During Medicare open enrollment, starting October 15th and ending December 7th, you might face a significant dilemma if a move is on your horizon. How does relocating to a different city or state impact the health coverage you select, and should those future moving plans influence your current enrollment decisions?
While there is no one-size-fits-all answer, understanding your options is essential. An insightful piece from Kiplinger, originally published a few years ago and recently updated, addresses this exact question. Reporter Donna LeValley explores how relocating impacts your options, highlighting that your plan’s specific geographic service area determines whether you must adjust your coverage.
Depending on your situation, relocating might expand or restrict your choices. Note that this guidance applies to domestic relocations within the United States. Overseas moves require entirely different coverage strategies, a subject we discuss in a companion article on our blog.
LeValley provides detailed guidance in her report, and while we highlight the fundamentals here, we strongly encourage you to research thoroughly before selecting a plan. It is a choice with far-reaching consequences for your healthcare and finances.
Why Your Current Medicare Plan May Not Travel to Your New Home
“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 certain beneficiaries, relocating requires minimal effort. “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 geographic restriction applies heavily to Medicare Advantage plans, as we explore below.
Enrollees on Original Medicare Experience the Highest Level of Portability
According to LeValley, individuals with Original Medicare (Part A and Part B) experience the smooth transitions during 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 policies, Original Medicare operates without restricted 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.”
To evaluate healthcare providers in your target location, review this official Medicare provider lookup tool to compare participating doctors and hospitals.
Medigap Supplement Plans and Guaranteed-Issue Rights After a Move
Generally, Medicare enrollees receive a six-month initial window upon becoming eligible to select a Medigap plan without facing medical underwriting. However, as the official Medicare situation guide on guaranteed-issue rights demonstrates, specific life events grant a secondary window, and a qualifying relocation often fits those criteria.
If you carry a Medigap policy and relocate beyond your plan’s established boundaries, you gain the right to purchase a new policy. “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.”
Leveraging Guaranteed-Issue Rights to Switch Healthcare Coverage
The benefits of relocating extend beyond maintaining basic supplement coverage. “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 rule offers an ideal opportunity if you wish to transition away from a Medicare Advantage network to a Medigap policy.
You can use this Medicare coverage selection guide to analyze available plans. Keep in mind that transitioning to Medigap requires enrolling in a standalone Part D prescription drug plan.
How Relocating Triggers Specific Medigap Guaranteed-Issue Rules
To test how this process works, we tested the Medicare search tool. After entering an age over 65 and selecting Medicare Advantage, we specified an upcoming move outside our plan’s coverage area.
The system returned clear guidance. “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 informed us.
However, strict timeline rules apply to this transition. “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,” the platform stated. “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.”
LeValley emphasizes the importance of these rights, noting 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.”
Relocating Usually Requires Changing Medicare Advantage or Part D Plans
Beneficiaries using Medicare Advantage or standalone Part D prescription coverage almost always must select a new plan upon moving. These managed care options operate within localized regional networks covering specific hospitals, doctors, and 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 Qualifies You for a Medicare Special Enrollment Period
The Kiplinger report details how relocating grants a Special Enrollment Period (SEP). You can use this Medicare Special Enrollment Period guide to adjust your coverage when moving outside your plan’s service area, or when moving to an area where new options exist.
“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.”
Remember to Update Your Address with the Social Security Administration
LeValley highlights one crucial administrative task: ensuring government agencies have your updated address.
“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.”
Kiplinger outlines the three methods to complete this update:
Online updates are fast and simple. Use the Social Security website at ssa.gov to update your details online. If you already maintain a My Social Security online account, log in directly to update your primary address.
By phone, contact Social Security directly at 1-800-772-1213 (TTY users can dial 1-800-325-0778), available Monday through Friday from 8:00 AM to 7:00 PM across all time zones.
In person, you can visit your local Social Security office location to update your record directly with a representative.
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