Key Takeaways

• Medicare Advantage and Part D plans vary by county, meaning your exact options depend on where you live in 2025.

• Moving to a different state or even a new zip code can trigger a Special Enrollment Period and open up (or limit) your Medicare choices.

Your ZIP Code Can Change Everything

Medicare is a federal program, but what it offers you is far from uniform across the United States. If you live in California, Florida, or New York, your list of available Medicare Advantage plans in 2025 may look entirely different than if you live in rural Wyoming or North Dakota. And it’s not just state-level variation. Your county, and sometimes even your zip code, determines which private plans are available to you.

This applies primarily to Medicare Advantage (Part C) and Medicare Part D (prescription drug) plans. These are offered by private insurance companies approved by Medicare, and their availability is shaped by provider networks, state regulations, local healthcare infrastructure, and even population density.

Why Location Affects Your Medicare Options

Provider Networks Are Local

Medicare Advantage plans must have networks of healthcare providers. That means they are built around doctors, hospitals, and specialists in your area. If a provider network isn’t strong in your location, the plan likely won’t be offered there.

In 2025, urban areas continue to offer more plan choices because they support larger networks. In contrast, rural counties often have fewer doctors and hospitals, limiting the plans that can realistically operate in those regions.

Part D Plans Follow Regional Rules

Medicare Part D plans are also regional. Each plan must be available to an entire Medicare-defined region. There are 34 of these regions across the U.S., and each includes one or more states. Plans are filed at the regional level, and the drugs they cover (formularies) may differ slightly even between neighboring regions.

So, while Original Medicare (Parts A and B) remains consistent across the country, your options for extra coverage (like prescription drugs or bundled benefits) will vary.

In 2025, More People Are Impacted by Geographic Variability

Several changes in 2025 make geography even more important this year:

• The number of Medicare Advantage plans has decreased slightly nationwide, with more plans consolidating into urban centers where enrollment is higher.

• Supplemental benefits (like dental, vision, and transportation) vary even more widely by region now than in 2024.

• Some states, especially in the Midwest and South, have seen significant shifts in which companies are offering plans at all.

That means you might have more or fewer options than last year, even if you didn’t move.

What If You Move in 2025?

A change in residence can have a big impact on your Medicare. In fact, Medicare rules recognize this and allow a Special Enrollment Period (SEP) when you move. This SEP typically lasts two full months after your move, during which you can:

• Enroll in a new Medicare Advantage plan

• Choose a new Part D prescription drug plan

• Return to Original Medicare if Advantage plans are no longer desirable or available

If your new area has significantly different plan offerings, your coverage needs to be updated to reflect what’s available there. Failing to do so could mean gaps in your coverage or higher costs.

Different States, Different Rules for Medicaid + Medicare

If you are enrolled in both Medicare and Medicaid (known as dual eligibility), the location-based differences are even more pronounced. While Medicare is federal, Medicaid is state-run, and each state sets its own rules.

So, if you move across state lines in 2025 and have Medicaid, you must reapply in your new state. Medicaid doesn’t transfer automatically, and different states may offer different levels of support with cost-sharing, nursing home care, or home services.

What You Might Gain (or Lose) Based on Location

Here are some examples of how your Medicare options may shift depending on where you live:

• Plan Choice: In some metro areas, there are over 40 Medicare Advantage plans. In rural counties, you may see fewer than 5.

• Supplemental Benefits: Dental, vision, meals, fitness programs, and over-the-counter items are more common in competitive markets. Rural areas might only offer plans with minimal extras.

• Drug Coverage: Some Part D plans have better formulary support for chronic conditions like diabetes or cancer depending on region.

• Special Needs Plans (SNPs): Available in select counties for people with chronic conditions or dual eligibility, but not offered everywhere.

Common Regional Limitations in 2025

Even with expanded Medicare reforms, some regional limitations persist this year:

• Not all counties have Medicare Advantage PPOs. If you prefer out-of-network flexibility, check if this type is even available in your area.

• Some supplemental benefits have been scaled back in less populated areas.

• Newer plans offering innovative supplemental benefits (such as caregiver support or meal delivery) tend to roll out in large metro areas first.

What If Your Current Plan Leaves the Area?

Each fall, Medicare Advantage and Part D providers can decide whether to renew their contracts in specific counties. If your plan is not being renewed in your area for 2025, you should receive a non-renewal notice by October 2, 2024. This gives you time before Open Enrollment (October 15 to December 7) to make a new choice.

If you do nothing, you may be automatically returned to Original Medicare without drug coverage, potentially increasing your out-of-pocket costs.

Comparing Plan Availability by State or County

You can use the Medicare Plan Finder tool on the official Medicare website to look up what’s available in your area. Each plan listing is specific to your zip code and can show which benefits are included, what the estimated out-of-pocket costs may be, and whether your preferred providers are in-network.

Key aspects to compare include:

• Monthly premiums and estimated yearly costs

• Deductibles and copayments

• Provider networks (in-network hospitals and doctors)

• Prescription drug coverage and formulary

• Maximum out-of-pocket limits

Just remember: these tools reflect general costs and benefits based on your area, but final costs depend on your personal health usage and preferences.

How Enrollment Periods Tie Into Location

In 2025, the key Medicare enrollment windows remain:

• Initial Enrollment Period (IEP): A 7-month window around your 65th birthday

• Annual Enrollment Period (AEP): October 15 to December 7 each year

• Special Enrollment Period (SEP): Triggered by a move, loss of coverage, or other qualifying life events

Your zip code determines which plans you’re eligible to choose during these periods. That’s why if you move to a different area, it’s important to act promptly within your SEP to avoid disruptions in coverage.

Watch for Your ANOC in the Mail

If you’re already enrolled in a Medicare Advantage or Part D plan, your Annual Notice of Change (ANOC) should arrive by the end of September. It lists any changes to your plan for 2025, including:

• Changes to premiums or copays

• Changes to drug formularies

• Provider network changes

• Discontinued plans

Compare the ANOC with other plans available in your zip code. You may find that what worked for you in 2024 is no longer your best option in 2025.

State Assistance Programs May Vary Too

Some states also offer Medicare Savings Programs (MSPs) or additional financial help. Eligibility thresholds and application procedures can differ. If you’re moving or planning to apply for one of these in 2025, contact your State Health Insurance Assistance Program (SHIP) office.

SHIPs offer free, unbiased support and can help you understand what local or state-based programs are available in your new zip code.

Local Geography Could Mean Real Changes in 2025

Where you live in 2025 isn’t just a detail. It’s a major factor that shapes what Medicare plans are available, which benefits you can receive, and what your costs might be. If you’re unsure about what options exist in your area—or if you’re considering a move—now is the right time to review your choices.

Speak with a licensed agent listed on this website to walk through your plan options and ensure you’re getting the coverage that fits your health and your location.