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How to Transfer Health Insurance to Another State: A Detailed Guide

Last updated on December 31, 2023

Moving to another state can be an exciting adventure, but it also requires adjusting many aspects of your life. One important consideration is how to transfer health insurance from another state to the new state you’re moving to. Though often overlooked, doing this properly ensures you have continuous health coverage.

Transferring health insurance across state lines can get confusing pretty quickly due to differing state regulations. This comprehensive guide covers everything you need to know, from types of health plans you can keep to specifics for employees, individuals, and families.

We’ll also compare and contrast the major health insurance providers across criteria important for relocating.

Comparison of Insurance Companies for Health Insurance Transfer

Take a quick look at how the top health insurance companies compare for transferring coverage across state lines:

ServiceAetnaBlue Cross Blue ShieldCignaUnitedHealthcare
Allows out-of-state providersYesYesYes, with MultiPlan PPOYes
National provider networkYesYesYesYes
AccreditationExcellentExcellentExcellentExcellent
Plan transferabilityVaries by state lawVaries by state lawVaries by state lawVaries by state law

As the table shows, the major insurers have national provider networks you can access after moving. However, keeping the same plan still depends on individual state regulations.

Below, we’ll explore the specifics in more detail.

Can You Keep Your Current Health Insurance Provider?

Whether you can keep your existing health insurance company depends on two key factors:

  1. Suppose they offer plans in your new state. The major national insurance providers offer plans in most states. However, smaller regional companies may only operate in certain areas.
  2. Individual state regulations. Some states limit plans from out-of-state companies. Rules can also vary for individual, small-group, and large-group plans.

In short – you may or may not be able to stick with the same insurer after relocating.

Below, we’ll break down how plan transferability works for specific situations.

Individual and Family Plans

Transferring an individual or family health plan to another state is entirely dependent on carrier availability and state regulations.

For example:

  • State A allows out-of-state individual plans as long as they meet minimum coverage requirements. You simply continue coverage with the other state’s network.
  • State B does not allow out-of-state individual plans. You must cancel your current policy and enroll in a new plan licensed in State B.

Rules also apply separately for individual major medical plans vs. supplemental coverage like dental insurance.

Before committing to a move, research regulations in your destination state carefully. Reach out to carriers directly with any questions.

Small Business Employer Plans

Small groups face more flexibility in keeping current health plans after interstate relocation.

Any small business with 1-50 employees can likely transfer coverage through the insurer’s national network. Larger groups may also qualify, but it depends on the carrier agreement.

That said, the new state may still impose different plan standards – such as:

  • Essential health benefits
  • Cost sharing limits
  • Out-of-pocket maximums
  • Deductibles

Ask your insurance provider if any benefit changes apply after transferring the plan.

Be aware that keeping the same carrier may mean plan tweaks to meet your new home state’s rules.

Large Group and Self-Insured Plans

The transfer process and requirements for larger employer groups depend on how their plan is funded:

Fully Insured Plans

Over 50 employees are covered by a traditional insurance policy.

The insurance company files with regulatory agencies in each state where it operates. So, transferring coverage to another location with that carrier is typically seamless.

Policies still have to bend to benefit mandates in the new state, though. As with small group plans, the insurer will communicate any changes after relocating.

Self-Insured Plans

These are also called self-funded, defined contribution, or Employee Retirement Income Security Act (ERISA) plans.

The employer collects premiums and then pays employee medical claims directly instead of buying a conventional policy. Third-party administrator services help manage the plan.

Self-insured groups enjoy special status to preserve benefits when moving between states. They are regulated under federal ERISA law instead of individual state mandates.

So, the existing health plan transfers as-is. The employer simply signs with a new third-party administrator licensed in their destination location.

Consult experts when navigating the complex regulations around self-funded plans, though.

Choosing New Individual and Family Coverage

How to Transfer Health Insurance to Another State
Source: iStock Photo

If your current health insurance carrier does not offer plans in your new state, you will need to find a new provider. Here is how to choose coverage that fits your situation after relocating.

Match Coverage Levels

Start by deciding which plan type you need:

  • Major medical (PPO, HMO)
  • Short term
  • Catastrophic
  • Supplemental (dental, vision etc)

Next, determine the right tier based on your budget and health profile:

Bronze – Lowest premiums but highest out-of-pocket costs

Silver – Middle ground with average deductibles

Gold/Platinum – Highest premiums and lower deductibles

Consult healthcare.gov’s insurance selector tool for personalized plan match recommendations.

Compare Plan Benefits

Dig into the details of each insurance policy using plan summaries:

  • Covered services – doctor visits, labs, hospitalization, prescriptions, etc
  • Cost sharing – deductibles, copays, coinsurance
  • Maximum out-of-pocket per year

Verify your medications are included in drug formularies. And ensure doctors you want to keep seeing participate in the carrier’s network.

Factor in Financial Assistance

If your income falls below a certain level, you may qualify for savings on marketplace insurance:

  • Premium tax credits – lower monthly payment
  • Cost-sharing reductions – decreased deductibles and copays

Financial help does not transfer automatically when moving. Visit healthcare.gov to update eligibility after relocating.

Carryover savings from spending accounts – like HSAs and FSAs – can also offset relocation costs.

Evaluate Add-On Services

Some health plans include value-added benefits like:

  • Wellness programs
  • Vision and dental
  • Retail and mail-order prescriptions
  • Telehealth visits
  • Health education tools

Compare complementary services between insurance companies when selecting new coverage.

Prioritizing convenience and overall experience can make a big difference while adapting to a new location!

How Insurers Handle Out-of-State Care

Virtually every major medical insurance plan today comes with out-of-network benefits for away-from-home care. Rules and reimbursement rates vary widely, however.

Below, we break down how national health insurance companies cover services across state lines:

1. Aetna

Aetna health plans include away-from-home care nationwide through the Aetna Open Access PPO network. This covers 94% of providers across all 50 states.

You pay higher costs for out-of-network care. But the plan still reimburses based on ‘reasonable and customary’ charges. Pre-approval for non-emergency treatment while traveling is recommended.

Aetna Medicare Advantage HMO options only cover urgent/emergency care outside your home state. So, these plans are not suitable for snowbirds splitting time between locations.

Read Also: Does Travel Insurance Cover Flight Cancellation?

2. Blue Cross Blue Shield (BCBS)

The BlueCard program grants BCBS members seamless national coverage with in-network costs. Simply swipe your member ID card at any BCBS provider around the country.

One thing to watch – deductibles and out-of-pocket maximums must be met separately for BlueCard visits. Requests get forwarded to your ‘home’ BCBS plan to handle claims.

Access to the multi-state BCBS network makes transferring coverage very convenient after moving.

3. Cigna

Like other big insurers, Cigna health plans extend across the country. Seek care from Cigna’s PPO network, and ‘in-network’ benefits apply, even out-of-state.

Cigna coverage includes over 1 million providers nationwide. Search for participating doctors or facilities on their website or app.

Those enrolled in Cigna + Oscar plans also gain access to Oscar’s statewide provider networks. This startup insurer partners with Cigna to improve tech capabilities.

4. UnitedHealthcare

UnitedHealthcare holds contracts with over 1.2 million caregivers in 6,000 hospitals and other facilities. The UnitedHealthcare Choice network covers all 50 states.

Just confirm participating providers when seeking care outside your home state. Be aware that UHC plans have multiple tiers like Premium and Elite – so benefits can vary.

In short, the major health insurance carriers allow quite flexible access to medical services across the US. Just beware of the fine print!

Special Considerations for Medicare Advantage

Retirees covered by private Medicare Advantage plans face limitations on out-of-state usage. These rules can complicate splitting time between two residences after relocating.

Medicare Advantage plans only cover non-emergency services from in-network providers. Using out-of-network care means much higher personal costs.

Each insurance company contracts with local provider groups. So, an HMO or PPO plan based in one state likely will not cover any routine care obtained in another location.

Furthermore, Medicare Advantage enrollees can only belong to one plan at a time.

There is no way to coordinate two policies based in separate states.

Solutions for Medicare recipients moving to another state include:

  • Maintain one primary residence – Keep getting care in your original home state and just travel to your second home periodically. This avoids disrupting insurance coverage through the same plan.
  • Switch Advantage plans seasonally – You can change plans during Medicare’s Open Enrollment Period each fall. Some states also have special election periods for address changes. Time annual plan swaps with your migration schedule.
  • Enroll in national PPO – A handful of big insurers offer PPOs that cover all states. But these still only treat non-emergency out-of-network care as ‘away from home’ subject to limitations. And you will likely need to switch doctors between locations.
  • Go back to Original Medicare – Traditional Medicare does not restrict out-of-state coverage. Combining government-run Medicare Parts A and B with a private Medigap plan allows the most flexibility to get care anywhere nationwide. But you lose the all-in-one convenience and extras like dental/vision/hearing that Medicare Advantage offers.

Frequently Asked Questions (FAQs)

Below, we answer some common questions about transferring health coverage across state lines.

Does my insurance cover me immediately after moving?
Health insurance plans typically offer emergency care benefits right away when relocating. However, coverage for routine services, prescription refills, etc., often requires updating your official address first. Make this a top priority!

Can I switch health insurance companies mid-year if moving?
Yes! The ‘qualifying life event’ of changing your primary residence opens a special enrollment period to get new insurance. This provides 60 days before and after the move to pick an alternate plan without waiting for yearly open enrollment. Just beware that overall deductibles and out-of-pocket maximums reset when swapping health plans mid-year. So expect some disruption.

What if my medications aren’t covered by new health insurance?
First, check if the drug is available in a higher tier with increased cost sharing. Meds are typically not outright excluded unless for safety reasons or because a very similar alternative exists. If you still cannot get coverage for a vital prescription, file a formulary exception request with the insurance company. Your doctor will need to document medical necessity.

Can I receive follow-up care out-of-state after an emergency?
Yes, but health insurance policies place limits depending on the specifics. For example:
1. Blue Cross Blue Shield requires care to be received within 90 days of the initial emergency.
2. UnitedHealthcare allows a single follow-up visit and any additional required treatment recommended by that doctor.

What is the best health insurance for living in two states part-time?
A Medigap or Medicare Supplement insurance plan combined with traditional Medicare provides the most seamless coverage across state lines. Medigaps standardize benefits nationwide, so policies translate between locations. For those not eligible for Medicare yet, choosing a national PPO plan also allows more flexibility with out-of-state providers. But this costs more than local HMO options.

The Bottom Line

Figuring out how to transfer health insurance to another state takes patience and planning. Every situation brings unique considerations between coverage networks, state mandates, costs, and convenience.

But taking advantage of enrollment period exceptions around relocation lets you make needed changes. So you can feel confident your medical safety net stays intact during a move.

Just be sure to consult the fine print of both current and prospective health plans when transitioning. This ensures you find an optimal new policy to fit your care needs in another location.

Our guide equips you to ask the right questions and budget for changes. Soon, you’ll be embracing exciting new adventures out of state without insurance worries holding you back!

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