Moving to a new state can be an exciting chapter, especially if you’re approaching retirement age and seeking a change in scenery or lifestyle. But this transition often comes with its own set of challenges — new internet, gas, and electric providers, new local regulations to be aware of, scouting out a reputable car mechanic, or the best supermarkets, and even adjusting to a new community.
One important concern for seniors and Medicare recipients is how to handle their healthcare coverage when making a move like this.
If you’re planning to relocate to another state and need some guidance on transferring your Medicare policy, you’re in the right place. Understanding the process, state-specific regulations, and how Medicare policies can differ across states will help pave the way for a smooth continuation of your healthcare benefits.
Why you may need to transfer your Medicare policy
Original Medicare is a federal program, and the core benefits of Medicare Part A and Medicare Part B remain consistent regardless of which state you move to. However, the details of your coverage can sway significantly depending on your location. You might find that costs, coverage options, and provider availability can vary a bit from one state to another.
So, while Medicare Parts A and B will remain accessible in your new state, other components like Medicare Advantage (Part C), Prescription Drug Coverage (Part D), and Medigap policies might throw you some curveballs and may require some adjustments.
No need to worry — this guide will help you sort all that out so you can keep your healthcare services uninterrupted and avoid — or at least mitigate unexpected costs.
Preparing for your out-of-state move
Creating a moving to-do list is a common practice. It helps you remember to turn off the utilities, check the attic or basement crawlspaces for holiday decorations you may have stored there, and forward your mail. And if you’re a Medicare beneficiary, you should add “Update Medicare” to that checklist. That’s because the process of updating Medicare coverage isn’t always straightforward, as not all parts of Medicare transfer seamlessly between states.
For instance, Medicare Advantage (Part C) and Part D drug plans are tied to specific areas. When you move, you’ll want to inform your Medicare Plan providers to prevent coverage gaps. Timing is crucial here—make sure to notify them within the designated timeframes, detailed below.
Relocating with Original Medicare and Medigap
Approximately 70 percent of Medicare beneficiaries use Original Medicare (Parts A and B) rather than Medicare Advantage. Some also have a Medicare supplement plan — aka Medigap — that complements their Medicare benefits.
Original Medicare remains unchanged regardless of where you move, and you can carry your Medigap plan with you. However, Medigap premiums vary by state due to differences in local healthcare costs, so your premium might increase or decrease based on your new location.
If you find that your new premium is too high, contact us to explore more affordable options. Note that switching plans often require medical underwriting, where you’ll need to answer health questions before being accepted to a new Medigap plan.
It should be noted that more populated states typically have more plan options available than less populated states. Medigap plans are standardized, so policies with the same letter offer the same basic benefits no matter where you live or which insurance company you buy the policy from.
That said, several U.S. states have unique Medigap regulations, including:
- Minnesota, Wisconsin, and Massachusetts. These outliers have their own Medigap regulations and plan structures.
- Connecticut, Massachusetts, Maine, and New York. These states require guaranteed issue protections for Medigap for all Original Medicare beneficiaries ages 65 and older, regardless of medical history.
Moving with Medicare Advantage (Part C)
Medicare Advantage plans operate within specific geographies — usually dictated by ZIP Code — so relocating to a different state typically means you’ll need to make changes to your coverage. Specifically, if you have a Medicare Advantage plan, you’ll need to either:
- Select a new Medicare Advantage plan that serves your new area.
- Sign up for a new Part D plan if you choose to keep your Medicare Advantage plan.
- Switch back to Original Medicare and enroll in a Part D plan separately.
The Special Election Period for Medicare Advantage
When moving states, you’re entitled to a Special Election Period (SEP) for changing your Medicare Advantage plan. If you notify your provider before moving, your SEP starts one month before your move and lasts for two months afterward.
For example, if your move is set for March, your SEP would be from February 1st to May 31st — one month before, the month of your move, and two months after.
If you delay notification until after your move, your SEP will end two months after your move month. This timeframe also applies to changing Medicare Part D Prescription Drug plans.
Medigap’s “Guaranteed Issue” rights
If you are a Medicare Advantage beneficiary with Megigap on the side, and you move outside your current Medicare Advantage plan’s service area, it will trigger a “Guaranteed Issue” period for the Medigap plan. This will allow you to enroll in a Medigap policy without having to endure health history questions.
As mentioned earlier, relocating outside your Medicare Advantage plan’s service area grants you Guaranteed Issue rights for Medigap policies. This means you can obtain a Medigap policy without a health screening. You cannot be denied or charged higher premiums due to your health status.
You have guaranteed-issue rights to a Medigap policy in the following situations:
- Your Medicare Advantage plan ends: You can switch back to Original Medicare with Medigap, but you need to apply within 123 days of your plan ending.
- You move out of your Medicare Advantage plan’s service area: Apply for a Medigap policy within 63 days of your move.
- You’re in your first 12 months with a Medicare Advantage plan: You can switch to a Medigap policy during this time.
- You switch from a Medigap policy to Medicare Advantage and later disenroll: You have 12 months to return to Medigap with guaranteed-issue rights.
Moving with Medicare Part D
Most people with a combination of Original Medicare and a Medigap plan also have a Medicare Part D prescription drug plan. Since Part D is state-specific, you will have to enroll in a new plan when moving out of state. Even if you stick with the same insurer, your Medicare Part D prescription drug plan number will change, and you’ll be forced to reapply.
The good news is that Medicare tracks your Part D spending, so you’ll continue at the same stage you were at when you left the old plan. The bad news is that if you choose not to enroll in a new Part D plan when you move, you may face a “late enrollment penalty” if you decide to sign up for a drug plan later.
We’re here to help with your Medicare policy transition
As you gear up for your big move, don’t let Medicare coverage add to your stress. At The Baldwin Group, our Medicare experts are here to make sure your healthcare coverage is one less thing to worry about. With several plans likely needing updates when you move, we’ve got you covered.
With a bit of planning and understanding of the local Medicare rules, changing your Medicare policy can be a smooth process.
Contact us today through our online form or visit a Medicare office nearby to speak with a broker who can guide you through the process.
