If you’ve decided to move, then you need to add another element to the equation: your Medicare coverage. If you’re wondering whether or not you should make any changes to your existing coverage, then the answer mainly depends on the type of coverage you have.
You might not even need to do anything if your Medicare plan can be used in your new town or state. But things change if you are enrolled in a plan that won’t be useful in your new locale. That’s when you should consider taking some kind of action, and in this article, we’re going to discuss just that.
Original Medicare and moving
You are definitely lucky if you are enrolled in Original Medicare, whether it’s Part A or B. You won’t have to make any type of changes to your coverage if you’re relocating, be it to another address in your state or even to another state.
Original Medicare is basically an insurance policy that can be used all over the country. Medicare Advantage plans are definitely more akin to an HMO, and participants are limited to their own doctors and facilities.
Original types of plans doesn’t have the limited provider networks that other Medicare Advantage plans do. You can easily use any hospital or doctor anywhere in the country, as long as they take Medicare assignments.
As soon as a doctor accepts your assignment, this also means he or she won’t even charge you more than the approved amount for a healthcare service, even if you will still be responsible for any additional copayments or deductibles that might apply. You can even use a special tool to find and compare providers close to your new location.
Guaranteed-issue rights and Medigap plans
In the wide majority of cases, you won’t be able to switch your Medigap policy outside your 6-month Medigap Open Enrollment Period, unless we’re talking about specific situations when you also have a guaranteed issue right.
Guaranteed-issue rights are generally granted if you move outside your Medigap plan’s service area. This is very important considering your guaranteed-issue rights are special protections you might have in some situations to buy Medigap insurance, like moving out of a service area.
In such cases, Medigap insurance companies won’t be able to deny your coverage, and most of them won’t charge you higher premiums because of other pre-existing conditions.
Medicare supplement insurance (Medigap) and moving
A Medigap policy, also known as Medicare supplement insurance, is a private health insurance that supplements Original Medicare. This also means it helps pay for a series of “gaps” that Original Medicare doesn’t technically cover, like copayments, coinsurance, and even deductibles. Medigap policies will only help pay if you are enrolled in Original Medicare.
You won’t require a Medigap policy if you are on a Medicare Advantage health plan. However, you might be able to purchase a Medigap plan with guaranteed-issue rights if you were enrolled in a Medicare Advantage plan and decide to move out of your Medicare Advantage plan’s service area.
However, you must first switch back to the Original one. After you return to it, you can enroll with guaranteed-issue rights in a series of Medigap insurance plans offered by any insurance company in your state.
If you decide to switch to a different Medigap plan offered in your new location, there’s another thing you need to keep in mind. If you don’t have guaranteed-issue rights, you will probably have to pay a much higher premium for that specific coverage. Otherwise, you might be rejected, especially if you have other pre-existing health issues.
Medicare Select Plans and Moving
If you’re relocating to a new state or within the same state, but it’s an area outside of your Medicare Select plan, you also have a guaranteed-issue right to buy a different Medigap plan. What do you need to know?
You need to apply for a new Medigap policy either 60 days before or no more than 63 days after your Medicare Select coverage ends. There are two options for coverage:
- You can buy a standardized Medigap policy from your current insurance company, just as long as it offers pretty much the same benefits. Also, if you’ve had your Medicare Select policy for over 6 months, you won’t have to answer any medical questions.
- You can also switch Medigap policies to Plan A, B, C, D, F, G, K, or even L, as long as they’re sold by an insurance company in your state or the state you’re relocating to.
Sidenote: Plans C and F aren’t available if you turn 65 after January 1, 2020, and also to certain people under 65. However, you could get these plans if you were eligible for Medicare before January 1, 2020, but you haven’t enrolled yet.
The Advantage plan or Part D (prescription drug plan) and moving
If you are enrolled in a Medicare Advantage plan or Medicare Part D (which is a prescription drug plan) and you are relocating to an area outside your plan’s service area, you might have to enroll in another plan that is within reach in the new location.
This applies whether you move to a new address in your state or even to a new state. In some instances, the insurance company could even offer the same plan in your new service area, and you might have the option to enroll in the same plan if they are open to accepting new members.
Using the Medicare Special Enrollment Period (SEP)
You can use the special enrollment period to make the needed changes to your coverage as long as you are moving out of your Medicare Advantage plan’s service area or you are moving to a brand new location that’s still in your Medicare plan’s service area, but there are also other plan options available.
You can also use your Special Election Period (SEP) to switch to a completely different Medicare Advantage plan or Part D coverage. You need to contact your Medicare Advantage plan to disenroll.
If you notify your Advantage plan right before you move, your SEP will start the month before moving and will continue for two more months after you relocate. Also, if you announce your Advantage plan that you relocated only after, then your SEP will start the month you announce your plan and will continue for another two months.
Switching back to the Original Plan
You can easily choose to return to your original plan if you have a Medicare Advantage plan and there aren’t other Advantage plans available in the new area you’re relocating to. It also applies if you don’t want to enroll in one. Then, you can sign up for a Part D prescription drug plan, and you will be able to buy a Medigap insurance policy.
Notifying the Social Security Administration (SSA) about your relocation
If you are moving, you might want to contact Social Security and update the mailing address that Medicare has on file for you. As a general rule, SSA keeps your records, so you don’t want to miss any important notifications. If you don’t know how to notify the SSA, you can either do it by updating your information online, by phone, or even in person.
If you found this article useful, then you’ll be happy to know we have many others in store, such as: 10 Reasons Why California Is so Expensive
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