How Snowbirds Can Find Quality Health Care

Not only had I lived my entire life in Minnesota, but I had also worked my 25-year health care career there. As a patient, I always trusted I was safe. As a nurse, the weight on my shoulders to be fully competent in all areas and get everything done was always heavy.

I never thought about how Minnesota ranked compared to other states, but if the stress put on nurses there to do it all while doing it well was any indication, I should have known we had something to prove.

My family moved to Texas last year. Good health care was an unconscious expectation and not a consideration in our decision to relocate. I was stopped in my medical knowledge tracks quickly, though, by health care culture shock, if you will.

When another winter was approaching, I began thinking about all the snowbirds that would soon move to their southern winter abode before Minnesota's blustery wind chills set in. How would retirees who didn't know anything but the best get the quality of care they needed if I, a long-time registered nurse, could instantly pick up on the laxness of southern health care and recognize that I needed to advocate for myself?

The United States health care system is often a point of public criticism. More than 70% of Americans feel failed by it. High costs, low insurance coverage and lack of time with health care providers are just a few grievances on patients' extensive litany of complaints.

Forbes in 2023 published a health care rankings list for all 50 states based on 24 metrics in four broad categories: health care access, health care outcomes, health care cost and quality of hospital care. Minnesota ranked as the best state for health care, with no marks against it. Texas ranked as the 8th worst state.

Overall, southern states ranked more poorly than northern states. Seven of the 10 worst-ranked states are in the South (Georgia, Alabama, North Carolina, Mississippi, South Carolina, Arkansas and Texas).

Trusting a new care team for winter travelers who need medical care year-round can be scary. However, new and seasoned snowbirds transitioning seasonally between a summer and winter home can be successful. Though you cannot control how health care organizations run, you can be prepared and take charge of your health needs when away from your primary home.

Millions of older people (about 5.5% of Medicare beneficiaries) migrate between two homes yearly to enjoy retirement benefits. Some are motivated to relieve cold-weather physical symptoms, such as winter-induced respiratory illnesses or arthritis, while some still need year-long medical management of their health conditions.

Whether you are healthy or in need of regular care, knowing the details of your health insurance plan(s) will be helpful when it is time to see someone other than your usual doctor.

Some types of insurance plans and services to consider:

• Medicare and Health Insurance. Find physicians and locations that are in your primary insurance and Medicare networks. Then, decide if supplemental insurance makes sense for you and your plans.
  
  Medicare.gov, an official government website, has information about its multiple plan options, covered provider locations and limitations. A Medicare specialist can help guide you through coverage and the complications of juggling locations.

• Snowbird Insurance. Yes! There is actual snowbird insurance through Medicare.

• Travel Medical Insurance. Travel insurance is for shorter trips. However, it may be useful for taking a trip or vacation while living in your winter home.

• Home Care Services. For continuity of care and insurance coverage, national home health care providers may be an option if you need to receive home care visits.

• Concierge Services. If cost is not a hindrance, concierge services can give you VIP status and take care of health care coordination for you.

Most snowbirds are younger retirees with higher education and income, so technology may not be a barrier to accessing and transferring information online.

One study on older seasonal migrators found that winter travelers had higher rates of emergency room visits than non-seasonal migrators. Many visits were not for emergencies; a primary care physician could have treated the ailment. However, many of the winter migrants did not have a primary care physician at their summer domicile. The study showed that those who had established primary care in their warm-season homes had reduced unnecessary ER visits by 58%.

Adding a secondary care team near your winter home can be manageable with the internet, cell phones and mobile apps. Here are some tips on how you can keep your primary care at your fingertips to set up and utilize secondary care at your home away from home:

• Telehealth and E-visits. You can meet with your primary care team via video call for non-urgent needs.

• Mail Prescriptions. Many mail-order pharmacies can switch between your winter and summer addresses with adequate advance notice. You can also use national chains near your homes for pick up or delivery.

• Universal Health Information Systems. Many major health systems use the same medical records software (EPIC is common). With consent from the patient, care teams can see your medical records from other providers.

• Patient Portals. Use your health care organization's patient portal to view, download and print visit medication lists, allergies, test results, immunization dates, visit notes and other documents. Make copies of these records for your secondary care team. You can also make requests and send messages to your doctor through the patient portal.

Taking time to make and check off your to-do list well before your departure will help keep you organized and have your necessary documents handy.

Here are some tips to get you started:

• Take a picture of your insurance card with your phone and store it in your phone's digital photo album. Also keep a hard copy on you.

• Designate one of your home locations as your primary home.

• Get your annual visits or checkups at your primary location at least a month before leaving to allow time to complete tests and follow-ups.

• Schedule planned surgeries and procedures at least three months before travel to allow for recovery and follow-up.

• See your annual specialists in your primary home state but know where to find one in your winter state if an urgent visit is needed.

• Request a three-month prescription refill just before departure.

• Research in-network providers in your winter state. After choosing one, complete the new patient forms online or print hard copies.

• Familiarize yourself with nearby hospitals, emergency rooms and urgent care locations.

• Provide both care teams with a copy of your advanced care directives and living will.

• Make a list of your emergency contacts and give them to friends, family and neighbors.

Savvy snowbirds can smoothly transition from state to state. Early research, planning and organization can provide the information your secondary team needs to establish care or maintain an ongoing relationship.

The less time it takes them to obtain your information and health history, the more quality time they can spend caring for you while you are there.

Andrea Wickstrom, BSN, PHN, RN, has been a nurse for 25 years. Most of her experience is in cardiology at the bedside, stress testing, and with cardiac medical devices. Health literacy is also a passion of hers. Now, she combines her nursing knowledge with her love for writing to reach and educate readers. Read More