The Five Best and Worst States for Health Care at 65+

A new analysis shows states with harsher winters tend to offer better quality health care for older adults.

By Michael LaPick

Every American over 65 knows how important a role Medicare plays in their life, especially as they age.  Last year, almost 63 million enrolled in Medicare. But you may not know that quality of care varies by state. Sunny beaches and desert golf courses sound enticing but those warm oases may not be the best for one’s health care.

Our team at MedicareGuide.com, an expert-reviewed content resource site, developed a data analysis to determine where adults over 65 receive the best health care.

We compared all 50 states and Washington, D.C. across 24 measures of cost, access and quality. We then analyzed data for critical factors such as prescription drug prices, doctors per capita and life expectancy. What did we learn? Where you live matters as you get older.

Colder States Thrive

According to our study, the states with the best Medicare: Minnesota, North Dakota, Massachusetts, California and Nebraska.

Minnesota, home of the Mayo Clinic, ranked the highest, highlighting low prescription drugs and max-out-of-pocket (MOOP) amounts for Medicare Advantage plans. Minnesotans are proud of great health care coverage and their snowbirds tend to access their plans up north. Its neighbor to the west, North Dakota, ranked second, offering the lowest prescription drug prices and the lowest number of doctors who opt out of Medicare, in the nation.

 Massachusetts took third with high numbers of physicians, home health aides and nurse practitioners per capita, as well as low drug prices. Northeast winters can be brutally cold but the quality of care can be worth it.

 California took fourth with low drug prices, low Medicare Advantage MOOP and premium costs. But it’s not all sunny in the Golden State. The state leads with the most physicians who opt out of Medicare.

Nebraska completes our top five states with a large number of rural  clinics and nursing/assisted living homes per capita.

Southeast Can’t Compete

The bottom five for older health care almost all belong to the South: Oklahoma, Georgia, Washington, D.C., Mississippi and Louisiana.

These states, besides having the highest mortality rates for conditions like heart disease and type 2 diabetes, also have the lowest life expectancies. And according to our research, they have low numbers of geriatricians, physicians and home health aides. When it comes to various plan costs and prescription drug prices, the southeast can’t compete with the rest of the nation.

Older adults looking to migrate south for the weather may not receive the same quality of health care as they would up north. Baby boomers aging in place seem more common than ever. According to an AARP survey, 76% of senior citizens in America say they prefer to remain in their current residence and 77% would like to live in their community as long as possible.

The future of Medicare is unclear as Congress proposes various new plans. Frank Lalli, a health correspondent for Parade and NPR and author of Your Best Health Care Now, offers some insight on what Medicare beneficiaries can look forward to.

Congressional Push

“The good news is that many lawmakers in Congress are pushing to expand Original Medicare benefits to eye care, hearing and dental. Many also continue to advocate for allowing the federal government to begin negotiating lower drug prices from the manufacturers. And lawmakers want to lower the eligibility age for Medicare from age 65 to 60, thereby lowering costs across the board by bringing in younger, healthier seniors.”

Lalli emphasizes,”Studies show healthy seniors can benefit from [Medicare] Advantage, but seniors with health issues have better outcomes signing up for Original Medicare.”

You can learn more tips and ways to save  along with policy outlooks from our expert panel. Our full analysis also provides several interactive maps, data tables and visualizations to learn how we calculated the best and worst states for elderly health care.

Michael LaPick is the content marketing manager of HealthCare.com,  a broker, marketer and developer of health insurance products.

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