The federal rule
42 CFR 422.74(d)(4)(ii) says that if you haven't moved out of your Medicare Advantage plan's service area but have left it for more than 6 months, the plan must disenroll you. CMS's 2027 enrollment guidance (section 60.2.1.2) makes the disenrollment effective the first day of the calendar month after the 6 months pass. If the plan can't confirm your address, it must send you a disenrollment notice within the first 10 days of the 6th month away.
This matters to snowbirds whose plan is based up north and who spend November through May in Florida, or to Floridians in a Florida plan who spend a long summer elsewhere.
The exception: visitor or traveler programs
Under 42 CFR 422.74(d)(4)(iii), a plan may offer a visitor or traveler benefit that lets you stay enrolled while you're out of its area but within the U.S. for more than 6 but less than 12 months in a row. While you're away, the plan must provide your Medicare-covered benefits at the same cost sharing as at home. Plans don't have to offer this, and they may limit it to certain areas and providers. You're disenrolled on the first day of the 13th month away, or sooner if the program is shorter.
Your options if you're disenrolled
- A special enrollment period. When the plan disenrolls you after more than 6 months away because it couldn't confirm your residence, CMS guidance (section 30.6.20) gives you an SEP that begins the first day of the 6th month away and ends the last day of the 8th month.
- Original Medicare. You're covered by Original Medicare after the disenrollment, with any provider in the U.S. that accepts Medicare. Add a Part D plan and consider Medigap; see Medigap for snowbirds.
- A plan where you permanently live. If you've made Florida your permanent home, a change in permanent residence gives you an SEP to join a plan that serves your Florida county.
How to avoid a surprise
- Count months, not seasons. Write down the day you leave your plan's area and the day you return.
- Ask about a visitor program before you leave. Ask which areas and providers it covers.
- Keep your mail flowing. Give your plan a seasonal mailing address or forward your mail.
- Rethink your coverage in Open Enrollment. If you're away more than 6 months most years, compare options from October 15 to December 7. See snowbirds: Medicare Advantage vs. Medigap.
To go over options from the companies they work with, you can request a call from a licensed insurance agent.
Related questions
Does Medicare Advantage cover snowbirds in Florida?
Emergencies, urgent care and routine care.
Which state should I use for Medicare?
Which home counts as permanent.
How do snowbirds get prescriptions in two states?
Part D networks and the 12-month rule.
Sources
- eCFR — 42 CFR 422.74, Disenrollment by the MA organization
- eCFR — 42 CFR 423.44, Involuntary disenrollment by the Part D plan
- CMS — Medicare Advantage and Part D Enrollment and Disenrollment Guidance, contract year 2027 (sections 30.6.20, 60.2.1)
- Medicare.gov — Special Enrollment Periods
More questions in this guide
- Does my Medicare Advantage plan cover me when I'm in Florida for the winter?
- Does Original Medicare work in every state for snowbirds?
- Does Medicare cover me if I live part of the year in Florida and part in Puerto Rico?
- Can snowbirds keep a Medigap policy bought in another state while in Florida?
- How do snowbirds get prescriptions filled in Florida and up north?
- Which state should I use for Medicare if I split my time between Florida and New York?
Part of the guide: Snowbirds and Medicare in Florida · All questions
Frequently asked questions
Does the 6-month clock reset if I go home for a week?
CMS counts consecutive months away from the service area. The rule doesn't spell out how a short trip home is treated, so ask your plan how it counts time away and keep a record of your travel dates.
How does my plan know I've been away?
Plans research address changes using CMS systems and other sources. CMS also treats you as temporarily absent if required plan mail sent by post comes back undeliverable with no forwarding address, so forward your mail.
What coverage do I have after the plan disenrolls me?
You return to Original Medicare, which works with any provider in the U.S. that accepts Medicare. If your Medicare Advantage plan included drug coverage, that ends too, so join a Part D plan during your special enrollment period.
Does the 6-month rule apply to standalone Part D plans?
No. A standalone Part D plan must disenroll you only after more than 12 months in a row out of its service area, effective the first day of the 13th month.
Medicare in your Florida county
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