People typically choose a Medicare Advantage plan that gives them access to doctors close to home. But what happens when that home moves to another state—or even another country?
In this week’s reader question, Phil Moeller, the author of Get What’s Yours for Medicare: Maximize Your Coverage, Minimize Your Costs and co-author of the updated edition of How to Get What’s Yours: The Revised Secrets to Maxing Out Your Social Security, explains how to make sure you’re still covered.
Got a question of your own about Medicare or Social Security? Send it to email@example.com.
Will my Medicare policy provide coverage in another state?
Judy, Florida: Michigan is our primary residence, but we spend winters in Florida. Last winter I had shingles, and also needed treatment for ongoing psoriasis. We have a Medicare Advantage policy, but there were no participating physicians in Florida to cover either of these situations. Can basic Medicare help, since it’s a national plan?
Phil Moeller: Original Medicare, which includes Part A for hospital services and Part B for doctors, outpatient services and medical equipment, will cover you anywhere in the U.S., and you are free to use any doctors or health providers who participate in Medicare (and nearly all do).
Medicare Advantage plans, on the other hand, cover you for services in their local network but not for health care needed when you travel outside it. If you are going to be in Florida regularly or elsewhere outside Michigan, your best bet is to see if there’s a Medicare Advantage plan in your ZIP that offers out-of-network coverage that works for you. If not, Original Medicare is your best bet.
If you wind up getting Original Medicare, you also should consider getting a supplement plan to cover Medicare copayments and other things that Original Medicare does not cover.
How can an expat get Medicare prescription drug coverage?
David, California: My plan when I retired was to live in the Philippines, and to return to the United States periodically for any needed medical care. My Medicare Part D insurer is threatening to cut me off because I don’t really live in the United States. What are expatriates like me supposed to do?
P.M: Realistically, you will need to develop your own network of health care providers in the Philippines and shoulder those costs. You can keep Medicare Part A and Medicare Part B while you live outside the United States, so long as you continue to pay your monthly Part B premium. So, you could come back here for treatment and have most hospital and doctor expenses covered.
However, drugs are trickier. To qualify for either a Part D drug plan or a Medicare Advantage plan (which can include drug coverage), you must live in that plan’s service area. There is one potential workaround, however, if you can plan for your prescription drug needs in advance.
Every time you come back from the Philippines, call your Part D plan about a month in advance and say that you are moving back to the United States. You will qualify for a special re-enrollment period (SEP) for a Part D plan, because you are moving back into its service area.
Are there any options to supplement Medicare for those who live “on the road”?
Susan, South Dakota: My husband and I are both on Medicare with a Medicare Advantage plan. However, this spring we are embarking on a two-year, full-time RV retirement holiday with no fixed base. Our domicile for legal, voting and tax purposes will be either South Dakota or Texas. Are there any Medicare Advantage plans or options to supplement Medicare for those of us who live “on the road”?
P.M: Geez, I wonder if Jack Kerouac ever worried about health insurance? It doesn’t really go with his image, does it? In any event, even Kerouac might want to vent about the cost of health care today.
Your first step should be to call your and/or your husbands’ Medicare Advantage insurer. Find out whether they provide any coverage outside your current service area, and whether they will send prescription medications to you while you’re on the road.
If you can live with your plan’s options, fine. This also might require periodic swings to your plan’s home territory for care not covered by your plan when you’re away.
If this doesn’t work for you, a common approach here is to switch to Original Medicare and get a stand-alone Part D drug plan and also perhaps a Medigap plan to plug coverage holes in basic Medicare. These policies are good anywhere in the country.
Before dropping your current plan, make sure you qualify for a special enrollment period that will permit you to change coverage right away. Otherwise, you would have to wait until the next open enrollment period, and your switch wouldn’t be effective until next Jan. 1.
These questions previously appeared on the PBS NewsHour Making Sen$e website.