Let’s say you move from California to Tennessee, does your insurance move with you, or do you need new insurance?
Most individual health insurance is not transferable from one US state to another. Therefore, if you move to a new state, a part of the moving process needs to be obtaining health insurance in your new state of residence. This holds true whether you have individual/family coverage or Medicare (including Supplements, Advantage plans, and Prescription Drug plans).
Let’s explore both types of insurance.
It You’re Under 65 and Moving from One State to Another - Health Insurance for Individuals and Families
Employer-sponsored Plans
If your employer transfers you to another state and you’re covered by their health plan, you probably don’t need to worry because you can most likely stay on the same plan as long as the employer-sponsored plan has an adequate network in the new state. If the plan doesn’t have an adequate network, the employer will likely find you a new, accommodating plan in the new state.
However, if you have coverage through a non-Marketplace individual or family plan, you will need to check with your insurance plan to see if they have a good network in your new state and change plans if necessary.
Marketplace Plans
If you have a plan through the Marketplace, your move will require some action because Marketplace plans don’t transfer from one state to another.
First, report your move to the Marketplace as soon as possible in order to avoid a gap in coverage. For most states (including Tennessee), this can be done by going to https://www.healthcare.gov/login and entering your new state or residence. If your new state appears on this list, it means they have their own website where you’ll apply.
Normally, enrolling through the Marketplace can only be done during the annual Open Enrollment Period at the end of the year, but a move to a new state is known as a “qualifying life event,” which makes you eligible for a Special Enrollment Period (SEP). The special enrollment period allows you 60 days from the time of your move to enroll in a qualified health insurance plan through the federal marketplace, your new state’s exchange, or elsewhere. It is important to note that the SEP onlys exists if you had credible coverage in the state you left (defined as having minimum essential coverage for at least one of the 60 days preceding the move).
Medicare Coverage when Moving from One State to Another
Necessary actions for Medicare coverage when moving to a new state vary depending on the type of coverage.
Original Medicare
If you only have Original Medicare (Parts A and B), your benefits and coverage won’t be affected since Original Medicare is a federal healthcare program. Still, you need to contact the Social Security Administration about your change of address in order to continue getting important information from them.
Medicare Advantage
Since Medicare Advantage plans are managed by private companies, any move to a new state will trigger a Special Enrollment Period, during which time you can:
Switch to a new Medicare Advantage Plan or Medicare drug plan.
Return to Original Medicare (if you’re in a Medicare Advantage Plan and you move outside of that plan’s service area).
It is important to note that if you don’t enroll in a new Medicare Advantage Plan during the SEP, you’ll automatically be enrolled in Original Medicare once you’re disenrolled from your old Medicare Advantage Plan.
There are certain windows during which you can report your move. If you tell your plan before you move, the SEP begins the month before the month you move and continues for 60 days after you move. If you tell your plan after you move, the SEP begins the month you tell your plan and lasts for 60 days more.
Prescription Drug Plans
Much like an Advantage plan, Medicare Part D drug plans are sold by private insurers and are specific to each state, so your move will mean you will need to enroll in a new plan.
If you tell your plan before you move, your chance to switch plans begins the month before the month you move and continues for 2 full months after you move. If you tell your plan after you move, your chance to switch plans begins the month you tell your plan, plus 2 more full months.
Medicare Supplements
Since Medicare Supplements (also known as Medigap plans) are supplemental to Original Medicare and have the same carriers nationwide, in most cases you can keep your current coverage in your new state. Any provider who accepts original Medicare in your new state will accept your Medigap insurance, but make sure to inform your carrier 30 days before your move.
There are 2 exceptions:
If you are moving into or out of Massachusetts, Minnesota, or Wisconsin. With Medigap, there are ten standard Supplement plans available in every state, designated by letters (A, B, C, D, F, G, K, L, M, and N), but the above states offer some different options.
If you have a Medicare SELECT plan that limits your providers to certain hospitals; however, you would have guaranteed issue rights in this instance.
Moving will allow you the opportunity to shop for coverage from a different Medigap plan in your new state, but as always, don’t terminate your current supplement until the new one has been issued.