Moving to another state involves completing numerous tasks, including updating health insurance coverage. For people enrolled in Medicare, the list of required actions may vary depending on specific Medicare options.
This article explains what a person may need to do to allow their health insurance to continue when they move to a new area.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare is federally funded health insurance for adults over the age of 65 years and some younger people with certain disabilities or conditions.
Medicare’s different parts cover various aspects of healthcare needs.
Medicare Part A covers hospital costs, including:
- semi-private room
- nursing care
- diagnostic tests and procedures as an inpatient
- skilled nursing home care (on a short-term basis)
- hospice care
Medicare Part B covers healthcare costs associated with preventive and outpatient services, including:
- doctor’s office visits
- durable medical equipment
- ambulance transport (for emergency care)
- some cancer screening tests
Together, Medicare Part A and Part B are known as original Medicare.
Medicare Part C, also known as Medicare Advantage, is an optional alternative to original Medicare. Private insurance companies administer Advantage plans, for which the federal government has implemented guidelines.
These include the requirement that all Advantage plans provide at least the same basic coverage as original Medicare.
These plans may also offer coverage for prescription drugs and dental, vision, and hearing care.
Private insurance companies also administer Medicare Part D plans, which provide coverage for prescription drugs.
A person must be enrolled in Medicare to get a Part D plan. Those who are not can look for an Advantage plan that includes prescription drug coverage if they need this benefit.
When it comes to Medicare, moving to another state may involve various actions, ranging from providing notification of the address change to looking for a new Medicare plan. The exact procedures depend on the Medicare parts in which a person has enrolled.
For example, in some cases, certain parts of Medicare are transferable between states and across the country. However, other parts of Medicare may be county- or state-specific and based on where a person currently lives. These parts may not be transferrable to a new location.
Moving to a new state may involve amending Medicare account details, such as changing the address, or a person may have to research and enroll in a new plan, such as Medicare Advantage.
Each part of Medicare has different rules. We have detailed these below.
Original Medicare consists of Part A and Part B. A person enrolled in original Medicare does not need to change plans when they move, as coverage will continue in their new location.
However, when a person moves to another state, they will need to contact the Social Security Administration (SSA) with details of their new address, which they can do in several ways:
- accessing the SSA website
- calling the SSA at 800-772-1213
- going to a local SSA office in the new location
People enrolled in a Medicare Advantage plan may need to select a new plan. Unlike original Medicare, many Advantage plan networks operate in specific counties, rather than nationwide. Some Advantage plans, such as Health Maintenance Organization (HMO) plans, limit a person’s access to the plan’s local network providers except in a medical emergency.
If a person is enrolled in a Medicare Advantage plan that does not operate in their new location, they can either look for a different Advantage plan in their new area or return to original Medicare. When moving to a new location, a person is eligible for the special enrollment period (SEP), during which they may select their new plan.
A person can find out which plans are available in their area by using this online tool or calling 800-MEDICARE (800-633-4227).
Medicare Part D plans are state specific. If a person is enrolled in a standalone Medicare Part D plan rather than getting prescription drug coverage through an Advantage plan, they may need a new Part D plan when they move to a different state.
Nationwide insurance companies offer Part D insurance, so a person can choose to stay with the same insurance company, but they must apply for a new plan. A person can use this online tool to find Part D plans.
A person enrolled in a Part D plan who moves to a new location is eligible for the SEP, during which they may select their new plan.
Medigap plans provide supplemental coverage to pay for healthcare costs that original Medicare does not cover, such as copays and deductibles.
The federal government standardizes Medigap plans, which means that they each provide the same coverage regardless of where a person lives and which provider they choose.
Therefore, if a person enrolled in a Medigap plan moves to a new location, they can keep their plan. However, the cost of Medigap plans varies depending on where a person lives, so it may increase or decrease as a result of the move.
A person can contact their State Health Insurance Assistance Program to get more information.
When a person enrolled in Medicare moves to another state, they must notify Medicare of their move.
In some cases, such as with original Medicare (Part A and Part B), coverage may continue without a person needing to change plans. Medigap plans are generally available nationwide, although the costs may increase or decrease depending on the location.
In other cases, such as with Medicare Advantage plans and Part D plans, a person may need to select a new plan. Moving to a new state qualifies an individual for the special enrollment period, during which they may select their new plan.