How to Change Health Insurance When Moving States

Moving between states brings significant life changes, and navigating health insurance can be complex. Health coverage is regulated at the state level, meaning a plan from one state may not provide adequate coverage in another. Understanding how to manage your health insurance when relocating helps ensure continuous medical care and avoids gaps.

Special Enrollment Period for Moving

Moving to a new state is a “Qualifying Life Event” (QLE) for health insurance, allowing enrollment in a new plan outside the annual Open Enrollment Period through a Special Enrollment Period (SEP).

The SEP provides a 60-day window before or after the move to enroll. Act within this timeframe to prevent a lapse in coverage. To qualify, you typically need existing health coverage in your prior location.

If you enroll promptly, new coverage can align closely with your move date. Generally, if a plan is selected by the 15th of a month, coverage can begin on the first day of the following month, minimizing potential gaps.

New State Health Insurance Options

Relocating to a new state requires exploring health insurance options, as plans and regulations vary significantly. Several avenues exist for securing coverage:

Employer-Sponsored Plans

If you have new employment, employer-sponsored health plans are a common option. Enrollment typically occurs through your new employer’s human resources department after starting employment. These plans often provide comprehensive benefits, with the employer usually contributing to premium costs.

Health Insurance Marketplace (ACA)

The Health Insurance Marketplace, established under the Affordable Care Act (ACA), is a primary source of individual health insurance. Most states use HealthCare.gov, while some operate their own exchanges. Through the Marketplace, you may qualify for financial assistance like premium tax credits (reducing monthly premiums) and cost-sharing reductions (lowering out-of-pocket expenses), based on household income and family size. Eligibility for these subsidies typically falls within specific income ranges relative to the federal poverty level, though recent legislation has expanded eligibility by removing the upper income cap for premium tax credits.

Medicaid and CHIP

Medicaid offers free or low-cost health coverage for eligible low-income individuals and families. Eligibility is determined by each state, based on factors such as income level, family size, age, and disability. You can apply directly through your state’s Medicaid agency or via the Health Insurance Marketplace.

Direct from Private Insurers

You can also purchase health insurance directly from private insurers outside the Marketplace. These “off-exchange” plans offer various coverage options but do not qualify for federal financial assistance. When choosing any plan, consider factors such as the provider network (e.g., HMO, PPO, EPO), deductible, monthly premiums, maximum out-of-pocket limits, and prescription drug coverage.

Information Needed for New Coverage

Before applying for new health insurance, gather specific personal and financial information. This ensures a smoother application process and determines eligibility for programs and financial assistance.

You will need to provide:
Full legal names and birth dates for all household members needing coverage.
Social Security Numbers (SSNs) for all applicants, primarily for identity and income validation (especially for those seeking subsidies).
Document numbers proving immigration status for lawfully present non-citizens.
Your new physical address in the new state, as health insurance is state-specific and eligibility depends on residency. This address determines available plans and premium costs.
An accurate estimate of your household’s income for the current year, including wages, self-employment earnings, and unemployment benefits. This income assesses eligibility for premium tax credits, cost-sharing reductions, or Medicaid.
Information about existing or new employers, especially if considering employer-sponsored plans, including details about any available job-based health coverage.
Information about your previous health insurance policy, helpful for confirming prior coverage if needed for the SEP.

Applying and Transitioning Coverage

Accessing the application for new health coverage depends on your chosen avenue:
Employer-sponsored plans: Engage with your new employer’s human resources department.
Marketplace plans: Use HealthCare.gov, which directs users to state-specific exchanges if applicable.
Medicaid: Contact your state’s Medicaid agency or use the Marketplace as an entry point.

The application process typically involves online submission. After submitting, expect a confirmation and potential requests for additional documentation to verify eligibility or income. An eligibility determination will follow, leading to enrollment confirmation once a plan is selected and the initial premium payment is made.

Canceling your old health insurance plan is important to avoid overlapping coverage or unnecessary premium payments. Secure new coverage and confirm its effective date before terminating the old plan. Contact your previous insurance provider or the Marketplace where the old plan was purchased to set a specific cancellation date, ideally aligning with the start of your new policy to prevent any gaps.