Every year, thousands of retirees, known as “snowbirds,” migrate between northern and southern states to escape extreme seasonal weather. If you’re one of them, ensuring your Medicare coverage travels with you is essential to maintaining your healthcare without unexpected costs or disruptions. Here’s what you need to know about Medicare when living in multiple states.
Does Medicare Work in Different States?
Yes, but with some caveats. Original Medicare (Part A and Part B) is a federal program, meaning it provides coverage nationwide. However, Medicare Advantage (Part C) and Medicare Supplement (Medigap) plans have specific provider networks that may limit your access to care when traveling.
Original Medicare (Part A and Part B)
- Works in all 50 states
- No network restrictions; you can visit any doctor or hospital that accepts Medicare
- Coverage remains the same regardless of where you receive care
Medicare Advantage (Part C)
- Plans are regionally based and may not cover non-emergency care outside the service area
- Some plans offer national networks, but this varies by provider
- If you have an HMO plan, you may need referrals or pre-authorizations to receive care outside your plan’s network
Medicare Supplement (Medigap) Plans
- These plans work with Original Medicare and typically allow care nationwide
- You can visit any provider that accepts Medicare
- Plans like Plan G or Plan N provide coverage for excess charges and out-of-pocket costs
What About Prescription Drug Coverage?
If you have a standalone Medicare Part D plan (prescription drug coverage), check if your plan’s pharmacy network includes locations in both states where you reside. Many national chain pharmacies are covered, but local or regional pharmacies may not be in-network. Some Medicare Advantage plans include prescription drug coverage, but these may have restrictions outside your primary service area.
Tips for Snowbirds Managing Medicare Coverage
- Choose the Right Plan: If you travel frequently, Original Medicare with a Medigap plan may provide the most flexibility.
- Check Provider Networks: If you have a Medicare Advantage plan, verify if your doctors and hospitals in both states are covered.
- Consider Telehealth Services: Medicare covers many telehealth visits, which can help you access care while traveling.
- Carry Your Medicare Card: Always have your Medicare and insurance cards handy when traveling.
- Review Your Coverage Annually: Plan networks and benefits can change, so reassess your needs every year during the Medicare Open Enrollment Period.
Emergency Coverage and Special Exceptions
- Emergency Care: Medicare Advantage plans must cover emergency care anywhere in the U.S.
- Temporary Address Changes: Some insurance carriers allow you to update your address temporarily, ensuring continued coverage.
- Out-of-Network Rules: Some plans have nationwide networks or offer out-of-network benefits at higher costs.
Conclusion
For snowbirds, understanding how Medicare works across state lines is crucial to avoiding gaps in coverage and unexpected medical expenses. Whether you choose Original Medicare with a Medigap plan or a Medicare Advantage plan with broader network coverage, proper planning ensures you receive the healthcare you need while enjoying your seasonal lifestyle.
If you’re unsure which Medicare plan best suits your lifestyle, consult with one of our Medicare advisors to explore your options and find a plan that keeps you covered wherever you go.
