What Does Zip Code Have To Do With Medicare?

What Does Zip Code Have To Do With Medicare

Medicare programs do vary depending on where you live, but many people are surprised by just how much they vary according to state or even by zip code.

But what is Medicare? It is a federal program, which means that its benefits are available to people all over the country. 

However, when it comes to planning options, the cover can vary. Some areas provide many coverage options, but if you live in a more rural area then you may have fewer coverage options. 

How Does My Zip Code Affect My Medicare Options?

How Does My Zip Code Affect My Medicare Options

As we have mentioned, zip code will affect what coverage options are available. In particular, Medicare Advantage and Medigap plans will have different pricing and cover different features depending on where you live.

To be able to enroll in either of these plans you must live in the plan’s service area.

The plan that is most affected by zip codes is Medicare Advantage plans, and this plan doesn’t cover you outside the service areas. If you move out of the service area then your coverage will stop.

The premium costs of the Medicare Advantage plan is usually cheaper in metropolitan areas, and costs more in rural areas.

A few of the areas covered by Medicare Advantage plans also offer more ancillary benefits and a bigger network of medical professionals. 

Medicare Supplement plans are standardized, meaning that they provide the same coverage in every state except Massachusetts, Minnesota, and Wisconsin. 

The reason your zip code can have an impact on your Medicare is because plan options vary from location to location. Plus, Medicare Advantage plan networks rely on private insurance companies. 

Is Medicare The Same Price In Every State?

No matter where you live, the original federal program of Medicare costs the same. But as we have seen, this is not the case for Medicare Advantage and Medigap plans. 

While Medigap costs more in some states, some zip codes offer Medicare Part C options that don’t cost anything. There are also zip codes with minimal plan options, and some with plans with higher premiums. 

What Are The Best Zip Codes For Medicare?

While it may be tempting to move to make the most of Medicare benefits, it’s important to remember Medicare Advantage plan options alter every year. Therefore, it’s advisable not to move!

One of the best areas to live for Medicare coverage are Arizona and Kansas, as they have zip codes that have high satisfaction scores. 

However, if you’re interested in cheaper Medicare Advantage plans, then Los Angeles and San Diego offer the most free plans with out-of-pocket costs that are very low too. There is a drawback however, as coverage is only available in the plan’s service area.

Meanwhile, Medigap covers the same areas as Medicare, and a few Medigap plans even cover illness or accidents when you’re travelling abroad. However, Medicare Supplement plans have different prices depending on where you live.

The price of Medigap also often changes, and the difference between the most costly state that Medigap covers and the cheapest is about $80 a month. Usually, the price of Medicare insurance stays in line with the cost of living. 

Can You Have Medicare In Two States?

Can You Have Medicare In Two States

Unfortunately, you can’t have Medicare coverage in two states. Instead, you are required to choose a primary state for where you live. Medicare will acknowledge your residence as the state where you file your taxes.

The Centers for Medicare & Medicaid Services reports that with Original Medicare, you can go to any hospital or medical professional that recognizes Medicare anywhere in the U.S.

However, this is not the case for Medicare Advantage and Medigap. The cost, the guidelines, and the availability of the plans differ according to the state you live in, and sometimes by zip code. 

If you regularly travel between two or more states, however, then it may be sensible to opt for a Medigap plan. You’re not restricted to a plan service area, but this is not the case with a MedigapSelect policy. 

So while where you live isn’t a concern with Original Medicare as it is a federal program that provides coverage anywhere, Medigap just covers their portion and Medicare approves the claim.

Will Moving To A Different State Increase Your Medicare Premiums?

Moving may bump up your Medicare Supplement or Medicare Advantage premiums. This is not the case with Medicare as it is available all over the country, so the costs and benefits stay the same. 

However, moving can sometimes lower your Medicare Advantage or Medigap premium. When you update your Medicare following your move, you will qualify for a Special Enrollment Period.

When you know your new zip code, you can then look into quotes so your coverage is effective as soon as you move.

Can Zip Codes Affect Social Security Payments?

Social security benefits are calculated the same way all over the country. No matter what state you live in, if you earn under a certain amount, part of your salary is paid into social security tax that you will then receive as a benefit when you retire.

However, some states put taxes on their benefits, and the rates and the exemptions that are available will change according to the state where you live. Railroad benefits and survivor benefits also follow the same rules as benefits paid to retirees. 

Final Thoughts

If you move across the street there is no need to change your plan, as your zip code will remain the same. 

But if you’re moving as nearby as the next county, or moving to another state, it’s always good to research the Medicare plans available to you in your new home.

We highly recommend contacting a licensed Medicare agent when looking for a new plan, as this will not only save you time but money too. A Medicare agent can also help you compare what’s available to you in your area.

Frequently Asked Questions

Is there a Medicare supplement that covers everything?

Medicare Plan F (also referred to as Medigap Plan F) is the most comprehensive Medicare supplement plan. This plan covers Medicare deductibles and all copays and coinsurance, which means you pay nothing out of pocket throughout the year.

What is the difference between Medicare Advantage and Medicare Supplement?

Some Medicare Advantage plans may also offer extra benefits, such as routine dental, vision and hearing services. A Medicare Supplement plan, also called Medigap, isn’t bundled with anything—it’s extra coverage you can buy to help pay the out-of-pocket expenses Original Medicare doesn’t pay.

What does Medigap cover?

If you have a Medigap, it pays part or all of certain remaining costs after Original Medicare pays first. Medigaps may cover outstanding deductibles, coinsurance, and copayments. Medigaps may also cover health care costs that Medicare does not cover at all, like care received when travelling abroad.

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