Changing Residences Can Impact You With the Medicare Advantage Program

It is essential that anyone with the Medicare Advantage Program makes sure to document any move, temporary or permanent.


The subject of Medicare for U.S. residents can be complicated at the best of times and with the changes recently made to the health-care laws, people may find themselves either paying more or even without coverage if they are not well informed. With the increasingly aging population – in other words, the ‘baby boomer’ generation that are approaching retirement – it is more crucial than ever that both the beneficiary (the person being insured) and their families know exactly how the system works. The basic four levels of Medicare cover:

• hospital stays (inpatient treatment, Part A)
• hospital and doctors visits (outpatient care, Part B)
• prescriptions from certain providers (‘Medicare Advantage Program’ Part C)
• extended prescription fees and additional charges (Part D)

Anyone over the age of 65 and who has been working for at least ten years is covered by Part A and, because it is more affordable, most people will also opt for the Part C drug plan. This is the easy part – it is the areas of Parts B and D, those that are affected by income, periods of enrollment and place of residence, that tend to cause the problems.

Part D is closely tied to where the patient (beneficiary) officially lives and as such, they will only be covered when residing in that specific state. Unfortunately, this fact can often not occur to family members or caregivers when temporarily moving their elderly relative to a nursing home or into the family home, until they receive a letter from Medicare announcing the termination of coverage. For this reason, it is essential that Medicare is informed of any move, temporary or permanent.

In the case of Part B, affecting any outpatient costs, the retiree must act within the first 8 months of leaving their job and also make sure their employer has informed Social Security of their employment status (i.e. that they are permanently retired). Retirees who have a higher income also need to be aware that despite increases in inflation, the premium threshold is remaining the same until 2019 and anyone with an income of $85,000 or more will automatically have to pay the higher price.

Finally, it should be known that the time period allowed for making changes to Medicare plans has been reduced substantially. Formerly, changes to a Part C (Medicare Advantage Program) plan to Part D could be made from Jan 1- March 31. As of 2011 any changes must be made before February 14th and missing this deadline can result in a lapse of, or inadequate, coverage.

Anyone with questions regarding the complicated area of Medicare should consider seeking professional advice from a qualified health-care consultant.