About Troy Medicare
A healthcare technology company founded by pharmacists and software engineers, providing chronic disease management solutions for Medicare beneficiaries in North Carolina.
Troy Medicare is a Medicare Advantage plan serving Medicare-eligible beneficiaries across communities in North Carolina. Operated by Troy Health, Inc., Troy Medicare is a healthcare technology company founded by pharmacists and software engineers who saw firsthand how big health insurance companies were becoming more expensive and less transparent. Troy Medicare was built to offer an alternative: a plan that is obvious, comprehensive, and easy to understand for every member.
Troy Medicare now serves thousands of low-income Medicare beneficiaries in some of the most underserved communities in the United States. What sets Troy Medicare apart is a pharmacy-first approach to chronic disease management — placing pharmacists at the center of care coordination and leveraging proprietary Troy.AI technology to drive meaningful behavioral changes and improve health outcomes.
What Makes Troy Medicare Different
Pharmacy-First Model
Troy Medicare's model puts pharmacists at the center of chronic disease management. Pharmacists are among the most accessible healthcare professionals, and Troy Medicare leverages their expertise as frontline providers to help members manage conditions such as diabetes, hypertension, and heart disease.
Through regular medication therapy management, adherence monitoring, and proactive outreach, Troy Medicare's pharmacy-first approach ensures members receive consistent, high-touch care between physician visits. This model is particularly effective in rural and underserved areas where community pharmacies often serve as the primary point of healthcare access. For a deeper look at how this model operates across Troy Medicare's care delivery framework, visit the Our Approach page.
Local Provider Partnerships
Troy Medicare partners with local healthcare providers across North Carolina to ensure members have access to high-quality care close to home. Rather than relying on distant or unfamiliar networks, Troy Medicare builds relationships with community-based physicians, specialists, and hospitals.
These partnerships allow Troy Medicare to coordinate care more effectively, reduce unnecessary referrals, and keep members connected to providers who understand their communities.
Member-Focused Support
Troy Medicare provides dedicated support to help members navigate their coverage, understand their benefits, and access the care they need. The member services team is available to answer questions about prescriptions, provider access, and care coordination.
Every interaction is designed to be straightforward and respectful, reflecting Troy Medicare's commitment to serving members in underserved communities who may face additional barriers to care.
Care Coordination & Technology
Troy Medicare's proprietary Troy.AI platform enables real-time data analysis, medication management, and proactive member outreach. This technology helps identify gaps in care, flag potential drug interactions, and ensure members stay on track with their treatment plans.
By combining clinical expertise with data-driven insights, Troy Medicare is able to deliver more personalized, effective care at scale — particularly for members managing multiple chronic conditions. All technology systems operate in full compliance with HIPAA requirements, and Troy Medicare maintains rigorous compliance standards to protect member data. Relevant plan materials and regulatory notices are available through the Documents & Forms library.
Our Principles
Member Obsession
Put members first, earning their trust in the process
Take Ownership
You are accountable: measure goals, processes, and outcomes
Invent and Simplify
Get creative when finding solutions, but showcase good judgment and instinct; stay curious
Act Rapidly
Bias for action — speed and action over inaction
Use Resources Wisely
Achieve goals with innovation and resourcefulness
Earn Trust
Listen and show respect for diverse perspectives; admit mistakes and stay humble
Have Backbone; Disagree and Commit
Challenge decisions with reason, but once a decision is reached, do everything you can to make it successful
Service Area
Troy Medicare serves Medicare-eligible individuals in select counties across North Carolina. Eligibility is based on residence in a Troy Medicare service area and enrollment in Medicare Parts A and B. Troy Medicare offers both HMO and Dual Eligible Special Needs Plan (D-SNP) options depending on the county.
To see the full list of eligible counties and learn how to enroll, visit the Get Started page.
Compliance & Member Resources
Troy Medicare is committed to transparency, regulatory compliance, and protecting the rights of every member. Members have the right to access plan documents, file appeals and grievances, and understand the full scope of their coverage.
For more information, visit Documents & Forms, or Your Coverage Rights.
Want to Learn More About Troy Medicare?
We are available 8am to 8pm Eastern Time
Oct 1 – Mar 31: 7 days a week · Apr 1 – Sep 30: Mon – Fri
Fax: 1-919-375-3533