When preparing for a move, many people create a checklist to keep everything on track. If you’re a Medicare beneficiary, one important item to include is to update your Medicare plans and information. This process isn’t always straightforward, as certain parts of Medicare don’t automatically transfer from one state to another, or even one county to another. For instance, Medicare Advantage (Part C) and Medicare Part D prescription drug plans are region-specific, meaning they depend on where you live.
If you’re relocating outside your current plan’s service area, you’ll need to notify your Medicare Advantage or Medicare Part D carriers. If you have a Medicare Supplement (Medigap) plan, the rules vary slightly. While your coverage remains intact, your premiums might change depending on your new location.
Moving States with Medicare Advantage
Medicare Advantage Plans operate within specific networks that are limited to certain counties. Therefore, if you’re relocating from one state to another, you will likely need to switch your plan.
Upon moving, you can either enroll in a new Medicare Advantage plan within your new zip code or switch back to Original Medicare and apply for a Medigap policy. Transitioning out of your current Medicare Advantage plan’s service area grants you access to a Guaranteed Issue period for Medigap plans, allowing you to apply without answering health-related questions.
If you have a Medicare Advantage plan and move to another region or state, you qualify for a Special Election Period (SEP) to adjust your coverage.
To take advantage of this opportunity, you should inform your insurance carrier about your move before you actually relocate. This will initiate your enrollment window one month prior to your move and will remain open for two months following your move date. For instance, if you are moving in October, your SEP will begin on September 1 and will end at the end of November.
If you wait to notify your plan until after your move, your enrollment opportunity will close two months after your relocation month. Keep in mind that waiting to inform your provider may shorten your SEP. These rules also apply when changing Part D plans after moving to a different state.
As previously mentioned, relocating from your Medicare Advantage plan’s service area allows you to enter a Guaranteed Issue window for enrolling in a new Medigap plan without having to pass medical underwriting. This window begins 60 days prior to the end of your existing coverage and ends 63 days after it officially terminates.
It’s important to note that there are specific Medigap plans available during this Guaranteed Issue window. If you became eligible for Medicare before 2020, you can choose from Medigap Plans A, B, C, F, K, or L during this period. However, if your Medicare eligibility began in 2020 or later, your options are limited to Medigap Plans A, B, D, G, K, or L. The availability of Plan N may vary based on the carrier and state regulations.
Moving States with Medicare Part D
Many beneficiaries who have Original Medicare and a Medigap plan also enroll in a standalone Part D prescription drug plan. If you are moving to a different state, you will need to get a new drug plan, as these plans are specific to each state. Even if you opt for the same insurance provider in your new location, your plan number will change, requiring you to complete a new application for coverage.
Fortunately, Medicare tracks your Part D expenditures. When you enroll in your new plan, you will start in the same stage of coverage where you left off with your previous plan. For instance, if you were in the coverage gap with your old plan, you will enter the new plan at that same stage.
If you decide against enrolling in a new PDP after your move, be mindful that you may face a late enrollment penalty if you choose to sign up for a drug plan at a later time.
Moving States with Original Medicare and Medigap
About 50% of Medicare beneficiaries are enrolled in Original Medicare, which includes Part A and Part B coverage, along with a Medigap policy that complements their Medicare benefits. Since Original Medicare is a federal program, your benefits under Parts A and B remain unchanged regardless of your move to another state. You can also take your Medigap plan with you.
However, the cost of your monthly Medigap premium is influenced by your zip code, and these prices can differ significantly from one state to another due to variations in healthcare costs. As a result, your premium may increase or decrease when you relocate.
If the new premium is more than you can manage, feel free to reach out to us to explore your options. There may be other insurance carriers in your new area offering more affordable rates.
Keep in mind that switching plans usually requires you to undergo medical underwriting, which involves answering health-related questions that the insurance provider uses to determine your eligibility for coverage.
If you decide to apply for a new plan, be aware that certain states have specific Medigap policies and regulations that differ from those in other states. For instance, moving from one state to another in Wisconsin, Massachusetts, or Minnesota may alter the structure of your benefits.
Make Your Medicare Moves with Us
It’s likely that you have multiple plans that require adjustments during your relocation. Whether you are a client of ours or are new to us, we’re happy to help make adjustments to your Medicare plans. We’ll make sure you’re aware of any enrollment windows and will help you shop for new plans if necessary.
