Does Medicare cover me if I live part of the year in Florida and part in Puerto Rico?

Original Medicare and Medigap: both places

For Medicare.gov, the U.S. includes Puerto Rico and the other territories, and with Original Medicare you can use any doctor or hospital that takes Medicare anywhere in the U.S. If you spend winters in Kissimmee and summers in Mayagüez, you can get care in both places. A Medigap policy pays its share wherever Original Medicare pays, and Medigap policies are also sold in Puerto Rico.

Medicare Advantage and Part D: one place

Private plans depend on your permanent residence, generally your primary home. In CMS's 2027 Landscape file, Puerto Rico is its own Part D region (Region 38) and Florida another (Region 11), and the island's Medicare Advantage plans serve Puerto Rico municipalities. So:

• A Puerto Rico plan doesn't cover routine care in Florida, and a Florida plan doesn't cover it in Puerto Rico; both cover emergencies and urgent care (42 CFR 422.113).
• More than 6 months in a row outside a Medicare Advantage plan's area ends your enrollment, unless the plan has a visitor or traveler program; ask whether it includes your other home. A standalone Part D plan allows up to 12 months.

If you have a Medicare Platino plan, see what happens to Medicare Platino if you move to Florida.

Part B in Puerto Rico isn't automatic

Medicare sends a special package to Puerto Rico residents who don't have Part B, because there you have to sign up for it. Without Part B you can't join a Medicare Advantage plan and, in most cases, can't buy Medigap. If you sign up late, you may have to wait for the General Enrollment Period (January 1 to March 31) and pay a penalty. See moving from Puerto Rico to Florida.

Extra Help and Medicaid

Extra Help with Part D costs isn't available in Puerto Rico, according to Medicare.gov; the island has other programs through its Medicaid program (Medicaid.pr.gov). In Florida, you apply for Extra Help through Social Security, and for Medicaid and the Medicare Savings Programs through ACCESS Florida, run by the Department of Children and Families (DCF). Each Medicaid program requires residency.

How to get organized

1. Decide which home is permanent. Everything depends on it.
2. Confirm you have Part B. Check your Medicare card.
3. Update your address with Social Security if your permanent residence changes: 1-800-772-1213 (TTY 1-800-325-0778).

To review Florida plans from the companies they work with, you can request a call from a licensed insurance agent.

Related questions

Sources

• Medicare.gov — Compare Original Medicare and Medicare Advantage
• Medicare.gov — Sign up for Medicare Part B, Puerto Rico package
• Medicare.gov — Help with drug costs (Extra Help)
• eCFR — 42 CFR 422.74, Disenrollment by the MA organization
• eCFR — 42 CFR 422.113, Emergency and urgently needed services
• CMS — Medicare Advantage and Part D Enrollment and Disenrollment Guidance, contract year 2027
• CMS — Medicare Advantage and Part D Landscape files, 2027
• eCFR — 42 CFR 435.403, State residence for Medicaid
• Florida DCF — Public Assistance (ACCESS Florida)

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?
• What happens to my Medicare Advantage plan if I stay in Florida more than 6 months?
• 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

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