Do Medicare Advantage Different Based on Where You Live?

You've probably seen a lot of ads asking you to go to a website to learn more about how you can save money on Medicare or pay lower rates and get a lot of additional benefits not covered by Original Medicare, such as hearing test, vision test, transportation, or even home care. Then you may read the fine print or learn that your actual benefit choices differ depending on where you reside.

What's going on?

When comparing Medicare Advantage plans, keep in mind that the benefits provided by private plans like Cigna, Mutual of Omaha, Aetna, Humana, and others differ not only between them but also depending on the county in which you live. That means you could search for a Cigna plan in one area of the country, have those benefits included in your coverage, only to discover that your benefits will be different if you traveled across a county line. You may discover that different cost-sharing provisions apply, or that you don't have access to those benefits at all in certain situations.

Facts: If you use our Plan Finder to look at Medicare Advantage Plans in Los Angeles County, you'll find options including plans for people with disabilities or Special Needs Plans (SNPs)

Read More: Things To Know About Medicare Special Needs Plans

You have the right to roll your eyes. Why are there so many options, and why do people in different areas have different options?

The short answer is that the Centers for Medicare & Medicaid Services (CMS), the federal department in charge of Medicare, is set up to run and regulate Medicare Advantage in this manner. Medicare Advantage operates on a county-by-county basis, unlike Medicare Supplement and Prescription Drug (Part D) programs, which are structured and administered at the state level.

Before you throw up your hands and walk away, know that although these policies may differ in how they provide some of the supplemental benefits, all Medicare Advantage plans are expected to provide all of the services provided by Original Medicare(Medicare Part A and Part B). That is, if you want Medicare Advantage, you will not lose any of your Original Medicare benefits. The distinction is really based on a subset of extra benefits that MA plans provide that aren't covered by Original Medicare.

So, if you're looking into Medicare Advantage, you're likely to find policies that include many of the common supplementary benefits. And if you want or need any of these extra options, that's a good thing. But keep in mind that just because one of them provides it in your region doesn't mean you'll find it elsewhere or with a different carrier.

Learn More About Medicare Advantage Plans 

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