable internet—here's a look at connectivity in Clay County, NC. For official guidance on virtual visits, see Telehealth.HHS.gov from the U.S. Department of Health & Human Services.

Internet Coverage in Clay County, NC

Fiber Available
87.3%
of households
Cable/DSL Available
94.8%
of households
Top Provider
BalsamWest
0.1% coverage
No Broadband
1.2%
of households

Internet coverage data from ISP Reports. View full internet report for Clay County, NC.

Medicare-Relevant Demographics in Clay County, NC

Understanding Clay County, NC's demographics helps contextualize why insurers offer the plans they do. Areas with more seniors and higher incomes tend to attract more insurer competition, while areas with higher Medicaid enrollment may have more Dual-Eligible Special Needs Plans (D-SNP) available.

Total Population
11,148
Population 65+
3,601
32.3% of total
Median Age
56
18.3 years older than the national average
Median Income
$56,488
24.8% below the National Average
On Medicare
3,212
28.8% of residents
On Medicaid
1,302
11.7% of residents
Uninsured
1,522
13.7% of residents
Social Security Recipients
6,132
55.0% of population

Demographic data from U.S. Census Bureau American Community Survey (2023). View full Clay County, NC demographics (BestNeighborhood.org).

Local Medicare FAQ: Clay County, NC

Common decision points based on Clay County, NC's specific plan market and local healthcare landscape.

How does Clay County, NC's Medicare Advantage market compare?

Clay County, NC has 60 Medicare Advantage plans from 6 insurers. This is above the national average of approximately 57 plans, suggesting healthy competition among insurers in this area. The local mix includes 33 HMO and 27 PPO plans. Plan availability updates annually during the Medicare Annual Enrollment Period (October 15 – December 7).

Should I choose an HMO or PPO Medicare Advantage plan in Clay County, NC?

With 3 hospitals nearby, a PPO plan may offer valuable flexibility if your preferred providers aren't all in the same network. HMO plans (33 available) cost less but limit your choices. In Clay County, NC, HMO plans dominate the market, which often means more competitive HMO pricing. Always verify your doctors are in-network before enrolling in any plan.

What's the real cost of $0 premium plans in Clay County, NC?

57 plans (95% of available options) in Clay County, NC charge $0 beyond the standard Part B premium. This high percentage reflects strong insurer competition in the area. However, $0 premium doesn't mean $0 cost. These plans may have higher copays, coinsurance, or out-of-pocket maximums. In Clay County, NC, maximum out-of-pocket limits range from $3,000 to an average of $7,848. We recommend calculating your total expected annual cost (premium + copays + drug costs) rather than choosing based on premium alone.

How does the 2026 $2,000 drug cap affect Clay County, NC beneficiaries?

The Inflation Reduction Act capped annual out-of-pocket drug spending at $2,000 starting in 2025, eliminating the old "donut hole" coverage gap. This applies to all 12 standalone Part D plans in Clay County, NC.

What this means locally:

  • Cost predictability — No matter which of the 12 Part D plans you choose, your drug costs are capped at $2,000/year
  • $0 deductible options — Some local plans offer $0 deductibles, meaning coverage starts immediately
  • Low-income options — 2 plans meet the regional benchmark for Extra Help/LIS eligibility

While the out-of-pocket cap standardizes maximum costs, formulary coverage still varies significantly between plans. A drug that costs $5/month on one plan's formulary might cost $50 on another. Always check that your specific medications are covered and compare tier placement before enrolling.

See all Medicare FAQs in our complete guide → · Enrollment checklist →
Medicare Glossary · Enrollment Dates & Deadlines · Doctor Questions

About the Data & Editorial Team

Wes Ward

Wes Ward

Founder & Data Lead

Wes Ward is the founder of InsuranceDataNow.org and reviews all content for data accuracy and methodology compliance.

With 25+ years in data analytics — including work with highly regulated genomic data at Ancestry.com — Wes brings enterprise-level rigor to consumer data tools. He is also a co-founder of BestNeighborhood.org, CrimeGrade.org, and ISPReports.org.

Role: Reviews and approves all content for data accuracy, source verification, and methodology compliance.

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Transparency & Disclosures

InsuranceDataNow is an advertising-supported publisher based in South Jordan, Utah. We are not affiliated with or endorsed by Medicare or the U.S. government.

TPMO Disclaimer: 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 (24 hours a day/7 days a week) to get information on all of your options.

Sources

All data is sourced from official government databases and trusted third-party providers. Data is updated regularly—see page header for last refresh dates.

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