People move for countless reasons. For example, the Covid pandemic uprooted millions of people as they moved to be near family. They also moved into or out of nursing homes or used work-from-home freedom to relocate. But more recently, they are moving because the skyrocketing real estate market and inflation make it impossible to stay where they are.
Whatever your reason and type of plan you have, it is critical to research and decide on your future health care insurance long before packing up, so your coverage is seamless.
Takeaway action step: Whatever your Medicare coverage, if you move, notify the Social Security Administration of your new address to update your Medicare files. You can do so online through the mySocialSecurity portal, by visiting the Social Security office in your new area or by calling 1-800-772-1213 or 1-800-MEDICARE.
What happens to my Original Medicare if I move?
Original Medicare’s Part A (hospital insurance) and Part B (medical insurance) are federal government programs, so they are not affected if you move across town or across the country.
Your Part B premium will be deducted as before, and Part A will not change either. And since no limiting networks are involved with Original Medicare, you will only have to find new doctors, hospitals, pharmacies and other providers near your new home.
Takeaway action step: When you find new providers, be sure they accept Medicare so you pay Medicare-approved prices and you’re not left with unnecessary out-of-pocket expenditures.
What happens to my Medicare Supplement (Medigap) plan if I move?
Medigap plans that supplement Original Medicare are standardized across most (but not all) states. This means you can generally move from one state to another without significant disruption, as long as your new state offers your plan. However, since premium rates can vary state-by-state, your premium may change, even for the same standardized Medigap plan (say, Plan C or G).
If you choose to switch plans when moving to a different state, you may not be eligible for a guaranteed issue. (Guaranteed issue rights state that an insurer must sell you a Medigap policy, must cover all pre-existing conditions and cannot charge you more because of past or present health issues.)
Without those rights, you could pay a higher premium or even be refused by insurers if you have pre-existing conditions. One exception is if you have a Medicare SELECT plan, in which case you have guaranteed issue rights when you move. (However, the tradeoff is that you are limited to the policy’s hospitals and doctors with SELECT plans.)
Takeaway action step: Research alternatives before canceling your Medigap plan and moving. Explore your options with your Medigap provider, as well as other insurers. Medigap is one plan you don’t want to lose without serious consideration because you may have no guarantee of qualifying for another one of similar (or even lesser) value.
What happens to my Medicare Advantage or Part D plan when I move?
If a plan operates based on a network, it will limit beneficiaries to a specific service area defined by zip code, county, state or region. That’s the case with most Part C (Medicare Advantage) and Part D (prescription drug) plans.
So if you move and have either one of these plans, you will most likely have to change them – unless your move leaves you within the same service area. Even then, it’s worth checking to see if your new location opens up any additional options.
If so, you may be able to use a Special Enrollment Period (SEP) to make a change with no penalties or losses. SEPs are available specifically so beneficiaries can respond to certain life events, such as moves, without having to wait for enrollment periods.
You have two choices if your new location takes you outside your plan’s network. You can use a SEP to move to a new plan or return to Original Medicare. If your Medicare Advantage plan covered prescription drugs and you move to Original Medicare, be sure to enroll in a Part D prescription drug plan, too.
Also, if no Medicare Advantage plans are available in your new residence area, you could be forced to return to Original Medicare. If so, you can be granted guaranteed issue rights for a Medigap plan sold by any provider in your state to go along with your Original Medicare.
Takeaway action step: Whatever change you make, your first action should be to contact your plan provider and other providers to discuss your options. Disenroll if needed. Depending on when you notify your provider, SEP could be the month of your move plus two months or the three months after you move.
What happens to my Medicare if I move out of the country?
Your Medicare benefits can only be used in the 50 U.S. States, Puerto Rico, Guam, the U.S. Virgin Islands and the Mariana Islands. However, some emergency services are covered if you have a Medigap policy.
If you have Original Medicare, you may choose to continue to hold Part A and Part B, especially if Part A is premium-free. However, your decision may rest on how long you intend to be abroad and how often you return to the U.S. Your Medigap provider should also allow you to keep your coverage as long as you pay your premiums.
If you discontinue your Part B coverage and later decide to return to the U.S., you may avoid a late enrollment penalty if you qualify for a SEP.
With Medicare Advantage and Part D prescription drug plans, you may have to disenroll if your insurer requires beneficiaries to live within the plan’s service area at least six months out of the year. But you’ll likely have a 2-month SEP to enroll in either if you move back.
Takeaway action step: Read the plan requirements in your Medicare Advantage and Part D policies. Call your insurers or 1-800-MEDICARE for answers to all your specific questions. You want to leave yourself the most flexibility for the future, but at a cost you can justify.
What happens to my Medicare if I move to a skilled nursing facility or long-term care hospital?
Moving into a skilled nursing facility or long-term care hospital should not affect your Original Medicare. However, if you have Medicare Advantage or a Part D prescription drug plan, you can drop, switch or join such a plan while in the facility or for two months after leaving.