When it comes to moving, many people create a checklist to stay organized in the process. As a Medicare beneficiary, one thing you will need to add to your checklist is “Updating Medicare”.
This is not as simple as it may seem as not all parts of Medicare are transferable between states. For example, Medicare Advantage (Part C) and Medicare Part D drug plans are offered based on the residential area in which you live.
When you move out of that area, you need to notify your Medicare Plan providers. It’s important to notify the right parties within the allotted timeframe so you don’t accidentally end up with a lapse in coverage.
If you enrolled in a Medicare supplement, your policy may also change in price depending on where you move to.
Timeline for Notifying Your Medicare Plan Providers
Whenever you have Medicare and you move to another state, you have a Special Election Period that you can use to change your Part D drug plan and/or your Medicare Advantage plan (if you are enrolled in one).
If you notify your Medicare Plan provider of the change before you actually move, your opportunity to switch will begin one month prior to your move date and will continue for two months after the month of which you move. See Figure A.
Figure A: Before You Move
If you wait until after you move to notify your plan, your chance to switch will begin the month you informed your plan provider and will continue for two additional months. Note that this gives you only three months to move your Medicare plan to the new state. See Figure B.
Figure B: After You Move
When You Have Original Medicare with a Medigap Plan
Nearly 70% of Medicare beneficiaries are NOT enrolled in a Medicare Advantage plan. Instead, they have Original Medicare consisting of Part A and Part B coverage.
Original Medicare is a federal benefit. Your benefits under Parts A and B do not change when you move from one state to another with Medicare. You can also take your Medicare supplement (Medigap plan) with you to another state.
Your zip code determines the price of your monthly Medigap premium. Medigap plan prices do vary from state to state. Healthcare in some areas is more expensive than in other areas. That said, there is a chance your plan’s price will increase or decrease when you move.
If the price increase is more than you can afford, contact your Medicare insurance broker to shop your plan. There may be another carrier in your new zip code with a more affordable premium for you.
Be aware that when you apply to change plans, you will most likely need to go through medical underwriting. This means answering health questions so the carrier can decide whether to accept or decline you based upon your answers to those questions.
If you choose to apply for a new plan, know that there are a few states that have unique Medigap plans and rules that aren’t like other states. Moving Medicare from one state to another in Wisconsin, Massachusetts or Minnesota means that the structure of your benefits may also change.
When You Have a Standalone Prescription Drug Plan (PDP)
Most people with Original Medicare and a Medigap plan also have a standalone Part D drug plan. When moving to another state, getting a new drug plan is inevitable because drug plans are state specific. Even if you choose the same insurance company for your drug plan in your new state, your plan number will be different, so you have to apply for the new plan.
If you decide that you don’t want to get a new PDP when you move, just be aware that there will likely be a late penalty when you do re-enroll in a drug plan.
When You Have a Medicare Advantage Plan
Unlike Medigap plans, Medicare Advantage Plans do have networks that operates in select counties where you live, so if you move from one state to another, you will almost always need to change your plan.
When you move, you can choose to return to Original Medicare and apply for a Medigap policy. Another option would be looking for another Medicare Advantage plan that operates where you are moving.
There are two main plan types of Part C Medicare Advantage Plans. They are called HMO and PPO plans. HMO plans are usually quite restricting to the local area when it comes to which providers they allow you to use. You may have to choose a specific Primary Care Provider (PCP). You will need to stay within the plan’s network for all of your care except in medical emergencies.
PPO type plans usually have larger networks and unlike HMO plans, you usually don’t have to select a PCP. With a PPO plan, you can see a provider outside of the network if the provider is willing to see you and to bill the plan. It is almost always cheaper to stay within the network though.
Medicare Advantage Plans pay instead of your Original Medicare. This means your providers must bill the Medicare Advantage plan instead of Original Medicare.
Let Us Handle your Medicare Move to Another State
Let our team take a little bit of the stress out of your move.
When you are a client of Boomer Benefits, we help you with this crazy process at no charge. Odds are you have multiple plans that you will need to change when moving to another state.
Our Client Service Team is excellent at reviewing rates and exploring options within your new state. We can get your plans updated in a timely manner, leaving you with no worries about changes in coverage.
We have team members who are licensed and appointed in every state with knowledge of each of their specific rules. They will be able to inform you on how Medicare works within your new state. You can compare basic options by state at our website as well.