Determining Medicare State of Residency – It’s more complicated than you think

Determining Medicare state of residency for a client may not be as straight forward as you think. Many factors go into determining principal residency. It’s not something you want to risk messing up! Let us help you navigate tricky Medicare state residency rules.

The Short Cut

If you’re not familiar with how to determine where a client’s primary Medicare state of residency is, you’re likely to waste your time tracking down information that won’t necessarily be correct. A lot of people assume it’s the state where the client votes, pays taxes, or spends most of their time. It could be, but that’s not a fool-proof way to determine primary residency. Who cares? You should! Don’t risk being penalized for selling a policy in a state that you are not licensed in.

If the client only has one property and lives there full-time, congratulations, they made your job easier for you. Say your client lives in one state but is a legal resident of another. They split their time evenly between the two locations. Lets say they have their car registered in one state but pay taxes in the other. Now what do you do?

The obvious (and time-wasting) next step might be to determine where the client votes and where they file their taxes. That’s a good thought, but it’s not guaranteed to be correct! What really matters in-regards to insurance is where they registered with Social Security and Medicare. Don’t remember? You’ll need to check with the government.

Go into the Blue Button and double check what address the government has for them. The Blue Button lets your client quickly download their personal health file. What they have on file is their primary Medicare state of residency. Check for yourself: Blue Button

Don’t Lose the Sale

When your client tracks down their state of residency, we hope you’re licensed to sell in that state. If you’re not, don’t lose the sale! Referral fees can really add up. It’s better to walk away with approximately $25 than to walk away with $0 and the potential to be terminated by the carrier for 12 months. Check our referral program out for yourself: Gordon Marketing Referrals

For more information see our YouTube video: Click Here


Sylvia Gordon and her sister, Rebecca, run Gordon Marketing, one of the nation’s largest Medicare FMO/NMA offices. They have a team of over 100 that train and support independent insurance agents in all 50 states. You can find Sylvia’s weekly posts on LinkedIn and the sisters' Youtube channel posts 2 training videos each week. Contact Sylvia at or 800-388-8342.


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