Is Medicare State Specific?

If you’re new to the world of Medicare, you probably have a lot of questions. It’s easy to feel overwhelmed by your options. United Medicare Advisors is here to give you the answers you need to inform your Medicare decisions.

One question we get a lot concerns our client’s location: “Is Medicare state specific?”

The answer is: Yes and No.

What isn’t state specific?

The Medicare program is a federally-regulated program that allows older adults and people with certain disabilities to get quality health insurance at an affordable price. No matter where you live, you’re eligible for Medicare once you turn 65 years old (or are diagnosed with a chronic condition like Lou Gehrig’s disease).

With Original Medicare (Parts A and B), your coverage is the exact same — it is not state specific. If you move to a different state, travel to a different state, or winter in the south, your health insurance never changes. Pretty cool, right?

The same goes for Medicare Supplement plans. These plans must follow the coverage outlined by the Centers of Medicare and Medicaid Services (CMS), so there are no provider networks or coverage changes, no matter where you go. The only thing that may be different per state is the cost.

Since Medicare Supplement plans are provided by private insurance companies, their rates will vary considerably. But since the coverage is the exact same, Medicare Supplement plans are uniquely easy to compare side-by-side. There’s no “best” plan, because they all must offer the same coverage — the only difference is price.

What is state specific?

Now the answer to this question is different for Medicare Advantage (Part C) and Part D. Insurance companies have a bit more flexibility in what they can offer with these plans, thus, your plan options depend highly on your location.

Medicare Advantage plans will have different coverage, rates, and networks not only depending on your state, but also your county. In 2022, some counties have a choice of 82 Medicare Advantage plans, while others may only have a few.

The same goes for Part D. Though these plans are made to work alongside Medicare, they will still have a network of pharmacies and differing coverage for prescriptions. The plans available to you will be different than the plans available to your friend across the country.

What’s the easiest way to shop for plans?

Due to the differing rules and availability around certain Medicare plans, many people prefer to shop with a licensed insurance agent. Getting help from a professional allows shoppers to talk through their options and learn about discounts and programs in their area.

At United Medicare Advisors, we take this very seriously. We have one-on-one conversations with each of our clients to find out what’s important to each person. Once we understand the kind of Medicare Supplement coverage you’re looking for, we help you compare available plans side-by-side so you get the best rate on your insurance without missing out. We work with over 20 insurance carriers to compare their plans and help you enroll — this takes hours’ worth of research & phone calls off of your plate. Plus, you can rest assured you’ll find a great plan for your unique needs.

If you’re looking for more educational Medicare articles, check out our blog here. If you’re ready to compare your options, call us at (855) 665-9200 or fill out our comparison shopping form.

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