According to the current law, you can buy health insurance only in a state in which you have a permanent address, and if you move to another state due to any reason, you will need to purchase a new health plan in that state. There have been no changes in this law in the current year, though the administration has expressed their view to change this since a health reform law has not yet passed, so currently, no changes have been made in this law.
Therefore, as far as using your health insurance plan outside your state is concerned you are not allowed to do so, but you need to know that all plans cover emergency services at any hospital in the United States, regardless of state from where you have purchased the plan, except for Hawaii state.
If the emergency medical service is life-threatening, then it will be covered as in-network, irrespective of the fact that the hospital is in your plan’s network or not. However, there are some limitations because every plan has a network of healthcare providers, and if you visit a healthcare provider outside of your network, then you will need to pay a larger share of the medical cost.
Ambetter is the only health insurance company in 2020 that offers out-of-state routine care, as both HMOs and PPOs plans have moved to local and more restricted networks to keep down the costs. Of course, if you are permanently moving to another state and you have official documents to support your move, then you will surely qualify for a special enrolment period to switch to a local plan of that state that will provide you proper coverage.
You need to know that your health plan only covers emergency medical care in case of out-of-state coverage and not anything else. Besides, there is also no clarity on what is considered an emergency. Health insurance companies in the majority of the cases are required to pay for reasonable emergency medical expenses regardless of the hospital you visit. It means that if unfortunately, you met with an accident and taken by ambulance to a hospital, which is not in your plan’s network, then also your health insurance carrier will be responsible for paying this expense.
Sadly, there is no fixed definition of emergency and some health carriers deny claims if according to them it is not a medical emergency. Therefore, you are advised to understand exactly what your health insurance plan will pay for before receiving any healthcare service so that you avoid the risk of a denied claim after a medical emergency. If you are required to travel a lot due to work, then you should go for supplemental accidental coverage.
If you need to obtain health coverage in another state, then you require to choose a plan that offers coverage in that state in which you seek to receive medical care. Some of the PPO plans offered by national carriers having large networks like Blue Cross Blue Shield or Anthem may offer out of the state benefits on certain plans but generally, HMOs and EPOs plans do not offer out of state benefits.
Health insurance providers’ networks generally vary state to state, and Blue Shield of California was the last health insurance carrier offering a National PPO network through the BlueCard program but this was discontinued in 2019. Currently, no state, on or off-exchange, has any national network PPO plan available, as the multistate program was discontinued in 2017.
Then How to Obtain Health Coverage
If you think that you may have to live in multiple states or you need to travel a lot for work, then you may either obtain supplemental coverage, or you may switch to catastrophic coverage. Supplemental coverage is an add-on to your present coverage that gives you two options when it comes to coverage that will nationally cover you. You will be entitled to receive additional critical illness or accident coverage that will financially pay you in case, you met with an accident or bad diagnosis, regardless of location or network. This is undoubtedly the best option for frequent travelers or for people who are more concerned about their out-of-network emergency cost. Besides these, you can also obtain hospital indemnity style plans in which the carriers pay you to cash to cover covered services such as doctor’s visits, second opinions, and hospital stays, etc. all with a national network.
The health plans that are often recommended for coverage with a national network are:
• National General Trio Med – This plan covers Accident & Critical illness & Hospital Stays.
• UnitedHealthOne ProGap – This plan covers accident & Critical illness & hospital stays.
• National PPO Network Plans – This is a Catastrophic plan.
United HealthOne – United Healthcare offers a year-long plan with a national PPO network. This plan is less expensive compared to most individual plans available in the market but this plan doesn’t cover preventative care or pre-existing conditions. This carrier also offers optional co-pay plans and additional accident or critical illness plans for more comprehensive coverage.