During these final weeks of Medicare open enrollment, which ends December 7th, you might be facing a bit of a conundrum if you’re planning to move in 2025. How would a relocation to a completely different city or state affect the coverage you select, and should that factor into the choice you make?
While there’s no one-size-fits-all answer, it’s an important query, according to this recent article from Kiplinger. Reporter Donna LeValley explores the question of how relocation might affect your Medicare choices. As she explains, your Medicare plan’s coverage area will determine if you need to make changes after a move. Depending on your specific circumstances, you may end up with more choices – or fewer – in your new home. (Remember, we’re talking about a domestic move within the U.S. Moving overseas will almost certainly require different coverage.)
LeValley provides a fair amount of detailed information in her article, and while we’re covering the basics, we encourage you to do your own research before you settle on a medical plan. It’s a decision with far-reaching consequences.
Your Medicare Plan May Not Travel Well
“If you’re moving, you may be wondering if you need to make changes to your Medicare coverage,” LeValley begins. “The answer depends on the type of coverage you have.”
For some, no action is required. “You may not need to do anything at all if your Medicare plan can be used in your new town or state,” the article continues. “However, if you are enrolled in a Medicare plan that isn’t offered in your new locale, you will need to take action.”
This is particularly true with Medicare Advantage plans, as we’ll see.
Those on Original Medicare Have the Greatest Portability
According to LeValley, those enrolled in Original Medicare (Part A and Part B) will see the least impact from a move. “You don’t need to make changes to your coverage if you’re moving, either to a new address in your state or out of state,” she writes. “Original Medicare is an insurance policy that can be used countrywide.”
Unlike Medicare Advantage plans, Original Medicare doesn’t have limited provider networks. “You can use any hospital or doctor throughout the country that takes Medicare assignment,” the article explains. “[Medicare assignment] means he or she won’t charge you more than the Medicare-approved amount for a health care service, although you’ll still be responsible for any copayments or deductibles that apply.”
The article includes a link to this Medicare tool that helps you find and compare providers in your new locale.
Medigap Plans Can Be Affected by “Guaranteed-Issue Rights”
Generally speaking, Medicare enrollees have a 6-month period when they are first eligible for coverage, during which time they can select a Medigap plan without medical underwriting. But as the Medicare website explains, specific situations can give you another shot at Medigap enrollment with a guaranteed-issue right, and a qualifying move can be one of them.
If you already have a Medigap plan and are moving out if your plan’s service area, you will have the right to purchase a new plan when you move. “In these situations,” says LeValley, “Medigap insurance companies can’t deny you coverage and most can’t charge you higher premiums because of pre-existing conditions.”
But the benefits of a move don’t stop there. “You can purchase a Medigap plan with guaranteed-issue rights if you were enrolled in a Medicare Advantage plan and are moving out of your Medicare Advantage plan’s service area,” the article continues. This is an excellent chance for do-over if you’ve been wanting to leave an MA plan and buy Medigap instead.
This Medicare link can help you explore your options. Remember, if you switch to a Medigap plan, you’ll also need to choose Part D drug coverage.
Here’s How a Move Might Affect Guaranteed Issue Rights
As a test, we tried the Medicare tool. It asked if we are over 65 and what kind of insurance we have. We clicked on Medicare Advantage, and we indicated that we were moving away from our plan’s coverage area.
The tool’s response was clear. “You can buy Medigap Plan A, B, C, D, F, G, K, or L that’s sold by an insurance company in your state, if you switch to Original Medicare,” it told us.
There are a few restrictions. “You must apply for a Medigap policy 60 days before the date your Medicare Advantage Plan coverage ends [and] no more than 63 days after your Medicare Advantage Plan coverage ends,” we were told. “You only have this right if you switch to Original Medicare (rather than joining another Medicare Advantage Plan). Medigap coverage can’t start until your Medicare Advantage Plan coverage ends.”
Remember, said LeValley, that “if you don’t have guaranteed-issue rights, you will probably have to pay a higher premium for [Medigap] coverage or [you] could be rejected if you have pre-existing health problems.”
Moving Will Probably Mean a Change of MA or Part D Plans
Those covered under the most popular category of Medicare plans, Medicare Advantage, as well as those with separate Part D drug coverage, will almost certainly have to choose a new plan if they relocate. That’s because these plans are often more geographically-centered and are accepted at a limited number of medical facilities or pharmacies.
“If you’re enrolled in a Medicare Advantage plan or Medicare Part D (prescription drug plan) and are moving outside your plan’s service area, you will need to enroll in a plan that is within your new service area,” says LeValley. “This is true whether you move to a new address in your state or to a new state.”
She adds, “In some instances, the insurance company may offer the same plan in your new service area, and you may have the option to enroll in the same plan if they are accepting new members.”
Moving May Qualify You for a Special Enrollment Period
The Kiplinger article explains the idea of a Special Enrollment Period, or SEP. You can use what Medicare calls a Special Enrollment Period to make changes to your coverage if you are moving out of your Medicare Advantage plan’s service area, or if you are moving to a new location that’s still in your Medicare plan’s service area, but there are new plan options available in your new area
“You can use your Special Election Period (SEP) to switch to a different Medicare Advantage plan or Part D coverage,” LeValley states. “You must contact your Medicare Advantage plan to disenroll. If you notify your Advantage plan before you move, your SEP starts the month before you move and continues for two more months after you move. If you let your Advantage plan know after you’ve moved, your SEP starts the month you tell your plan and continues for another two months.”
If You Move, Tell the Folks at Social Security
LeValley reminds us of one final requirement: make sure the good folks at Social Security know where you are.
“If you’re moving, you should contact Social Security to update the mailing address that Medicare has on file for you,” she advises. “Medicare works with SSA to maintain your records and you don’t want to miss any important notifications.” Here’s how, says Kiplinger:
Online: Use the Social Security website, ssa.gov, to update your information online. If you have a My Social Security account, you can log into your account to update your address.
By Phone: Call Social Security at 1-800-772-1213 (TTY users, dial 1-800-325-0778), Monday through Friday, from 8am to 7pm in all time zones.
In person: Visit your local Social Security office to update your information in person.
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(originally reported at www.kiplinger.com)