Do you purchase your own major medical insurance plan from the federally-facilitated exchange Healthcare.gov or a state-based exchange? Or have you bought your plan directly from an insurance carrier or agent?
If so, look at the chart below to see if your move might require you to buy a new insurance plan.
Do You Have to Buy New Insurance If You Move?
|If you’re moving…||Probably won’t need a new plan||Possibly may need a new plan||Probably will need a new plan||Definitely will need a new plan|
|Within the same zip code|
|To a different city in the same state|
|To another state|
|To another country|
If your move results in a qualifying life event, you may be eligible for a special enrollment period, allowing you to switch plans outside of the annual open enrollment period. However, you could experience a coverage gap between the time your current insurance plan ends and your new plan begins.
The good news is that non-Affordable Care Act-compliant products, such as short term health insurance, can help temporarily until you’re able to enroll in a new major medical plan.
Short term health plans have limited benefits for unexpected illnesses and injuries, covering few if any of the ACA’s essential health benefits, and are not guaranteed-issue, meaning you can be charged more or denied coverage altogether based on pre-existing conditions. Policies can last as few as 30 days or as long as 364 days depending on state laws.
Typically, you can begin your short term coverage soon after your application is accepted, so you don’t have to wait weeks to obtain covered healthcare services. Short term insurance is not available in all states.
To find out if short term plans are available in the area you’re moving to, get a quote using your new zip code.
Keep reading this article for tips on how to manage your health insurance needs during a move, whether you’re moving to a new zip code, relocating to a new state, or going international.
If You Are Moving Locally (Same Zip Code or County)
If you’re moving from an apartment or house and your zip code or county remains the same, you probably won’t need new coverage. But be sure to contact your health insurance company and update your address on file.
If You’re Moving Within the Same State But to a New City
A new zip code or city may mean you need to enroll in a new health plan. Did you know that your location is factored into the pricing of your major medical insurance plan due to industry competition, state and local rules and cost of living? That means your monthly insurance premium could change just by moving to a new zip code.
Will You Need to Purchase a New Insurance Plan?
With plan and insurance company availability varying within the same state, you might have to switch to a new plan or even a different insurance company.
Depending on where you purchase your major medical coverage, here’s how to verify whether you can keep your current coverage:
|You get your plan through:||Here’s what to do…|
|Healthcare.gov||Update your application online, by phone or in person (not mail). You’ll be notified if you need to change to a new plan or insurance company.|
|State-based exchange||Contact your state-based exchange with your new address information, and you’ll be informed about whether you need a new plan or insurance company.|
|Private insurance market||Contact your insurance company directly. A representative can instruct you on whether you’ll need to switch to a new plan or insurer.|
If You Need to Change Plans
Should you need to switch to a new plan, these steps can help ease the transition from one major medical plan to the next:
- Choose your new plan within the special enrollment period – be sure to take note of the rules which apply to moves that qualify for a special enrollment period.
- Select a plan that meets your coverage needs – HMO, POS, PPO…it can be hard to know which type of major medical plan to choose. An agent can help you determine the plan structure that might work best for you.
- Find health providers that participate in your new network – your new insurance company’s website should list in-network providers. Remember that depending on your new plan, you may have to pay more for services from out-of-network providers.
- Consider short term health insurance or telemedicine if you’ll experience a gap between major medical insurance plans – call 888.855.6837 to speak with an agent that can help you learn more about these products, both of which can help you access health care while you’re waiting for your new coverage to start.
Qualifying for a Special Enrollment Period: Moving
Under ACA rules, your move qualifies for a special enrollment period to enroll in a new plan regardless of whether or not you already had ACA-compliant coverage before your move, and if you are:
- Moving to a new home in a new ZIP code or county
- Moving to the U.S. from a foreign country or U.S. territory
- A student moving to or from the place you attend school
- A seasonal worker moving to or from the place you live and work
- Moving to or from a shelter or other transitional housing
You have 60 days within the date of your move to select a new plan. Then within 30 days of choosing your new plan, you also must submit your:
- Paperwork which verifies that you have moved
- Documentation that you had qualifying health insurance for at least one day during the 60 days prior to your move
- Your premium payment.
Avoid gaps in health insurance coverage
If you enroll in a Healthcare.gov or state-based exchange plan, your new coverage takes effect on the first day of the following month if you pick your new plan between the 1st and 15th day of the month. If you pick a plan after the 16th of the month, your coverage becomes effective on the first day of the second following month.
Be sure to note that if you don’t enroll in coverage before your special enrollment period ends, you will need to wait under the next annual open enrollment period to purchase a plan through Healthcare.gov or your state-based exchange.
If you miss your special enrollment period don’t go without any coverage at all.
Temporary coverage through a short term medical insurance policy can help with costs related to hospitalization and emergency medical treatment for unexpected illnesses and injuries.
If You’re Moving Out-of-State
Do you have to change health insurance if you move out of state? Chances are, your health plan won’t be moving with you. With a new location, you can expect a different premium rate, a new plan and possibly a new insurance company.
You might also encounter different rules about qualifying insurance requirements, and discover that different types of non-ACA plans are available to you.
Does Your New State Require You to Buy Health Insurance?
Although the federal mandate requiring you to have health insurance or pay a penalty has been eliminated, several states have their own mandates, which require you to pay a penalty if you live in that state and don’t have qualifying health insurance.
Penalties for not having ACA-compliant coverage vary by state. Be sure to check with your tax advisor if you move to one of these states and do not purchase qualifying health insurance.
Buying an Insurance Plan in Your New State
These tips can be useful in managing your health insurance-related needs when you move to a different state:
- Check to see if your new state has an individual mandate for health insurance – if you don’t purchase qualifying coverage in a mandate state, you may pay a penalty when you file your taxes.
- Make your new plan selection within the special enrollment period – if you intend to purchase an ACA-qualifying plan, be sure to follow the rules that apply to qualifying moves.
- Choose a new plan that meets your coverage needs – you may have different insurance plan choices available to you in your new state. An agent can work with you to determine which type of plan would meet your needs well.
- Select health providers that participate in your new plan’s network – a new state and a new plan will probably mean a new network. Check your new insurance company’s website for a list of in-network providers to help keep your out-of-pockets lower.
- Protect yourself from unexpected medical expenses in the gap between your major medical plans with short term health insurance or telemedicine – it takes just a few minutes of your time to learn which types of products are available in your state.
Moving to a Different Country
If you purchased your major medical insurance through Healthcare.gov or a state-based exchange, medical costs are typically covered only for providers and services within the U.S.
That means you’ll want to explore your expat health insurance options to ensure you have access to care and prescriptions you’ll need while living in another country.
Contact your current health insurance company to see what options they might have for you, or work with a health insurance agent to find coverage. And review this list of what else to expect as an American living abroad, compiled by a group of experienced expats.
Protect Yourself During a Major Medical Coverage Gap
Moving can be stressful and a physically taxing process – and the last thing you want to worry about is getting sick or injured during the gap between your major medical plans being in effect.
Non-ACA products can help protect you from unexpected medical costs during a gap in your ACA coverage.
Short Term Health Insurance
Also known as short term medical, short term health insurance is an affordable non-ACA insurance solution designed to provide coverage on a temporary basis for medical costs such as doctor office visits, hospital room and board, surgery and emergency room treatment.
Depending on your state, you can keep this coverage for 30-364 days.
Short term health insurance is not guaranteed-issue, which means you may be denied coverage based on pre-existing conditions or your medical history. But if you’re approved, you can often start coverage within 24 hours of your approval date.
Because short term medical does not provide all of the essential health benefits required by ACA-qualifying plans, premiums for this type of insurance can be lower than ACA-qualifying plan premiums. However, premiums will vary based on the benefits you choose.
Find plans in your new state and compare benefits and costs.
Summary + Next Steps
You may be able to avoid paying unexpected medical costs on your own during a gap between your major medical insurance plans with temporary, non-ACA products such as short term health insurance and telemedicine.
Working with real estate agents and moving professionals can make your move to a new location much easier. In the same way, working with a licensed insurance agent can provide you guidance if your move requires you to buy a new insurance plan.
Call 888.855.6837 to speak with a licensed agent for help understanding your insurance options during your move.