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Best and worst states for health care in retirement

The quality of health care that the 63 million Medicare recipients get largely depends on where they live, a new study found. Some states provide a higher level of access and care than others, which should be a key consideration for retirement, especially if plans include a relocation.

“Tax rates and climate are only part of the picture. Your health care should be part of that decision-making process as well,” said Jeff Smedsrud, co-founder of MedicareGuide, which released a state-by-state ranking of health care for seniors. “We all have to advocate for ourselves, we all have to shop for ourselves, and we all need to get the most that we can out of the health care system.”

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The analysis evaluated the 50 states plus Washington, D.C. on 24 relevant metrics categorized by cost, access, and quality to determine which states offered the best and worst health care for adults over 65.

Four out of the ten highest-ranking states are in the Midwest. Minnesota boasts the country’s overall best health care for older Americans overall, while also leading in two categories: best average monthly insurance premium and heart disease mortality.

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North Dakota (No. 2), Nebraska (No. 5), and Iowa (No. 9) — all located in the heartland — broke into the top 10, according to MedicareGuide. The other six best states included: Massachusetts (No. 3); California (No. 4), Hawaii (No. 6); Montana (No. 7); Colorado (No. 8), and Connecticut (No. 10).

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On the other end of the spectrum were states like Oklahoma, which came in last at (No. 51); Georgia (No. 50); Washington, D.C. (No. 49); Mississippi (No. 48), and Louisiana (No. 47). All five scored at the bottom of the heap for expensive healthcare relative to quality and access.

Washington, D.C. was ranked the worst for out-of-pocket medical spending; Mississippi was found to have the worst Alzheimer’s mortality and average life expectancy at birth, and lowest physicians per capita; Louisiana has the worst public hospital system; and Oklahoma has the worst heart disease mortality.

Minnesota boasts the country’s overall best health care for older Americans overall, while also leading in two categories: best average monthly insurance premium and heart disease mortality. (Photo: Getty)
Minnesota boasts the country’s overall best health care for older Americans overall, while also leading in two categories: best average monthly insurance premium and heart disease mortality. (Photo: Getty) (FatCamera via Getty Images)

Smedsrud didn’t find the results too surprising, because state spending plays a factor, he explained. The overall score “does show some pretty distinct differences between experiences” depending on where retirees choose to live out their golden years.

“There's a cause and effect,” Smedsrud said.

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Among the states that have historically invested in programs like health care and education, their health care networks were among the country’s most robust. On the other hand, “those at the bottom,” he said, were more likely to display “education funding and nutrition-related issues.”

“If [states] invest long-term [to improve] access to health care, health insurance, education, food and safety,” Smedsrud said, “you're going to have better outcomes for people.”

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Stephanie is a reporter for Yahoo Money and Cashay, a new personal finance website. Follow her on Twitter @SJAsymkos.

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