-- Prescott, AZ - June 26, 2025 — A newly published report from Healthline is drawing attention to a hidden risk for seniors who live in two different states during the year: their Medicare Advantage coverage may not travel with them.
According to Healthline, “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.”
(Source: Healthline — "How Medicare Works When You Move to Another State")
Healthline cites CMS.gov and a Medicare.org article, “Medicare for Snowbirds Living in Two States & Dual Residency,” to explain how coverage depends on a Medicare beneficiary's specific plan and pharmacy.
Medicare Advantage plans are built on local provider networks. While they may offer additional benefits like dental or vision, their geographic limitations can catch retirees off guard. Original Medicare, by contrast, is accepted nationwide by any provider that participates in the Medicare program.
This portability difference can create major problems for snowbirds and dual-state retirees — especially those who assume their existing plan will provide the same coverage no matter where they go.
“The reality is, Medicare Advantage plans are ZIP-code specific,” said David Bynon, a Medicare analyst based in Arizona. “If you spend half the year in another state, you could lose access to your doctors, your preferred pharmacy, or even be forced to pay out-of-pocket if you receive care outside of your plan’s network.”
However, portability comes at a price. While Original Medicare travels well, it doesn't cap out-of-pocket expenses. Beneficiaries typically pay 20% of the cost of outpatient services, and hospital stays require a $1,632 deductible per benefit period (as of 2025). There’s also no annual out-of-pocket maximum unless a supplemental Medigap policy is in place. Unfortunately, not all states offer the same Medigap plans, and some beneficiaries may be denied based on health history.
“It’s not just about coverage — it’s also about cost,” Bynon added. “Original Medicare is more flexible, but without a Medigap plan, that flexibility can get expensive fast.”
For retirees considering a move — even temporarily — resources like Medicare.org provide tools to compare Medicare Advantage and Medigap plan options by ZIP code. Paired with Healthline’s recent article, these tools can help consumers evaluate not just whether coverage follows them — but what it might cost if it does.
The Centers for Medicare & Medicaid Services (CMS) allow retirees to change Medicare Advantage or Part D plans during a Special Enrollment Period (SEP) triggered by a permanent move. However, temporary dual-state living doesn’t always qualify.
Seniors are encouraged to confirm their official primary residence with Social Security and review their current plan's provider directory before traveling. A local plan in Arizona may not serve them during a summer in Michigan.
Dual-state living is on the rise — but Medicare coverage may not keep up. Without careful planning, retirees risk losing access to in-network providers, incurring unexpected out-of-pocket costs, or paying steep hospital bills without a supplemental policy in place.
Contact Info:
Name: David Bynon
Email: Send Email
Organization: David Bynon
Address: 101 W Goodwin St # 2487, Prescott, Arizona 86303, United States
Website: https://davidbynon.com
Release ID: 89163380