Love spending the winter months in warmer climates, but unsure how that affects health care coverage? Are you splitting the time between different accommodations and want to know if your health insurance will cover you in both places? Whether you’re snowbirding or just splitting the time between two states, we’re here to help.
Navigating Medicare coverage can be quite confusing without incorporating different locales. CoverRight makes it easier for you to determine which Medicare coverage is right for you. We’ve partnered with Medicare’s Free Concierge Service to help savvy snowbirds and two-state Medicare beneficiaries determine if they are covered, wherever they are. Here’s the scoop for Medicare beneficiaries 65 and over.
Register for health insurance
When you sign up for Medicare, you typically sign up using your primary residence address – the state that issues your driver’s license, where you vote, and where you file your taxes. The location of your primary residence will impact the availability of plans you can sign up for and potentially the price of your plan. Need help signing up for Medicare? CoverRight has you covered.
Original Medicare: Understanding the Mission
If you have original Medicare, Medicare Part A (hospital insurance) and Part B (medical insurance) provide Medicare benefits no matter where you are in the United States, as long as the doctor or hospital you are looking for. visit “accept the mission”. According to medicare.gov, “Assignment means that your doctor, provider, or provider agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services.” So it all comes down to the doctor’s availability. As long as your health care provider accepts Medicare, you will be covered, even out of state.
However, the downside of being in Original Medicare is that without any private or additional coverage you are responsible for 20% of all costs and there is no annual limit on how much you spend, which means that you have unlimited exposure to medical expenses.
This is where private plans like Medicare Advantage and Medicare Supplement come in.
Medicare benefit plans
Medicare Advantage (Part C) plans are offered by private insurance companies and cover the same services as Original Medicare (Part A and Part B) but are often bundled into prescription drug coverage at no additional cost as well as ” additional benefits’ such as vision and dental.
Instead of paying 20% blanket coverage for all medical expenses, Medicare Advantage plans typically have fixed co-payments when using health services as well as an annual maximum disbursement limit that caps your disbursements each. year.
Copays can be as low as $ 0 to see your attending physician.
The downside to Medicare Advantage plans is that they usually have physician networks that you must use to receive your health services. The plan options, and therefore the network of physicians available, are determined by your primary residence.
If you are on a Medicare Advantage plan and must have specific doctors and prescription drugs, CoverRight can check to see if they are included in the plan.
PPO vs. HMO Medicare Advantage Plans
PPO (Preferred Provider Organization) is a type of Medicare Advantage plan. As the name suggests, these plans have “preferred providers” that belong to the plan’s network. Using preferred providers (also referred to as using “on-network” providers) allows you to get the lowest cost, however, PPO plans also give you the option of seeing non-preferred or “off-grid” providers. The quota will generally be higher when using non-preferred suppliers.
HMOs (Health Maintenance Organizations), on the other hand, have a smaller network than PPO plans and do not cover any off-grid expenses except in an emergency. The advantage of an HMO is that you can reduce your healthcare costs by staying within a network.
In between, a PPO plan may be more beneficial for those who have two residences because you can get out of the network. Speak with a CoverRight representative to see if a PPO or HMO plan that offers off-grid emergency coverage is right for you.
Health Insurance Supplement: Bridging the Gap
As mentioned earlier, Original Medicare (Part A and Part B) does not cover all costs for hospital and physician services. There are still personal expenses, including deductibles, co-payments and coinsurance. To help pay for these “gaps” in coverage, private insurance companies offer Medicare Supplement Plans, or Medigap.
According to CoverRight, “About 24% of all Medicare beneficiaries (or about 15 million people) have chosen to purchase some type of Medigap plan.” There are currently 10 different Medigap plans: A, B, C, D, F, G, K, L, M, and N. Each is standardized by the federal government so coverage remains the same between companies. However, prices may vary depending on the location of your primary residence and the type of package you choose.
While the true alphabet soup of Medigap plans isn’t confusing enough, Plans C and F are no longer available to those who became eligible for Medicare coverage after January 1, 2020. You may have noticed that other letters are missing above: E, H, I and J are also no longer available, although they still offer coverage to those who have already purchased them. So, if you are newly eligible, your choices for Medigap plans include A, B, D, G, K, L, and M.
“Plan A provides the most basic coverage, while Plans F and G offer the most comprehensive coverage. The coverage provided by other plans falls between these two extremes, ”according to CoverRight.
Medigap plans can also come in handy when traveling abroad. According to medicare.gov, “Medigap Standard C, D, F, G, M, and N plans provide emergency health care coverage for overseas travel when traveling outside of the United States.”
For more comprehensive nationwide coverage, you may consider combining your original health insurance with some form of Medigap coverage. Visit the CoverRight website to compare and chat with, chat with, email or call CoverRight’s licensed expert advisor team at any time.
Prescription Drug Plans
If you have original Medicare, you must purchase stand-alone Medicare Part D, also known as prescription drug plans (PDP). Medicare Advantage plans provide bundled coverage for prescription drugs.
The PDP options available to you depend on your primary residence, and each plan varies in its coverage. Some have a regional network of pharmacies while others are national. Obviously, a national network would be a better choice for those who divide their time between different states. If you are on a prescription drug plan (PDP), CoverRight will help you check if the plan covers your prescriptions.
CoverRight can help
CoverRight’s dedicated Medicare advisors can answer your questions, walk you through your best options based on your personal health care and budget, and help you figure it all out so there are no surprises, all of it. free ! Plus, they won’t bother you or give out your details like other businesses.
Other options online for comparing health insurance policies sell your information, making your phone ringing hard with offers from sellers who are just trying to make money.
Unlike these companies, CoverRight will not sell your information or redirect you to other sites. Certified experts only contact you with your permission – no unwanted calls! If you’re wondering if your Medicare coverage will extend to any medical needs you may have while living in your second home, contact CoverRight today!