Terry Turner, writer and researcher for RetireGuide
  • Written by
    Terry Turner

    Terry Turner

    Senior Financial Writer and Financial Wellness Facilitator

    Terry Turner has more than 30 years of journalism experience, including covering benefits, spending and congressional action on federal programs such as Social Security and Medicare. He is a Certified Financial Wellness Facilitator through the National Wellness Institute and the Foundation for Financial Wellness and a member of the Association for Financial Counseling & Planning Education (AFCPE®).

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  • Edited By
    Lee Williams
    Lee Williams, senior editor for RetireGuide.com

    Lee Williams

    Senior Financial Editor

    Lee Williams is a professional writer, editor and content strategist with 10 years of professional experience working for global and nationally recognized brands. He has contributed to Forbes, The Huffington Post, SUCCESS Magazine, AskMen.com, Electric Literature and The Wall Street Journal. His career also includes ghostwriting for Fortune 500 CEOs and published authors.

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  • Published: October 26, 2020
  • Updated: September 15, 2022
  • 8 min read time
  • This page features 13 Cited Research Articles
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How to Cite RetireGuide.com's Article

APA Turner, T. (2022, September 15). Medicare by State. RetireGuide.com. Retrieved September 25, 2022, from https://www.retireguide.com/medicare/costs-and-coverage/state/

MLA Turner, Terry. "Medicare by State." RetireGuide.com, 15 Sep 2022, https://www.retireguide.com/medicare/costs-and-coverage/state/.

Chicago Turner, Terry. "Medicare by State." RetireGuide.com. Last modified September 15, 2022. https://www.retireguide.com/medicare/costs-and-coverage/state/.

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Key Takeaways
  • Original Medicare is the only coverage that does not vary by state. Medigap, Medicare Advantage and Part D prescription drug plans are all sold privately and vary by state.
  • Larger states typically have more plan options available than less populated states.
  • Medigap plans offer the same benefits across most states.

Is Medicare a State or Federal Program?

Medicare is a federal program, meaning that its eligibility and coverage are mostly the same across the U.S. It’s important to remember that this distinction is only the case for Original Medicare, which includes Parts A and B. If you have Original Medicare, there is essentially no difference in coverage depending on where you live.

This is not true of Medicare Advantage plans, which vary significantly by the state in cost and coverage. Medicare Advantage plans, or Medicare Part C, are provided by private insurers and include additional benefits and coverage beyond the scope of Original Medicare.

Medicare Part D, an optional benefit to cover prescription drugs, also varies by state and region.

Anne Novak | 0:47 Is Medicare the same in every state?
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Learn how Original Medicare and Medicare supplemental products work in each state from Anne Novak, who is licensed in Life and Annuities, Sickness, Accident and Health by the Nebraska Department of Insurance.

How Do Medicare Plans Differ by State?

Even though it’s a federal program, Medicare coverage, costs and benefits can vary widely from state to state. Medicare covered nearly 64 million Americans as of October 2021, according to the most recent data from the U.S. Centers for Medicare & Medicaid Services.

More than 36 million of those people were covered by Original Medicare — Medicare Part A and Part B. It’s managed 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 either overlap with or replace Original Medicare for millions of people on Medicare. These are private plans sold by insurance companies.

These private plans are regulated by state insurance commissions and they differ from state to state.

Roughly 28 million people were enrolled in Medicare Advantage plans as of October 2021. These are private plans that replace Original Medicare coverage.

More than 49 million people were enrolled in a Medicare Part D prescription drug plan in 2021. About 21% of people on Medicare also had a Medigap policy in 2018, according to a report from the Kaiser Family Foundation. These plans can be added to Original Medicare coverage.

Medicare Advantage Plans by State

The number of Medicare Advantage plans and their prices vary from state to state. Larger states typically have more options available.

Medicare Advantage Plans and Premiums by State
State Average Monthly Premium Number of Plans
California$19.94424
Texas$11.42289
Florida$8.28527
Ohio$20.69202
Alabama$11.0682
Illinois$14.76147
Georgia$14.84149
Michigan$38169
Colorado$15.8080
Indiana$16.07126
Source: Centers for Medicare and Medicaid Services

State Differences in Medicare Advantage

Medicare Advantage plans are private policies that you can buy to replace Original Medicare coverage.

The federal government requires them to cover everything Original Medicare covers in all 50 states. But Medicare Advantage plans may also offer benefits beyond what Original Medicare covers, such as dental, vision, prescription drug and hearing benefits.

The federal government requires an annual open enrollment for Medicare Advantage in every state that coincides with Original Medicare enrollment. This happens every year from October 15 to December 7.

Since 2019, the federal government has also allowed a second open enrollment period for Medicare Advantage from January 1 through March 31. This period allows people with Medicare Advantage to switch to another Medicare Advantage plan or to switch to Original Medicare.

Medicare Advantage Popularity by State

Because Medicare prices, benefits and population vary from state to state, Medicare Advantage may be more popular alternatives to Original Medicare in some states compared to others.

States with Highest and Lowest Medicare Advantage Enrollment (2018)
5 Highest Ranking StatesMedicare Advantage Plans5 Lowest Ranking StatesMedicare Advantage Plans
California2,451,604North Dakota21,917
Florida1,910,338District of Columbia15,525
Texas1,453,573Vermont13,566
New York1,320,208Wyoming2,572
Pennsylvania1,048,026Alaska746

As a percentage of the population, only about one percent of Alaskans enrolled in Medicare had Medicare Advantage plans in 2018. But 56 percent of Medicare beneficiaries in Minnesota were enrolled in a Medicare Advantage plan that same year.

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How Medicare Part D Prescription Drug Plans Differ Between States

Medicare Part D prescription drug plans are private insurance plans that work with Original Medicare to help cover the costs of your prescription medicine. Many Medicare Advantage plans also provide prescription drug coverage.

Medicare plan prices and plan availability varies from state to state, but all states are required to have open enrollment in Medicare Part D plans at the same time as open enrollment for Original Medicare — October 15 to December 7 every year.

The availability of Medicare Part D plans vary from state to state. The number of plans available in any state in 2022 ranges from 19 choices in New York to 27 choices in Arizona, according to the Kaiser Family Foundation.

Differences in Medigap Plans Between States

Medicare Supplement insurance — also known as Medigap — policies help you cover your out-of-pocket expenses if you have Original Medicare. It’s the only private Medicare-related insurance for which the federal government does not set a mandatory open enrollment period.

You have six months starting with your 65th birthday — and once you’re enrolled in Medicare Part B — to buy a Medigap policy available in your area.

After that, you’re often locked into the Medigap plan you choose. It is difficult or extremely expensive to switch to another Medigap plan in most states.

Medigap plans are standardized across most states, meaning they offer the same benefits. The exceptions are Wisconsin, Minnesota and Massachusetts. Plans in those states may have options that differ from Medigap plans in other states.

Examples of Rare State Rules for Medigap
RuleStates
Medigap plan prices are community-rated, meaning policies typically charge the same premiums regardless of your age or gender.Arkansas, Connecticut, Massachusetts, Maine, Minnesota, New York, Vermont, Washington
A “birthday rule” allows you to switch Medigap plans within 30 days of your birthday each year without costly medical underwriting.California, Oregon
Two states have “guaranteed issue” rights year-round in which companies must offer you certain Medigap policies in certain situations.Connecticut, New York
One state allows you to switch Medigap plans at any time during the year so long as the new policy has the same or lesser benefits.Maine
One state has an Anniversary Guaranteed Issue Period meaning if you have a Medigap plan, you have a 60-day period around your plan’s anniversary date every year to switch to the same plan from a different insurance company.Missouri

Medicare does not require states to guarantee access to Medigap plans for people under 65 who qualify for Medicare due to a disability such as End-Stage Renal Disease or ALS (also known as Lou Gehrig’s disease). But most states have some type of rule in place giving people with these conditions access.

Using Medicare in Other States

If you have Original Medicare, then you will be covered anywhere in the U.S.

Since Original Medicare is a federal program, it provides blanket coverage across the country. But, even in another state, you still have to receive treatment from a doctor who is enrolled in Medicare.

If you have Medicare Advantage, then it will depend on your specific plan. Some plans require you to stay within a network or use certain doctors, limiting you if you travel outside of your network.

Transferring Medicare to Another State

If you move to another state or region, you will 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 you’ve arrived in your new state of residence.

If you have Original Medicare, all you need to do if you move is give Medicare your new address and location info.

Frequently Asked Questions About Nationwide Medicare Coverage

Is Medicare different in each state?

Since it is a federal program, Original Medicare is the same everywhere in the U.S. This is not the case for Medicare Advantage. Since Medicare Advantage plans are purchased from private insurers, they are offered regionally and often include plan networks that limit your coverage to a general area.

How do you transfer Medicare to another state?

If you have Original Medicare, then your coverage isn’t affected if you move to another state. Since Medicare Advantage plans are often limited by networks, you will likely need to find a new plan when you move rather than transferring your current plan.

Do Medicare Advantage plans cover out-of-state?

Some Medicare Advantage plans may be used out-of-state, but most are limited to a region or certain doctors and facilities. If you are moving to another state or city and have Medicare Advantage, you will likely need to select a new plan in your area.

Last Modified: September 15, 2022

13 Cited Research Articles

  1. U.S. Centers for Medicare & Medicaid Services. (2021, December 21). CMS Releases Latest Enrollment Figures for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP). Retrieved from https://www.cms.gov/newsroom/news-alert/cms-releases-latest-enrollment-figures-medicare-medicaid-and-childrens-health-insurance-program-chip
  2. Kaiser Family Foundation. (2021, October 13). An Overview of the Medicare Part D Prescription Drug Benefit. Retrieved from https://www.kff.org/medicare/fact-sheet/an-overview-of-the-medicare-part-d-prescription-drug-benefit/
  3. U.S. Centers for Medicare & Medicaid Services. (2021, March 23). A Snapshot of Sources of Coverage Among Medicare Beneficiaries in 2018. Retrieved from https://www.kff.org/medicare/issue-brief/a-snapshot-of-sources-of-coverage-among-medicare-beneficiaries-in-2018/
  4. U.S. Centers for Medicare & Medicaid Services. (2020, February 13). Medicare Part D Enrollment: Part D Enrollees by Type of Plan, Low Income Subsidy (LIS), and Retiree Drug Subsidy, Calendar Years 2013-2018. Retrieved from https://www.cms.gov/files/document/2018-mdcr-enroll-d-1.pdf
  5. U.S. Centers for Medicare & Medicaid Services. (2015, April). What’s a Medicare Advantage Plan? https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/medicare-advantage-plans
  6. Davis, K., Schoen, C., and Bandeali, F. (2015, April). Medicare; 50 Years of Ensuring Coverage and Care. Retrieved from https://collections.nlm.nih.gov/master/borndig/101659299/Medicare_50_years_coverage_care.pdf
  7. U.S. Centers for Medicare & Medicaid Services. (n.d.). Your Medicare Coverage Choices. Retrieved from https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices
  8. U.S. Centers for Medicare & Medicaid Services. (n.d.). Find Contact Information. Retrieved from https://www.medicare.gov/talk-to-someone
  9. U.S. Centers for Medicare & Medicaid Services. (n.d.). Medicare Advantage Plans. Retrieved from https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/medicare-advantage-plans
  10. U.S. Centers for Medicare & Medicaid Services. (n.d.). How Do Medicare Advantage Plans Work? Retrieved from https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/medicare-advantage-plans/how-do-medicare-advantage-plans-work
  11. U.S. Centers for Medicare & Medicaid Services. (n.d.). Your Guide to Prescription Drug Coverage. Retrieved from https://www.medicare.gov/sites/default/files/2021-07/11109-Medicare-Drug-Coverage-Guide_0.pdf
  12. U.S. Centers for Medicare & Medicaid Services. (n.d.). How to Compare Medigap Policies. https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies
  13. Kaiser Family Foundation. (n.d.). Medicare Advantage: Total Enrollment. Retrieved from https://www.kff.org/medicare/state-indicator/ma-total-enrollment/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D