John: I’m turning 65 soon. I am a resident of New Jersey and need to remain so for at least several months. Sometime this year, I can become a resident of Texas. However, I’m in Texas now and will be through the end of the year. I’m caring for a grandchild here. Since I will be living in Texas do I get a Medigap plan for Texas, or must I get one for New Jersey? If I get one for New Jersey and have health issues in Texas, would my costs be out-of-network expenses? When I get on the phone and ask providers, I get dead air or no response at all.
Phil Moeller: Medigap plans provide supplemental coverage for people who have basic Medicare (Parts A and B). Basic Medicare will cover you anywhere in the U.S. for care by medical providers (doctors and hospitals) who accept Medicare. Your Medigap plan will then help pay those expenses that aren’t fully paid by basic Medicare. There should be no out-of-network charges.
Once you have one, you can keep it regardless of where you live, so long as you keep paying your premiums.
So, it doesn’t matter where your Medigap plan is issued. Once you have one, you can keep it regardless of where you live, so long as you keep paying your premiums. It’s good all over the U.S. If you will be a New Jersey resident when you turn 65, you probably should get the Medigap plan from a New Jersey insurer. That’s because you are entitled to what are called “guaranteed issue rights” when you are first eligible for Medigap. You definitely want these rights, which are explained in Medicare’s annual guide to Medigap.
Once you have established residence in Texas, you could try to switch to a Medigap insurer there, but you don’t have to. If you do try, and insurers there want to charge you more because you no longer have guaranteed issue rights, you can just keep your original New Jersey policy.