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Enrolling in Medicare When You're a Snowbird

Q. We live five months of the year in Maine and seven months of the year in Florida. Can we sign up for Medicare in both places? If not, how do we receive our benefits?

A. You can enroll in Medicare only in one place. Social Security requires this place to be your principal residence, which it defines as the address you use for filing taxes, voter registration, driver’s license and so on. However, this does not prevent you from receiving Medicare benefits somewhere else.

If you’re a snowbird or sunbird who migrates to another part of the country for several months of the year, here are some tips for ensuring that you get the medical services you need under Medicare, in whatever state you happen to be in at the time:

  • Choose the traditional Medicare program to receive your benefits. Under this program you can use your Medicare card to obtain Medicare-covered treatment at any provider (doctor, specialist, hospital, lab, etc.) that accepts Medicare patients, anywhere in the country.
  • Beware of enrolling in a Medicare HMO or PPO. These private plans—part of the Medicare Advantage program that provides an alternative to traditional Medicare—operate within specific regions and localities, sometimes no larger than a county or ZIP code and have their own regulations.
  • HMOs typically require you to go to doctors and hospitals within their networks and will not cover your bills outside of their service areas except in emergencies. (A few insurers, however, offer six-month “guest memberships” at other HMOs for snowbirds.)
  • PPOs allow you to see out-of-network providers, but usually for much higher copays, except in emergencies. So your costs for any regular services while at your second home could be significantly more.
  • If you buy Medigap supplemental insurance to cover some of your out-of-pocket costs under traditional Medicare, it’s good anywhere, as long as the treatment in question is from a Medicare provider for a service that Medicare covers. However, avoid policies known as “Medigap SELECT.” They often cost less, but provide coverage only if you go to certain providers within their networks—again, except in emergencies.
  • If you enroll in traditional Medicare, you also will need to enroll in a private prescription drug plan to receive Medicare’s Part D drug coverage. Under the regulations, you must enroll in a plan offered in the state where you have your principal residence. You can’t be enrolled in two plans at the same time. Part D plans do not cover medications bought at pharmacies outside their networks, and their mail-order services don’t cover more than a 90-day supply at a time. So be sure to pick a plan that allows you to fill prescriptions at its network pharmacies anywhere in the country. Many plans do, but some don’t.
  • While at your second home, make sure your mail is being forwarded there from your principal residence, because you may receive letters you need to pay attention to. For example:
  • If your Part D plan tries to contact you and receives no response within six months, under Medicare regulations it can drop you.
  • Part D drug plans can change their costs and benefits every year and usually do. In September or October they send out an important mailing called the “Annual Notice of Change.” It gives details of any changes in coverage that will go into effect in January—including the cost of premiums and copays and even the drugs the plan covers. Reading this notice gives you the opportunity to review next year’s coverage under this plan, compare it to other plans and, if you so choose, switch to another during open enrollment (Nov. 15 through Dec. 31).

Patricia Barry is a senior editor at the AARP Bulletin.

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