Does Your Medicare Advantage Plan Include Duke?

Open enrollment for Medicare Advantage runs from from October 15 through December 7. If you want to choose a plan that includes Duke Medicine providers, hospitals and clinics, here is what you need to know.

Duke Medicine is an "in network" provider for Medicare Advantage plans offered by

  • Aetna

  • Blue Medicare/BCBSNC

  • Coventry Healthcare - Advantra

  • Gateway Health Plan


However, not all of these plans are offered in each county. Choose the plan in your county that includes Duke Medicine physicians, clinics and hospitals as part of its network.

In addition, please note that some Duke providers may be in network for AARP/United Healthcare products and the Humana Medicare Advantage HMO product, however, Duke hospitals and Duke Primary Care providers are not. If you are seeing a Duke provider who is "in network" for these plans, and need care at Duke Hospital, Duke Regional Hospital or Duke Raleigh Hospital you will be charged for out-of-network services. If you are a retired North Carolina state employee, United Healthcare and Humana's Medicare Advantage plans do cover Duke doctors and hospitals.

Need more help selecting a Medicare Advantage plan?

Contact the Senior Health Insurance Information Program (SHIIP). They list Medicare Advantage plans by county that are available in 2016. Call them at 855-408-1212 or visit their website.

Know your options if you are a retired state employee

As a retired North Carolina state employee, you are eligible to choose either a Medicare Advantage plan from Humana or United Healthcare. You can continue to receive your care at Duke and receive the maximum benefits regardless of Duke Medicine's participation status under these products.

If there is no longer a Medicare Advantage plan that includes Duke in your county you may want to consider enrolling in traditional Medicare through Centers for Medicare & Medicaid Services (CMS).

To find out which plans are offered in your county that include Duke Medicine

Contact the Senior Health Insurance Information Program (SHIIP). They list Medicare Advantage plans by county that are available in 2016. Call them at 855-408-1212 or visit their website.
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