Medicare Advantage by State
Plan availability is local. Begin with ZIP code, county, providers, prescriptions, and service area.
Residence determines the first list
A Medicare Advantage plan has a defined service area. Enrollment requires residence in the area, and plan availability can differ by county and ZIP even within the same state. State insurance licensing is a different question from whether a specific Medicare plan serves a person’s address. Use the actual residential ZIP in Medicare’s plan tool and verify eligibility with the plan before treating it as available.
Official source: Medicare: Joining a plan ↗ · Medicare: Compare plans ↗
Provider usefulness is even more local
A plan may be sold throughout a county but the desired primary physician, hospital, specialist or dialysis center may not participate in its exact network. Networks can change within a plan year. Confirm each named provider with both the plan and office and ask about referrals, prior approval and whether an out-of-network visit is covered and at what cost.
Official source: Medicare: Provider network fact sheet ↗ · Medicare: Compare plan types ↗
Prescription terms can vary across plans
Two locally available Advantage plans may cover the same drug in different tiers, require different authorizations or use different preferred pharmacies. Enter exact prescriptions and pharmacies in Medicare’s comparison tool for the intended plan year. A $0 advertised plan premium does not determine total drug spending, and the 2026 $2,100 cap applies only to covered Part D drugs.
Official source: Medicare: Compare plans ↗ · Medicare: What drug plans cover ↗ · Medicare: 2026 drug cap and payment option ↗
Moving can change options
A permanent move outside a plan’s service area can create a special opportunity to switch coverage. A move within an area may also expose new plan options. The permitted action and deadline depend on the facts and notice timing. Inform Medicare and the plan of the real residence; do not use a temporary mailing address or a licensing map as a substitute for the service-area rule.
Official source: Medicare: Special election situations ↗ · Medicare: Joining a plan ↗
Produce an actual local comparison
For one person, list the ZIP, county, intended effective date, A/B start dates, providers and prescriptions. Compare exact plan IDs on their premiums, medical maximum, hospital cost sharing, prescription estimate, network and extra-benefit restrictions. Plan availability and terms change annually, so a static national table cannot be an accurate substitute for live local plan documents.
Official source: Medicare: Compare plans ↗ · Medicare: Evidence of Coverage ↗ · Medicare: Annual Notice of Change ↗