North Carolina
Senior Citizens Association

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Section 1 - Company, Plan, and Premium Information
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Section 2 - Applicant Information
First Name* MI Last Name*
Residence Address* City* State* Zip Code* County* Phone* Phone Type Mailing Address (if different from residence address) E-mail* Date of Birth* Date of birth is not formatted properly. Gender*


Section 1 - Applicant B Information
First Name* MI Last Name*
Residence Address* City* State* Zip Code* Phone* Phone Type Mailing Address (if different from residence address) E-mail* Gender*
Date of Birth* Date of birth is not formatted properly.
Do you live in the same household with your spouse, partner, friend or relative?* What is their DOB?* Date of birth is not formatted properly. Relationship?* What is their first name?*
If you have any questions or need help completing the E-App, please contact us at 800-290-7535.

*Required Information

T65, 1/1/2026

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North Carolina Senior Citizens Association (NCSCA)

Non-Profit Organization Since 1977

Turning65NC.com

Administrative Offices:

Asheville • Charlotte • Durham • Fayetteville • Greensboro • Greenville • Pinehurst • Raleigh • Rock Mount • Wilmington • Wilson • Winston-Salem

NCSCA National Administrative Office:

PO Box 34 Fayetteville, NC 28302

Terms & Conditions

An Official North Carolina Senior Citizens Association Website

BUILDING A BETTER QUALITY OF LIFE FOR SENIORS SINCE 1977

North Carolina Senior Citizens Association (NCSCA) is a non-profit organization chartered by the state of North Carolina in 1977. NCSCA's mission is to build a better quality of life through education, information, and service. The collective strength of our membership enables us to serve the broader community, improving the quality of life for all seniors. Any person age 50 and over is eligible to join. There are no membership dues. NCSCA does not endorse any Medicare Plan. Royalty fees are paid to NCSCA from the leading Medicare companies in America for the use of its intellectual property. These fees are used for the general purposes of NCSCA

NCSCA provides an online resource for Medicare, Medicare plans, Social Security, Taxes, Discounts, Lifestyle, and Senior benefits to make life easier. NCSCA also offers health insurance information, along with competitive quotes from some of the nation's leading insurance companies. Rates shown are provided as a public service and not intended as an endorsement of any company. The information contained herein is to be used for information purposes only. Nothing contained herein constitutes an application for insurance with any specific insurance company. Final rates can only be confirmed by a licensed agent approved by the appropriate insurance company.

NCSCA Medicare Advisors are licensed agents and can provide complete information on Medicare plans, prescription drug plans, dental plans, final expense plans, and long-term care insurance. NCSCA Certified Medicare Advisors have helped thousands of people new to Medicare with their transition into Medicare each year.

NCSCA's mission is to help individuals in North Carolina by offering the best available quotes at affordable prices. By using this site and submitting your online quote request, you agree to give NCSCA, or its affiliates, your express consent to communications with you via emails, text messages, and phone calls at the email address and phone numbers provided, including your wireless phone for the purpose of all federal and state telemarketing DO-NOT-CALL laws. Your consent to receive communications in this way is not required as a condition of purchasing any goods or services. By using this site, you acknowledge that you have read and agree to the Terms and Conditions and Privacy Policy.

We are not connected with or endorsed by the U.S. Government or the federal Medicare program. We may not offer every plan available in your area. Any information we provide is limited to the plans we offer in your area. For a full listing of your options, please visit Medicare.gov or call 1-800-MEDICARE (TTY: 1-877-486-2048).