Hayek Insurance Blog
How does your health insurance coverage work if you live in more than one state? But what if you have your health insurance or are a Medicare or Medicaid recipient? Others who have houses in two states aren't simply retirees; they include college students and people who move for study or work. The details differ based on your coverage and where you live.
Health Coverage for Individuals
Individual market coverage is available to over 13 million Americans through the exchanges. Individual and family health insurance is coverage purchased independently, either through a health insurance exchange or directly from an insurance company. Plans are controlled at the state level, and the plans available for purchase differ greatly from one state to the next.
Health Plan Categories
In recent years, individual market insurers have shifted away from preferred provider organization plans. PPO plans are still available in some states, but no individual market plans with out-of-network coverage are available in others. HMOs and EPOs do not cover non-emergency emergency care, whereas PPOs do.
Individual market plan networks are typically fairly localized, rarely extending into other states unless a major metropolitan area spans two states.
If you live in one state predominantly, your residency is determined by that state's principal residence. You can choose to establish residency in another state if you have a second home in that state and spend "a significant amount of time" there.
Early retirees who haven't yet reached Medicare eligibility may find themselves in this scenario. While having the option of establishing residency and purchasing insurance in either or both states is advantageous, certain considerations must be made.
Suggestions for Living in Two States
When your move qualifies as a "permanent move," you might not have coverage for anything other than emergency treatment. You may be required to meet three deductibles and out-of-pocket maximums in any given calendar year if you opt to purchase a new plan each time you relocate.
If the plan's network is limited to providers in your home state, you'll have to return to your initial residence to get in-network care. While the option of purchasing a new plan each time you move ensures that you'll have access to in-network care all year, it's crucial to keep in mind that it could become prohibitively expensive if you require major medical attention.
You should normally acquire health insurance in the state where you reside and work if you live in one and work in another. Generally, you should get health insurance in the state where you spend the majority of your time if you live in multiple states.
At Hayek Insurance, we do our best in making sure that our clients are well-protected with affordable and comprehensive policies. We make sure to go the extra mile to help you with your needs. To learn more about how we can help you, please contact our agency at (805) 496-8835 or Click Here to request a free quote. The coverage discussed is not guaranteed. Please contact our agents to make sure you have adequate coverage and your needs are being met. We are happy to help!