Medicare Advantage Cost by State

Summary: Your Medicare Advantage cost will vary depending on which state you call home. It’s important to compare your coverage needs and all of the costs, not just your premiums, that you’ll face when using your benefits. Learn how to stay covered for less with the right Medicare benefits. Estimated Read Time: 6 mins

Medicare Advantage cost is essential for anyone eligible for Original Medicare to consider. For some, the Medicare Advantage plan cost can be a better alternative than forgoing the benefits, as they can help cover healthcare expenses. Still, everyone has different healthcare and budgets to consider.

Unlike Original Medicare (Medicare Part A and Part B), the price of Medicare Advantage plans (Medicare Part C) varies depending on where you live. This is because Original Medicare benefits are provided through a federal government-run program, whereas Medicare Advantage benefits come from private insurance companies.

Therefore, the average cost of Medicare Advantage will vary from state to state, plan to plan, and company to company. It’s also worth mentioning that while Medicare Advantage plans offer great benefits, there are additional considerations regarding restrictions and the alternative of Medicare Supplement (Medigap) plans.

Below, we’ll break down the cost of Medicare Advantage plans, how your state fairs, the variables that can affect how much you’ll pay for benefits, and the alternatives available to help you cover healthcare costs and save money in the long run.

How Much Does Medicare Advantage Cost?

Medicare Advantage cost is set by private insurance companies offering the benefits. While Medicare Advantage plans are available to those eligible for Medicare, plan availability depends on the county you live in. Your ZIP Code is one of the most significant factors that will go into determining your cost of Medicare Advantage plan benefits. Nationally, Medicare Advantage plans cost beneficiaries an average of $18 per month.

Furthermore, while you have out-of-pocket expenses, each Medicare Advantage plan comes with a yearly cap on yearly out-of-pocket costs, called the maximum out-of-pocket limit (MOOP). This is an important consideration because your MOOP can reach over $10,000 when using your benefits outside of your plan’s network. However, the limit on MOOP (when using providers in your network) nationwide is $8,850 in 2024. In 2023, the MOOP limit is $8,300.

How Much Does Medicare Advantage Cost per Month?

The average cost of Medicare Advantage plans ranges from $4 to $89 across the 49 states where they are available. Prescription drug deductibles for Medicare Advantage plans range from $182 to $448. As you can see, Medicare Advantage costs have a broad range wherever they are offered, which excludes the state of Alaska.

Medicare Advantage Plan Cost in Each State

Medicare costs by state can vary when it comes to Advantage plans. This is for many reasons, including the plans available in your county. There are also different copayments, coinsurances, and your Medicare Part C deductible to cover.

The table below breaks down the average Medicare Advantage plans cost in terms of average premium per state. You’ll also notice the percentage change from the previous year, which for many states in 2023, meant a reduction in cost. See where your state lands and the average costs you can expect to incur:

*Data for Alaska is unavailable because there are very few (2) Medicare Advantage plans available to residents of the Final Frontier, and they are relatively new.

Factors That Affect Medicare Advantage Plan Cost for Seniors

As you can see above, how much you pay can change significantly depending on where you reside. Private insurance companies provide you with your benefits and must cover everything that Original Medicare covers, but they can charge different amounts for their individual plans.

This allows companies to provide additional benefits, but you should compare and shop around for the right coverage and price. Furthermore, there are different types of Medicare Advantage plans that will affect your rates:

• Health Maintenance Organization (HMO) plans
• Health Maintenance Organization Point of Service (HMO POS) plans
• Medicare Advantage Special Needs (Special Needs Plans)
• Preferred Provider Organization (PPO) plans
• Private Fee for Service (PFFS) plans

Not only will each type of Medicare Advantage plan affect how much you pay, but they also come with restrictions and guidelines that dictate your coverage. Depending on your healthcare needs, this could complicate receiving healthcare or cost you more overall.

It’s also worth noting that your Medicare Advantage cost can increase if you enroll in a plan with prescription drug coverage but don’t enroll as soon as you become eligible. Beneficiaries without credible drug coverage that enroll later or have a gap between their coverage and enroll again later on, will face penalties for their benefits each month.

Your Cost for Medicare Is More Than Your Premium

The cost of Medicare Advantage coverage will vary and can even be as low as $0 for premiums. While many beneficiaries can find their low monthly costs enticing, it’s essential to understand that your healthcare costs are more than your premium.

Above all, you’re going to want to enroll in coverage that will help cover you for the healthcare expenses you’ll face. This is why it’s always a good idea to assess your coverage needs, compare your options, and enroll in what makes sense for your healthcare on a personal level.

For example, if you travel often, Medicare Advantage plans may not be the best option for your coverage because of their restrictive networks. Therefore, you could pay much more for your healthcare costs despite having a low premium.

Medicare Supplement (Medigap) plans can cover healthcare costs that remain after using Medicare Part A and Part B. For many beneficiaries, they present a more comprehensive form of coverage. This includes covering things such as your Medicare Part B deductible, coinsurances, copays, and more, depending on your plan.

But ultimately, it all depends on your personal factors. This is why it’s always important to work with a licensed Medicare agent who can help you find the right coverage, review your options, compare rates, and save on healthcare expenses in the long run.

How To Save on Medicare Advantage Cost and Cover Your Healthcare

Saving on the cost of Medicare Advantage plans is simple, but you must first sign up for Original Medicare. Medicare Advantage plans are also known as Part C and are commonly called replacement plans, but this isn’t quite true. You’ll need Original Medicare in order to enroll in Part C.

Some Medicare Advantage plans even partially or fully pay your Medicare Part B premium, but this isn’t always the case. Many beneficiaries are still responsible for Medicare Parts A and B premiums. Thus, a Medicare Advantage plan with a zero-dollar premium does not mean your Medicare is free.

When enrolling in a Medicare Advantage plan, you have plenty of options, including whether or not to enroll in a plan that includes prescription drug coverage. Though, if you do, you must meet the deductible for the coverage to kick in. This means you’ll need to look beyond the price of the premium and see if the deductibles are also reasonable.