Open Enrollment Considerations by State

While Original Medicare is consistent nationwide, Medicare Advantage, Medigap and Part D prescription drug plans can vary by state in terms of coverage, costs and eligibility. Understand what’s available in your state before open enrollment to ensure you get the best plan for your needs.

Lamia Chowdhury, editor for RetireGuide.com
  • Written by
    Lamia Chowdhury

    Lamia Chowdhury

    Financial Editor

    Lamia Chowdhury is a financial content editor for RetireGuide and has over three years of marketing experience in the finance industry. She has written copy for both digital and print pieces ranging from blogs, radio scripts and search ads to billboards, brochures, mailers and more.

    Read More
  • Edited By
    Savannah Hanson
    Savannah Hanson, financial editor for RetireGuide

    Savannah Hanson

    Financial Editor

    Savannah Hanson is a professional writer and content editor with over 15 years of professional experience across multiple industries. She has ghostwritten for entrepreneurs and industry leaders and been published in mediums such as The Huffington Post, Southern Living and Interior Appeal Magazine.

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  • Published: September 8, 2022
  • Updated: September 13, 2022
  • 14 min read time
  • This page features 6 Cited Research Articles
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How to Cite RetireGuide.com's Article

APA Chowdhury, L. (2022, September 13). Open Enrollment Considerations by State. RetireGuide.com. Retrieved September 30, 2022, from https://www.retireguide.com/medicare/eligibility-and-enrollment/open-enrollment-period/considerations-by-state/

MLA Chowdhury, Lamia. "Open Enrollment Considerations by State." RetireGuide.com, 13 Sep 2022, https://www.retireguide.com/medicare/eligibility-and-enrollment/open-enrollment-period/considerations-by-state/.

Chicago Chowdhury, Lamia. "Open Enrollment Considerations by State." RetireGuide.com. Last modified September 13, 2022. https://www.retireguide.com/medicare/eligibility-and-enrollment/open-enrollment-period/considerations-by-state/.

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What Types of Medicare Plans Can Vary by State?

Since Original Medicare is a federal program, its eligibility requirements, costs and coverage are steady across the country. That means, you can move to any state and still receive the same care for Medicare Parts A and B as you did in another state.

On the other hand, Medicare Advantage, Medigap and Part D prescription drug plans are provided by private insurers, so these plans may vary by state. For example, the coverage you receive for a Medicare Advantage plan in Alabama may be different from what is available in Wyoming.

Variations by state include average premium costs, the period to change plans and the type of coverage provided.

Medicare Advantage Plans

Medicare Advantage plans are provided by private, Medicare-approved companies and offer the same benefits as Original Medicare, plus additional benefits. These plans, also known as Medicare Part C, are popular due to the expansive services they offer, with many including prescription drug coverage.

Medicare Advantage plans vary by state and the plans available change yearly. The number of plans available in your area will depend on the county and state in which you live. The only state that does not offer any Medicare Advantage plans is Alaska.

The cost of Medicare Advantage plans also varies by state. For example, in 2022, the average premium rate in Florida, Iowa, Missouri and Nevada was under $10, whereas the average premium in Minnesota was nearly $90.

Medigap Plans

Medigap is supplemental insurance to help support your Original Medicare coverage. It is offered by private insurers and helps cover costs related to deductibles, copayments and coinsurance.

There are 47 states that offer 10 Medigap plans — each categorized by the letters A through N — which are standardized by federal rules. That means, all 47 states offer the same Medigap plans, regardless of the provider.

Since most states offer the same Medigap plans, it can make it easier for you to compare plans based on coverage for each. You generally must have Medicare Parts A and B to qualify.

The three exceptional states to federal rules are Massachusetts, Minnesota and Wisconsin since they have waivers to offer state-approved plans.

Part D Prescription Drug Plans

Part D prescription drug plans can be purchased as a standalone plan or oftentimes are included with Medicare Advantage plans. Part D plans help cover prescription drug costs and are offered by government-approved providers.

According to Kaiser Family Foundation, Arizona had the most standalone Part D plans available in 2022, with 27 plans — whereas New York had the lowest number of plans available at just 19.

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State-by-State Open Enrollment Considerations

The open enrollment period allows you to join, switch or drop your Original Medicare and Part D plans. The window for this remains the same for every state — between Oct. 15 and Dec. 7.

If you are enrolled in a Medicare Advantage plan, then you can switch Medicare Advantage plans from Jan. 1 to March 31.

For Medigap, you have a six-month window to apply when you turn 65, regardless of pre-existing conditions. This six-month window opens when your Medicare Part B benefits start. After that window, you can be denied coverage if you don’t meet the medical underwriting requirements depending on your insurer.

Some states are authorized to offer Medigap policies year-round or outside of your six-month enrollment window.

Below, you will find what you need to know about open enrollment for Medicare Advantage and Medigap based on your state.

StateNumber of Medicare Advantage Plans Available Average Medicare Advantage Premium CostNumber of Medigap Insurers AvailableState Resources
Alabama91 plans$11.21 41 insurers

In Alabama, enrollees under 65 can apply for a plan, but are not guaranteed a policy.
Website: Alabama Department of Senior Services

Phone: 1-800-243-5463
AlaskaAlaska does not offer individual Medicare Advantage plans.14 insurers

Alaska only has one insurer that offers select plans to enrollees under 65.
Website: Alaska Department of Health and Social Services

Phone: 1-800-478-6065

TTY: 1-800-770-8973
Arizona155 plans$11.64 65 insurers

Arizona is not required to offer plans for enrollees under 65.
Website: Arizona Department of Economic Security

Phone: 1-800-432-4040
Arkansas82 plans$11.55 58 insurers

Arkansas requires insurers to offer at least one plan to those under 65.

Arkansas is one of eight states where premiums cannot change based on age or overall health.
Website: Arkansas Seniors Health Insurance Information Program

Phone: 1-800-224-6330
California458 plans$18.12 30 insurers

California law provides you with 60 days from the first day of your birth month to switch to a plan with equal or lesser benefits.

In California, insurers can determine premiums, meaning your premium can stay the same based on when you enrolled, increase as you get older or not vary at all.

California is required to offer coverage to those under 65 unless they have end-stage renal disease.
Website: California Department of Aging

Phone: 1-800-434-0222
Colorado94 plans$14.11 43 insurers

In Colorado, insurers can determine premiums, meaning your premium can stay the same based on when you enrolled, increase as you get older or not vary at all.

Colorado is required to offer plans to those under 65 who are disabled, but the premiums are higher.
Website: Colorado Department of Regulatory Agencies

Phone: 1-888-696-7213
Connecticut57 plans$19.95 14 insurers

You can enroll in a Medigap plan anytime during the year if you are enrolled in Medicare Part B.

You are guaranteed enrollment, and you also have the option to change your Medigap plan regardless of your health conditions.

Connecticut is one of eight states where premiums cannot change based on age or overall health.

Connecticut is required to sell at least Plans A, B and C to those under 65.
Website: Connecticut State Department of Aging and Disability Services

Phone: 1-800-994-9422
Delaware28 plans$11.92 33 insurers

In Delaware, insurers can determine premiums, meaning your premium can stay the same based on when you enrolled, increase as you get older or not vary at all.

Delaware is required to offer plans to those under 65 who are disabled, but the premiums are higher.
Website: Delaware Department of Insurance

Phone: 1-800-336-9500
District of Columbia16 plans$37.59 15 insurers

If you have a pre-existing condition and didn’t have at least six months of continuous coverage, you may be penalized with a six-month waiting period for coverage of that condition.

The District of Columbia is not required to offer plans to those under 65.
Website: DC Department of Aging and Community Living

Phone: 202-727-8370
Florida583 plans$8.54 Florida offers plans to those under 65 but at higher premiums.

Plan F is no longer available to those who are eligible after December 2019.
Website: Florida SHIP Department of Elder Affairs

Phone: 1-800-963-5337

TTY: 1-800-955-8770
Georgia157 plans$13.55 41 insurers

In Georgia, insurers can determine premiums, meaning your premium can stay the same based on when you enrolled, increase as you get older or not vary at all.

Georgia is required to offer plans to those under 65 who are disabled, but the premiums are higher.
Website: Georgia SHIP Division of Aging Services

Phone: 1-866-552-4464
Hawaii33 plans$54.47 13 insurers

Hawaii prohibits insurers to charge higher premiums for beneficiaries under 65.
Website: Hawaii SHIP

Phone: 1-888-875-9229

TTY: 1-866-810-4379
Idaho80 plans$28.59 40 insurers

In Idaho, insurers cannot increase your premium based on your age.

You can also change plans (to one of equal or lesser benefits) during a 63-day window that begins on your birthday.
Website: Idaho Department of Insurance

Phone: 1-800-247-4422
Illinois166 plans$12.83 41 insurers

Illinois law provides you 45 days annually following your birthday (between the ages of 65 and 75), when you can switch to a plan of equal or lesser benefits.
Website: Illinois Department on Aging

Phone: 1-800-252-8966
Indiana133 plans$14.86 47 insurers

As of 2020, Indiana requires insurers to offer Plan A to beneficiaries under 65.
Website: Indiana Department of Insurance

Phone: 1-800-452-4800

TTY: 1-866-846-0139
Iowa61 plans$8.99 60 insurers

Iowa is not required to offer plans to those under 65.
Website: Iowa SHIIP

Phone: 1-800-351-4664

TTY: 1-800-735-2942
Kansas88 plans$7.79 62 insurers

Kansas does not allow insurers to charge higher premium rates for enrollees under 65.
Website: Kansas Department For Aging and Disability Services

Phone: 1-800-860-5260
Kentucky98 plans$14.02 59 insurers

Kentucky allows the use of medical underwriting to determine whether to accept beneficiaries under 65.
Website: Kentucky Cabinet For Health and Family Services

Phone: 1-877-293-7447
Louisiana102 plans$14.53 37 insurers

Louisiana offers plans for those under 65 but at higher premiums.
Website: Louisiana Department of Insurance

Phone: 1-800-259-5300
Maine57 plans$14.04 14 insurers

You can switch to a lesser plan at any time of year. In addition, every insurer must indicate one month per year for Medigap Plan A open enrollment.

Maine is also one of eight states where premiums cannot change based on age or overall health.

Enrollees under 65 are granted the same enrollment window as those 65 and up.
Website: Maine Department of Health and Human Services

Phone: 1-800-262-2232
Maryland49 plans$45.97 45 insurers

Maryland requires Plan A and Plan D to be offered to those under 65, as well as Plan C in some cases.
Website: Maryland Department of Aging

Phone: 1-800-243-3425
Massachusetts113 plans$50.48 9 insurers

Massachusetts is one of three states where Medigap does not follow federal standardization rules.

There is an open-enrollment window from Feb. 1 to March 31, when residents are guaranteed enrollment for the first time (if you missed your initial six-month window) or can switch plans.

Insurers cannot deny you coverage based on pre-existing conditions or lapses in coverage.

Massachusetts is one of eight states where premiums cannot change based on age or overall health.
Website: Mass Health and Social Services

Phone: 1-800-243-4636

TTY: 1-877-610-0241
Michigan191 plans$28.74 48 insurers

In Michigan, insurers can determine premiums, meaning your premium can stay the same based on when you enrolled, increase as you get older or not vary at all.

Only six insurers offer plans to those under 65.
Website: MMAP

Phone: 1-800-803-7174
Minnesota101 plans$76.92 21 insurers

Minnesota is one of eight states where premiums cannot change based on age or overall health.

Minnesota is also one of three states where Medigap does not follow federal standardization rules. Rather than the 10 plans offered in most states, Minnesota offers Basic, Basic with riders, Extended Basic, and Medigap plans F, K, L, M and N.
Website: Minnesota Senior Linkage Line

Phone: 1-800-333-2433
Mississippi61 plans$21.41 65 insurers

Mississippi is required to offer all plans to those under 65.
Website: Mississippi Department of Human Services

Phone: 1-844-822-4622
Missouri126 plans$8.04 39 insurers

In Missouri, you have a 60-day window around your plan anniversary to change insurers within the same letter plan.

Missouri also offers plans to those under 65.
Website: Missouri Claim

Phone: 1-800-390-3330
Montana27 plans$28.45 27 insurers

In Montana, insurers can determine premiums, meaning your premium can stay the same based on when you enrolled, increase as you get older or not vary at all.

Montana offers plans to those under 65, but premiums are higher.
Website: Montana SHIP

Phone: 1-800-551-3191
Nebraska36 plans$13.83 47 insurers

Nebraska is not required to offer plans to those under 65.
Website: Nebraska SHIP

Phone: 1-800-234-7119
Nevada94 plans$3.4131 insurers

In Nevada, you can change plans (to one of equal or lesser benefits) during a 60-day window that begins on your birthday. You are guaranteed coverage regardless of pre-existing conditions.

Nevada is not required to offer plans to those under 65.
Website: Nevada Medicare Assistance Program

Phone: 1-800-307-4444
New Hampshire44 plans$21.02 22 insurers

In New Hampshire, insurers can determine premiums, meaning your premium can stay the same based on when you enrolled, increase as you get older or not vary at all.

New Hampshire offers plans to those who are disabled under 65 but at higher premiums.
Website: New Hampshire Aging and Disability Resource Center

Phone: 1-866-634-9412
New Jersey84 plans$17.41 26 insurers

In New Jersey, you cannot enroll in Medigap Plans C and F if you became eligible for Medicare on or after Jan. 1, 2020.
Website: New Jersey Division of Aging Services

Phone: 1-800-792-8820
New Mexico69 plans$14.73 34 insurers

New Mexico is not required to offer plans to those under 65, but three insurers do anyway.
Website: New Mexico Aging and Long-Term Services Department

Phone: 1-800-432-2080
New York280 plans$30.20 12 insurers

You can enroll in a Medigap plan anytime during the year without medical underwriting.

New York is also one of eight states where premiums cannot change based on age or overall health.
Website: New York Office For the Aging

Phone: 1-800-701-0501
North Carolina145 plans$15.22 48 insurers

In North Carolina, most insurers use attained-age rating, meaning your premiums will increase as you get older, regardless of when you first enrolled.

North Carolina requires insurers to offer Plan A to those under 65.
Website: NC SHIIP

Phone: 1-855-408-1212
North Dakota23 plans$41.14 55 insurers

In North Dakota, most insurers use attained-age rating, meaning your premiums will increase as you get older, regardless of when you first enrolled.

North Dakota does not require insurers to offer plans to those under 65.
Website: North Dakota Medicare Assistance

Phone: 1-888-575-6611

TTY: 1-800-366-6888
Ohio202 plans$18.75 59 insurers

Ohio is not required to offer plans to those under 65.
Website: Ohio Department of Insurance

Phone: 1-800-686-1578
Oregon132 plans$39.77 30 insurers

In Oregon, you can change plans (to one of equal or lesser benefits) during a 30-day window that begins on your birthday. You are guaranteed coverage regardless of your medical history.

Oregon offers guaranteed issue coverage for disabled beneficiaries under 65.
Website: Oregon SHIBA

Phone: 1-800-722-4134
Pennsylvania240 plans$32.79 69 insurers

In Pennsylvania, enrollees with disabilities are guaranteed access to plans if they’re under 65.
Website: Pennsylvania Department of Aging

Phone: 1-800-783-7067
Rhode Island33 plans$25.46 19 insurers

Only two insurers in Rhode Island offer plans to enrollees under 65.
Website: Rhode Island Office of Healthy Aging

Phone: 1-888-884-8721

TTY: 401-462-0740
South Carolina96 plans$11.66 63 insurers

South Carolina offers high-premium plans to those under 65 with disabilities.
Website: South Carolina Department of Aging

Phone: 1-800-868-9095
South Dakota25 plans$27.14 43 insurers

South Dakota offers plans to those under 65, but the rates cannot exceed the price for a 75-year-old.
Website: South Dakota SHINE

Phone: 1-800-536-8197
Tennessee112 plans$18.74 11 insurers

Tennessee offers plans for those under 65 but at higher premiums.
Website: Tennessee SHIP

Phone: 1-877-801-0044

TTY: 1-800-848-0299
Texas337 plans$10.68 70 insurers

Texas is required to offer at least Plan A to disabled beneficiaries under 65.
Website: Texas Health and Human Services

Phone: 1-800-252-9240
Utah54 plans$17.71 47 insurers

Only three insurers offer plans for those under 65 in Utah.
Website: Utah Senior Services

Phone: 1-800-541-7735
Vermont26 plans$22.58 12 insurers

Vermont is one of eight states where premiums cannot change based on age or overall health.
Website: Vermont Association of Area Agencies on Aging

Phone: 1-800-642-5119
Virginia132 plans$16.15 42 insurers

In Virginia, most insurers use attained-age rating, meaning your premiums will increase as you get older, regardless of when you first enrolled.

Virginia is required to offer plans to those under 65, but premiums may be higher.
Website: Virginia Office For Aging Services

Phone: 1-800-552-3402
Washington159 plans.

Seven counties in Washington don’t offer any plans.
$34.45 23 insurers

Washington is one of only a few states that will allow you to change policies at any time after the initial enrollment window closes, as long as you have been covered under a Medigap plan for at least 90 days.

Washington is one of eight states where premiums cannot change based on age or overall health.

After the initial enrollment period closes, insurers can impose a three-month pre-existing condition waiting period if you didn’t have continuous coverage prior to enrollment.
Website: Washington State SHIBA

Phone: 1-800-562-6900

TTY: 1-360-586-0241
West Virginia46 plans$25.53 86 insurers

In West Virginia, most insurers use attained-age rating, meaning your premiums will increase as you get older, regardless of when you first enrolled.

West Virginia is not required to sell plans to those under 65, but some do voluntarily.
Website: West Virginia SHIP

Phone: 1-877-987-4463
Wisconsin115 plans$29.87 32 insurers

Wisconsin is one of three states where Medigap does not follow federal standardization rules.

This state offers a Basic Plan and riders to add on.

Wisconsin offers plans to those who are disabled under 65, but premiums are higher.
Website: Wisconsin Department of Health Services

Phone: 1-800-242-1060
Wyoming9 plans$47.58 26 insurers

Only two insurers in Wyoming consider enrollees under 65.
Website: Wyoming Senior Citizens

Phone: 1-800-856-4398
Last Modified: September 13, 2022

6 Cited Research Articles

  1. Jerusalimiec, V. (2021, Nov. 17) Tennessee Medicare Plans in 2022. Retrieved from https://www.healthline.com/health/medicare/medicare-plans-tennessee
  2. Department of Health & Human Services. (2021, Sept. 29) Medicare Open Enrollment 2022 State by State Fact Sheet. Retrieved from https://www.cms.gov/files/document/92921-state-state-fact-sheets-2022-medicare-advantage-and-part-d-landscape-final.pdf
  3. Boccuti, C. et al. (2018, July). Medigap Enrollment and Consumer Protections Vary Across States. Retrieved from https://files.kff.org/attachment/Issue-Brief-Medigap-Enrollment-and-Consumer-Protections-Vary-Across-States
  4. Centers for Medicare and Medicaid Services. (n.d.) Medicare Advantage Plans. Retrieved from https://www.medicare.gov/types-of-medicare-health-plans/medicare-advantage-plans
  5. Norris, L. (n.d.) A guide to Medicare private coverage availability and enrollment in each state. Retrieved from https://www.medicareresources.org/enrollment-options/
  6. State Health Insurance Assistance Program. (n.d.) Regional SHIP Location. Retrieved from https://www.shiphelp.org/about-medicare/regional-ship-location