Some Medicare Advantage plans don’t work across state lines, leaving snowbirds at risk for denied coverage or high out-of-pocket costs. Original Medicare travels, but without Medigap, it can be expensive. Experts urge retirees to compare coverage before splitting time between states.
If you spend part of the year in a second home — like thousands of retirees who migrate between states — your Medicare coverage might not follow you. That’s the warning from a recent Healthline report, and it’s a wake-up call for snowbirds and dual-state retirees who rely on Medicare Advantage plans.
Medicare Advantage, or “Part C,” is a popular alternative to Original Medicare. These plans often include extra benefits and lower premiums, but many seniors don’t realize they’re also geographically limited.
Medicare Advantage plans are offered by private insurers and built around narrow provider networks based on ZIP code. These plans typically only cover care within a specific service area, and if you’re outside that area — even temporarily — you could be stuck paying full price or being denied care altogether.
In its article “How Medicare Works When You Move to Another State,” Healthline explains:
“If you split your residence between homes in two states… Original Medicare should apply in both locations as long as you go to medical providers covered by Medicare. When it comes to Medicare Advantage or Part D, your coverage depends on the specific plan and on the pharmacy that your plan contracts with.”
Healthline also cites CMS.gov, and an article from Medicare.org that explains how coverage varies depending on your specific plan and the pharmacy network it uses. The educational resource offers consumer guidance on how ZIP-code-specific limitations may affect snowbirds and dual-state retirees.
This is especially important for retirees who spend half the year in a second state, such as Arizona or Florida. While your plan might cover everything at home, it may not include providers, specialists, or pharmacies near your seasonal address.
By contrast, Original Medicare (Parts A and B) is accepted by any provider nationwide who participates in the program. If flexibility is your top priority, Original Medicare gives you the freedom to seek care in either state.
But that freedom has a price.
With Original Medicare, you’re responsible for 20% of all outpatient costs, and you’ll face a $1,632 hospital deductible (per benefit period in 2025). Unlike Medicare Advantage, there’s no out-of-pocket maximum.
Many seniors purchase a Medigap plan to cover those costs — but not everyone qualifies, and availability depends on your state of residence.
“Original Medicare is more flexible, but without a Medigap plan, that flexibility can get expensive fast,” explains Medicare analyst David Bynon. “The people most at risk are those who think they’re fully covered in both homes, but haven’t compared networks or checked if their doctor is even in their plan.”
Medigap plans help fill the gaps in Original Medicare. These supplemental plans cover things like deductibles, coinsurance, and hospital stays. But here’s the catch: not every state offers the same plans, and not every retiree qualifies.
If you didn’t buy a Medigap policy when you first enrolled in Medicare, you may be subject to underwriting — especially if you try to switch after moving.
A few states like New York, Connecticut, and Massachusetts offer guaranteed issue year-round. But in most states, you could be denied coverage or charged more based on your health history.
Medicare does offer Special Enrollment Periods (SEPs) when you move permanently. If you officially change your legal address, you may have a two-month window to switch plans.
But if you’re only living temporarily in another state — say, from November to April — you may not qualify for a SEP. Your coverage could lapse, and your providers may not be in-network.
That’s why confirming your official address with the Social Security Administration is critical. Even if you spend equal time in two places, Medicare will treat one of them as your primary residence — and your coverage will be tied to that ZIP code.
Here are a few steps retirees can take to protect their coverage:
Dual-state retirement is becoming more popular — but your Medicare plan may not be ready for it. If you assume your coverage travels with you, you could end up paying out-of-pocket or going without care.
The good news? With a little planning, you can avoid the pitfalls. Review your coverage before you relocate — not after. And if in doubt, call your provider and confirm what’s covered where.
Snowbird season should mean sun, not stress.
