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How to Change Health Insurance When Moving Out of State

The lowdown...
  • The Rules of Obamacare allow changing policies during open enrollment
  • The rules prohibit changing policies after open enrollment
  • Moving out of state may be a qualifying event for a Special Enrollment Period
  • The rules provide for a special enrollment for a substantial change in status
  • A new location may be a substantial change in status requiring a special enrollment

The rules that carry out the Affordable Care Act recognize moving as a change of status. It refers to a qualifying move as permanently moving to an area that offers different health insurance options.

Insurance companies base their insurance coverage and plans on populations within county lines and state boundaries. Moving to a new state would typically qualify as a move requiring a new opportunity to buy insurance.

Comparison shopping is a powerful tool for finding the best values in Obamacare health plans. Consumers can focus on the features of greatest value to them and which meet their preferences.

Enter a zip code above to compare health insurance quotes in your new state now!

Changes in Residence

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Changes in residence can provide a basis for a Special Enrollment period. Some household moves are qualifying events for the special enrollment and a 60-day window to get new insurance. The below-listed items describe household moves that qualify for a Special Enrollment Period under federal and state rules.

A condition to most of these moves is that the individual must have had insurance coverage for at least one day before the move. The exception involves moving from a foreign country or territory in which coverage may not have been feasible.

  • Moving to a new residence with a new ZIP code or to a new country.
  • Moving from a foreign country or US territory to one of the fifty states.
  • A student relocation to or from the place they go to school.
  • A seasonal worker that moves to or from residences where they work.
  • A person that moves from transitional housing to or from another transitional housing location.

How to Get New Insurance

After moving to a new state, one can get new insurance coverage by making a request to the state exchange or the federal marketplace. If made during open enrollment, the request can get an immediate response.

Every eligible person can buy insurance during the open enrollment period without regard to prior insurance status.

If the request occurs after the close of open enrollment, then the move must qualify as a life event, and moving to a different state will qualify the applicant for a special enrollment period. The special enrollment period lasts for sixty days, and the applicant must get coverage within that time.

Medicaid Expansion States

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One change that can come from a new location is in Medicaid Expansion. Many Republican-controlled states did not accept the benefits of Medicaid expansion for their citizens even though it would have provided coverage for their most vulnerable residents.

A change in location could deliver the applicant to a state that embraced Medicaid Expansion, and this could mean low or no-cost coverage for an individual or family.

Medicaid Expansion raised the income limit for getting Medicaid so that those applicants that had too little income for Obamacare policies could get coverage through Medicaid. Before the expansion, there was an uncovered gap between the minimum for Obamacare and the maximum for Medicaid.

Individual Mandate

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The individual mandate requires that eligible residents must have qualified insurance coverage. They must get coverage and keep it for the entire calendar year. Those that fail or refuse to buy insurance must get an exemption or pay the tax penalty for uninsured persons.

The individual mandate applies to persons that move during the calendar year. They must get new insurance coverage that applies to their new location. Some moves will not require a change in coverage, and they do not qualify as life events.

Moves that cross state, county or national boundaries typically do require new insurance. The mandate applies to residents that move, and the applicant must get new coverage within the time allowed in the open enrollment period or a special enrollment period.

Qualified Health Plans

The Affordable Care Act requires coverage through qualified health plans. Qualified plans have the below-listed components, and every policy sold through the state exchanges or federal Marketplace is a qualified health plan.

  • Minimum actuarial value of sixty percent.
  • Minimum essential coverage from essential health benefits and no costs prevention programs.
  • Annual limits on consumer payments for expenses.

Federal Marketplace and State Exchanges

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Moving to a new state may occasion the difference between buying a policy on the federal marketplace or through a state exchange. Both the federal marketplace and the state exchanges can issue policies and provide financial assistance to qualified applicants.

Some state exchanges provide active purchaser oversight over the insurance providers. This special attention to the make-up of the plans offered on a state exchange can cause lower prices and higher levels of benefits than when the government merely reviews the plans for consistency with the Affordable Care Act.

Open Enrollment Period

The open enrollment period provides an opportunity for every eligible person to purchase health insurance. All of the policies sold on the state exchanges or the federal Marketplace meet the requirements for qualified health plans. The coverage will avoid the tax penalty of the individual mandate.

After Open Enrollment

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After the open enrollment period, it is possible to purchase a qualified health plan. For example, Nevada and A few states require insurers to offer their plans on a year-round basis. However, one cannot get the benefits of the Affordable Care Act subsidies outside of the Marketplace and state exchanges.

A person qualified for subsidies would not benefit from a policy outside of the marketplace. They would forego substantial savings and benefits that include advance premium tax credits, costs sharing reduction assistance, and health savings accounts.

Change in Status

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Status changes include matters like becoming a member of a recognized Indian tribal organization and status as an employee in a grandfathered plan. Moving will not affect employer-sponsored coverage in the same ways as with marketplace plans.

The employer can continue to offer insurance coverage in the new location, and the employee will not get a special enrollment period. The special enrollment would follow the loss of coverage from an employer plan or a grandfathered plan.

Moving to a Different Market

Moving out of state can require a new opportunity to buy insurance because an existing insurance contract may have a geographic limitation. Most policies are not multi-state policies, and many insurers do not provide multi-state coverage. Moving out of state will put the applicant into a different market.

There will be new or fewer insurers, more or fewer options for coverage and prices. The consumer will have a different array of treatment facilities, doctors, and types of coverage such as HMO, PPO, EPO, and other forms of managed care.

The available plans will have a different mix of the essential health benefits and medical care providers in a new service area.

New Levels of Competition

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A new location can provide more competition among insurers, and this will bring better coverage and lower prices than locations with no or low competition.

A large percentage of US counties have low or no competition, and a shift to a high competition could bring a noticeable improvement for many consumers. Costs and premiums can be lower in another area due to competition.

Prices and Coverage Vary by Location

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The rules that carry out the Affordable Care Act permit price discrimination based on location. When reviewing insurance plan submissions, the states and the federal government give weight to the location. The geographic area served by a given plan has an impact on the prices and services that insurers can offer.

Some areas lack the robust levels of facilities and medical care professionals that occur in other areas. One easy comparison is a remote rural area contrasted to a busy metropolitan center.

The Affordable Care Act permits individual price discrimination that uses the below-listed standards.

  • Age
  • Tobacco usage
  • Insurers charge more for family versus individual plans
  • The type of Obamacare plan causes severe price differences by coverage and locality. The platinum, gold, silver, and bronze plans have different levels of coverage, premiums, and deductibles.
  • Location affects price and availability of medical care service providers.

Qualifying Events

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The so-called life events qualify for special enrollment periods after the close of the open enrollment period. The federal government and state exchanges agree on the below-listed items as qualifying events. These life events represent substantial changes in insurance status that require a new opportunity to buy coverage.

  • Marriage
  • Divorce
  • Childbirth
  • Adoption
  • Loss of coverage as an employee
  • Loss of coverage as a dependent
  • Loss of coverage at the 26th birthday
  • Moving to a new zip code, county, state, or from a foreign country

Special Enrollment Periods

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The rule that no one can buy insurance after open enrollment would have harsh consequences were it not for qualifying events and special enrollments. Insurance prices and coverage depend on insurance status. The Affordable Care Act limits the differences that insurers can make in price and coverage based on individual status.

But some changes are fundamental such as giving birth to a child. The status of the mother changes and the child requires coverage on her individual or family policy. She will require postnatal services and prevention services.

Similarly, a death in the family can cause significant changes in status in particular for dependents of the deceased family member. Death in the household can entitle every member to a special enrollment period to get new insurance coverage.

How to Keep insurance when Moving

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One can start the process of getting new insurance up to sixty days before the move date. This can avoid a break in coverage. One must make a request to the state exchange or federal marketplace that covers the destination state. A move across state lines will qualify as a life event and open a 60-day window for getting new insurance coverage.

Comparison shopping is a proven technique for finding high-value health plans in the federal marketplace and state insurance exchanges. Comparison shopping can put the consumer’s priorities at the heart of the search and evaluation.

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