Snowbird Medicare: A Two-State Plan That Actually Works
If you split the year between two homes, you already know about duplicate utility bills and the art of packing one jacket that somehow works in two climates. But there’s one thing snowbirds often overlook: how to make Medicare work seamlessly in two locations—without surprise bills, last-minute pharmacy scrambles, or losing your favorite doctor.
This quick guide walks you through a “two-state” checklist so your healthcare follows you as smoothly as your luggage.
Step 1: Map Your Real Pattern (Not Your Wish List)
Before picking or changing coverage, be brutally honest about:
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Where you spend 6+ months (this is usually your “permanent residence” for plan eligibility).
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Which state you actually use doctors in (primary care, specialists, routine labs).
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How many months you’ll be away (2–3 vs. 5–6 can change the best plan type).
Pro tip: Write down your Top 3 Doctors and Top 3 Pharmacies you rely on. We’ll use that list in Steps 3 and 4.
Step 2: Choose the Right Plan Structure for Mobility
There are three common “snowbird” approaches:
A) Original Medicare + Medigap + Part D
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Why it works: Medigap plans don’t have networks; any provider that takes Medicare generally works across states.
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Watch-outs: Medigap premiums can be higher; your Part D drug plan still has pharmacy networks/formularies to check in both states.
B) Medicare Advantage PPO (with strong out-of-area coverage)
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Why it works: PPOs often allow out-of-network use at higher copays/coinsurance, and many include nationwide urgent/emergency coverage.
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Watch-outs: Routine care out-of-area can still cost more; confirm provider acceptance before you go.
C) Medicare Advantage HMO (with visitor/travel programs)
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Why it works: Select HMOs have visitor programs or multi-state systems that temporarily assign you to a second network.
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Watch-outs: Not all HMOs offer this; pre-enroll in the visitor program and verify participating doctors in your destination zip code.
Step 3: Lock In Your Doctors (Both States)
Use the Top-3 list from Step 1 and check each plan’s directory:
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Primary care: Will they accept your plan for routine visits when you’re in town?
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Specialists: Ask specifically about referrals between states; some groups won’t process out-of-area referrals.
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Telehealth backup: Keep one in-network primary care option that offers virtual visits—handy for minor issues while traveling.
Pro move: Call the offices directly and ask:
“Do you accept [Plan Name] for routine (non-emergency) care for a patient whose permanent address is [Home ZIP]?”
Document the name of the staff member and the date you called.
Step 4: Make Your Pharmacy Portable
Prescriptions are where snowbirds get tripped up. Fix it now:
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Chain pharmacy strategy: Choose a plan whose preferred pharmacy has locations in both places.
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90-day supplies + mail order: Combine these so you’re never down to 2 pills and a prayer.
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Temperature-sensitive meds: If you rely on insulin or injectables, ask about seasonal shipping and destination pick-up options.
Checklist:
☐ Your Part D plan (or MAPD) covers all meds on formulary
☐ Preferred pharmacies exist near both homes
☐ You’ve set auto-refills to the address you’ll be at during that month
Step 5: Plan for Emergencies (Before They Happen)
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Urgent & ER coverage: Know where you can go today in each location. Save the addresses in your phone.
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After-hours plan: Which urgent care accepts your coverage for sprains, infections, minor procedures?
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Care continuity: Ask your primary to add a brief note in your chart about your snowbird status so out-of-state providers can see it.
Step 6: Don’t Forget These “Gotchas”
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Plan address rules: Your permanent address determines what plans you can enroll in. If you change it, your plan eligibility can change, too.
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Referrals & authorizations: Some Advantage plans require them even for out-of-area visits—ask before you schedule.
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Routine vs. emergency: “Emergency” is broadly covered; routine care out of area is where people get surprised.
Snowbird-Ready Packing List (Healthcare Edition)
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Digital ID cards for Medicare/Medigap/Part D or Advantage
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A current medication list (names, doses, prescribers)
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Portal logins for your doctors & pharmacy
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Telehealth app installed and tested
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An in-network urgent care and lab near each home saved in your maps
When to Change (or Not Change) Your Plan
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Stay put if: your doctors/pharmacies work in both places and your costs are predictable.
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Review options if: you’ve had new diagnoses, added pricey meds, or one of your key doctors left the network.
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Definitely revisit if: you officially changed your primary residence (different ZIP code = different plan menu).
Bottom Line
A great snowbird setup is simple: one plan, two locations, zero drama. That takes a bit of pre-planning—but it pays off the first time you need a routine refill or a quick specialist visit in your second home.