Sun City Hilton Head

Part-Time Residents of Sun City Hilton Head: How Medicare Works When You Split the Year

by

Skyler Abilla

Part-Time Residents of Sun City Hilton Head: How Medicare Works When You Split the Year

Snowbirds and seasonal residents: how plan service areas, networks and enrollment windows affect Medicare when you live in two places.

Part-Time Residents of Sun City Hilton Head: Medicare When You Split the Year

Part-Time Residents of Sun City Hilton Head: How Medicare Works When You Split the Year

Spending part of the year in Sun City and part somewhere else changes which Medicare setup makes sense. Here is what to check.

54
Days in the Oct 15 to Dec 7 Annual Enrollment Period
90
Days in the Jan 1 to Mar 31 Medicare Advantage Open Enrollment
Nationwide
Where Original Medicare works, at any provider that accepts it

Original Medicare travels. Plans may not.

Original Medicare covers you at any provider in the country that accepts Medicare. Medicare Advantage and Part D plans are tied to a service area, and most expect you to live in it. An HMO may cover only emergency and urgent care when you are outside its network area, while a PPO usually offers some out-of-network coverage at a higher cost.

Where you are matters

Your plan is based on the address you give it. If Sun City is your main home, that is usually the address on file. If it is your second home, check how the plan treats a stay of several months in another state. Some plans have rules about how long you can be outside the service area before you can be disenrolled.

Questions to ask before you enroll

  • Where will I be when I need routine care, and are those doctors in the plan's network?
  • What does the plan cover for non-emergency care outside its service area?
  • Does the plan have a travel or visitor program, and how long can I be away?
  • If I move my main home, when can I change plans?

Comparing the two main setups

Original Medicare + Medigap + Part DMedicare Advantage
Away from homeCovered nationwide at providers that accept MedicareDepends on the plan type and its network
Monthly costPart B premium, Medigap premium and drug plan premiumPart B premium plus the plan premium, often low or $0
Changing laterMedigap may require medical underwriting after your first windowYou can switch during enrollment periods
Moving homes: a permanent move out of your plan's service area can open a Special Enrollment Period. A seasonal stay generally does not, so confirm with the plan how it defines your residence.
Your Windows to Change Plans, October 15 to March 31
Annual Enrollment: Oct 15 to Dec 7 (54 days)
Medicare Advantage Open Enrollment: Jan 1 to Mar 31 (90 days, for people already in a Medicare Advantage plan)

Source: Medicare.gov enrollment periods. Bar lengths are drawn to scale across the 168 days shown.

Talk to a local agent

Skyler Abilla is a licensed Medicare agent who lives near Sun City. Call (843) 284-6815 or book a free call and we will plan coverage for both homes.

A note on this data: Plan rules about time away from the service area vary by plan. Confirm with the plan before you enroll.

Abilla Advisors is not affiliated with, endorsed by, or sponsored by Sun City Hilton Head, Del Webb, or the Sun City Community Association. The name is used only to describe the area we serve. This article is for educational purposes only. Abilla Advisors does not offer every plan available in your area. For information on all of your options, contact Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Assistance Program (SHIP). This content is not connected with or endorsed by the U.S. Government or the federal Medicare program.

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