People who plan to snowbird or split their time between two places in retirement have a lot to consider—finances, taxes, community, lifestyle, housing; the list goes on and on.
Once you determine the “major” stuff like where you want to live, how you’ll use your values to create routines and community that leave you fulfilled, and the best ways to pay for it all, you may think you’re set.
But there’s likely one more big-ticket item you left off your list: healthcare.
Healthcare for snowbirds can cause trouble in paradise faster than an unexpected thunderstorm on a beach holiday.
- What do snowbirds need to know about healthcare?
- What are Medicare’s strengths and limitations regarding multiple locations?
- How can you find the right healthcare coverage for you, no matter where you live in the U.S?
Before You Move, Know Your Options
So you know you can’t stand one more winter of shoveling snow from your driveway or shivering until early April—totally understandable!
Before you pack your bags for your sun-filled destination, it’s important to prepare for your medical coverage along the way. When you’re healthy, medical care is usually the last thing on your mind, and you don’t think about which doctors, specialists, or medical systems take your insurance.
But if you need to refill a prescription, attend a routine check-in, or go in for an emergency, you could be stuck with massive costs if you’re not careful about your coverage.
Many snowbirds benefit from establishing a patient relationship with doctors and specialists in both locations, including:
- Internists—doctors that specialize in internal medicine. These physicians are often more specialized in working with older adults, making them an excellent provider in the area of your winter home.
And any other providers you see regularly.
Why do you need to think about this stuff?
Because in most circumstances, doctors can’t manage your healthcare across state lines, even if you’re using TeleHealth. A doctor must be licensed to practice medicine in the state where you’re receiving care, so your primary care doctor in Washington couldn’t manage your healthcare or dictate treatment while you’re living in Arizona.
When you retire, you have a few options for medical coverage, including:
- Health insurance from your previous employer
- Private insurance
The best option for you depends on the total costs (premiums, deductibles, co-pays/co-insurance, and other out-of-pocket expenses), range of coverage (in-network hospital systems and providers, HMO vs. PPO plans, etc.), and your unique health needs.
Since Medicare is the most popular and complex, we’ll focus on what you should know to maximize Medicare coverage in multiple locations.
Medicare For Snowbirds
Unless you have qualified health coverage via an employer or other private insurance, when you turn 65, you’ll likely enroll in Medicare. But enrolling in Medicare isn’t a one-step process. Even under the most typical circumstances, there are numerous considerations to securing the most appropriate Medicare coverage for your situation.
So, what should snowbirds consider during Medicare open enrollment? You’ll need to parse through the nuances of the following:
- Original Medicare
- Medicare Advantage Plan (Part C)
- Medicare Supplement Plan (Medigap policies)
- Medicare Part D, Prescription Drug coverage
Let’s review each in more detail.
How Original Medicare Impacts Snowbirds
Original Medicare comprises two pieces:
- Part A, hospital insurance (hospital stays, skilled nursing care, hospice, etc.)
- Part B, medical insurance (doctor care, medical supplies, preventative care, etc.)
Think of Original Medicare as your foundation—it doesn’t cover everything, but it’s an excellent place to build from. The good news is that with Original Medicare, you can receive care from any hospital or system that accepts Medicare.
This fact makes it super flexible for snowbirds. Whether you’re in Seattle or Tucson, you can receive qualified preventative care if the facility accepts Medicare.
The bad news is that the coverage isn’t comprehensive.
If you want coverage for dental, vision, hearing, specialist work, or other health conditions, you’ll need to secure additional coverage either via an advantage or supplement plan. Each carries different implications for those that live in multiple locations.
How “Advantageous” Are Medicare Advantage Plans For Travelers?
A Medicare Advantage Plan, Part C, is coverage you can purchase via a private insurance lender that contracts with Medicare.
Advantage plans offer Original Medicare coverage in addition to other elements like dental, vision, prescription (Part D), wellness, and additional benefits, making it much more comprehensive than Original Medicare alone. An advantage plan is like a one-stop shop for your medical coverage in retirement. But what it boasts in convenience, it lacks in flexibility.
First, Advantage plans tend to carry lower premiums and higher out-of-pocket costs. In 2023, the average monthly premium is $18—not too bad! But the out-of-pocket maximum is much higher, at $8,300, and that’s just for in-network coverage. Those costs could be much higher if you receive care out of network.
Keep in mind that each plan has different premiums, deductibles, co-pay/co-insurance, and other out-of-pocket costs, so evaluate carefully before enrolling.
So what qualifies as in-network or out-of-network care?
Here’s the kicker: With advantage plans, qualified care is usually area or zip-code-specific. Since your regional location becomes incredibly important for your medical care eligibility, you may not qualify for care if you live outside the service offering radius. Even if your plan covers multiple zip codes, you’ll unlikely be covered in different states.
Why do Advantage plans tend to operate like this? Remember, advantage plans are issued by private insurance companies, and private companies are more selective, not universal, in their coverage windows.
If you plan on splitting your time nearly equally between two places, a Medicare Advantage plan may limit your ability to receive comprehensive coverage.
Supplement Plans and Snowbirds, The Ideal Combination?
If you plan to live in two areas that don’t share any zip code numbers, an excellent option to consider is securing a Medicare supplement plan in addition to Original Medicare.
Unlike Advantage plans that build Original Medicare into their offering, supplement plans require separate enrollment. There are 10 Supplement, or Medigap, plan options, and most states have standardized the benefits for each letter. So, if you enroll in Medigap Plan G, the benefits would be the same in California, New Mexico, and most other states.
It’s important to note that Supplement plans tend to have higher monthly premiums than Advantage plans. In 2023, the average premium for supplement plans is $139 per month, but that number greatly depends on the actual plan you choose and the associated coverage (some plans are over $400 a month).
Supplement plans also don’t come with prescription drug coverage, so you’ll also have to enroll in Part D separately.
Perhaps the most compelling reason snowbirds could benefit from a supplement plan is that they can receive care from any provider who accepts Medicare. That’s right; supplement plans don’t have the same border control as Advantage plans, so you could qualify for care in any state and facility that accepts your coverage.
Plus, the benefits within each Medigap plan are standardized by the government. So no matter where you purchase the policy (private insurance companies sell supplement plans), you know what you’re getting. Advantage plans don’t have that same standardization. What’s offered in each could vary by city, county, state, etc.
Another bonus point for supplement plans is that they aren’t bound by the Medicare open enrollment cycle, so you can change or update your plan throughout the year if needed. You can only switch Advantage plans during the open enrollment period, limiting your options if the plan no longer suits your needs.
What About Your Medications?
Prescription drug coverage (Part D) is critical for those splitting their time between retirement destinations.
If you decide to enroll in a Supplement plan, you’ll need to procure a separate Part D contract. Before you sign up, consider the following:
- National vs. regional coverage. You have to specifically find a Part D plan that offers national coverage because not all plans have that feature.
- Pharmacy networks. Enrolling in a national network doesn’t mean you can fill prescriptions at any pharmacy. Some pharmacy networks aren’t available in every state or region, so check what’s available in both of your residences.
If you don’t find a national plan that meets your needs, many Part D plans offer mail services, where you can order a 90-day supply of your medications. That way, you can have them sent to wherever you are, which is convenient for those who only spend a couple of months in a separate location or plan on extended travel.
The Right Medical Coverage For Your Snowbird Goals
Snowbirds must secure Medicare coverage that allows them to receive quality care no matter where they live. The best combination of care for you depends on several factors:
- Your lifestyle and health goals. How much time do you plan to spend away from your primary residence? Will you split your time nearly 50/50? What’s your current health picture? Do you have an underlying condition you need to address more regularly?
- The medical care in each location. Do you have access to quality healthcare in each place you want to live? Can you see the necessary doctors and specialists? Are the providers nearby and in-network?
- Total costs for care. Snowbirds already have to plan for additional expenses in retirement—housing, transportation, entertainment, taxes, and more. It’s also important to remember that you’ll likely have to add healthcare to that list. Enrolling in Medicare plans that enable you to receive coverage nationally might come at a higher cost, and it’s necessary to plan for that when saving for your golden years.
If snowbirding is an important goal for your retirement lifestyle, you can’t forget about protecting your health along the way. We’d love to help you consider your healthcare options so you can live vibrantly and purposefully in any retirement destination.
Set up a time to talk with us today.
UPDATE: February 2023