:max_bytes(150000):strip_icc()/GettyImages-2205398466-27622f107a214778b732b05618f1d6c3.jpg "These States Have The Best—And Worst—Medicare Services")
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KEY TAKEAWAYS
- States with higher-ranking Medicare programs generally had plans with better coverage and easier access to providers.
- Medicare enrollees in the lowest-ranking states had a hard time accessing care due to a lack of transportation, fewer local providers, and increased requirements that delay services.
- Beneficiaries in rural areas were less likely to have a regular health care provider and spent more on care.
Open enrollment for 2026 Medicare plans nationwide began last week, but a new report found that the quality of care Americans experience varies widely depending on where they live.
One in five Americans is currently on Medicare, the federal health insurance plan for disabled Americans and those 65 years of age and older. Depending on the state they reside in, some beneficiaries have better health care access and coverage, according to the Commonwealth Fund, a health care research group. However, almost all Medicare enrollees will see changes to their coverage and higher costs in 2026.
Why This Matter to You
Most Americans rely on Medicare, the federal health insurance program, at some point in their lives—generally when they are seniors. So it’s important to understand that this national program can have significant geographic disparities.
Top-Performing States
The top three best-ranked states for Medicare were Vermont, Utah, and Minnesota. In the higher-performing states, Medicare enrollees could more easily find a regular health care provider, and their plans generally had better coverage for health services and prescriptions.
Beneficiaries with Medicare Advantage and add-on prescription drug plans in particular had more generous coverage in the higher-ranking states.
Higher-ranked states also didn’t require as many Medicare Advantage enrollees to have prior authorization for preventive services and specialty care. This authorization process is meant to help reduce spending on care that some enrollees don’t need, but it can also delay or disrupt necessary care for others.
Bottom-Performing States
The lowest-ranked states were Louisiana, Mississippi, and Kentucky.
Beneficiaries in the lower-ranking states had difficulty accessing care. Part of that was due to a lack of transportation and infrastructure in the area that made it hard to physically get to providers, while prior authorization requirements for certain services presented another hurdle.
The quality of care in most of these lower-ranked states was also typically worse. Beneficiaries in these areas are less likely to receive the appropriate tests, treatments, and services. In particular, beneficiaries in southeastern states, such as Louisiana, Florida, Alabama, Arkansas, and West Virginia, were more likely to be prescribed unnecessary and inappropriate medications, which could cause further health problems for the elderly.
Beneficiaries in Rural Areas Had Less Access to Quality Care
The study also found that beneficiaries in rural areas, no matter what state they live in, are less likely to have a regular health care provider. That in turn makes it harder for them to manage chronic conditions and get preventative treatment.
Nationally, less than 5% of older Americans did not have a regular health care provider. However that number jumps in rural areas, to between 9% and 12%.
In addition, those in rural states, specifically in the West and Upper Great Plains, paid more on average for total health care costs. More elderly beneficiaries in rural areas also reported going without medical care due to high costs.
