Many seniors enjoy warm weather living year-round by maintaining a dual residence or living for part of the year in two different states. The dual residence is nothing new, and “snowbirds” have been fleeing to southern states in winter for generations. But how does dual residence impact your Medicare options, will you still be covered if you live in two states? Here’s some guidance on Medicare and what you should know if you head south for the winter.
Original Medicare Benefits Work Anywhere Within the United States
With Original Medicare (Part A and Part B), you can travel anywhere within the United States and still be covered—as long as you choose providers who accept Medicare. This is good news for anyone planning to spend part of the year in one state and part of the year in another. Whether you are in Florida or Michigan, any doctor or hospital that accepts assignments will honor your Part A and Part B benefits.
While in most cases, Medicare does not cover care you receive outside of the country, it does include:
All 50 states
The District of Columbia
Puerto Rico
The Virgin Islands
Guam, American Samoa
The Northern Mariana Islands
Medicare Supplement Insurance Is Not Restricted By Service Networks
Like Original Medicare, Medicare Supplement Insurance, or Medigap, does not rely on service networks, and as long as the doctor or hospital you choose accepts Medicare, you’re covered. As a senior with homes in two states, you can travel freely with the peace of mind and confidence that when you need medical care, you can get it and your Medicare Supplement Insurance plan will be applied. Note: if you are a dual resident considering Medigap, be sure to compare policies offered by each state to learn about any differences that may impact your coverage.
Medicare Advantage and Part D Plans Don’t Always Extend Across State Lines
For Medicare Part C and D, the rules for out-of-state coverage are different and your plan may not cover your care while you travel within the United States. With many plans, you need to be a permanent resident of the state where you originally enrolled and you must live in the service area of your plan. In some cases, you can receive out-of-network care, but it will likely cost you more money. In addition, your plan may have specific rules you need to follow, such as needing prior authorization before receiving care that can impact your coverage. With all Medicare plans, Original Medicare, Medicare Advantage, and Medigap, you are covered in any state if you need emergency medical care or urgent care out of network.
Resources:
https://www.medicare.gov/supplement-other-insurance/when-can-i-buy-medigap/switching-plans/switch-medigap-.html#collapse-2514
https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/original-medicare/how-original-medicare-works.html#collapse-3111
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