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Medicare Plan Availability Based on Residence 

 

Because Medicare is a federal program, people may think that it operates the same no matter where you live.  While that is true for Original Medicare only, when it comes to Medicare Advantage, Supplements, and Prescription Drug plans, plan availability and cost will be based on the state or even county that you live in.  Let’s take a look at how these things can vary. 

Original Medicare 

As previously mentioned, because Medicare is a federal program, if you only have Original Medicare the coverage will be the same no matter where you live.  You are also free to use any doctor or hospital in the U.S. as long as they accept Original Medicare. 

Supplements 

The supplements or Medigap plans must follow Medicare rules, but because they are run by private insurance companies, their availability and pricing varies from state to state.  There are a few different ways in which insurance companies determine the price and those include community-rated, issue-age-rated, and attained-age-rated.  With the community-rated structure everyone pays the same price.  The issue-age-rated means that the premium is based on the age when you are first issued the policy.  Attained-age-rated pricing is based on your current age, so the premium will go up as you get older.   

Medicare Advantage 

Much like the supplements, Medicare Advantage plans are offered by private insurance companies and must follow rules set forth by Medicare.  However, these plans utilize a network of providers and so the availability of plans will vary by region.  In order to be eligible for a specific Medicare Advantage plan, you must live in the plan’s service area, and this can vary from county to county.  Like the Medicare Advantage plans, you must reside in the service area for prescription drug plans as well. 

As you can see, the plans available to you as well as the pricing structures will depend on where you live.  We always recommend working with an agent who specializes in Medicare who will not only know the plans that are available in your area, but who also keep up to date with all things related to Medicare.  Our agents here at VibrantUSA specialize in Medicare and are available year-round to help any way that they can.   

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