Medicare in Every State: A 50-State Quick Reference Guide

Medicare is a federal program -- the same Parts A, B, C, and D apply whether you live in Maine or Montana. But here's what most people don't realize: your actual Medicare experience can vary dramatically depending on your state. The number of plans available, the cost of Medigap policies, whether your state expanded Medicaid, and even the quality of local providers all change based on your zip code. Here's what you need to know.

How Medicare Works Across All 50 States

• Original Medicare (Parts A and B) is identical nationwide -- same benefits, same rules
• Medicare Advantage (Part C) plans are offered by private insurers and vary by county
• Part D prescription drug plans also vary by region, with different formularies and premiums
• Medigap (Medicare Supplement) policies are standardized by letter (A, B, C, D, F, G, K, L, M, N) but prices differ
• Your state determines Medigap pricing methods: community-rated, issue-age, or attained-age
• State Health Insurance Assistance Programs (SHIP) provide free local Medicare counseling in every state

State Differences That Actually Matter

• Medigap rules: Most states only guarantee Medigap open enrollment when you first turn 65; a few (like Connecticut, Massachusetts, New York) offer continuous open enrollment
• Medicaid expansion: 40 states + D.C. have expanded Medicaid, which affects dual-eligible (Medicare + Medicaid) beneficiaries
• Cost of living: Medicare premiums are the same, but out-of-pocket costs for services and supplemental coverage vary by region
• Provider availability: Rural states may have fewer specialists, hospital systems, and Medicare Advantage options
• State pharmaceutical assistance programs (SPAPs): Some states offer extra help paying for prescriptions beyond Part D

Highest-Rated States for Medicare Beneficiaries

• States with high Medicare Advantage star ratings tend to cluster in the Midwest and Northeast
• Minnesota, Wisconsin, and Iowa consistently rank high for healthcare quality and Medicare plan performance
• Hawaii offers excellent overall health outcomes and strong plan options
• States with robust Medicaid expansion provide more support for low-income Medicare beneficiaries
• Access to SHIP counselors and local Medicare resources also varies -- some states fund these programs more heavily

States with the Most Medicare Advantage Options

• Florida leads the country in Medicare Advantage enrollment and plan availability
• California, Texas, New York, and Pennsylvania also have exceptionally competitive MA markets
• Urban counties in these states may have 50+ plans to choose from
• Rural counties in states like Wyoming, Montana, and Alaska may have fewer than 10 MA options
• More options doesn't always mean better -- it means you need to compare carefully

How to Find Help in Your State

• Contact your State Health Insurance Assistance Program (SHIP) for free, unbiased Medicare counseling
• Visit Medicare.gov and enter your zip code to see all plans available in your area
• Call 1-800-MEDICARE (1-800-633-4227) for general Medicare questions
• Work with a licensed Medicare advisor who knows the plans and providers in your specific state
• Check your state's Department of Insurance website for Medigap rate comparisons and consumer complaints
• Look into your state's Area Agency on Aging for additional senior resources and support

Need Help?

Your state matters more than you think when it comes to Medicare. At Insuras Health Benefits, we help beneficiaries across the country find the right plan for their location, lifestyle, and budget.

Contact us for a free consultation -- no matter what state you're in, we'll help you make sense of your options.