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Medicare Programs By State

Medicare can be confusing, even for those whose job it is to know about it.  Knowing what applies to you specifically with regards to your locality can be a challenge, and online resources, while helpful, may not always have the answers you need.  In this article, we are hoping to change that.  

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While some people may be under the impression that Medicare is free for everyone who qualifies, this isn’t exactly true.  Medicare is usually less expensive than regular insurance, but there are still premiums to pay. The cost of premiums can vary, fluctuating from state to state and  year to year.  Medicare Part B premiums do not vary by location but can depend on income. Medicare Part C premiums vary by location but do not depend on income. Medicare also still comes with deductibles, co-pays, out of pocket costs and (for some) the cost of coinsurance. Additionally, factors such as government price changes, services and medications used, personal income, and in some cases a beneficiary’s health, can also contribute to the overall cost. Knowing your situation will help determine what plans and coverage is ideal for you.  

What Changes State By State?

While certain Medicare premiums are the same everywhere in the country, other types of Medicare premiums can change depending on:

  • Where you move
  • What type of Medicare coverage you have
  • Which Medicare-approved health insurance company offers the plan

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Medicare Premiums By Part

Medicare comes broken down into Parts. Here are the changes you may see to each individual Medicare part, varying by state.  Here’s a breakdown of each individual part: 

  • Part A – For most people, Part A is fully covered and doesn’t cost anything. However, if you don’t qualify for Part A, you may be able to buy it.  Typically, you don’t pay a premium for Part A if you or your spouse worked and paid Medicare taxes for at least 10 years or 40 quarters.   

If you paid these taxes for less than 30 quarters, your monthly premium for Part A is $499 in 2022. If you paid Medicare taxes for 30-39 quarters, your monthly premium is $274 in 2020. These rates are the same across the country.

  • Part B – Everyone is subject to a premium of some kind for Part B.  While Medicare Part B is optional, you are likely to be enrolled automatically if you are auto-enrolled in Part A, but you have the option to drop it.  The Medicare premium for Part B varies based on your income level, rather than your location. The standard monthly premium is $170.10 in 2022. Your Part B premium may be more if your income is above a certain level. As with Part A, the Part B premium doesn’t change across the states.

Many people are automatically enrolled in Original Medicare A and B when they become eligible. 

  • Part C – Premiums for Part C are sold in the private marketplace, which means they vary by insurance carrier, plan and location.  Private, Medicare-approved health insurance companies offer Medicare Advantage plans. Premiums and other out-of-pocket costs can vary from plan to plan. 
  • Part D – Medicare Part D strictly covers prescription drugs only, and it is sold by private insurance providers.  This means the premiums may vary plan to plan and can also change by location. In order to qualify for Medicare Part D, you will also need to enroll in a Medicare-approved plan.  That being said, all plans come with a standard amount of minimum coverage set by Medicare.  

If you’re moving to another state, you might be able to buy a similar or even the same plan type that you currently have in the new state.  However, the premiums you pay may be different.  As for your Original Medicare benefits, they will remain the same no matter where you live. 

There are so many details and difficulties to enrolling, navigating the system, and keeping up with what plan will be right for you.  Opportunities to save money may go amiss, and certain coverage needs may be overlooked.  Don’t go it alone.  Get a quote and talk to a licensed insurance agent today.  

Shop Medicare Plans in Your Area

Disclaimers: Plan availability varies by region and state. To request information without providing personal information, please call the phone number listed above. By completing the quotes form or calling the above number, you can be directed to a licensed insurance agent who can provide more information about your options and answer your questions via a third-party partner of MedicareGap. Participating sales agencies represent Medicare Advantage HMO, PPO, PFFS organizations that are contracted with Medicare. Enrollment in any plan depends on contract renewal. This is a solicitation for insurance, and the information is not a complete description of benefits or coverage options. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply. Outside of the Medicare Annual Enrollment Period, members can enroll in a plan only if they meet certain criteria. A licensed insurance agent can help you determine whether you are eligible.


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