The term “snowbird” often refers to retirees who temporarily migrate from the cold winter months of their long-time home to a second residence in the warmer, southern region of the United States. If you’re a Medicare beneficiary with homes in different states, you understandably want to know if your health insurance covers you in both locations. While you can only enroll in Medicare in one state – your principal residence where you hold a driver’s license, file taxes, and vote, etc. – you may still have access to Medicare coverage in both states depending on the following factors.
Original Medicare & Medicare Supplement Plans
Regardless of where you are within the United States, Original Medicare (Part A and Part B) and/or Medicare Supplement Plans (Medigap) will provide all of your Medicare benefits, as long as you visit a doctor or hospital that accepts assignment. For more comprehensive coverage nationwide, consider pairing one of the 10 standard Medigap plans (A, B, C, D, F, G, K, L, M, and N) with your Original Medicare coverage. Additionally, some Medigap plans may offer coverage for health care services or supplies when traveling outside of the country.
Because Medicare Advantage plans (Part C) are offered by private health insurance companies, individual plans will have different networks and benefits in different states. Therefore, check with your current provider that your coverage extends to any medical needs you may have while living in your second home.
If you have a PPO (Preferred Provider Organization) and receive care in any state from a doctor, health care provider, facility, or supplier that belongs to the plan’s network, your services and costs are typically covered. Some PPO plans may pay part of the costs when going out-of-network; however, your out-of-pocket costs will depend on your plan’s individual rules for in-network and out-of-network services.
If you have an HMO (Health Maintenance Organizations), your services and costs are also typically covered when you receive care from a doctor, health care provider, facility, or supplier that is in your plan’s network. However, HMOs have a smaller network than PPO plans and do not include out-of-network benefits, which means it is common to end up paying more with an HMO. Therefore, it may be less costly overall for you to switch to a PPO plan that would allow you to go out-of-network for a slightly higher cost. If you have an HMO plan, understand that you may be responsible for all expenses incurred when you visit a doctor outside the plan’s network. As a precaution, you might consider buying a PPO or an HMO plan that offers emergency out-of-network coverage.
Prescription Drug Plans (PDPs) can be purchased as stand-alone Part D plans along with Original Medicare. Prescription drug coverage can also be available as part of a Medicare Advantage plan (MA-PD). All plans vary in their costs, covered medications, and in-network, preferred, and mail-order pharmacy services. For example, some PDPs offer a regional pharmacy network while others offer a national pharmacy network. As a precaution, you might consider a PDP with a national network.
Looking for Medicare coverage? We offer free comparisons for Medicare Advantage plans (Part C), Medicare Supplement (Medigap), and Medicare Prescription Drug Plans (PDP). Find out more detailed plan information at Medicare.org, or contact a licensed sales agent at (888) 815-3313 – TTY 711 to help you find the right Medicare coverage for your needs.