Moving is a big life event, whether you’re moving for a new job, to attend school, or simply to start your next adventure in life. And between finding new housing, packing, and doing the actual moving, the last thing you probably want to deal with is your health insurance—but you will likely need to change your health insurance if you move out-of-state.
In this article we’ll go over how a move might impact your health insurance coverage and what you can do to ensure you are covered to get the care you need, no matter where you are located.
Does my health insurance cover me when I’m out of my home state?
To begin to understand how your health insurance might be impacted by a move, you first need to understand how various health plans work when you’re not in your home state.
Health insurance plans and benefits vary across the U.S. because most plans are tied to a specific state. However, some plans — mainly PPO and POS plans — offer health insurance coverage for medical care outside of the insured person’s home state. They do this through the use of out-of-network coverage. With these kinds of plans, if you see a provider for a non-emergency medical situation, you won’t have to assume all the costs for that care yourself. Instead you’ll pay for a percentage of the total amount and your insurance plan will pay for the remaining amount. That’s why PPO or POS plans are a good option for people who travel a significant portion of the year.
Grab our quick guide to learn the differences between HMO, PPO, POS, and EPO health plans.
There are also multi-state plans, which offer in-network providers across a region or even nationally. However, this coverage depends on the specific plan a person is enrolled in. And not all multi-state plans have out-of-state coverage, despite their name.
In almost all cases, insurance plans will cover emergencies, regardless of where a person seeks medical care. Customers should still check and see what counts as an emergency under their health insurance plan. Simply going to the emergency room does not make a situation an emergency. Plus, insurance companies use different definitions to categorize emergency situations.
Do I have to change health insurance if I move out-of-state?
Out-of-network care is usually more expensive. So if you’re moving to a new state, typically, you won’t want to keep your current plan. With a new plan, you will be able to see in-network providers, and not have to rely solely on out-of-network benefits.
For someone whose health insurance is provided as part of their benefits package from their employer, it’s possible that they won’t have to change health insurance plans if they move to a new state. But if you’re someone who bought health insurance through the Health Insurance Marketplace (otherwise known as Obamacare), the process is different. You will have to pick a new plan in order to get covered.
Luckily, moving is one of the qualifying life events that count for a Special Enrollment Period (SEP). That means someone moving to a different state can enroll in a Marketplace health insurance plan outside of Open Enrollment. If you had a Marketplace plan before your move, you’ll need to report the change and then begin the enrollment process again in your new location. So you’ll be completing the same kind of application you did when you previously enrolled in Marketplace coverage.
To see plans and prices, and to see if you’ll qualify for Medicaid or financial help on Marketplace insurance (aka Obamacare), enter your zip code below.
Reporting your move
If you enrolled in Marketplace coverage (aka Obamacare or Affordable Care Act insurance), you have a couple different ways you can report your move.
1. You can report a change by calling the HealthSherpa Consumer Advocate team at (872) 228-2549.
2. You can report your change online through HealthSherpa. To do so, just log into your HealthSherpa account, or if you don’t have one, create an account here. Once signed in, you’ll see your plan name, the effective date, your subsidy amount, plus additional details. On the right-hand side of that, click on the blue “update” button. From there you will be able to access your application and report the change.
3. Log into your HealthCare.gov account to report your move. First head over to the “My Profile” section and update your mailing address. Once that’s finished, click on the “My Applications & Coverage” tab, where you can select your application for the current calendar year. From there, you’ll click on the “Report a Life Change” option where you can indicate your move.
Then you can apply for a new Marketplace plan. You’ll select the year and state for which you need coverage. Then you’ll complete an application again, just as you did when applying for your previous Marketplace plan. At this time, you’ll also want to make any updates to your application. This includes the number of people in your household and your income. That way you can see some important information including: 1. Your health insurance options based on your new location. 2. The costs associated with each plan. 3. And any subsidies that you’re eligible for.
Keep in mind that a move may also mean a change in eligibility for Medicaid. That’s because some states have expanded Medicaid programs and others haven’t. This means that in some places the income threshold is higher when it comes to qualifying for low- to no-cost Medicaid coverage. If you’re currently on Medicaid in your state, be sure to check your new state’s Medicaid eligibility rules to see if you still qualify. And if you think you may be eligible for Medicaid in your new state, starting an application for Marketplace coverage will also let you know if you qualify.
When will my new plan begin?
If you qualify for an SEP, you should make sure to take advantage of it—it’s a 60-day window where you can enroll in a health insurance plan. And sometimes this can occur even when you move within your state. Research your plan options, and apply for your new health insurance within the 60-day SEP window. Be sure to do this as soon as you get a new address to prevent a gap in coverage.
If you enroll between the 1st–15th of the month, your new plan will typically start on the first day of the next month. However, if you apply after the 15th, your new coverage won’t begin until the first day of the second month after your enrollment.
Grab our step-by-step guide to enrolling in Marketplace health coverage to learn more.
What if I live in two states during the year?
Changing health insurance from one state to another can be complicated for those who move frequently during the year. Seasonal workers, snowbirds, and college students are among the biggest groups of people who live in multiple locations each year.
Generally, health coverage should be purchased in the state where someone spends the majority of their time, and the same state where they vote and pay taxes. Opting for a PPO or POS plan that has out-of-network coverage is a good idea for someone in this situation.
If you’re not someone who is in a single location for the majority of the year, you can look for a multi-state plan that has in-network providers in all the places you might find yourself living. Or enroll in a new plan whenever you move, as long as you qualify for an SEP. Typically students and seasonal workers qualify, but moves for medical treatment or vacation don’t. You should be aware that joining a new plan does reset the deductible and out-of-pocket costs to zero. Plus, it may impact any available tax credits, as well.
What if I live in one state but my dependent children move to another state?
Under the ACA, insurance companies must allow children up to age 26 to be on their parents’ health insurance plan. However, if a child lives in a different state than their parents, and the parent’s plan does not offer in-network providers where he or she is located, it may be worth looking into a separate health coverage plan for their child. Comparing individual health insurance plans for their child may also make sense if adding them to their plan is more expensive than buying a separate plan.
Moving out-of-state can be stressful enough. Thankfully, HealthCare.gov and HealthSherpa provide numerous resources to make this part of the planning process as simple as possible.