We’ve all heard retirement called “the golden years.” It’s the time of your life when you reap the benefits of your hard work, kick back and relax.
Once you’re eligible for Medicare, you may have bought — or will be thinking about buying — a Medicare Advantage Plan, also known as Medicare Part C coverage. In most cases, you can only buy or change that plan during your Initial Enrollment Period (when you reach age 65), or during Medicare’s Annual Enrollment Period (Oct. 15 – Dec. 7) each year.
But you may also have a situation that triggers a Special Enrollment Period, giving you the opportunity to make changes to your current Medicare Advantage Plan at other times during the year. Your Part D Prescription coverage, if you have it, could also be affected. If you’re covered only by Original Medicare (Part A and B) this doesn’t apply.
You can find a full list of events that open a Special Enrollment Period on Medicare.gov, but some of the more common examples include:
In this article, we’ll focus on the first bullet point: moving. Perhaps you’re changing where you live in pursuit of warmer weather, or to be closer to your children and grandchildren, or to downsize from your house to a lower-maintenance condo.
Different types of move may affect your Medicare coverage in different ways. In all cases you’ll have a limited amount of time to make changes to your plan, so let’s take a look at how some specific changes may affect your coverage and how long you have to modify your Medicare Advantage Plan or Medicare Part D coverage after you move.
But Medicare Advantage plans, since they’re offered by private insurance companies, are tied to particular regions. If you move outside of your current Medicare Advantage Plan’s service area, you’ll want to select a new Medicare Advantage Plan or prescription drug plan that provides coverage in your new location.
If you’re enrolled in a Medicare Advantage Plan and you move outside your plan’s service area, you can also choose to return to Original Medicare coverage rather than pick a new Medicare Advantage Plan.
If you’re moving outside of your plan’s service area, you will have a limited amount of time to make changes to your plan, and you may notify your insurance company before or after you move. Regardless of when you notify your insurance company that you’re moving, you will have at least two full months to select a new plan.
If you contact your insurer before you move, your chance to switch plans begins the month before the month you move and continues for two full months after you move. If you tell your plan after you move, your opportunity to switch plans begins the month you tell your insurance company, plus two more full months.
If you don’t enroll in a new Medicare Advantage Plan during the allocated timeframe, you’ll be enrolled in Original Medicare once you’re disenrolled from your old Medicare Advantage Plan.
If you decide to move somewhere that’s still in your current Medicare Advantage Plan’s service area, you may be able to switch if there are other insurance companies that offer Medicare Advantage and/or Medicare Part D plans in your new location. Likewise, if you move across a county line within your insurer’s service area, it may not offer the same plan or premium that you had previously; in that case, you would also become eligible for a Special Enrollment Period.
When moving to a new location where you are still covered by your current plan, you’ll have a limited amount of time to make changes to your plan. The same timeframe applies as if you were moving outside of your coverage area. (See previous section.)
If you’ve been living outside of the U.S., you may not be covered by your current health insurance when you return to the country. You will have the opportunity to enroll in a Medicare Advantage and/or Medicare Part D plan when you arrive in the U.S.
If repatriating to the U.S., you’ll have to wait until you return to the U.S. before enrolling in a Medicare Advantage Plan. Your chance to secure coverage lasts for two full months after the month you move back.
If you move into or out of a skilled nursing facility or long-term care hospital, you may be eligible to reevaluate your Medicare Advantage coverage. Reasons for being in such a facility for weeks, months or years include:
The length of your stay in a facility does not affect your ability to make changes to your Medicare Advantage Plan. Your chance to join, switch, or drop coverage lasts as long as you live in a skilled nursing facility or long-term care hospital, and for two full months after the month you move out of the institution.
If you are enrolled in Medicare when you are arrested, you will still be eligible for Original Medicare coverage while you are in jail. When incarcerated, however, you are no longer eligible for Medicare Advantage or Medicare Part D plans.
If you turn 65 while incarcerated, you should enroll in Medicare Part A and Part B when you become eligible. If you fail to enroll, you may have to wait until the Annual Enrollment Period after you are released.
If you have continued to pay your Medicare Part B premium while in jail, you will be eligible to enroll in a Medicare Advantage Plan or Part D Prescription Drug Plan without having to wait for the Annual Enrollment Period when you are released.
When you are released from a correctional facility, you will have two full months after the month you are released to enroll in a Medicare Advantage or Medicare Prescription Drug Plan.
If you’re looking for more information about how your move may affect your Medicare coverage — or have other questions about Medicare coverage — Highmark is here to help. A good place to start is these online resources to help you understand your Medicare plan options.
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