Moving? Avoid the 3 Biggest Medicare Pitfalls When Switching Addresses

We’re continuing to see an unprecedented amount of our clients moving out of their current state for warmer weather, lower taxes, family, or lower costs. Although there is a 3-month opportunity (1 month before to 2 months after your move) to switch Medicare Advantage or prescription plans, there are some pitfalls to be aware of when looking at additional options.

1) Out of pocket calculations reset

If you’re switching from one plan to another midway through the year, your out-of-pocket calculation also resets in most cases. This primarily affects individuals on Part D plans with high-cost medications.  

The annual Part D deductible is up tp $545/year for most standalone Part D plans. This means that you must pay for the first $545 in costs before insurance kicks in. By switching plans midway through the year, the deductible resets. Unfortunately, this means that you would be responsible for another $545 deductible once you switch plans. 

When switching midway through the year, it would be worthwhile to consider whether choosing a higher-cost plan with a lower deductible may result in a lower overall cost.   

2) Dental networks

If you have an individual dental plan, make sure to confirm whether you can keep your plan when you move and if so, whether it will cover dentists in your new area. The easiest way to check is to give your dental insurance company a call.  

Some plans have a national network of dentists while other plans have a narrow network. Most dentist practices do a pre-check with your insurance to make sure you’re covered so that there are no surprises. 

If your new dentist does not pre-check your insurance, it’s important to have them double-check when you book your appointment (not on the day of your appointment). In many cases, you may be able to switch dental plans midway through the year to cover your routine services.  

3) Enrollment periods for Supplemental vs Advantage plans

A big area of confusion is which plans you need to switch when you move. In general, if you have a Medicare Supplement (Medigap) such as a plan F, G, or N, you can keep the same plan with the same company when you move. Some companies will adjust your rates based on the state you’re moving to when you change your address. 

Since Supplemental plans are based on the original Medicare network (93% of providers nationally), you’ll still be able to see any provider that takes Medicare without referrals regardless of state. When you move, you typically do not get an opportunity to switch to another supplement without having to go through a medical questionnaire (NY/MA/CT/ME are exceptions) unless you have a limited Select supplement. 

For Prescription Part D and Medicare Advantage (Part C) plans, you will have to switch plans if you move outside of their service area. For most Part D plans, you’ll be able to find a similar plan with the same company. For Advantage plans, it’ll be important to make sure that whichever plan you choose covers your preferred providers, medications, and extra services such as dental/vision/hearing.