Open Enrollment Considerations 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.

While the coverage for Medigap plans is standardized, the costs are not. Premiums depend on many factors, including your age, your health and where you live.

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.

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.