What Are the Rules for Using Medicare in Different States?

Medicare is a federal health care program that provides services throughout the United States. No matter what state you live in, your basic Medicare coverage will stay the same. However, if you are using Original Medicare, Medicare Advantage, Medicare Part D, or a Medigap plan, the rules for using them in other states or when traveling abroad may vary. Original Medicare coverage can be used in any state, just as it can be used in your home state.

If you have a Medigap plan with a Medicare SELECT provider network, you will need to buy a new plan if you move out of state. Hospitalization and inpatient care are covered by Medicare Part A, which is part of original Medicare and is required to be part of all Medicare Advantage plans. These plans also have out-of-pocket maximums (which Basic Medicare doesn't have) and can offer extras such as dental and basic vision coverage. If you are moving to another state, it is important to alert both Medicare and your insurer if you have a Medicare supplement plan, Medicare Advantage plan, and/or Medicare Part D prescription drug plan.

From January 1 to March 31, you can switch from one Medicare Advantage plan to another or return to original Medicare. Physicians must accept Medicare payment terms and meet certain requirements to participate in the program. It's important to make sure your new primary care doctor accepts Medicare so that you can use your benefits when you get care. About one-third of beneficiaries choose to receive these benefits through a Medicare Advantage plan (Part C). If you have a Medicare Advantage plan, you'll need to enroll in a new one for the state you're moving to.

Medicare is an invaluable resource for seniors and those with certain health conditions or disabilities. It is important to understand the rules for using it in different states so that you can make sure you are getting the most out of your coverage.

Elise Woehl
Elise Woehl

Subtly charming student. Award-winning twitter practitioner. Incurable coffee scholar. Friendly thinker.