Are Medicare plans and requirements different for every state?

Question

Morgan Greer · Accepted Answer

Medicare plans are different in regions even, so within a state, there will be multiple carriers offering multiple plans, sometimes differing zip code to zip code. Working with an independent broker, like myself, can help to widen your options and explore what will be best for you.

Answered by Morgan Greer on March 27, 2025

Agent Licensed in KS & MO

Answered by Morgan Greer Medicare Insurance Agent

Mark Maliwauki · Answer

They certainly can be. Medicare plans are based on the county you live in and the benefits associated with the plan are normally driven around the # of members or potential members in that county.

William Gray · Answer

Medicare Advantage Plans are different in almost every county in the country..some plans cover multiple counties. 

Medicare Supplement Plans are standardized by CMS and cannot be different based on state or county.

Amy Putrino · Answer

Plans look different in every state, and in most states, they will differ by counties. There are enrollment rules that may differ between states. You need to reach out to someone who represents multiple companies and plans to ensure you are getting all of the information you need to make an educated decision before enrolling.

Answered by Amy Putrino on March 25, 2025

Agent Licensed in RI, CT, FL & 11 other states

Answered by Amy Putrino Medicare Insurance Agent

Michael Caldwell · Answer

Yes, while the core benefits of Original Medicare are standardized across all states, some aspects of Medicare plans and enrollment can vary by state, particularly for Medicare Advantage and Medigap plans. Your best bet is to talk to a profressional who can guide you to the right answers for your specific state and situation.

Answered by Michael Caldwell on May 20, 2025

Broker Licensed in IN, AL, AR & 31 other states

Answered by Michael Caldwell Medicare Insurance Agent

Sean Willingham · Answer

Yes, Medicare plans and requirements can differ by state. White Original Medicare (Parts A & B) has the same cost and coverage nationwide, Medicare Supplement (Medigap) policies have state specific plans and requirements. Moreover, Medicare Advantage (Part C) plans are specific to your county of residence, so Medicare Advantage plans not only differ by state, but they also differ by county.

Answered by Sean Willingham on May 27, 2025

Broker Licensed in TX, AL, FL & 8 other states

Answered by Sean Willingham Medicare Insurance Agent

Steven Bleicher · Answer

Differences occur from state to state with respect to the Medicare Advantage plans. However, since a Medicare Supplement follows all CMS rules, those are sacrosanct and cannot vary without Congress agreeing to a new set of rules. This is why it is imperative to carefully review the variables between insurance companies. This also means that you should consider whether your agent is a “captive agent” (only works for one firm) and therefore cannot compare the HMO, the PPO and the SNP’s (Special Needs Plans for those with Medicaid & who are close to being eligible for Medicare), all of which are types of Advantage plans.

Answered by Steven Bleicher on April 12, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Timothy Brown · Answer

It's possible but it depends on the rules and regulations pertaining to each state. Some of the requirements are consist via CMS (Centers for Medicare and Medicaid Services) rules while other state specific.

Answered by Timothy Brown on March 27, 2025

Broker Licensed in PA, CT, DE & 15 other states

Answered by Timothy Brown Medicare Insurance Agent

Gregg Matheny · Answer

Medicare advantage plans can actually vary from county to county. Medicare Supplement plans are standardized across every single state But will typically have a different monthly premium, depending upon the ZIP Code that you are enrolled in or currently live in.

Answered by Gregg Matheny on March 25, 2025

Agent Licensed in AZ & UT

Answered by Gregg Matheny Medicare Insurance Agent

John L Herman Jr · Answer

Yes. Not only does every State have different Plans...sometimes every County within a State has a variety of Plans and options for a client. That is why it is paramount to use an Independent Broker who can navigate the maze of Medicare in your geography.

Answered by John L Herman Jr on April 3, 2025

Broker Licensed in MD, DE & PA

Answered by John L Herman Jr Medicare Insurance Agent

Michael Yost · Answer

Yes plans vary by county. If someone moves out of a county or service area, that person would probably have to change plans to the new county they are in.

David Silver · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/are-medicare-plans-and-requirements-different-for-every-state#david-silver

Fred Manas · Answer

Yes.
Medicare plans and requirements can differ significantly by state, especially when it comes to Medicare Advantage and Medigap (Medicare Supplement) plans. 
While Original Medicare (Part A and B) generally offers the same coverage and costs nationwide, private plans like Medicare Advantage and Medigap can have variations in availability, benefits, costs, and even enrollment opportunities.

Suzanne Lamperti · Answer

Ni, CMS puts out standardized plans that are available in all states. The difference is the price from the carriers.

Fran Lovelace · Answer

Medicare Advantage plan benefits can differ from county to county, not just state to state.  Medicare Supplement plans, however. are the same from state to state with a few exceptions,

Louanne Allison · Answer

Yes and even can vary by zip codes in the same state. All will require Medicare Part A and/or Medicare Part B. Medicare Supplements are more expensive with a higher monthly premium generally than Medicare Advantage plans, but the benefits are: Any doctor, Any specialist, Any Hospital and Any state.

Answered by Louanne Allison on April 14, 2025

Agent Licensed in MI, FL, IL & OH, TN, TX & UT

Answered by Louanne Allison Medicare Insurance Agent

Judi Norton · Answer

Medicare Advantage plans are different from state to state.  That is why a zip code required because not all services/doctors are available in different states.  

Medicare Supplement plans are the same coverage for each insurance company, but some Medicare supplements have different requirements and monthly premium that varies from state to state.

Daniel Keane · Answer

Medicare Plans may be different in each state and possibly 
different in each zip code. In general, the benefits remain constant but the requirements for obtaining them may differ in each state.

Robert Vitale · Answer

Yes, Medicare plan options and some rules do vary by state, especially for Medicare Advantage plans. While original Medicare (Part A and Part B) offers standardized coverage nationwide, Medicare Advantage plans, which are offered by private companies, can have different coverage, cost, and network requirements depending on the state and even specific counties.

Answered by Robert Vitale on May 21, 2025

Agent Licensed in FL & OH

Answered by Robert Vitale Medicare Insurance Agent

Adriane Williams · Answer

Hi there! Medicare plans are different for every state and company. They are also based on your eligibility. I’d be happy to review plans with you if you like! Give me a call at (918) 210-3319.

Lenora Sikkenga · Answer

Actually , Medicare Advantage can vary from county to county on availability. Some rural counties have no Medicare advantage plans available at all, only med supp and plan D. As far as regular Medicare that is the same across the board because of CMS policies .

Answered by Lenora Sikkenga on April 30, 2025

Broker Licensed in NV

Answered by Lenora Sikkenga Medicare Insurance Agent

Are Medicare plans and requirements different for every state?

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Are Medicare plans and requirements different for every state?

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