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How Medicare and Dual Residency Works


Many individuals on Medicare participate in or are considered to have dual residency. Sometimes, known as “snowbirds.” If this sounds like you, and you’re a Medicare beneficiary, you might have questions. Luckily, we’re here with the information you need about how dual residency affects your coverage.

Can You Have Medicare and Dual Residency?

You can have Medicare while living in two states, but you’ll choose one location as your primary residence. There will be some Medicare plans that benefit you more than others when you have multiple homes.

Some retired people choose to reside in two different locations. An example is living in New York for half the year and staying in Florida for the colder half.

The last thing you want to worry about when enjoying the snowbird lifestyle is whether your health coverage is comprehensive. So, we’ll walk you through what you need to know about Medicare while living in more than one state.

What are the Medicare Dual Residency Requirements?

You must enroll in Medicare only in the state in which you primarily reside. Your primary residence is where you live most of the time. It’s where you hold your driver’s license, register to vote, and file taxes.

Yet, your coverage will work as long as you visit practitioners who accept Medicare assignment. Fortunately, this list includes almost all practitioners in the United States.

Do Medicare Advantage Plans Work for Snowbirds?

Advantage plans involve networks. If you go outside of your network, you’ll need to pay the full cost of services. As private insurance companies offer Advantage plans, it’s best to determine whether the specific plan you’re considering provides the coverage you need. Unlike Original Medicare or Medicare Supplements, Advantage plans don’t work everywhere.

Does Part D Cover Me Out of State?

Part D plans are available to buy separately with Medicare coverage. If you choose an Advantage plan, it might include Part D. Before enrolling, you’ll want to make sure that the plan you choose covers both of your areas of residence.

A good choice is a plan with a nationwide network, so your meds will have coverage no matter where you are in the United States.

Does Medigap Work With Dual Residency?

If you visit doctors accepting Medicare, Part A and Part B will cover a portion of the costs. Medigap plans are standardized by the federal government, meaning that each plan’s benefits are the same for all enrollees. The provider and the state that offers the plan don’t affect its benefits.

Unlike Advantage plans, it doesn’t matter which state your doctor or facility is in if they accept assignment, and you have a Medigap plan. For those traveling outside of the United States, a Medigap plan covering foreign travel emergencies is the best choice.

Can I Keep my Medicare Supplement if I Move to Another State?

Yes, you should be able to keep your Medigap plan if you move to another state. But, you might be paying more than you need. Suppose your principal residence changes from New York to Florida, and you’re still paying premiums for the plan you bought in New York.

To do so doesn’t make sense when Medigap plans in Florida cost less per month and provide the same coverage. When moving from one of the states with the most expensive Medigap premiums, make sure to update your coverage to save money.

FAQs

Does living in the U.S. and another country count as dual-residency for Medicare?
Living outside the U.S. part-time doesn’t count as a dual-residency for Medicare. You’ll need to determine if keeping your coverage or buying a Supplement is right for you. Make sure to obtain information about coverage in the other country where you reside.
Will Medicare pay for out of state care?
Yes, if you’re a Medicare beneficiary, your coverage travels with you. However, Advantage plans require patients to stay in their network. So, those with Advantage plans might need to pay more if they see a doctor out of the service area.
Does Medicare cost the same in every state?
Your Part A is premium-free if you’ve paid into enough quarters. The Part B premium is based on income. Yet, the price of Medigap plans varies. Your state of residence is one of the factors that influence your Medigap costs.

How to Get Medicare When Residing in Two States

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Lindsay Malzone

Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

11 thoughts on “How Medicare and Dual Residency Works

  1. My husband has cancer. We reside 7 months in Florida and 5 months in WI. He is so sick and requiring a stem cell transplant; ergo, we cannot leave WI. We may exceed the 6 month residency requirement if we cannot go back to Fl in time and our Aetna advantage plan will drop us. What then? Are there exceptions?

    1. Hi Diane. If you update your primary residence to WI, that would qualify you for a SEP to get you into a Medicare Advantage plan in WI.

  2. I have houses in 2 counties in North Carolina. The Advantage plans are different in each county. Can I choose the county and the Advantage plan that is where my doctor is even though my driver’s license has another county on it?

    1. Hi Bo! I believe it would have to match the address you have on file with Social Security. However, I would verify this with your Medicare agent. Also, your coverage will not leave the county when you go to your other home. It may be better for you to enroll in a Medigap plan so that your coverage travels with you as you go between both of your homes.

  3. Thanks for your article. My mom was recently diagnosed with Alzheimer’s and lives in Georgia but I’m taking her home with me to North Carolina for a while to look after her until she needs a skilled nursing facility. I don’t want to lose her doctors in Georgia, and they have prescribed home health for her, but I’m finding that agencies in NC can’t accept orders from doctors from another state even though Medicare would cover her. Any advice on how to get her home health while she’s with me in NC without having to change her GA doctors?

    1. Hi Melony. Unfortunately, there is no way around that. She will need to see a doctor in North Carolina to get prescribed home health in that state. However, she can still see her doctors in Georgia as well via Telehealth while she stays with you. She won’t lose her Georgia doctors because she sees another doctor in North Carolina.

  4. My mother is mentally ill and she qualifies for Medicare and Medicaid. Her home state is Florida but she spends a few months out of the year with me in New Mexico. I was curious if you know if she can have dual residency so she can go to the Dr if she needs mental care while she’s with me in NM. I have asked her social worker and there is not clear information on the subject.

    1. Hi Brittany! Your mother’s Medicare coverage will travel with her across state lines. However, her Medicaid coverage will not. Medicaid can only be used in the state where the recipient resides with the exception of emergencies or rare prearranged circumstances. This is because even though Medicaid is a federal program, it’s also a state partnership in which each state has its own set of rules.

  5. What if you have a MAPD – PPO in one town and that town is where you have your Homestead, but you are going to live with a family member in a different town in the same state because of health issues. You plan on retaining your home however, in the original town. Can you do a SEP and change plans to the family members town so that you can use their doctors.

    1. Hi Deb! As long as the plan you currently have is not available in your family members’ town, then yes you can use a SEP to switch plans. You will have to show proof of residency.

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