Does Medicare Cover You in Multiple States? The Truth for Snowbirds

How Original Medicare Works Across States

Original Medicare (Part A and Part B) is a federal program, meaning it provides coverage anywhere in the U.S. as long as the healthcare provider accepts Medicare. This is great news for snowbirds because you don’t have to worry about your coverage changing when you travel between states.

• Medicare Part A (Hospital Insurance) covers inpatient hospital stays, skilled nursing facilities, and hospice care. Since hospitals nationwide accept Medicare, you can use this coverage anywhere in the country.
• Medicare Part B (Medical Insurance) covers doctor visits, outpatient care, and preventive services. As long as you visit a provider that accepts Medicare, you won’t run into any issues.

The key takeaway here is that if you have Original Medicare, you’re covered anywhere in the U.S., no matter where you receive care. However, some services, such as durable medical equipment (DME) and home health care, may have restrictions based on where you originally enrolled in Medicare.

Medicare Advantage Plans and State-Specific Coverage

Things get trickier when you have a Medicare Advantage plan (Part C). Medicare Advantage plans are offered by private insurance companies and typically have provider networks limited to a specific geographic area. This means:

• HMO Plans: If you have a Health Maintenance Organization (HMO) plan, you’re usually required to use in-network doctors and hospitals in your plan’s service area. If you go out of network, your care may not be covered except for emergencies.
• PPO Plans: Preferred Provider Organization (PPO) plans offer more flexibility, allowing you to see out-of-network providers. However, you’ll likely pay higher costs for care received outside your home state.
• Emergency Coverage: Medicare Advantage plans must cover emergency and urgent care anywhere in the U.S., regardless of the provider network. If you need immediate medical attention while traveling, your plan will cover it, but routine care could be a different story.

If you split your time between two states, it’s important to check whether your Medicare Advantage plan includes providers in both locations. Some plans have national networks, but many are state- or region-specific.

Medicare Supplement (Medigap) Plans: The Best Option for Snowbirds?

Medicare Supplement plans (Medigap) work alongside Original Medicare to help cover out-of-pocket costs like deductibles, copayments, and coinsurance. These plans are a great option for snowbirds because they provide coverage anywhere in the U.S. as long as the provider accepts Medicare.

• No Network Restrictions: Unlike Medicare Advantage, Medigap plans do not have provider networks. You can see any doctor or specialist who accepts Medicare, regardless of the state you’re in.
• Standardized Plans: Medigap plans are standardized across most states, so the benefits remain the same no matter where you live.

However, Medigap plans do not include prescription drug coverage, so you’ll need a separate Medicare Part D plan to cover your medications.

How Prescription Drug Coverage (Medicare Part D) Works in Multiple States

Medicare Part D plans (prescription drug coverage) are state- or region-specific, which means:

• If you live in multiple states throughout the year, you’ll need to ensure that your Part D plan covers pharmacies in both locations.
• Many national pharmacy chains, like CVS and Walgreens, are included in most Part D plans’ networks, making it easier for snowbirds to access medications in different states.
• If you change your permanent residence, you may need to switch to a new Part D plan available in your new state.

Before traveling, it’s always a good idea to check your plan’s pharmacy network to make sure you can access your medications wherever you are.

What About Medicaid and Dual Eligibility?

If you qualify for both Medicare and Medicaid, also known as being “dual eligible,” you may face additional challenges when moving between states. Medicaid is a state-run program, so benefits and provider networks vary by location. If you move permanently to another state, you’ll need to reapply for Medicaid in your new state of residence.

Some states offer Medicaid programs that work with Medicare Advantage Dual Special Needs Plans (D-SNPs), which may provide multi-state coverage. If you rely on Medicaid, check with your plan provider to see how coverage works across state lines.

Tips for Snowbirds to Maximize Medicare Coverage in Multiple States

1. Stick with Original Medicare and a Medigap Plan: If you travel frequently, Original Medicare combined with a Medigap plan offers the most flexibility. You can see any Medicare-approved provider nationwide without network restrictions.
2. Check Your Medicare Advantage Plan’s Network: If you have a Medicare Advantage plan, make sure your plan covers providers in both of your home states. Some PPO plans offer better flexibility than HMOs.
3. Ensure Your Part D Plan Covers Pharmacies in Both States: If you rely on Medicare Part D for prescription drug coverage, check if your preferred pharmacies are in-network in both states.
4. Know Your Emergency Coverage: No matter which Medicare plan you have, emergency care is always covered anywhere in the U.S. However, routine care may not be, especially with Medicare Advantage plans.
5. Consider Changing Plans If Needed: If your current plan doesn’t work well for your snowbird lifestyle, you may want to switch during Medicare’s Annual Enrollment Period (October 15 – December 7) or a Special Enrollment Period if you permanently change your residence.

Final Thoughts: Choosing the Right Medicare Coverage for a Multi-State Lifestyle

Snowbirds and frequent travelers need a Medicare plan that provides flexibility across state lines. Original Medicare with a Medigap plan is often the best option for multi-state coverage, as it allows you to see any provider that accepts Medicare. However, if you prefer a Medicare Advantage plan, make sure you choose one with a broad provider network that fits your travel needs.

If you’re unsure about your current coverage or need help selecting the best plan for your lifestyle, give us a call at 800-208-4974. Our team of Medicare experts is here to answer your questions and help you find the best plan for your unique situation—at no cost to you!