Category: Uncategorized

Medicare Options in Texas

Texas residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 4,680,000 Medicare beneficiaries, Texas is one of the larger Medicare markets, which means strong plan competition and generally lower premiums.

Medicare Advantage in Texas

Texas has 118 Medicare Advantage plans available, with an average star rating of 3.8 out of 5.0. The average monthly premium across all MA plans in the state is $7.60/month average premium. Medicare Advantage plans in Texas typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in Texas

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Texas is 3.8 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in Texas

Texas has 28 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for Texas Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in Texas

Medigap Plan G is the most popular Medicare Supplement plan in Texas, with an average monthly premium of $126. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for Texas

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$126/month
Plan N	Covered	Covered (with copays)	Covered	$103/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$145/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$57/month

Medicaid in Texas

Texas has not expanded Medicaid, meaning most adults without dependent children do not qualify for Medicaid regardless of income. Only parents earning up to 15% FPL ($4,098/year for a family of three) may qualify.

Medicaid Income Limits in Texas (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$994/month	For seniors and disabled individuals

Medicare Savings Programs in Texas

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Texas residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in Texas

Social Security Disability Insurance (SSDI) recipients in Texas automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Texas, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Texas residents may qualify for Medicaid to bridge the coverage gap.

Medicare Options in Tennessee

Tennessee residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 1,440,000 Medicare beneficiaries, Tennessee is one of the larger Medicare markets, which means strong plan competition and generally lower premiums.

Medicare Advantage in Tennessee

Tennessee has 44 Medicare Advantage plans available, with an average star rating of 3.8 out of 5.0. The average monthly premium across all MA plans in the state is $7.40/month average premium. Medicare Advantage plans in Tennessee typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in Tennessee

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Tennessee is 3.8 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in Tennessee

Tennessee has 24 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for Tennessee Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in Tennessee

Medigap Plan G is the most popular Medicare Supplement plan in Tennessee, with an average monthly premium of $118. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for Tennessee

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$118/month
Plan N	Covered	Covered (with copays)	Covered	$97/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$136/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$53/month

Medicaid in Tennessee

Tennessee has not expanded Medicaid, meaning most adults without dependent children do not qualify for Medicaid regardless of income. Only parents earning up to 105% FPL ($28,686/year for a family of three) may qualify.

Medicaid Income Limits in Tennessee (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$994/month	For seniors and disabled individuals

Medicare Savings Programs in Tennessee

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Tennessee residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in Tennessee

Social Security Disability Insurance (SSDI) recipients in Tennessee automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Tennessee, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Tennessee residents may qualify for Medicaid to bridge the coverage gap.

Medicare Options in South Dakota

South Dakota residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 200,000 Medicare beneficiaries, South Dakota is a mid-sized Medicare markets, which means fewer plan options but often more personalized service.

Medicare Advantage in South Dakota

South Dakota has 10 Medicare Advantage plans available, with an average star rating of 3.7 out of 5.0. The average monthly premium across all MA plans in the state is $5.80/month average premium. Medicare Advantage plans in South Dakota typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in South Dakota

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in South Dakota is 3.7 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in South Dakota

South Dakota has 20 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for South Dakota Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in South Dakota

Medigap Plan G is the most popular Medicare Supplement plan in South Dakota, with an average monthly premium of $112. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for South Dakota

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$112/month
Plan N	Covered	Covered (with copays)	Covered	$92/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$129/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$50/month

Medicaid in South Dakota

South Dakota has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

Medicaid Income Limits in South Dakota (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$994/month	For seniors and disabled individuals

Medicare Savings Programs in South Dakota

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. South Dakota residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in South Dakota

Social Security Disability Insurance (SSDI) recipients in South Dakota automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in South Dakota, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, South Dakota residents may qualify for Medicaid to bridge the coverage gap.

Medicare Options in South Carolina

South Carolina residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 1,120,000 Medicare beneficiaries, South Carolina is one of the larger Medicare markets, which means strong plan competition and generally lower premiums.

Medicare Advantage in South Carolina

South Carolina has 36 Medicare Advantage plans available, with an average star rating of 3.8 out of 5.0. The average monthly premium across all MA plans in the state is $7.20/month average premium. Medicare Advantage plans in South Carolina typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in South Carolina

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in South Carolina is 3.8 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in South Carolina

South Carolina has 23 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for South Carolina Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in South Carolina

Medigap Plan G is the most popular Medicare Supplement plan in South Carolina, with an average monthly premium of $118. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for South Carolina

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$118/month
Plan N	Covered	Covered (with copays)	Covered	$97/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$136/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$53/month

Medicaid in South Carolina

South Carolina has not expanded Medicaid, meaning most adults without dependent children do not qualify for Medicaid regardless of income. Only parents earning up to 67% FPL ($18,304/year for a family of three) may qualify.

Medicaid Income Limits in South Carolina (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$994/month	For seniors and disabled individuals

Medicare Savings Programs in South Carolina

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. South Carolina residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in South Carolina

Social Security Disability Insurance (SSDI) recipients in South Carolina automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in South Carolina, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, South Carolina residents may qualify for Medicaid to bridge the coverage gap.

Medicare Options in Rhode Island

Rhode Island residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 260,000 Medicare beneficiaries, Rhode Island is a mid-sized Medicare markets, which means fewer plan options but often more personalized service.

Medicare Advantage in Rhode Island

Rhode Island has 12 Medicare Advantage plans available, with an average star rating of 4.1 out of 5.0. The average monthly premium across all MA plans in the state is $17.20/month average premium. Medicare Advantage plans in Rhode Island typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in Rhode Island

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Rhode Island is 4.1 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in Rhode Island

Rhode Island has 20 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for Rhode Island Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in Rhode Island

Medigap Plan G is the most popular Medicare Supplement plan in Rhode Island, with an average monthly premium of $168. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for Rhode Island

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$168/month
Plan N	Covered	Covered (with copays)	Covered	$138/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$193/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$76/month

Medicaid in Rhode Island

Rhode Island has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

Medicaid Income Limits in Rhode Island (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$1,118/month	For seniors and disabled individuals

Medicare Savings Programs in Rhode Island

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Rhode Island residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in Rhode Island

Social Security Disability Insurance (SSDI) recipients in Rhode Island automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Rhode Island, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Rhode Island residents may qualify for Medicaid to bridge the coverage gap.

Medicare Options in Pennsylvania

Pennsylvania residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 3,080,000 Medicare beneficiaries, Pennsylvania is one of the larger Medicare markets, which means strong plan competition and generally lower premiums.

Medicare Advantage in Pennsylvania

Pennsylvania has 62 Medicare Advantage plans available, with an average star rating of 4.0 out of 5.0. The average monthly premium across all MA plans in the state is $12.80/month average premium. Medicare Advantage plans in Pennsylvania typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in Pennsylvania

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Pennsylvania is 4.0 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in Pennsylvania

Pennsylvania has 26 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for Pennsylvania Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in Pennsylvania

Medigap Plan G is the most popular Medicare Supplement plan in Pennsylvania, with an average monthly premium of $148. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for Pennsylvania

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$148/month
Plan N	Covered	Covered (with copays)	Covered	$121/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$170/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$67/month

Medicaid in Pennsylvania

Pennsylvania has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

Medicaid Income Limits in Pennsylvania (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$994/month	For seniors and disabled individuals

Medicare Savings Programs in Pennsylvania

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Pennsylvania residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in Pennsylvania

Social Security Disability Insurance (SSDI) recipients in Pennsylvania automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Pennsylvania, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Pennsylvania residents may qualify for Medicaid to bridge the coverage gap.

Medicare Options in Oregon

Oregon residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 920,000 Medicare beneficiaries, Oregon is a mid-sized Medicare markets, which means fewer plan options but often more personalized service.

Medicare Advantage in Oregon

Oregon has 28 Medicare Advantage plans available, with an average star rating of 4.1 out of 5.0. The average monthly premium across all MA plans in the state is $10.40/month average premium. Medicare Advantage plans in Oregon typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in Oregon

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Oregon is 4.1 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in Oregon

Oregon has 23 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for Oregon Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in Oregon

Medigap Plan G is the most popular Medicare Supplement plan in Oregon, with an average monthly premium of $148. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for Oregon

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$148/month
Plan N	Covered	Covered (with copays)	Covered	$121/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$170/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$67/month

Medicaid in Oregon

Oregon has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

Medicaid Income Limits in Oregon (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$1,118/month	For seniors and disabled individuals

Medicare Savings Programs in Oregon

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Oregon residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in Oregon

Social Security Disability Insurance (SSDI) recipients in Oregon automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Oregon, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Oregon residents may qualify for Medicaid to bridge the coverage gap.

Medicare Options in Oklahoma

Oklahoma residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 820,000 Medicare beneficiaries, Oklahoma is a mid-sized Medicare markets, which means fewer plan options but often more personalized service.

Medicare Advantage in Oklahoma

Oklahoma has 26 Medicare Advantage plans available, with an average star rating of 3.7 out of 5.0. The average monthly premium across all MA plans in the state is $6.80/month average premium. Medicare Advantage plans in Oklahoma typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in Oklahoma

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Oklahoma is 3.7 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in Oklahoma

Oklahoma has 22 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for Oklahoma Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in Oklahoma

Medigap Plan G is the most popular Medicare Supplement plan in Oklahoma, with an average monthly premium of $116. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for Oklahoma

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$116/month
Plan N	Covered	Covered (with copays)	Covered	$95/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$133/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$52/month

Medicaid in Oklahoma

Oklahoma has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

Medicaid Income Limits in Oklahoma (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$994/month	For seniors and disabled individuals

Medicare Savings Programs in Oklahoma

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Oklahoma residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in Oklahoma

Social Security Disability Insurance (SSDI) recipients in Oklahoma automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Oklahoma, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Oklahoma residents may qualify for Medicaid to bridge the coverage gap.

Medicare Options in Ohio

Ohio residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 2,680,000 Medicare beneficiaries, Ohio is one of the larger Medicare markets, which means strong plan competition and generally lower premiums.

Medicare Advantage in Ohio

Ohio has 58 Medicare Advantage plans available, with an average star rating of 4.0 out of 5.0. The average monthly premium across all MA plans in the state is $9.20/month average premium. Medicare Advantage plans in Ohio typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in Ohio

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in Ohio is 4.0 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in Ohio

Ohio has 25 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for Ohio Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in Ohio

Medigap Plan G is the most popular Medicare Supplement plan in Ohio, with an average monthly premium of $128. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for Ohio

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$128/month
Plan N	Covered	Covered (with copays)	Covered	$105/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$147/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$58/month

Medicaid in Ohio

Ohio has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

Medicaid Income Limits in Ohio (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$994/month	For seniors and disabled individuals

Medicare Savings Programs in Ohio

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. Ohio residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in Ohio

Social Security Disability Insurance (SSDI) recipients in Ohio automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in Ohio, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, Ohio residents may qualify for Medicaid to bridge the coverage gap.

Medicare Options in North Dakota

North Dakota residents on Medicare have three primary coverage paths: Original Medicare (Parts A and B), Medicare Advantage (Part C), and Medicare Supplement (Medigap) insurance paired with a Part D prescription drug plan. With 160,000 Medicare beneficiaries, North Dakota is a mid-sized Medicare markets, which means fewer plan options but often more personalized service.

Medicare Advantage in North Dakota

North Dakota has 8 Medicare Advantage plans available, with an average star rating of 3.7 out of 5.0. The average monthly premium across all MA plans in the state is $5.40/month average premium. Medicare Advantage plans in North Dakota typically include prescription drug coverage, dental, vision, and hearing benefits not available through Original Medicare.

2026 Medicare Advantage Star Ratings in North Dakota

CMS rates Medicare Advantage plans on a 1–5 star scale based on quality measures including preventive care, managing chronic conditions, member experience, and customer service. Plans rated 4 stars or higher receive bonus payments from CMS, which they typically pass on to members through lower premiums or enhanced benefits. The average MA plan star rating in North Dakota is 3.7 stars.

Star Rating	What It Means	Bonus Payments
5 Stars	Excellent — top-performing plan	Yes — highest bonus
4.5 Stars	Above average quality	Yes
4 Stars	Good quality	Yes
3.5 Stars	Average quality	No
3 Stars or below	Below average — consider switching	No

Medicare Part D in North Dakota

North Dakota has 19 standalone Part D prescription drug plans available. In 2026, the maximum out-of-pocket cap for Part D drugs is $2,100 — a major change from prior years that eliminates catastrophic drug costs. The maximum Part D deductible is $615.

2026 Part D Key Numbers for North Dakota Residents

2026 Part D Limit	Amount
Out-of-pocket maximum	$2,100/year
Maximum deductible	$615/year
National base beneficiary premium	$38.99/month
Late enrollment penalty (per month uncovered)	1% × $38.99
Coverage gap (“donut hole”)	Eliminated as of 2025

Medicare Supplement (Medigap) in North Dakota

Medigap Plan G is the most popular Medicare Supplement plan in North Dakota, with an average monthly premium of $114. Plan G covers the Part A deductible ($1676 in 2026), Part B coinsurance (20% of all covered services), skilled nursing facility coinsurance, and foreign travel emergency coverage. The only cost Plan G does not cover is the Part B deductible ($240 in 2026).

Medigap Plan Comparison for North Dakota

Plan	Part A Deductible	Part B Coinsurance	SNF Coinsurance	Estimated Monthly Premium
Plan G (most popular)	Covered	Covered	Covered	$114/month
Plan N	Covered	Covered (with copays)	Covered	$93/month
Plan F (pre-2020 enrollees only)	Covered	Covered	Covered	$131/month
Plan K (high-deductible)	50% covered	50% covered	50% covered	$51/month

Medicaid in North Dakota

North Dakota has fully expanded Medicaid under the Affordable Care Act, meaning adults earning up to 138% of the Federal Poverty Level ($22,025/year for an individual) qualify for Medicaid coverage.

Medicaid Income Limits in North Dakota (2026)

Medicaid Program	Income Limit (Single)	Notes
Nursing Home / Institutional Medicaid	$2,982/month	Nearly all income goes toward cost of care
HCBS Waiver (home-based care)	$2,982/month	Recipient keeps income for living expenses
Regular Medicaid (Aged, Blind, Disabled)	$994/month	For seniors and disabled individuals

Medicare Savings Programs in North Dakota

Medicare Savings Programs (MSPs) help low-income Medicare beneficiaries pay their premiums, deductibles, and copays. North Dakota residents may qualify for one of four programs based on income:

Program	Individual Income Limit	Couple Income Limit	Benefit
QMB (Qualified Medicare Beneficiary)	$1,255/month	$1,704/month	Pays Part A and B premiums, deductibles, and copays
SLMB (Specified Low-Income MB)	$1,478/month	$1,992/month	Pays Part B premium only
QI (Qualifying Individual)	$1,660/month	$2,239/month	Pays Part B premium only, limited slots
QDWI (Qualified Disabled Working)	$4,945/month	$6,659/month	Pays Part A premium for working disabled under 65

SSDI Recipients and Medicare in North Dakota

Social Security Disability Insurance (SSDI) recipients in North Dakota automatically become eligible for Medicare after a 24-month waiting period from their disability onset date. This means that if you were approved for SSDI in North Dakota, your Medicare coverage begins in month 25 of your disability. During the 24-month waiting period, North Dakota residents may qualify for Medicaid to bridge the coverage gap.