Moving to Spokane & Medicare

Moving to Spokane with Medicare: A Coverage Checklist

A move can affect Medicare even when Parts A and B remain unchanged. Medicare Advantage and Part D plans are offered by service area, and the plans, provider networks, pharmacies, premiums, and benefits available in Spokane County may differ from the old location.

The safest approach is to notify the current plan before the move, confirm the Special Enrollment Period, and arrange replacement coverage before the old plan ends.

First identify the current coverage

Gather:

• Medicare card
• Medicare Advantage card, if any
• Part D card, if any
• Medicare Supplement (Medigap) card, if any
• Medicaid, Extra Help, retiree, union, VA, or TRICARE information
• Current address and new Spokane address
• Move date
• Current doctors and prescriptions
• Prior-authorizations and ongoing treatment
• Premium payment information

Do not cancel any coverage until replacement eligibility, approval, and effective dates are confirmed.

What usually does not change

A move within the United States generally does not end Medicare Part A or Part B. Original Medicare is federal coverage.

The move can still affect:

• Medicare Advantage
• Part D
• Medicare Cost Plans
• Medicare SELECT
• Medicaid
• Extra Help administration
• State assistance programs
• Provider and pharmacy access
• Medigap premiums or available switching options
• Retiree or employer coverage coordination

Medicare Advantage and Part D are location-based

Medicare Advantage and stand-alone Part D plans have service areas. A plan available at the old ZIP code may not serve Spokane County. Even if the same insurance company operates in Spokane, the available plan can have a different plan ID, premium, network, formulary, cost sharing, and benefits.

Use the exact new residential address when comparing plans.

Do not assume:

• The same insurer means the same plan
• A doctor accepting an insurer means the doctor is in every plan network
• The old pharmacy is preferred under the new plan
• Prior authorization transfers automatically
• Extra benefits are identical
• A national brand has a national routine-care network

Moving Special Enrollment Period

Medicare provides a Special Enrollment Period when a person moves outside a plan's service area or moves within the service area and gains new plan options.

If you notify the plan before moving, Medicare says the opportunity generally starts the month before the move and continues for two full months after the month of the move.

If you notify the plan after moving, the opportunity generally begins when you move and continues for two full months after the move.

The exact dates and permitted changes depend on the situation. Confirm them with the current plan or 1-800-MEDICARE.

During an eligible move period, a person may be able to:

• Switch Medicare Advantage plans
• Join a stand-alone Part D plan
• Return from Medicare Advantage to Original Medicare
• Make another change allowed for the specific event

If a person moves outside a Medicare Advantage plan's service area and does not join another Medicare Advantage plan during the available period, the person generally returns to Original Medicare when the old plan drops the member. That does not automatically provide a Medigap policy or Part D coverage.

Tell the plan before moving

Early notice can:

• Start the Special Enrollment Period sooner
• Give more time to compare Spokane options
• Reduce risk of a coverage gap
• Allow provider and prescription planning
• Clarify the final date of the old plan
• Identify required proof of the new address

Ask the current plan:

1. Is the new address outside the service area?
2. What is my exact Special Enrollment Period?
3. When will current coverage end?
4. Which changes am I allowed to make?
5. Will any authorization or transition-of-care protection apply?
6. How should I refill prescriptions during the move?
7. What written confirmation will I receive?

Keep the notice, call date, representative name, and reference number.

Update official addresses

Update the address with the organizations that maintain Medicare and benefit records, including as applicable:

• Social Security
• Medicare account
• Current health or drug plan
• Medigap insurer
• Medicaid agency
• Retiree or union benefit administrator
• VA or TRICARE
• Pharmacy
• Providers
• Premium billing service

A postal forwarding order alone does not update Medicare or plan records.

Use official websites or phone numbers from current cards. Do not give a Medicare or Social Security number to an unexpected caller claiming to update the address.

Comparing Medicare Advantage plans in Spokane

Check the exact plan for:

Providers

• Primary-care provider
• Specialists
• Hospitals
• Urgent care
• Behavioral health
• Therapy
• Laboratories and imaging
• Skilled nursing facilities
• Home health
• Durable medical equipment
• Dialysis or infusion providers

Confirm with both the plan and provider. Provider directories can change.

Costs

• Monthly premium
• Medical deductible
• Hospital copayments
• Specialist and therapy costs
• Imaging and outpatient surgery
• Skilled nursing facility costs
• Ambulance and equipment
• In-network maximum out of pocket
• Out-of-network costs and maximum, if applicable

Plan rules

• HMO or PPO
• Primary-care selection
• Referrals
• Prior authorization
• Out-of-area routine care
• Travel coverage
• Supplemental-benefit limits

Prescriptions

• Exact formulary
• Tier
• Deductible
• Preferred pharmacies
• Mail order
• Prior authorization
• Step therapy
• Quantity limits
• Specialty-pharmacy requirements

Comparing stand-alone Part D plans

A move can change available Part D plans and pharmacy pricing.

Prepare each drug's:

• Exact name
• Strength
• Dose
• Quantity
• Frequency
• Preferred pharmacy

Then compare the full-year estimate, not just premium. Check the deductible, formulary, restrictions, preferred pharmacies, and mail-order pricing.

Joining a stand-alone Part D plan while enrolled in most Medicare Advantage plans can disenroll the person from the Medicare Advantage plan and return the person to Original Medicare. Verify before enrolling.

What happens to Medigap when moving?

A standard Medigap policy can generally be kept after moving to another state as long as the person remains in Original Medicare. The insurer may adjust the premium based on the new location and policy terms.

Contact the insurer before moving to ask:

• Can the current policy remain in force?
• What will the new premium be?
• Does the address change affect any discount?
• Is any form required?
• Is the policy Medicare SELECT?
• Are there Washington switching rights worth reviewing?

Medicare SELECT

Medicare SELECT is a type of Medigap policy that can require use of a provider network for full benefits. A move out of its service area can create different rights. Contact the insurer and the Washington State Office of the Insurance Commissioner before canceling or replacing it.

Switching Medigap

Moving does not automatically guarantee the right to buy any Medigap policy desired. Outside the one-time Medigap Open Enrollment Period or another protected right, underwriting may apply.

If the current Medicare Advantage plan ends because of the move, a guaranteed-issue right may be available for certain Medigap policies under federal rules. The available plans and deadlines are specific. Apply during the protected window and keep proof that the old coverage ended.

Never drop Medicare Advantage or Medigap until the replacement path is confirmed.

Original Medicare in Spokane

If using Original Medicare:

• Find providers who accept Medicare
• Ask whether they accept assignment
• Confirm specialists and facilities
• Arrange transfer of records
• Set up prescriptions and equipment suppliers
• Confirm Medigap and Part D coverage
• Review access to urgent and emergency care

Original Medicare provides broad national access, but each provider can decide whether to accept new Medicare patients.

Transfer ongoing care

Start early for:

• Cancer treatment
• Dialysis
• Infusions
• Oxygen
• Durable medical equipment
• Home health
• Physical or occupational therapy
• Behavioral health
• Skilled nursing
• Pain management
• Specialty prescriptions
• Scheduled surgery

Ask both old and new plans or providers about transition-of-care rules. Obtain copies of current treatment plans, medication lists, imaging, laboratory results, and prior-authorization decisions through secure processes.

Do not email medical records through an unsecured account.

Prescriptions during the move

Before leaving:

1. Ask whether an appropriate refill is available.
2. Confirm how the current plan handles out-of-area pharmacies.
3. Identify Spokane pharmacies.
4. Check whether specialty medication delivery needs a new address or pharmacy.
5. Transfer prescriptions at the appropriate time.
6. Keep medication in carry-on or accessible luggage, not a moving truck.

Do not stockpile or alter dosing without medical guidance.

Durable medical equipment and supplies

Oxygen, CPAP, diabetic supplies, wheelchairs, walkers, and other equipment can involve supplier enrollment, contracts, rental periods, and authorization.

Ask:

• Can the old supplier serve Spokane?
• Is a new supplier required?
• Who owns the equipment?
• Is it rented or purchased?
• Does an authorization transfer?
• Is a new prescription or medical record required?
• How will supplies be delivered during the transition?

Medicaid, Extra Help, and state programs

Medicaid is administered by states. A move from another state to Washington can require a new Apple Health application because Medicaid does not transfer like Original Medicare.

Extra Help is federal, but notices, plan assignment, and Medicaid coordination can still require attention after a move.

Ask Washington SHIBA or the Washington Health Care Authority about:

• Apple Health eligibility
• Medicare Savings Programs
• Extra Help
• State-specific assistance
• Coordination with Medicare
• Effective dates

Do not assume benefits begin immediately.

Moving from Spokane to another county

A move within Washington can also change plan availability. Spokane County plans and networks may differ from those in Lincoln, Stevens, Pend Oreille, Whitman, or another county.

Use the residential ZIP code and county. A mailing address alone may not establish the correct service area.

Moving into or out of a facility

Moving into, living in, or moving out of an institution such as a nursing home or rehabilitation hospital can create a different Special Enrollment Period. Medicare states that eligible individuals may be able to join, switch, or drop Medicare Advantage or Part D coverage while living in the institution and for two full months after the month they move out.

The definition and eligibility are specific. Verify with Medicare before changing coverage.

Moving back to the United States

A person returning to the United States after living abroad may have a Special Enrollment Period to join Medicare Advantage or Part D that lasts for two full months after the month of return.

Parts A and B enrollment or premium issues can be separate. Contact Social Security and Medicare.

A 60-day moving timeline

Before the move

• Notify the current plan
• Confirm the exact Special Enrollment Period
• Compare Spokane plans
• Check doctors, hospitals, pharmacies, and drugs
• Contact the Medigap insurer
• Update Social Security and benefit records
• Arrange ongoing treatment and equipment
• Save notices and reference numbers

During the move

• Keep cards, medications, and key records accessible
• Confirm new plan enrollment
• Pay any required premium
• Confirm effective dates
• Avoid canceling old coverage prematurely

After arrival

• Verify the address with each organization
• Establish primary and specialty care
• Transfer prescriptions
• Confirm equipment and supplies
• Review the first claims and bills
• Apply for Washington assistance programs if needed
• Keep proof of the move and coverage changes

Common moving mistakes

• Waiting until after the move to tell the plan
• Assuming the old plan works in Spokane
• Choosing by insurer name instead of exact plan
• Forgetting Part D
• Joining Part D without understanding the effect on Medicare Advantage
• Canceling Medigap before replacement is issued
• Assuming a move guarantees any Medigap policy
• Ignoring Medicaid and state-assistance changes
• Failing to transfer prior authorization or equipment
• Using only postal forwarding
• Sharing Medicare information with an unsolicited caller

Where to get help

• Current plan: service area, termination date, Special Enrollment Period, and transition rules
• 1-800-MEDICARE: official enrollment rights and plan changes
• Social Security: Parts A and B and benefit-record address changes
• Washington SHIBA: free, unbiased Medicare counseling
• Washington State Office of the Insurance Commissioner: Medigap and insurance rights
• Washington Health Care Authority: Apple Health and Medicare Savings Programs
• A licensed agent: comparison of represented Spokane plans

Your next step

Call the current Medicare Advantage or Part D plan before the move. Give the new residential address and move date, ask for the exact Special Enrollment Period and end date, and request written confirmation. Then compare Spokane providers, prescriptions, total costs, and replacement effective dates.

Health Insurance Options LLC is a licensed independent insurance agency. We may be compensated by insurers and do not represent every Medicare plan. Currently, we represent 8 organizations offering 75 products in the area. Contact Medicare.gov, 1-800-MEDICARE, or Washington SHIBA for information about all options. We are not affiliated with or endorsed by the U.S. government or Medicare.