What's Covered in 2026: A Guide to Troy Medicare's Benefits for North Carolina Seniors

CHARLOTTE, NC — With the new plan year underway, Troy Medicare is reminding current and prospective members of the comprehensive benefits available through its 2026 Medicare Advantage plans — all with $0 monthly premiums and $0 copays for the care seniors use most.

Troy Medicare continues to offer two plans across 34 North Carolina counties. Members can review complete plan details in the Documents & Forms section.

Troy Medicare (HMO)

Troy Medicare (HMO) provides $0 monthly premiums, $0 copays for primary care, specialist, and urgent care visits, Part D prescription drug coverage with no deductible, and a monthly over-the-counter allowance. Members also receive hearing, vision, and dental benefits, with a maximum out-of-pocket limit of $3,950 for in-network services. The plan is designed around Troy Medicare's pharmacy-first care model, meaning members benefit from integrated medication management and access to a dedicated Care Manager at no additional cost.

Troy Medicare D-SNP (HMO)

Troy Medicare D-SNP (HMO) serves beneficiaries who qualify for both Medicare and Medicaid. The D-SNP plan includes up to $2,200 in combined benefits for over-the-counter items, healthy foods, and utility assistance through the Special Supplemental Benefits for the Chronically Ill (SSBCI) program. These benefits are designed to address the social determinants of health — nutrition, housing costs, and daily necessities — that directly affect health outcomes for dual-eligible seniors.

The D-SNP plan also provides enhanced care coordination for members managing complex health needs. Dual-eligible beneficiaries often navigate multiple healthcare programs and coverage sources simultaneously, which can lead to confusion, missed appointments, and gaps in care. Troy Medicare's Care Managers work directly with D-SNP members to simplify this process, ensuring that Medicare and Medicaid benefits are coordinated effectively and that members receive the full range of support they are entitled to.

Care Management and Pharmacy Integration

Both plans include access to Troy Medicare's Care Management team, which provides proactive outreach on chronic disease management, fall prevention, medication reviews, and health risk assessments. Care Managers are available Monday through Friday, 9 a.m. to 5 p.m. at 910-878-2730.

Troy Medicare's pharmacy-first approach means that members also benefit from close collaboration between their Care Manager and their community pharmacist. This partnership allows for real-time medication therapy management, identification of potential drug interactions, and personalized counseling on how to get the most from their prescriptions. For seniors taking multiple medications — which is common among Medicare beneficiaries — this level of coordination can prevent adverse events and improve overall health outcomes. Members can review their prescription drug coverage and formulary online.

Supplemental Benefits and Availability

In addition to medical and pharmacy benefits, Troy Medicare members have access to supplemental services that support everyday wellness. These include fitness benefits, telehealth services for convenient access to care from home, and transportation assistance for members who need help getting to medical appointments. Troy Medicare recognizes that access to care extends beyond the doctor's office and that removing barriers to routine healthcare is essential for maintaining long-term health.

Troy Medicare's 2026 plans are available in Alexander, Anson, Bladen, Buncombe, Burke, Caldwell, Catawba, Chatham, Columbus, Cumberland, Durham, Franklin, Granville, Harnett, Haywood, Henderson, Hoke, Iredell, Jackson, Lee, McDowell, Mitchell, Montgomery, Moore, Orange, Person, Polk, Richmond, Robeson, Sampson, Scotland, Swain, Transylvania, Vance, and Yancey counties.

Members with questions about their benefits can call Troy Medicare at 1-888-494-TROY (8769) or contact us online. Troy Medicare operates under strict compliance guidelines to ensure all plan information meets CMS standards.

About Troy Medicare
Troy Medicare is a pharmacy-powered Medicare Advantage plan serving North Carolina. Founded by pharmacists, physicians, and technologists, Troy Medicare combines data-driven care management with deep community relationships to deliver better outcomes for seniors.