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Do Medicare Benefits Vary By State

What If Im Moving Out Of State

Medicare Explained – Part D (2023)

As opposed to traveling to or through another state, if youre planing to move to another state, you need to give Medicare your new address.

The fastest way to update your contact information for Medicare is to use the My Profile tab on the Social Security website. You do not have to be receiving Social Security benefits to use this site.

However, to access this site, you must first register. You can only create an account for your own use, and you must be able to verify information about yourself, including your:

  • Social Security number
  • U.S. mailing address
  • valid email address

You can also update your Medicare contact information by calling the Social Security Administration at 800-772-1213. If youd prefer to update in person, you can go to your local Social Security field office, which you can find here.

State Differences In Medicare Advantage

Medicare Advantage plans are private policies that you can buy to replace Original Medicare coverage.

The federal government requires them to cover everything Original Medicare covers in all 50 states. But Medicare Advantage plans may also offer benefits beyond what Original Medicare covers, such as dental, vision, prescription drug and hearing benefits.

The federal government requires an annual open enrollment for Medicare Advantage in every state that coincides with Original Medicare enrollment. This happens every year from October 15 to December 7.

Since 2019, the federal government has also allowed a second open enrollment period for Medicare Advantage from January 1 through March 31. This period allows people with Medicare Advantage to switch to another Medicare Advantage plan or to switch to Original Medicare.

Medicare Supplement Plan L

Medicare Supplement Plan L policy also includes a cap on your expenses. This is referred to as your out-of-pocket limit or maximum. Medicare sets this limit annually, and in 2018, the limit for Plan L is $2,620. This means that if in any one calendar year your spending reaches $2,480 in Medicare-approved covered expenses, then the Medigap insurance carrier pays the rest. The cap makes it much easier to agree to share in 25% of the costs on the items listed because you know that even if a year of bad health occurs, you wont have more exposure than the maximum cap figure.

Medicare Part A coinsurance and coverage for hospital benefits

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What Is The Average Cost Of Medicare Part D In 2022 By State

The chart below lists the average monthly premiums for Medicare Part D prescription drug plans by state.1

  • The lowest average Part D premiums were for plans in Mississippi, Kentucky, Indiana and Oklahoma, with average premiums around $41 or less per month.
  • California, Florida, Pennsylvania and West Virginia had Part D plans with the highest average premiums, around $52 or more per month.

You can also compare Part D plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

What Is The Average Monthly Cost Of A Medicare Advantage Plan

Medicare Part D

The average premium for a Medicare Advantage plan in 2021 was $21.22 per month. For 2022 it will be $19 per month. Although this is the average, some premiums cost $0, and others cost well over $100. For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.

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Great For Nationwide Coverage: Humana

  • Ranked 2nd by J.D. Power for customer satisfaction

  • Benefits for over-the-counter drugs

  • Wide range of plan types available

  • Few plans offer additional drug coverage in the gap

Humana is the second-largest provider of Medicare Advantage plans nationwide, with 18% of the market in 2022. It also stands out as the second-best company for customer satisfaction, according to J.D. Powerâs 2022 U.S. Medicare Advantage Study . HMO, PPO, and PFFS plans are available, depending on where you live, and Humana offers perks like an over-the-counter drug benefit.

The reason Humana doesnât score higher is that few of its Medicare Advantage plans with drug coverage offer any additional coverage in the coverage gap. Fewer than one third, in fact. If you rely on prescription drugs and they cost more than $4,660 in 2023, you could be on the hook for 25% of their cost in the coverage gap.

Plans are available in all states except for Alaska, Rhode Island, and Wyoming.

Read more in our Humana Medicare review.

Will My Medicare Coverage Follow Me If I Move Out Of The State

Medicare reimbursement refers to the payments that hospitals and physicians receive in return for services rendered to Medicare beneficiaries. The reimbursement rates for these services are set by Medicare, and are typically less than the amount billed or the amount that a private insurance company would pay.

Enrollment dates for Medicare are critical. Missing an enrollment date could cost you higher premiums down the line or it could cost you coverage entirely.

Q: Will my Medicare coverage follow me if I move out of the state?

A: If youre enrolled in Original Medicare, then yes. But Medicare Advantage, Part D prescription drug coverage, and some Medigap plans can be state-specific.

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How Much Is Medicare Part B In 2021

Medicare Part B premium. The Medicare premium for Part B varies based on your income level, rather than your location. The standard monthly premium is $148.50 in 2021. Your Part B premium may be more if your income is above a certain level. As with Part A, the Part B premium doesnt change across the states.

The Parts Of Medicare

Medicare Part D Explained (2022)

Social Security enrolls you in Original Medicare .

  • Medicare Part A helps pay for inpatient care in a hospital or limited time at a skilled nursing facility . Part A also pays for some home health care and hospice care.
  • Medicare Part B helps pay for services from doctors and other health care providers, outpatient care, home health care, durable medical equipment, and some preventive services.

Other parts of Medicare are run by private insurance companies that follow rules set by Medicare.

  • Supplemental policies help pay Medicare out-of-pocket copayments, coinsurance, and deductible expenses.
  • Medicare Advantage Plan includes all benefits and services covered under Part A and Part B prescription drugs and additional benefits such as vision, hearing, and dental bundled together in one plan.
  • Medicare Part D helps cover the cost of prescription drugs.

Most people age 65 or older are eligible for free Medicare hospital insurance if they have worked and paid Medicare taxes long enough. You can sign up for Medicare medical insurance by paying a monthly premium. Some beneficiaries with higher incomes will pay a higher monthly Part B premium. To learn more, read .

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Your Part D Prescription Drug Plan

If you have a standalone Part D plan for prescription drug coverage, you’ll need to sign up for a new one in your new state of residence.

“The Part D benefits may be different in another state,” Roberts said. “Even if the plan has the same name, you still have to switch because those plans are state-specific.”

You get two months to do that otherwise you would need to wait until the next open enrollment and could be penalized for having no acceptable prescription drug coverage. Those penalties are 1% of the national base premium for each full month that you didn’t have coverage.

When Does Medicare Special Enrollment Period Begin If You Move To Another State

The special enrollment period allows Medicare beneficiaries to enroll or switch to a different plan in special circumstances. Moving to another state qualifies you for special enrollment. Your special enrollment period will typically run for 3 months, beginning one month before you move.

During the special enrollment period, you can:

· Change your Medicare Advantage plan

· Change from Original Medicare to Medicare Advantage

· Go back to Original Medicare from Medicare Advantage

· Change your Medicare Part D plan

· Enroll in Medicare part D

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What Should I Watch For With The Part B Give Back Benefit

Its always a good idea to compare all the costs and benefits of any Medicare plan you are considering. Think of premium reduction as just another extra benefit available with Medicare Advantage.

When an insurance company decides which extra benefits to offer each year, it has to weigh costs and make choices. So an insurer may drop one extra benefit, such as vision or hearing, to offer the premium reduction benefit. Anecdotal evidence suggests this might be the case.

Some data suggest that extra benefits such as dental care, meal delivery, and transportation arent as common among give back plans. You may have to give up one extra benefit youve enjoyed in the past to get the premium reduction benefit with a different plan.

Remember that the give back amount is just one cost to consider when you compare Medicare plans. Pay attention to your annual deductibles, copays, and other cost-sharing amounts. Suppose you get a $40 monthly premium credit with one plan but the annual deductible is $500 more than a similar plan. In that case, you may actually pay more for your healthcare even though your premium is lower.

Also, keep in mind that these plans arent available in every ZIP code, and not every insurance company offers them. So you may not have a giveback option in your area yet.

That said, these plans are currently available in over 2,800 counties across the US, so if you dont have access to one now, chances are good you will soon.

Does My Zip Code Affect My Medicare Coverage

Medicare Supplement Plans

The Centers for Medicare & Medicaid Services reports that, with Original Medicare , you can use any doctor or hospital that takes Medicare, anywhere in the U.S. Medicare plans like Medigap and Medicare Advantage are a different story, though. The pricing, rules, and availability of these plans vary by state, and even sometimes by zip code. Here, we cover what you need to know about Medicare coverage based on where you live, using the official U.S. government website for Medicare as a guide.

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Notify Social Security If Youre Moving

If youâre moving out of state, you should contact Social Security to update the mailing address that Medicare has on file for you. You can do so in the following ways:

  • Visit the Social Security website, ssa.gov, to update your information online. If you have a My Social Security account, you can log into your account to update your address.
  • Visit a local Social Security office to update your information in person.

If you worked for a railroad, you can update your information through the Railroad Retirement Board . Call 1-877-772-5772, Monday through Friday, from 9AM to 3:30PM, to speak with a representative. TTY users may call 1-312-751-4701.

Medicare Advantage Popularity By State

Because Medicare prices, benefits and population vary from state to state, Medicare Advantage may be more popular alternatives to Original Medicare in some states compared to others.

States with Highest and Lowest Medicare Advantage Enrollment

5 Highest Ranking States

As a percentage of the population, only about one percent of Alaskans enrolled in Medicare had Medicare Advantage plans in 2018. But 56 percent of Medicare beneficiaries in Minnesota were enrolled in a Medicare Advantage plan that same year.

Have you selected your 2023 Medicare plan?

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Medicare Considerations When Moving

When it comes to Medicare, moving to another state may involve various actions, ranging from providing notification of the address change to looking for a new Medicare plan. The exact procedures depend on the Medicare parts in which a person has enrolled.

For example, in some cases, certain parts of Medicare are transferable between states and across the country. However, other parts of Medicare may be county- or state-specific and based on where a person currently lives. These parts may not be transferrable to a new location.

Moving to a new state may involve amending Medicare account details, such as changing the address, or a person may have to research and enroll in a new plan, such as Medicare Advantage.

Each part of Medicare has different rules. We have detailed these below.

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Does One Need To Pay For Medicare

Medicare 101

The simple answer is yes. There are deductibles when it comes to Medicare. These are based on the kinds of care you are paying for, so keep that in mind. There are different plans with Medicare, and you need to figure out which care you are paying for. You can always pay for Part C if you want to access Medicare’s perks. It is slightly costly but worth it in the long run.

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Which States Have Guaranteed Issue

Iowa. New Mexico. Oklahoma. Virginia. West Virginia. This change may only take effect when your employers policy reduces health benefits. In the state of Wisconsin, if the annual premium of your employer plan is over 125% of the Basic Annual Premium for your gender and age, then you may qualify for Guaranteed Issue.

What Is The Medicare Part B Giveback

If you choose to enroll in a Medicare Advantage plan, you pay the premium for Part B plus the premium for the Advantage plan. Well over half of all Advantage plans have $0 premiums, which means their enrollees just pay the Part B premium.

But some of those plans go a step further, offering giveback rebates that pay a portion of their enrollees Part B premiums. This benefit, also referred to as a Medicare Part B premium reduction, has been available since 2003. And although most Advantage plans do not offer a giveback rebate, the benefit has become more popular and widespread in recent years, and is increasingly marketed as a stand-out benefit by Medicare Advantage plans that do offer it.

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What Are The Factors That Determine The Premiums For Medicare Supplement

Medicare Supplement insurance plan premiums might depend on a few factors, including: The plan type you choose. The state where the plan is sold. The private insurance company that offers the plan. The plan rating, which may be determined in part by your age. Each plan type offers a different set of basic benefits.

I Have Original Medicare And Im Moving Out Of State Can I Transfer My Medicare

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If youâre enrolled in Original Medicare, Part A and Part B, you donât need to make changes to your coverage if youâre moving, either to a new address in your state or out of state.

Original Medicare doesnât have provider networks instead, you can use any hospital or doctor throughout the country that takes Medicare assignment. When a doctor accepts assignment, this means he or she wonât charge you more than the Medicare-approved amount for a health-care service, although youâll still be responsible for any copayments or deductibles that apply.

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How Often Do Medicare Part B Premiums Increase

The standard monthly premium for Medicare Part B enrollees will be $170.10 for 2022, an increase of $21.60 from $148.50 in 2021. This represents a 14.5% increase. The annual deductible for all Medicare Part B beneficiaries will be $233 in 2022, an increase of $30 from the annual deductible of $203 in 2021.

How To Get A Medicare Part B Give Back Plan

Its important to compare Medicare Advantage and Medigap plans before enrolling in either option. Many beneficiaries are unaware of the many limitations that come with Medicare Advantage plans, so a Medicare Part B premium reduction may not be worth the additional cost-sharing for some. It is essential to fully understand your policy limitations before deciding on a plan.

If you want to keep Original Medicare but wish to save money on monthly premiums, you should consider the High Deductible Plan G or High Deductible Plan F Medigap options. Another comprehensive yet affordable Medigap option is Plan N. .

Whichever route you decide to go, speaking with a licensed agent is always helpful when comparing benefits. To see what Medicare Advantage options are available in your area, enter your ZIP Code in this portal.

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How Does Medicare Advantage Differ From Medicare Supplement

Medicare Advantage plans serve as a substitute for Original Medicare, providing that same coverage plus additional benefits like prescription drugs coverage . Meanwhile, Medicare Supplement plans are sold by private insurance companies to people enrolled in Original Medicare to help fill the gaps of that coverage. There are 10 types of Medigap planswith letter names ranging from A to Nthat provide standardized coverage and help pay for expenses like deductibles, coinsurance and copays. Another important difference to note: Medigap policies dont cover prescription drugs. A person enrolled in Original Medicare who wants prescription drug coverage must purchase a separate Medicare Part D plan in addition to any Medicare Supplement plan.

Timeframe For Making Changes Without Penalty

Medicare Supplement Insurance Company Ratings

Medicare offers a special enrollment period for beneficiaries to make changes to their Medicare Advantage or Part D coverage when moving to a new location that is outside of their current Medicare coverage area. According to Medicare.gov:

If you tell your plan before you move, your chance to switch plans begins the month before the month you move and continues for 2 full months after you move.

If you tell your plan after you move, your chance to switch plans begins the month you tell your plan, plus 2 more full months.

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