Medicare by State
Original Medicare is standardized for beneficiaries across the country. However, your Medicare Advantage, Medicare Supplement, and Part D plan options vary depending on where you reside.
Click on a state to find its specific Medicare plan coverage details, including Medigap, Medicare Advantage, and Part D information.
Medicare Supplement Insurance by State
Medicare Supplement plans are standardized by the federal government. This means that in most states, the benefits offered by any given plan will be the same as in another state.
The only exceptions are Massachusetts, Minnesota, and Wisconsin, where Medigap plans are standardized in a different way. Additionally, you should be aware that not all states offer all of the possible Medigap plans.
Though you can get the same plan with the same benefits in different states, the cost of your monthly premium will likely vary. For example, a Plan N monthly premium for a 65-year-old female in Austin, TX could be as low as $69. In California a Plan N for the same person can cost around $111.
Medigap Enrollment
Each state offers an initial Medigap Open Enrollment Period. This occurs when you first become eligible for Medicare: it begins as soon as your Medicare Part B enrollment is in effect and lasts for six months.
If you would like to enroll in Medicare Supplement Insurance outside of your Medigap Open Enrollment Period, you will likely have to undergo medical underwriting. In this case, insurance companies reserve the right to deny you coverage or can charge you a higher premium given your medical history.
However, certain states offer additional enrollment periods with guaranteed issue rights which secure your right to enroll in a Medigap plan outside of your initial Medigap enrollment period.
Connecticut and New York, for example, offer continuous open enrollment and guaranteed issue rights all year round. Massachusetts has established a Medigap open enrollment period from February 1-March 31 each year. And Maine requires insurance companies to issue Medigap Plan A (the most basic Medicare Supplement) during an annual one-month open enrollment period.
Other states offer Medigap enrollment protections for people who are already enrolled in a Medigap plan and want to change to another one. California and Oregon allow beneficiaries to switch to a Medigap plan with equal or lesser benefits each year within the 30 days following their birthday. In Missouri, you are allowed to change to an equivalent Medigap plan during the 30 days before and after the anniversary date of your policy.
As you can see, where you live has a significant impact on which Medigap plan you can enroll in and when you can do so. To get state-specific Medigap advice, reach out to a licensed insurance here at Medicare Plans Direct free of charge.
Medicare Advantage by State
Medicare Advantage also varies on a state-by-state basis, and the coverage details of Part C plans are based on where you live. Additionally, the same types of Medicare Advantage plans are not available in every state.
Medicare ranks Advantage plans using a star rating system. In fact, some states offer more high-ranked plans than others. Additionally, premium rates for the same plan can vary significantly across states.
This is why Medicare Advantage popularity also differs significantly from state to state. For example, as of February 2021, only 2% of Medicare-eligible individuals in Alaska were enrolled in Part C. You can contrast this with Michigan and Minnesota, where 52% of Medicare enrollees had a Medicare Advantage plan.
Medicare Advantage enrollment periods, however, are standardized across states. Your first chance to enroll in Part C is during your Initial Coverage Enrollment Period, which occurs when you first become eligible for Medicare.
You can also join a new Medicare Advantage plan, change plans, or drop your plan during the Annual Election Period, which lasts from October 15-December 7 each year.
Additionally, you can change plans or drop your plan during the annual Medicare Advantage Open Enrollment Period that occurs annually from January 1-March 31 .
Finally, you may be granted a Special Enrollment Period that allows you to modify your Medicare Advantage coverage at a time other than the ones listed above.
Medicare Part D by State
Part D plans also differ from state to state. Therefore, just because you are enrolled in a certain drug plan in one state doesn’t mean that you would be able to enroll in that plan in another.
Also, the cost of Medicare prescription drug plans varies significantly between states. Though the average Part D premium is projected to be $43 in 2022, you can find stark differences depending on where you live.
The variety of plans for sale also differs between states. In 2022, states offer between 19 and 27 different stand-alone prescription drug plans. Plus some states offer more plans for low-income earners who qualify for the Part D Low-Income Subsidy than others.
As you can see, your Medicare coverage options depend significantly on where you reside. If you would like individualized Medicare advice, don’t hesitate to reach out to us today for a free consultation.
