Two addresses, one plan, and the county line: snowbirds and Medicare

I'm glad you brought it up because it's one of those topics where people feel like they've got it handled, and then they find out later that they didn't. And the gap between those two moments can be really expensive.

Ian opens with three real callers. One person says they spend half the year in Arizona, half in Connecticut. Another describes going back and forth from here to New York, six months on each end. And then the one that stopped the whole conversation: someone who moved from Arizona to Massachusetts and wasn't sure if they could still be helped at all. Three different situations, and as Ian puts it, three different answers. The difference between them comes down to something as specific as a county line.

Right, and that surprises people every time. Medicare Advantage plans are built around counties. The regulations actually say an enrollee has to reside in the plan's service area. And the plan can disenroll you if you move outside it. So when someone says they have an Advantage plan they love, the first question is always: where does that plan live? Because it may not live where you're going.

That's the exact picture Ian paints. House in Scottsdale, house near the grandkids, Advantage plan they're happy with. And there are two rules buried in that schedule that decide whether they still have that plan when they come home. Neither of those rules cares how good the plan is.

The KFF data Ian cites puts the average at 32 Advantage plans with drug coverage per beneficiary for 2026. But that average hides a lot. If you're in an urban county you're choosing from around 42 plans. In the most rural counties it drops to about 20. And then state by state it varies too. Arizona has 133 Advantage plans available for 2026. Nevada has 105.

Exactly. And that county line matters twice: once for which plans exist where you sleep, and once for whether your current plan keeps you. That second part is where the six-month rule comes in.

Ian actually quotes the federal regulation directly, which I think is the right move, because this is one of those places where the plain language matters. The rule says that if you haven't moved from your plan's service area but you've left it for more than six months, the plan must disenroll you. Must. It's filed under a section called required disenrollment. So this isn't a plan being difficult. It's the rule.

Correct. And here's the detail in the article that I think most people would never guess: returned mail can start the clock. The rule says you're considered temporarily absent if required plan mail comes back as undeliverable and you haven't provided a forwarding address. So if you forget to set up your mail forwarding, or you don't tell the plan your seasonal address, you might trigger the process without knowing it.

Yes. Ian's advice is simple and practical: keep your forwarding current and tell the plan your seasonal address. Those are two separate things and both matter.

So the regulation does build in an exception, and it's worth understanding what it actually says versus what people sometimes assume it says. If a plan offers this visitor or traveler benefit, it may allow you to stay enrolled for an absence longer than six months but less than twelve, at the same cost sharing you'd have at home. Three things to flag. One, the word in the rule is may elect. That means it's the plan's choice. A lot of plans don't offer it. Two, the plan can limit which areas qualify, so just because you're traveling doesn't mean your destination is on the list. Three, and this is the hard ceiling, even with the benefit, you are disenrolled on the first day of the thirteenth month after you left. Twelve months is the absolute outside limit.

Nothing. And Ian's guidance is clear: ask your plan, in writing, before you leave. Not when you get back. Not if something goes wrong. Before you go.

Completely different conversation if you ever need to dispute something later.

This is the crux of it. Ian draws a really clear line. The person who left for seven months and still has her Arizona address, that's the six-month rule situation. The plan can drop her, and Medicare does not publish a special enrollment period for absence the way it does for a formal move. So if that happens to you, the default is Original Medicare with no drug plan. You'd want to ask immediately whether any enrollment period applies to your specific situation.

And the question of exactly what options are available to you at that point is one I'd want you to put directly to one of our advisors, because the specifics of what windows might or might not apply are going to depend on your situation. Our team at American Retirement Advisors knows that landscape. But the broader point Ian is making is: don't assume a window exists. Get ahead of it.

Two doors open for them. The first is a Special Enrollment Period. Your chance to switch begins when you move and continues for two full months after you move. But here's the detail that's worth the price of admission on its own: if you tell your plan before you move, that window opens the month before the month you move. Same two months on the back end either way. Telling the plan early buys you an extra month, at no cost.

And if you do nothing during that window, you land in Original Medicare. Which brings us to the second door. Moving out of a plan's service area triggers guaranteed issue rights for a Medicare Supplement. You have up to 63 days after your Advantage plan coverage ends to act on that. But there's a catch, and Ian is very precise about it: you only have that right if you switch to Original Medicare rather than join another Advantage plan. And the clock starts from the day coverage ends, not the day you moved.

That's a real scenario. The 63 days runs from the end of coverage, not from the moving date. Those can be different days.

This depends entirely on whether your plan is an HMO or a PPO. If it's an HMO, Medicare is pretty blunt about it: you generally must get your care from providers in the plan's network. The exceptions are emergency care, out-of-area urgent care, and temporary out-of-area dialysis. Everything else, you may have to pay the full cost.

Correct. Medicare defines urgent care as a sudden illness or injury that isn't an emergency and isn't life threatening. Routine is not that. Ongoing management of a condition is not that. So an HMO member in the other state for five months who needs to see their regular doctor is in a complicated position.

Friendlier language. You can generally go to out-of-network providers for covered services, but you'll pay more. Still covered, just at a different cost sharing. So the first thing any two-address family should nail down is which of those two sentences describes their plan.

Original Medicare. It doesn't have a county line. The rule is simple: you can use any doctor or hospital that takes Medicare, anywhere in the United States, which includes the 50 states, the District of Columbia, and five territories. A Medigap policy rides with it. Ian quotes this directly: you can keep your current Medigap policy no matter where you live, as long as you still have Original Medicare.

The policy travels. Now, the premium might change if you establish a new permanent address, and if you switch supplement companies after a move you might have to answer some medical questions. Ian notes both of those. But the policy itself follows you. For a family that genuinely splits the year between two states, that structural difference is significant.

It sits in between the two worlds. Part D drug plans are sold by region, not by county. There are 34 regions nationally, and a plan has to cover at least an entire region. Arizona and Nevada each had ten stand-alone drug plans for 2026. So you have options. But the question Ian raises is a practical one: what does your plan's pharmacy network look like in the other state? Because as he notes, Thursday's piece on preferred pharmacies explains how the answer can change your copay. If you're in Connecticut for six months and your plan's preferred pharmacies aren't there, you could be paying more than you expect.

Ian says it directly: mail order, shipped to the right porch, solves a lot of it. Make sure the porch you're having it shipped to is the right one and that the plan knows about it.

Ian addresses it briefly but clearly. Original Medicare generally doesn't cover medical care outside the United States. And Advantage plans are in the same position, generally no coverage outside the U.S. either. He specifically says Mexico is a separate conversation. Some Medigap policies have a foreign travel emergency benefit, but it's capped and time-limited. So if cross-border care is part of your life, that's a conversation that needs to happen on its own.

Not at all. The geography of your coverage matters as much as the quality of it.

He lays it out in a really concrete way. They ask for both addresses and the dates before they ask about benefits. That's the starting point. Then they figure out which sentence your plan lives under, the HMO sentence or the PPO sentence, and they tell you what a routine visit in the other state actually costs before you're sitting in a waiting room finding out.

And then they ask the plan, in writing, whether it offers the visitor benefit and for how long. They put the six-month date on the calendar the day you leave. They know the difference between visiting and moving, and when a move is real, they tell the plan before the truck comes because it buys that extra month and it starts everything from the right date. The 63-day Supplement clock starts from the right day, not the moving day.

Ian is direct about this. They put Original Medicare plus a Supplement on the table right next to the Advantage plan and they run the whole year, both houses, before anyone picks. Because the question isn't just what works at home. It's what works across the full life you're actually living.

And those two things can have very different answers. Which is exactly why you need someone who asks the two-address question first.

Those workshops are a really good way to ask the questions that are specific to your own schedule. Because as Ian's three callers show, the same situation can have three different answers. You want someone who knows which answer is yours.