Best Medicare Coverage for Snowbirds & RVers
Key Take-aways:
Use your permanent residence address when enrolling in Medicare and purchasing any plans. This is the address from which you vote and pay taxes.
Your permanent resident address must match the address on file at Social Security.
Original Medicare plus a supplement is your best options because you are not limited to a network and have no pre-authorization requirements.
Shop Part D carefully, make sure their network includes preferred nationwide pharmacies you can access.
Consider Advantage Plans only if budget is a priority.
There are times you can use a foreign hospital when close to the border.
Enrolling in Medicare
The first step you will take with your Medicare is to enroll in Medicare Part A and Part B, also called Original Medicare or Traditional Medicare. the most common question we are asked is “Which state do I use on the application?”.
The address you must use is what is referred to as your principal residence or Permanent Address. It doesn’t matter how much time you spend in one state versus the other. Both Medicare and Social Security consider your permanent address to be the one you use when you pay taxes, vote and is displayed on your driver’s license. It’s that simple.
Keep in mind, Medicare is a subset of Social Security law. Whatever address you use for Social Security will trickle down to Medicare. In fact, you enroll in Medicare through the SSA.gov website or your local SSA office. For more details and guidance on signing up for Medicare, please see my video and article How to Sign-Up For Medicare and When.
One last point on signing-up for Medicare; I strongly advise my clients to hold back enrolling in Medicare Part B until you wish to use Medicare as your primary health coverage. If you enroll in Part B while also using your or your spouse’s employer group coverage you may lose your ability to ever get a Medicare supplement plan. If you need further guidance on this, you can reach out to us over the telephone (800-847-9680) or via our Contact Us page.
Original Medicare Part A & Part B
Approximately 30-days after signing-up for Medicare you should receive your red, white, and blue Medicare card in the mail. That card represent Original Medicare Parts A and B and displays your Medicare number plus when your coverage will start.
Benefits of Original Medicare Coverage
Original Medicare has some great positives and a few drawbacks worth considering. Your Original Medicare coverage does not include prescription drug coverage and has no annual maximum out-of-pocket limit. In other words, you do not have a cap on your financial risk.
In order to create an annual maximum out-of-pocket limit you will need to consider either adding a Medicare supplement plan to your Medicare coverage or replace your Original Medicare coverage with a Medicare advantage plan.
You can review the benefits of Original Medicare on our website Resources page.
Not shown on the list of benefits are what I believe the two greatest features of Original Medicare is that 1. you have no Network limitations. You do not have to worry about in network providers vs out of network providers. Every medical provider in the U.S. that will accept Medicare will accept your Original Medicare and any Medicare supplement you have. That is over 98% of all doctors and 99% of hospitals. Second, no insurance company can interfere with your healthcare. You do not ever have to be concerned with insurance company pre-approvals or denial of coverage. Your healthcare decisions are between you and your doctor.
Medicare Advantage Plan
Medicare Advantage plans are also called Medicare Part C. Medicare Part C replaces your Part A & B with a privatized version of Medicare. Most Medicare Advantage plans include a bundled Part D prescription coverage plan.
With an MA Plan, you receive your Medicare through the private insurance, not through the government program. The insurance company will require pre-approval for most non-emergency or non-urgent care procedures and can deny or limit your coverage.
Medicare Advantage HMO or PPO
Most Advantage plans are structured as either a Preferred Provider Organization
(PPO) or a Health Maintenance Organization (HMO). These structures are designed as local coverage. You have a local group of in network of providers that you are expected to use. Receiving out of network services or seeing an out of network provider can be expensive as you may either pay more for your care or pay 100% of your care. There is no national network coverage with Medicare Advantage HMOs or PPOs.
This is obviously not consistent with the health insurance needs of Snowbird lifestyle or RVer lifestyle. Still, if you wish to learn more, please see my post and video Medicare Advantage Plans Explained.
Benefits, Networks & Costs Change Every Year
In addition to your plan’s network limitations, every feature and cost of a Medicare Advantage plan can change every calendar year. Your network participating providers can change, The deductibles, copays and coinsurance can change. If your Advantage plan’s network coverage included vision coverage or prescription drugs any of that can change. Your maximum out of pocket costs can change. In fact, the Advantage plan maximum out of pocket costs are set by CMS (Center for Medicare and Medicaid Services)and has increase by 27% in just the past three years.
From a practical standpoint most Medicare plans have minimal changes in their health care services and features from year to year. But it is your responsibility to understand those changes and act within an eight week period of time to make changes for the coming year. Do not assume next year will be the same coverage as the current year.
Annual Election Period
Every year from October 15 through December 07 you will have the opportunity to view the changes in your plan’s cost and benefits and choose a new plan for the coming year. There is also an annual Open Enrollment from January 01 through March 31 where you can make one change with your Medicare.
I guess if you enjoy shopping for and researching Medicare, an Advantage plan can be an ideal choice because you get to do that every year for the rest of your life.
Best Medicare Advantage Plans for Snowbirds and RVers
If you are considering an Advantage plan due to its low premium, you might want to
look into a type of Advantage plan called a Medicare Savings Account (MSA). It offers more flexibility than an HMO or PPO in that it has no network. But doctors still must agree to accept your plan. They are not obligated to accept it.
The MSA may provide coverage better than other Part C plans because there is no pre-authorization requirement. It is a unique Medicare plan and the one Medicare Advantage Plan that can fit the needs of snowbirds and RVers. FYI – one of the few drawbacks is that it adds another form to complete when you file taxes.
Rather than detail the plan here, please use our Contact Us form and let us know you have an interest in an MSA plan.
Medicare Supplement Plans
Your other choice to set a limit to your financial risk for healthcare costs is to add a Medicare supplement plan to your Original Medicare. Medicare supplement plans are also referred to as Medigap plans.
What is a Medicare Supplement Plan?
A Medicare supplement or Medigap plan is a health insurance policy designed to work hand-in-glove with your Traditional Medicare. Medigap plans are administered by private health insurance companies but, because they are secondary to Medicare they have no say in your coverage. They pay the deductibles, copays, and coinsurance to minimize your out-of-pocket costs. I detail how low your out of pocket risk can be in the video; Medicare Supplement Maximum Out of Pocket.
With a Medicare supplement you keep the features and benefits of Traditional Medicare coverage. You can see any doctor in the U.S. or any medical facility that accepts Traditional Medicare. Which is over 98% of medical facilities and providers in the U.S. Medicare beneficiaries with a Medigap plans have nationwide coverage. If they accept Medicare, they will accept your supplement no matter which insurance company you use.
Which supplement plan is best for you? My video on finding the Best Medicare Supplement Plan walks you step by step through the process of selecting the right plan for your needs and budget.
Original Medicare Outside the U.S.
As a Medicare beneficiary there may be times when the closest medical help is across the border. This can happen if you are RVing near the border or if your traveling from Alaska to the contiguous states (or vise versa) through Canada.
There are three situations where you can use your Traditional Medicare Outside the U.S.
You are in the U.S. and have a medical emergency and a foreign hospital that can treat you is closer than a US Hospital. Your Medicare and supplement will cover you.
If you have a medical emergency while traveling directly “without unreasonable delay” through Canada to or from Alaska and a Canadian Hospital is closest option.
You live in the U.S. and a foreign hospital is closer to your home than a U.S. hospital. In this case you can visit the foreign hospital even for non-emergency services.
In all of the above cases, you will receive coverage from Medicare and you supplement.
Your Supplement Outside the U.S.
The most popular Medicare supplement plans offer a $50,000 life-time benefit for emergency or urgent care when Medicare beneficiaries travel abroad. The supplement will reimburse you for 80% of your emergency care bill, up to $50,000 after a $250 deductible. You will need to pay the medical bill and submit the receipt to Medicare.
Medicare Part D Prescription Drug Coverage
If you have a Medicare supplement you will also want to get prescription drug coverage through a stand-alone Part D plan. Part D prescription drug plans help pay for your prescriptions medication and, unless congress changes the rules, will soon gave their own maximum out of pocket limit on costs.
We encourage our clients to shop for Part D coverage through our PartDShopper.com website. Input your specific prescriptions, if any, and make sure a national pharmacy network is available so you can pick up your prescriptions anywhere you are traveling within the U.S. you can also use mail order pharmacy services with any Part d plan, if you wish.
When reviewing pharmacies, make certain you fill prescriptions using a preferred pharmacy. Most Part D plans have a national or regional pharmacy network so you can pick up prescriptions anywhere you travel within the US.
Like Advantage plans, you re-shop your Part D plan every year during the Annual Election Period (AEP) from October 15 through December 07. However, the great feature of a stand-alone plan is that you re-shop for the best Part D plan without interfering with your health care plan.
Conclusion
Original Medicare plus a supplement is the best Medicare option for most Snowbird’s and RVers. If budget is a strong consideration, compare an MSA plan to a high deductible supplement.
The reason so many retirees who travel the country to Texas, California, Florida and other states so popular with RVers is that a supplement can offer coverage anywhere in the US. You are free to see any medical
provider that accepts Original Medicare without the interference of an insurance company. Plus you have additional benefits while traveling outside the U.S. or near the U.S. border.
Lastly, you know your benefits are secure because they do not change from year to year like Medicare Advantage Plans. Medicare supplement plan benefits never change.
If you are still unsure which direction is right for you, check out my video titled Medicare Explained – the Secrets of Who & Why. I review the demographics of who usually choose Advantage plans versus supplements. It’s a unique way to see what people like yourself decided to do and what regrets, if any, they may have had.
Matthew Claassen
Matthew Claassen, CMT and CEO of Medigap Seminars Insurance Agency. Medigap Seminars is an award winning premier national Medicare Insurance Brokerage, ranked among the top in the U.S.A. Matthew is considered a leading national expert on Medicare and Social Security. Mr. Claassen is a distinguished member of the Forbes Business council, an invitation only organization of business leaders and entrepreneurs. He and his team have received awards from many of the countries largest insurance companies including Mutual of Omaha, Aetna, Humana, Cigna, United American, United Healthcare and others. His videos have become the most popular Medicare educational videos on YouTube with millions of views. As a financial analyst Matthew lead a team of researchers to win the 2009 Best Equity Research & Strategy Award from The Technical analysis magazine.
