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Does Medicare Provide Coverage Anywhere in the United States?

Increasingly Americans travel to other states to visit relatives, take vacations and take care of family. As people move between states it is important to keep track of Medicare coverage. For instance what happens if your home state is South Dakota and you take up residence in Florida to care for a family member? Do you need to get a Medigap plan in Florida or one in South Dakota? Would there be any out-of-network expenses involved here? These are some of the questions many people ask.

Original Medicare offers coverage anywhere in the United States provided medical professionals accept Medicare and nearly all do. When you have Original Medicare, you should also consider Medigap plans which offer additional coverage for copayments, deductibles and coinsurance. For anyone traveling inside the country it is important to note that once you have a plan, you may retain that plan regardless of your location in the United States.

If you decide to move out of your home state, you can keep your current Medigap policy as long as you have Original Medicare. If you want to switch to a new Medigap policy, however, you will have to check with both your current and new insurance company to see the Medigap policy options they offer. There are 10 standardized Medigap plans, this means that you may be able to reaming with your plan. Therefore, you may get a Medigap policy in South Dakota or in Florida.

What if you decide to switch to a Medigap issuer in Florida? You can certainly do that once you have established residence there, but it is not required that you do so. If you do make the decision to switch, you might be charged more in Florida because you do not have “guaranteed first rights.” “Guaranteed first rights” are rights that you have in certain situations when insurance companies are required to offer certain Medigap policies.

Your situation may look different if you are enrolled in a Medicare Advantage plan or in Medicare Part D when you decide to move out of state. If your current Advantage plan is not available in the area you are moving to, your plan is required by Medicare to disenroll you. If this happens outside of the special election period (SEP) you will be returned to Original Medicare. However, if you notify your plan provider before you move, you SEP will be changed. The SEP will begin one month before the move and last three months. If you forget to notify your provider about your move, you can still do so the month of the move. In such a situation, you will also receive a three month SEP, which begins the same month of the move.

Always check with an experienced insurance agent if you have any questions about how changes in your situation may affect your Medicare coverage.