Medicare and Health Coverage When You Move Out of the Bay Area to Be Near Family

When my clients plan a move to be near their children, they think carefully about the house, the neighborhood, and the taxes. Health coverage is often an afterthought until someone realizes their Medicare Advantage plan only works in the Bay Area, or that their cardiologist will be 500 miles away. After 23 years and more than 460 sales, many of them for older homeowners relocating out of Silicon Valley, I’ve learned that getting this right isn’t hard, but the timing matters a lot. This article walks through what happens to Medicare, Medigap, prescription coverage, Medi-Cal, and your premiums when you move, and it’s part of my guide to moving from Silicon Valley to be near family. I’m a REALTOR® and Certified Senior Advisor, not your Medicare counselor, so please use the free counseling resources at the end before you change anything. The figures below were checked against Medicare, Social Security, and California sources in October 2026.

Original Medicare and Medigap: The Coverage That Travels

If you have Original Medicare, Parts A and B, you can see any doctor or use any hospital in the country that accepts Medicare, so the move itself doesn’t disrupt your coverage. You’ll still want to update your address with Social Security, since that’s who administers Medicare enrollment and premium billing. If you also have a Medigap supplement, you can generally keep it after the move as long as you stay on Original Medicare, although the insurer may change the premium to reflect pricing in your new area. The one exception is a Medicare SELECT policy, which uses a local network. If you move out of a SELECT policy’s area, you have a guaranteed right to buy a different Medigap policy.

There’s also a California-specific benefit to understand before you leave. California’s birthday rule gives Medigap policyholders a 60-day window starting on their birthday each year to switch to a plan with equal or lesser benefits, from any company, without medical underwriting. That right comes from California law, so it doesn’t follow you. About 15 states have some version of a birthday rule, including popular destinations for my clients like Idaho, Nevada, Oregon, and Utah, while states like Arizona and Texas don’t have one. Washington, New York, Connecticut, and Vermont allow switching year-round under their own rules. If you think you might want a different Medigap plan, and especially if your health has changed, it often makes sense to use your California window before you go.

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Medicare Advantage and Part D: The Plans That Don’t Travel

Medicare Advantage plans and stand-alone Part D drug plans are approved county by county, so a plan you bought in Santa Clara or Santa Cruz County usually won’t cover routine care in Reno, Boise, or Phoenix. A move within California can go either way. Someone moving from San Jose to Sacramento may still be inside their plan’s service area (Kaiser’s Northern California region covers both, for example), while a move to Southern California or out of state almost always means a new plan. When you move out of your plan’s service area, Medicare gives you a special enrollment period to join a new Medicare Advantage or Part D plan in your new area, or to go back to Original Medicare.

The timing depends on when you tell your plan. If you notify your plan before you move, the window begins the month before the month you move and continues for two full months after you move. If you notify them after you move, the window begins the month you tell them, plus two more full months. If you never pick a new plan, your current plan will disenroll you because you no longer live in its area, which drops you into Original Medicare. If that leaves you without drug coverage for 63 days or more in a row, you can owe a Part D late enrollment penalty for as long as you have Part D, so put these dates on the calendar.

A Sample Timeline

Say you’re moving on June 15 and you call your plan in May. Your special enrollment period runs from May 1 through August 31, and you can usually have the new plan start the first of the month after you enroll. Picking July 1 in that example means you’re covered by a local plan as soon as you’re settled. Use the Medicare Plan Finder with your new ZIP code to see which plans cover your doctors and prescriptions.

There’s one more opportunity worth knowing about. If your Medicare Advantage coverage ends because you moved out of the service area, you generally have a guaranteed right to buy certain Medigap policies without medical underwriting, as long as you apply no later than 63 days after your coverage ends. For someone who’s been on Medicare Advantage for years and now has health issues, that can be the cleanest way to switch to Original Medicare with a supplement, which works anywhere in the country if you end up splitting time between your new home and visits back to the Bay Area.

Retiree and Employer Coverage

Many of my Silicon Valley clients have retiree health benefits from a former employer, a union, or CalPERS. These plans follow their own rules, and some only offer certain options inside California. Call the benefits office before you move and ask exactly what changes when your address does. Be careful about dropping employer or union retiree coverage, because in many cases you can’t get it back once it’s gone.

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Your Home Sale Can Raise Your Medicare Premiums

This one catches a lot of Silicon Valley sellers off guard, and it has nothing to do with where you move. Medicare charges higher-income people an Income-Related Monthly Adjustment Amount, or IRMAA, on top of the standard Part B premium, which is $202.90 a month in 2026. For 2026, the surcharges start when modified adjusted gross income exceeds $109,000 for an individual or $218,000 for a married couple filing jointly, and Social Security uses your tax return from two years earlier to decide. In other words, a home you sell in 2026 can raise your Part B and Part D premiums in 2028.

The primary residence exclusion shields up to $250,000 of gain for a single person or $500,000 for a married couple, but longtime Bay Area owners often have gains well beyond that, and everything above the exclusion counts toward your income. Social Security lets you ask for a lower IRMAA after certain life-changing events like retirement, marriage, divorce, or the death of a spouse, but a one-time gain from selling your home isn’t on that list. It’s worth running the numbers with your CPA before you set a closing date, and my guide to capital gains tax when selling a home you’ve owned for 30 years and my article on taxes when you sell your California home and move out of state explain the moving parts.

Medi-Cal and Medicaid

Medi-Cal is California’s Medicaid program, and it ends when you establish residence in another state. The new state’s Medicaid program has its own eligibility rules, asset limits, and long-term care benefits, which can be very different from California’s. If you currently rely on Medi-Cal, or expect to need Medicaid for long-term care, talk to an elder law attorney in the destination state before you move. It’s also worth knowing that California brought back an asset test on January 1, 2026, for older adults and people with disabilities. The limit is $130,000 for one person plus $65,000 for each additional household member, and while the home you live in doesn’t count, the cash from selling it generally will.

Two related programs behave differently. Extra Help, which lowers Part D drug costs, is a federal program, so it can continue after you move as long as you update your address with Social Security. However, if you qualified automatically because you were on Medi-Cal or a Medicare Savings Program, that automatic status depends on qualifying for the new state’s program. Medicare Savings Programs, which help pay Part B premiums, are run by each state, so you’ll need to reapply after you arrive. For California’s rules on the family home, see what happens to your home when a parent goes on Medi-Cal.

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Doctors, Prescriptions, and Records

The paperwork side of the move is easy to put off, and it’s much harder to sort out once you’re 500 miles away from your current doctors. Here’s what I suggest my clients handle in the last month or two before they leave.

• Ask your current doctors for referrals in the new area, especially specialists.
• Request copies of your medical records, imaging, and a current medication list before you move.
• Check that your new plan covers your medications and that preferred pharmacies are nearby, and ask for a 90-day supply before you go.
• Look at the distance from the new home to the nearest hospital and urgent care, which matters as much as the school ratings did when you bought your first house.
• Schedule a first appointment with a new primary care doctor soon after moving, since new patient waits can be long.
• Have an attorney in the new state review your advance health care directive, POLST, and powers of attorney, because states don’t all handle California documents the same way. If a parent has memory loss, my guide to moving a parent with dementia or cognitive decline covers the extra steps.

A Moving-Month Medicare Checklist

When the moving truck is booked, this is the order I’d work through things. It keeps you from having a gap in coverage while everything else is going on.

1. Meet with HICAP before you list the house, so you understand your options and deadlines.
2. If you might switch Medigap plans, use your California birthday window before you move.
3. Call your Medicare Advantage or Part D plan with your moving date before you leave.
4. Update your address with Social Security at ssa.gov or by phone.
5. Enroll in a new plan for your new ZIP code during your special enrollment period.
6. Meet with the destination state’s SHIP counselor soon after you arrive and reapply for any state programs.

Free Help

In California, the Health Insurance Counseling and Advocacy Program, known as HICAP, offers free, unbiased Medicare counseling through the California Department of Aging, and you can reach your local office at 1-800-434-0222. Every state has a similar State Health Insurance Assistance Program, and you can find the one where you’re moving through the SHIP national locator. I encourage clients to meet with HICAP before leaving and with the destination state’s program soon after arriving. If you’d rather stay in California but move closer to family, my article on Prop 19 when moving to another county to be near family covers the property tax side. For the full picture, including housing costs and taxes, see my guide to selling in Silicon Valley to move near family.

Sources and Further Reading

• Medicare.gov: Special Enrollment Periods
• CMS: Understanding Medicare Advantage and Medicare Drug Plan Enrollment Periods
• Medicare.gov: When Can I Buy a Medigap Policy?
• CMS: Choosing a Medigap Policy
• CMS: 2026 Medicare Parts A and B Premiums and Deductibles
• Social Security: Request a Lower IRMAA
• Health Consumer Alliance: Medi-Cal Asset Limit FAQ
• California Department of Aging: HICAP Medicare Counseling

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