Do Medicare Benefits Vary by State? - Medicare Consumer - Medicare Consumer

Do Medicare Benefits Vary by State?

There are four main “parts” to Medicare. These include Part A and B – which form Original Medicare. There is also Part C, known as Medicare Advantage, and Medicare Part D, which offers prescription drug coverage.

Original Medicare is provided by the government to those who are age 65 and over, and who have worked in Medicare-covered employment for at least 10 years. Some individuals who are under the age of 65 may also qualify for Medicare benefits, provided that they have received Social Security disability benefits for at least 24 consecutive months.

Coverage that is provided via Medicare Parts A and B is primarily the same from state to state in terms of hospitalization (Part A) and medical insurance (Part B), as well as the required out-of-pocket co-payments and deductibles that are required from enrollees.

However, for those who opt to also include Medicare Part D for prescription drug coverage, benefits can vary from one plan to another, as well as from state to state. In many instances, the benefits can even differ from one region to another.

Likewise, for those who choose to receive their Medicare coverage through a Medicare Advantage plan (Medicare Part C), both the cost and availability of plans can vary from one state to another, as well as by the private health insurance company that offers them.

This is because both Medicare Part C and Medicare Part D plans are provided by private insurance companies – and because of this, the benefits that are offered, as well as the premiums that are charged – can differ. Because of these variations in cost, it is important to shop around prior to making a final decision on the plan that you purchase in order to determine which will be the best for you and for your budget.


Additional Medicare Benefits

Those who are enrolled in Original Medicare, may choose to fill in some of the coverage “gaps” with a Medicare Supplement insurance plan. These policies, oftentimes referred to as “Medigap” insurance, can provide coverage for some or all of Medicare’s deductibles, co-insurance, and / or co-payments that are required by enrollees (depending on the Medigap plan that is chosen).

There are ten different Medicare Supplement plans that are available – each named after a letter of the alphabet, with Plan A providing the most basic set of benefits. While the benefits that are offered in each Medicare Supplement plan of the same letter must be identical, which plans are available to an enrollee could differ depending on his or her state, as well as the insurer that offers it.

The premiums that are charged for Medicare Supplement insurance plans can also differ from one insurer to another, so it is important to shop carefully prior to making a decision on a Medigap plan purchase.

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