What Are the Differences in Medicare Plans Across States?

Medicare Part A and Part B, also known as “original Medicare”, is a federal program that has an established standard for costs and coverage across the country. This means that no matter what state you live in, your coverage will be the same and you can use it in any state you visit. However, optional Medicare plans such as Medicare Advantage, Medicare Part D, and Medigap plans are available through private insurers and are regulated by the state. These plans tend to vary from state to state. Our data verification process begins with researching all sources to ensure that they are authoritative and relevant. We then verify the facts with original reports published by those sources, or we confirm the facts with qualified experts. For full transparency, we clearly identify our sources in a list at the bottom of each page. More than 36 million people are covered by original Medicare Parts A and B. It is administered by the federal government and is the same from state to state. But there are also Medicare Advantage plans, Medicare Part D drug plans, and Medigap policies that overlap or replace the original Medicare for millions of people who receive Medicare. These are private plans that insurance companies sell and are regulated by state insurance commissions. The number of Medicare Advantage plans and their prices vary from state to state. Larger states tend to have more options available. Medicare Advantage plans are private policies that you can purchase to replace the original Medicare coverage. The federal government requires them to cover everything that Original Medicare covers in all 50 states. However, they can also offer benefits beyond those covered by Original Medicare, such as dental, eye, prescription drug, and hearing benefits. Medicare Part D prescription drug plans are private insurance plans that work with Original Medicare to help cover the costs of your prescription drugs. Many Medicare Advantage plans also offer prescription drug coverage. The prices and availability of Medicare plans vary from state to state, but all states must have open enrollment in Medicare Part D plans at the same time as open enrollment in Original Medicare from October 15 to December 7 of each year. Medicare supplement insurance, also known as Medigap policies, helps you cover your out-of-pocket costs if you have the original Medicare. It is the only private insurance related to Medicare for which the federal government does not establish a mandatory open enrollment period. You have six months starting from your 65th birthday and, once you've enrolled in Medicare Part B, to buy a Medigap policy available in your area. After that, it's difficult or extremely expensive to switch to another Medigap plan in most states. If you have Original Medicare, you'll have coverage anywhere in the U. S., but if you have a Medicare Advantage plan it will depend on your specific plan. Some plans require that you stay within a network or see certain doctors, limiting you if you travel outside the network. If you move to another state or region, you'll need to find a new Medicare Advantage plan available in that area. According to CNBC, you will have two months to change and update your plan after arriving in your new state of residence. State-specific rules allow Medicare beneficiaries who move from one state to another access to Medigap policies even if they are under 65 years old and qualify for Medicare due to a disability such as end-stage renal disease or ALS (also known as Lou Gehrig's disease). However, most states have some type of rule that gives access to people with these conditions.