“Now I feel like all the time I am in NV I essentially am voiding my health care.” That sentence was posted publicly on a consumer forum by someone who splits the year between California and Nevada, and it is the most accurate description of the part-year resident problem we have read. She had already written that her “main concern is health insurance, since I found out my provider in CA would might well refuse to honor a large claim were they to find out I am spending most of my time in NV.” Nobody explained any of that before she bought.
Change the two states and it is a conversation we have every spring in Fernandina Beach and every autumn in St. Augustine. Amelia Island and Ohio. Ponte Vedra Beach and Pennsylvania. A Jacksonville house and a lake house ninety minutes up into Georgia. Someone on a different public forum asked it in the plainest words anyone has managed: “Will i have any issues using my FL insurance here in Georgia? Or is it good anywhere in the United States?”
The answer depends entirely on which kind of coverage you bought. Original Medicare travels. A Medicare Supplement travels with it. A Medicare Advantage plan is built around the county you enrolled from and behaves differently once you leave it. A stand-alone drug plan is sold statewide but filled at a local pharmacy counter. An ACA plan follows where you live. Almost nobody lays that out before the sale, so here it is with the 2026 numbers.
parent organizations offer Medicare Advantage and Special Needs Plans in Nassau County versus Broward County, Florida for the 2026 plan year — 59 plan records against 119. One state, two network maps that barely overlap.
Source: CMS CY2026 Medicare Advantage / Part D Landscape Source File, via the Ambrose Insurance Brain (healthcare-db), retrieved July 2026Why doesn’t my plan work the same way in both places?
Because most private health plans are not sold to the country. They are sold to a county. CMS publishes a landscape file every autumn with one row for each plan offering in each county, and the county is the unit of the whole system. A carrier contracts with the hospitals and doctors inside a defined service area, prices the plan for that area, and files it that way. When a plan describes its network, it is describing a map, and every map has an edge.
The 2026 file shows how local those edges are without leaving Florida. Nassau County, which holds Fernandina Beach and Amelia Island, has 59 Medicare Advantage and Special Needs Plan records from six parent organizations. Broward has 119 records from sixteen. St. Johns sits at 76 from seven, Clay at 85 from ten, Duval at 90 from twelve. Same federal rules, same plan year, and the shelf changes at every county line.
Cross a state line and the differences grow. Fulton County, Georgia has 97 records from twelve parent organizations for 2026, and Chatham County, which covers Savannah, has 91 from eleven. Different companies, different hospital systems, different contracts. A plan designed for Jacksonville has no claim on any of it, because it was never filed to serve it. That is the design rather than a loophole, and it is invisible at the point of sale.
What travels and what doesn’t
Here is the whole argument in one table. Read the middle column first; it decides whether your summer is comfortable or expensive.
| What you have | Away from home | What to ask before you buy |
|---|---|---|
| Original Medicare (Part A and Part B) | Works anywhere in the United States that accepts Medicare | Does this provider accept Medicare assignment? Ask the office, not the plan. |
| Medicare Supplement (Medigap) | Pays alongside Original Medicare wherever Original Medicare pays | Am I inside my one-time 6-month Medigap open enrollment window, or will health questions apply? |
| Medicare Advantage (HMO or PPO) | Built on the network of the county you enrolled from; away from it you are generally looking at emergency and urgent care | Is a routine specialist visit in my second state covered at all? Get it in writing. |
| Stand-alone Part D drug plan | Sold statewide in Florida — but the pharmacy counter you use up north may sit outside the network | Is there a network pharmacy near my second address? What does mail order do for a refrigerated drug? |
| ACA Marketplace plan (under 65) | Tied to where you legally live, and to a local network | Which state am I a resident of, and does the network reach my other address? |
| Employer or retiree group coverage | Varies by plan document; some are national, some are not | Ask the benefits administrator for the out-of-area rules in writing. |
The Medicare Advantage problem, stated fairly
We are not here to tell you Medicare Advantage is a bad product. For someone whose doctors, hospital and pharmacy all sit inside one county it is a reasonable choice, and we place people into these plans every year without embarrassment. Roughly four in five carry a $0 monthly premium, which is exactly why premium tells you so little.
The problem is narrower and specific to you. A local network is a strength when you live in one place and a liability when you do not. Emergency and urgent care are handled away from home, but the care that fills a retiree’s calendar is not emergency care. It is the cardiologist every three months, the imaging that follows a scan somebody did not like, the physical therapy after a knee. A plan built around a Florida county is under no obligation to pay for those in Ohio.
Plans differ in how hard that edge is. Some require the network for routine care and pay considerably less, or nothing, outside it. The only way to know which you hold is to ask the plan directly, name the service, and get the answer in writing. We walk through the whole trade in our Medicare Advantage versus Medicare Supplement comparison.
One wrinkle before you assume you can switch plans once you get north. Medicare Advantage is enrolled from your permanent address, not from wherever you are sleeping in July. Moving out of a plan’s service area is a life event that can open a Special Enrollment Period, but that is a rule about moving rather than travelling, and the terms should be confirmed at Medicare.gov or on 1-800-MEDICARE rather than assumed. Someone who keeps a Florida residence and visits Pennsylvania each summer has not moved. They have a network problem.
Original Medicare travels, and a supplement rides along
Original Medicare is federal. Parts A and B work anywhere in the United States that accepts Medicare, which covers most places that treat patients, and nothing changes when you cross the Georgia line or fly to Cleveland. That single fact is why so many genuine part-year residents end up on Original Medicare with a supplement.
A Medicare Supplement, which almost everybody calls a supplement rather than Medigap, pays its share of what Original Medicare approves. Because Original Medicare sets the terms, a supplement does not carry a local provider network of its own the way an Advantage plan does. You show the same two cards in Fernandina Beach in January and in Ohio in July, and the arithmetic behind the scenes is the same in both places.
Now the honest part. A supplement charges a premium every month, including the years you barely see a doctor, and it sits on top of the standard Part B premium everybody pays. A $0-premium Advantage plan does not. If the year goes quietly, the Advantage enrollee spent less. What the supplement buys is the removal of one specific risk, and that risk is worth seeing in numbers.
| Item | 2026 amount | Why a part-year resident should care |
|---|---|---|
| Standard Part B premium | $202.90 per month | Owed whether or not you join a private plan, in either state, all year. |
| Part B annual deductible | $283 | Once per calendar year before Part B pays, wherever you are. |
| Part B coinsurance | 20% | Of most covered services, with no annual cap under Original Medicare alone. This is the gap a supplement closes. |
| Part A hospital deductible | $1,736 per benefit period | Per benefit period, not per year — an admission in Florida and another up north can be two deductibles. |
| Part D maximum deductible | $615 | No 2026 Medicare drug plan may set its deductible higher. |
| Part D out-of-pocket cap | $2,100 | Covered drugs cost $0 for the rest of the year once you reach it. |
Read the coinsurance row twice. Twenty percent of most Part B services with no annual ceiling is open-ended, and it does not care which state you are standing in. Medicare Advantage answers that with an in-network out-of-pocket maximum, which is real protection as long as the care is in network. A supplement answers it wherever Medicare pays. For someone in two states, only one of those works in both places.
The Part A row matters too. The $1,736 hospital deductible applies per benefit period rather than per calendar year, so a February admission in Jacksonville and an August admission in Pennsylvania can each carry their own. The rest of the holes are in our post on what Medicare doesn’t cover in 2026.
The Florida timing rule that makes this urgent
If the portability argument has landed, there is a deadline attached, and it is not the one on the postcards. Federal law gives you a single Medicare Supplement open enrollment window: six months, beginning the first day of the month in which you are both 65 or older and enrolled in Part B. Inside it a carrier must sell to you regardless of health history. Outside it, Medicare.gov says it plainly — there is no federal guarantee that an insurance company will sell you a Medigap policy.
Some states add rights on top of that federal floor. Florida does not add a birthday rule. We read the Florida Office of Insurance Regulation’s 2026 Medigap FAQ end to end and no birthday-based right to change carriers without health questions appears in it. So the sequence matters for a snowbird: taking an Advantage plan at 65 because it looked free, learning at 71 that it does not follow you to the lake house, then applying for a supplement is a sequence that can end in a decline.
Florida has no Medigap birthday rule. Outside your one-time 6-month Medigap open enrollment window, or one of the specific guaranteed-issue situations Florida recognises, a carrier here can ask health questions, rate you up, or turn you down. If you already know you will spend months of every year in another state, settle the question at 65 rather than at 71.
What Florida law does give you is worth knowing. Every Medicare Supplement policy sold here is guaranteed renewable and carries a 30-day free look. The federal Medicare Advantage trial right also applies: join an Advantage plan when you first become eligible for Part A at 65, leave within one year, and you can buy any supplement from any company on a guaranteed-issue basis. Our post on being denied a Medigap policy in Florida covers what happens when someone misses all of these, and our guide to switching from Medicare Advantage back to Original Medicare maps the windows.
What about a cruise, or a few weeks in Canada?
That is a different question with a different answer. Original Medicare itself generally does not follow you abroad, so the portability argument that works in Pennsylvania stops working in Nova Scotia.
Florida Medicare Supplement policies address this with a foreign travel emergency benefit, and the Florida Office of Insurance Regulation states its 2026 terms exactly: the benefit pays 80% of the actual billed charges after a $250 emergency medical deductible, subject to a lifetime maximum benefit of $50,000. Read all three numbers together. Eighty percent still leaves a fifth of the bill with you, the $250 applies before anything pays, and the $50,000 is a lifetime ceiling rather than an annual one.
For a week in the Bahamas that is probably adequate. For a long cruise or an extended stay abroad it is a starting point, and standalone travel medical coverage is the usual answer. Before you book, find out whether your policy includes the benefit.
Part D is regional, but your pharmacy counter is local
Drug coverage is the piece people assume is simple, and it is simpler than the rest, up to a point. A stand-alone Part D plan in Florida is sold statewide. For 2026 the Florida records carry no county restriction: ten plans from five parent organizations, and a resident of Nassau County chooses from the same ten as a resident of Broward.
The 2026 Florida shelf is worth a careful look while you are in it. Published premiums for those ten plans run from $0.00 to $217.00 a month. Seven of the ten charge the full $615 maximum deductible, and one charges nothing at all, which happens to be one of the more expensive plans by premium. Not one earned a 4-star Part D summary rating for 2026. All ten carry the same $2,100 annual out-of-pocket cap, because that cap is federal.
So where does a part-year resident get caught? At the counter. A plan sold statewide still contracts with individual pharmacy chains, and the pharmacy two blocks from your summer house may sit outside that network, which changes what you pay for the same drug. Mail order solves some of it and creates other problems, particularly for anything refrigerated or controlled. Run your drug list through the Plan Finder at Medicare.gov twice: once with your Florida pharmacy, once with a pharmacy near your other address.
Send us the plan name and we’ll tell you what changed this year. The drug side moves more money for most retirees than the medical side does, and formularies reset on 1 January whether or not anybody writes to tell you.
Under 65: an ACA plan follows where you live
If you are not yet on Medicare and you split the year, the question stops being about networks and becomes about residency. A Marketplace plan is issued to a household at an address. Where you live sets the price and sets the network, and the person on the forum who wrote that “all of my doctors/care providers/facilities are in Toledo/Ohio — for all practical purposes I live in Toledo” had found the real issue.
The first step is not an insurance step. Decide honestly which state is your legal residence, then make the rest of the paperwork agree — driver’s licence, voter registration, tax filing, vehicle registration, the address on the policy. A household that files as a resident of one state and buys coverage as a resident of another has built a problem into the file, and it surfaces while a large claim is being reviewed.
Then there is the platform question, and for anyone splitting Florida and Georgia it is now live. Georgia is a state-based marketplace: Georgians enrol through Georgia Access rather than HealthCare.gov, run by the Georgia Office of Commissioner of Insurance and Safety Fire, with a consumer contact centre on 888-687-1503. Florida and Texas remain federally-facilitated marketplaces. The full picture is in our guide to health insurance in Georgia and Georgia Access.
What it costs to get this wrong
The expensive version rarely announces itself. It is not usually a denied emergency room claim, because emergency care is the one thing almost every plan handles away from home. It is quieter: you are in Ohio in July, your Florida plan does not cover the routine specialist visit you booked, and you choose between paying full price, driving south in the middle of summer, or letting the appointment slide until autumn. People pick the third option, and that is the one that turns a manageable problem into an admission.
Then there is the cost of finding out late and finding the exits closed. The supplement window does not reopen in Florida because you changed your mind. Someone who realises in year six that they bought the wrong structure is asking a carrier to underwrite them at an age when underwriting tends to find something. The cure is cheap and boring: decide your residence, document it consistently, and buy the coverage that matches it.
is the median in-network out-of-pocket maximum for 2026 Medicare Advantage plans in both Fulton and Chatham counties, Georgia — against $6,750 in Duval, Clay, St. Johns and Nassau counties, Florida, and $3,900 in Broward. Identically-priced plans in two states can differ by thousands in worst-case exposure.
Source: CMS CY2026 Medicare Advantage / Part D Landscape Source File, via the Ambrose Insurance Brain (healthcare-db), retrieved July 2026How to sort this out yourself, in one evening
You can do almost all of this without an agent, and you should do it before the enrollment window rather than during it. Work the steps in order; each one narrows the list for the next.
- Decide which state is your legal residence, and make the paperwork agreeDriver’s licence, voter registration, tax filing, vehicle registration and the address on any policy should tell the same story. It is the question an insurer asks when a large claim lands.
- Pull your Medicare number and your Part A and Part B start datesThey are on your red, white and blue card. The Part B date sets your one-time 6-month Medicare Supplement open enrollment window, which in Florida decides whether portability is still available on guaranteed-issue terms.
- List the doctors you use in both places, not just the ones at homePrimary care and every specialist at each address, plus the hospital system you would want a serious problem handled by in each state. Mark which relationships you would refuse to give up.
- Ask the plan the out-of-area question in writingName a specific routine service — a cardiology follow-up, an MRI, a course of physical therapy — name the town, and ask whether it is covered away from the service area. Ask for the answer by email. A directory screenshot is not an answer.
- Check the drug side in both statesRun your exact drug list, with doses, through the Plan Finder at Medicare.gov using your Florida pharmacy, then again against a pharmacy near your second address. Ask what mail order does for anything refrigerated or controlled.
- Price the honest comparison, not the premium comparisonFor each finalist write the cost you would pay across twelve months, and next to it the worst case. For Medicare Advantage that worst case is the in-network out-of-pocket maximum, and only in network.
- Decide before the enrollment window opens, not during itAnnual Enrollment runs 15 October to 7 December for coverage starting 1 January, and if you are already in a Medicare Advantage plan a second window runs 1 January to 31 March. Those are deadlines, not research time.
- Get a second opinion from somebody with nothing to sellCall 1-800-MEDICARE, use the Plan Finder at Medicare.gov, or ring Florida’s free counselling programme SHINE on 1-800-963-5337. SHINE is run by the Florida Department of Elder Affairs and its counsellors are not paid by any carrier.
Bring your current plan and your prescription list; we’ll do the comparison with you. Households that arrive with both doctor lists written have done the part that takes time.
Before and after: one Amelia Island couple, on paper
Meet Ray and Dot, both 67, who keep a house on Amelia Island from October to May and a house outside Columbus, Ohio for the summer. They are invented, and the table applies published 2026 figures to their invented situation.
In the before column they did what the mail suggested: a $0-premium Advantage plan sold to their Nassau County address at 65, no questions asked about Ohio, and a surprise in their second summer when Ray’s cardiology follow-up came back as a routine out-of-area service rather than an emergency. In the after column they had the conversation before Annual Enrollment and priced Original Medicare with a supplement.
| What they looked at | Before | After |
|---|---|---|
| Coverage structure | Medicare Advantage, enrolled from a Nassau County address | Original Medicare plus a Medicare Supplement |
| Routine specialist visit in Ohio in July | Out of area — routine, not an emergency | Paid as Medicare pays anywhere in the U.S. that accepts Medicare |
| Part B coinsurance exposure | 20% with no cap outside the network | Most of the 20% paid by the supplement wherever Medicare pays |
| Monthly cost in a quiet year | Lower — $202.90 Part B, no plan premium | Higher — $202.90 Part B plus a supplement premium |
| Drug coverage | Bundled, one pharmacy checked | Stand-alone Part D, checked at both addresses |
| Reversible later? | Only inside a window; Florida has no birthday rule | Settled inside the 6-month Medigap window |
Notice what the after column costs them. Money every month, in every quiet year. That is the trade and we will not pretend otherwise. What it buys is that the summer half of their life is covered like the winter half.
Where to get help that has nothing to sell you
Keep an unbiased source in your pocket. Medicare.gov is the official government site and its Plan Finder runs on the same landscape data every agent uses. 1-800-MEDICARE is staffed around the clock. Florida’s State Health Insurance Assistance Program is SHINE, on 1-800-963-5337, run by the Florida Department of Elder Affairs, and its counsellors are paid by no carrier.
If your second state is Georgia and the question is a Marketplace one, the Georgia Access contact centre is 888-687-1503. If it is Texas, the Texas Department of Insurance consumer help line is 800-252-3439. Every state runs its own version of SHINE, so free counselling exists at both ends of your year.
McDowell Business Resources is an independent agency, not an insurance carrier, and we are not affiliated with or endorsed by the U.S. government, the federal Medicare program or CMS. We do not offer every plan available in your area, and the information we give is limited to the plans we do offer. The numbers above plus Medicare.gov will get you most of the way to a good decision without us.
How we help people who live in two places
This is the one reader for whom our licensing footprint is not a marketing line. We are licensed in Florida, Georgia and Texas, so the household with a Jacksonville address and a Georgia lake house, or a Fernandina Beach winter and a Texas summer, can have both halves of the year handled in one conversation.
Beyond the licences, what we add is the labour. We run your exact doctors and your exact drug list against every plan we represent, at both addresses where that applies, and we show you the total expected cost in a healthy year and in a heavy-care year rather than the premium alone. Where the answer is a supplement, we say so and tell you what it costs every month.
We’re in Jacksonville, and we’ll meet you where it suits — in person, by phone or by video, at whichever end of the year you are at home. The county detail lives on our Nassau County page and our St. Johns County page, the service outline on our Medicare page, and the numbers behind the chart above in our review of the Fernandina Beach and Nassau County plan market.
What you get out of doing this properly
You stop feeling like you are voiding your health care for five months a year. You know, before you need it, which card works in which state and what happens at a pharmacy eight hundred miles from the one on your file. You have the out-of-area answer in an email you can find. And if a supplement turns out to be the structure your life requires, you made that decision while the door was still open.
None of it is complicated once somebody tells you that coverage types travel differently. The review takes an evening in September and a shorter one each autumn after. Whatever you decide, decide it on the numbers. If you want help getting to them, we’re here.
Free, no-pressure help with medicare — in plain language.