Medicare expert Christian Worstell explains how beneficiaries can take advantage of the fall Medicare Open Enrollment Period and other enrollment periods after a move.
In this Q&A series, Medicare expert Christian Worstell answers your questions about Medicare coverage, benefits, eligibility, enrollment and more. Christian is a licensed insurance agent and frequent contributor to MedicareAdvantage.com.
"I would like to sign up for prescription drug coverage during the Medicare Annual Enrollment Period this fall, but I will be moving to a new state right after the enrollment period ends. How will that affect me and what do I need to do?" – Rodney A., Augusta, GA
Your situation could present quite the pickle, but there are very likely some other Medicare beneficiaries out there who are in the same boat. What you’ll need to do is take a bit of a “scenic route” to getting your Medicare prescription drug coverage.
Let me explain.
Enrolling in Medicare prescription drug coverage during a Special Enrollment Period
Medicare prescription drug coverage includes geographical boundaries known as “service areas.” This is true whether you get Medicare drug coverage from a standalone Medicare Part D plan or a Medicare Advantage plan that includes drug coverage. In other words, your coverage may be valid in one state or area of the country but not in another.
If you move to a new service area, you may be eligible for a Special Enrollment Period (SEP). Your SEP may allow you to disenroll from your previous plan (from your old place of residence) and enroll in a plan that does business in your new service area.
Make sense? Here is where things can get tricky for some people in your situation.
In order to qualify for a Special Enrollment Period because of an address change, you must be enrolled in a Medicare Advantage plan or a Medicare Part D plan that doesn’t cover you in the new service area you’re moving to.
Since you aren’t moving until after the fall Medicare Annual Enrollment Period (also called AEP or the fall Medicare Open Enrollment Period, which lasts from October 15 to December 7), you may want to go ahead and enroll in a plan during AEP or do nothing and remain in your current plan. After AEP when you complete your move, you should then be able to enroll in a plan that is provided in your new service area.
A few things to note:
In order to qualify for a Special Enrollment Period, the current plan you have when you move must not provide coverage at your new address OR your new service area must include plan options that don’t exist in your current service area.
To put it more simply, if the plan offerings are exactly the same in the two locations, you may not qualify for an SEP. But if the plan offerings are not exactly the same, you should qualify for an SEP.
When you sign up for a new plan during AEP, your first premium for the new plan won’t come due and coverage won’t begin until January 1. So you should not need to worry about “wasting” any money signing up for a plan that you may never actually use.
If have a Medicare Advantage plan that includes drug coverage and you do not like any of the similar plan offerings in your new location once you move, you do not have to switch to any of them. You can consider simply dropping your old plan and returning to Original Medicare.
You do not have to enroll now in a Medicare Advantage plan that contains drug coverage in order to do so later. You may enroll in a plan that does not include drug coverage and switch to one that does once you move.
How to make a change during a Special Enrollment Period
Once you move, your Special Enrollment Period should typically last for three months. The time at which this period starts may depend on when you notify your current plan carrier of your move.
If you inform your plan carrier of your upcoming move more than a month before you actually move, your opportunity to switch plans will begin the month before you move and continue for two more months after that month.
If you wait to notify your plan of your move until after you have already moved, your opportunity to switch plans begins the month you tell them about your move and then continues for two more months after that.
I recommend following these steps:
Contact a licensed Medicare insurance agent at 1-800-557-60591-800-557-6059TTY Users: 711 and explain your situation. They can help you compare plans that are available in both your current service area as well as your future service area.
Shop around for plans in your future service area. When you find the one you hope to enroll in, see if there are any plans in your current service area offered by the same carrier. If there are, it may be easiest to sign up for one of one those plans to serve as your “temporary” plan. That way, you will not have to deal with two different carriers when it comes time to make the switch.
Prior to your move, contact your plan carrier and notify them of your move. Explain that you recently enrolled in “this” plan during AEP but want to enroll in “that” plan upon moving to your new residence. The carrier will be able to walk you through the necessary steps.
While this may feel like a lot of work, the process of enrolling and disenrolling is typically quite fast and smooth, and you will hopefully secure Medicare drug coverage that works for your needs.
Good luck with the move and don’t hesitate to reach out with any follow up questions.
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