Is Medicare different in each state?
Asked by: Dr. Jazlyn Stokes | Last update: December 31, 2025Score: 4.3/5 (60 votes)
Is Medicare the same for every state?
Original Medicare covers hospital care and doctor visits in all 50 U.S. states and its territories, as long as providers accept Medicare. Certain Medicare Advantage plans also provide state-to-state coverage, but some limit coverage to a defined service area.
Does it matter what state you live in for Medicare?
If you move anywhere within the United States, you won't lose your original Medicare coverage as long as your new health care facility, doctor or other provider accepts Medicare.
Does Medicare vary by location?
Medicare Advantage plans are available in all 50 states and Washington D.C. Medicare-approved private insurance companies provide these plans. These insurance companies must follow certain rules that Medicare stipulate. However, the type of plans, coverage, and cost may vary by state and area.
What are the 6 things Medicare doesn't cover?
- Eye exams (for prescription eyeglasses)
- Long-term care.
- Cosmetic surgery.
- Massage therapy.
- Routine physical exams.
- Hearing aids and exams for fitting them.
Is Medicare Usable in Any State?
Why are people leaving Medicare Advantage plans?
Key takeaways: People leave Medicare Advantage plans because out-of-pocket costs vary between plans, network restrictions can cause frustration, prior authorization requests can delay care, and it can be difficult to use the additional benefits they provide.
What is the best Medicare plan that covers everything for seniors?
Original Medicare with Medigap likely offers the most comprehensive coverage, but it may also be the most costly. A person can consider their income and how much they are able to spend before choosing a Medicare plan. Original Medicare with Medigap also offers a lot of flexibility when choosing a doctor or specialist.
What happens to Medicare if I move to another state?
You won't lose your Original Medicare, Part A and Part B coverage if you move to another state. However, if you have a Medicare Advantage plan or a stand-alone Medicare prescription drug plan, you should tell the plan before you move. Typically these plans won't cover you in another state.
How many doctor visits does Medicare cover for seniors?
Medicare does not limit the number of times a person can consult their doctor, but it may limit how often they can have a particular test and access other services. Individuals can contact Medicare directly at 800-MEDICARE (800-633-4227) to discuss physician coverage in further detail.
Can you have Medicare in two states?
While you can only enroll in Medicare in one state – your principal residence where you hold a driver's license, file taxes, and vote, etc. – you may still have access to Medicare coverage in both states depending on the following factors.
Does Medicare cover me on a cruise?
Medicare doesn't cover health care services you get when the ship is more than 6 hours away from a U.S. port. Medicare may cover medically-necessary health care services you get on a cruise ship if: • The doctor is allowed under certain laws to provide medical services on the cruise ship.
Why do doctors not like Medicare Advantage plans?
Across the country, provider grumbling about claim denials and onerous preapproval requirements by Advantage plans is crescendoing. Some hospitals and physician practices are so fed up they're refusing to accept the plans — even big ones like those offered by UnitedHealthcare and Humana.
Is Medicare cheaper in different states?
Part A and Part B of Medicare have standardized costs that are the same across every state. Most people qualify for premium-free Part A. To qualify for premium-free Part A, you or your spouse must have worked and paid Medicare taxes for the equivalent of 10 years (40 quarters).
Does everyone have to pay $170 a month for Medicare?
Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.
Can I drop my Medicare Advantage plan and go back to original Medicare?
Medicare Advantage Open Enrollment Period: Between January 1 and March 31 of each year, if you already have a Medicare Advantage Plan (with or without drug coverage) you can: Switch to another Medicare Advantage Plan (with or without drug coverage). Drop your Medicare Advantage Plan and return to Original Medicare.
What is the biggest disadvantage of the Medicare Advantage plan?
Medicare Advantage Plan Pros And Cons
One disadvantage is that some Medicare Advantage plans may offer fewer options when it comes to doctors and hospitals, as they may have smaller plan networks than Original Medicare.
Does my Medicare cover me in other states?
If you have Original Medicare, you have coverage anywhere in the U.S. and its territories. This includes all 50 states, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. Most doctors and hospitals take Original Medicare.
Does Medicare cover dental?
In most cases, Medicare doesn't cover dental services like routine cleanings, fillings, tooth extractions, or items like dentures.
What is the best supplemental insurance for Medicare?
- Best for extra plan benefits: Humana.
- Best for straightforward coverage: State Farm.
- Best for extensive medical care coverage: AARP by UnitedHealthcare.
- Best for a range of Medigap plans: Blue Cross Blue Shield.
Why are hospitals not taking Medicare Advantage plans?
Health systems have cited delayed reimbursements, cumbersome prior authorization requirements and high rates of patient claim denials for their decisions to drop Medicare Advantage plans.
What is the disadvantage of UnitedHealthcare for seniors?
Cons About UnitedHealthcare Medicare Advantage
You may only have access to certain HMO or PPO plans in your area. And while UnitedHealthCare has competitive pricing, your location may only have access to plans with higher deductibles, more copays, and fewer additional benefits.
Why is Humana dropping Medicare?
Rising medical costs and lower reimbursements from CMS led Humana and other insurers to plan market exits in 2025.