What happens to your Medicare plan if you move depends on a couple factors including what type of coverage you have and where you move to. Here’s what you need to know:
Medicare Parts A and B
Known as Original Medicare, Parts A and B always travel with you regardless of where you go. Since Original Medicare has no provider networks, your coverage is good as long as the medical provider you see accepts Medicare assignment, meaning they accept the Medicare approved amount as payment. You are covered in all 50 states plus the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. If you move you need to update your address with Social Security. This will automatically update your information with Medicare as well.
Medicare Supplement or Medigap Plans
If you have Original Medicare you may also have a Medigap plan that covers some of your out of pocket expenses. In most cases you can keep your current Medigap plan if you move to another state but there are some exceptions. Most states offer the same 10 plans with the same standardized benefits, but not all plans are offered in all areas, meaning your plan may not be offered by your insurance carrier in the state you are moving to. Wisconsin, Minnesota, and Massachusetts have different standardized plans. You should contact your Medigap insurer to see what coverage options are available in the state you are moving to.
If you have to change plans it’s important to understand that except in specific situations it may be difficult to find new coverage outside of your original Medigap Open Enrollment Period. This is the six month period that starts once you have turned 65 and enrolled in Part B. Once this period is over you could be required to answer a series of questions related to your health, known as medical underwriting. If you have health issues you could be charged more for your Medigap coverage or denied coverage altogether. For this reason, it is recommended that if you have the option to stay with your current Medigap plan, you don’t cancel your coverage until you know for certain that your application for a new Medigap plan has been approved.
There are eight states that allow you to change your Medigap plan without underwriting, but even these states may have certain restrictions such as specific enrollment periods. These states are Connecticut, Maine, Massachusetts, Minnesota, New York, Oregon, Rhode Island, and Vermont.
If you are considering changing your Medigap plan, you will need to find out what plans are available in your new state as well as any restrictions or requirements that could affect you.
Medicare Advantage and Part D Prescription Drug Plans
Medicare Advantage and Part D drug plans are designed to operate within a specific geographic location known as a service area. What happens to your coverage depends on whether or not you are moving outside of your plans service area. If you move you may qualify for a Special Enrollment Period.
- If you move within your current plans service area you don’t have to do anything other than update your address with your insurance carrier. However, if there are new plan options in your new location you will qualify for a special enrollment period that allows you to change your Medicare Advantage plan or Part D plan if you choose to do so.
- If you move outside your plans service area you can switch to a new Medicare Advantage plan, or a new Part D drug plan offered in your new location. You can also choose to return to Original Medicare. If you don’t join a new Medicare Advantage plan within the special enrollment time period, you will automatically be enrolled in Original Medicare and disenrolled from your Medicare Advantage plan. In most cases if don’t tell your plan you have moved, they will find out through the U.S. Post Office or the Social Security Administration when you update your address with them.
Special Enrollment Time Period
If you tell your insurer prior to your move, your enrollment period begins the month before you move and lasts for two full months after you move. If you tell you insurer after you move, your enrollment period begins the month you tell them, plus the two full months after.
Special Note for Dual Eligible Medicare Advantage Plans
If you qualify for Medicare and Medicaid and are moving out of state, you will need to contact the Medicaid office in the new state where you will be relocating to find out your Medicaid options. Each state determines their own Medicaid eligibility rules so the criteria to qualify may be different. If you still qualify for Medicaid and want to be enrolled in a dual eligible Medicare plan, you will need to look for private insurers who offer these plans in your new location. Dual eligible plans are not offered in all areas and are not offered by all insurance carriers.
What if You Move Out of the Country?
Medicare does not cover care received outside the United States if you have permanently moved outside the country. Depending on where you go, you might consider buying private health insurance or see if you qualify for national health insurance in your new country of residence.
What should you do about Medicare Part A and B?
If you move out of the country you may want to keep your Part A and B to ensure you have coverage when you travel back to the U.S. for visits or in the event you move back. If you maintain your premium payments you are protected against gaps in coverage and late enrollment penalties. Late penalties are permanent and continue to accrue over time.
If you return to the United States after living outside the country, you will have a special enrollment period to join a Medicare Advantage plan or Part D drug plan. Your enrollment period will last for 2 full months after the month you move back to the U.S. You must be enrolled in both Part A and B to enroll in a Medicare Advantage plan. You must be enrolled in either Part A or B, or both, to enroll in a Part D plan.
A Licensed Medicare Agent Can Help
If you are moving you don’t have to navigate your Medicare options alone. A licensed Medicare agent or broker can provide the individual guidance you need to make the right coverage decision. Silver&Smart’s Medicare Insurance Agent Directory can help connect you with a licensed Medicare Agent in your state.