In Triage Cancer's free Quick Guide to Navigating Health Insurance When Moving, you'll learn how to make changes if you have a plan through the State Health Insurance Marketplace, an employer, Medicare, or Medicaid.
When you are moving, either to a new zip code, or a new state, it is important to review your health insurance options to see if you need to make any changes to your coverage. If your move causes you to have to change your health care providers, the first step is to check if any new plans that you are considering will cover those providers.
Open enrollment for the Marketplace begins 11/1 and will end on 1/15. If you are in a state that runs its own Marketplace, open enrollment may end at a different time. During open enrollment, you can make changes to your coverage. The earliest that coverage will begin is 1/1. If you move outside the open enrollment period, certain moves qualify you for a 60-day special enrollment period (SEP):
To qualify for a SEP, you must prove that you had qualifying insurance for at least one day during the 60 days before your move (unless you are moving from a foreign country or U.S. territory).
COVID-19: If you qualified for a SEP, but missed your deadline because of a COVID-19 emergency, you may still be eligible for a SEP. Contact the Marketplace at 800-318-2596 for help.
Moving Within the Same State: If you are moving to a new address within the same state, you may be able to keep your current plan if the plan’s network still includes the geographic area where you are moving to. You still need to report your move to the Marketplace: (note: you cannot update your account by mail)
Moving Out of State: If you are moving to a new state, you may not want to keep your current plan, because most plans will not cover in-network providers in another state. You will need to start a new Marketplace application and enroll in a plan in your new state. You can complete this process online:
*If your new state is not listed, it may run its own Marketplace instead of using HealthCare.gov. To apply in CA, CO, CT, DC, ID, KY, ME, MD, MA, MN, NV, NJ, NM, NY, PA, RI, VT, VA, or WA, use the Marketplace In Your State directory.
More information:
You may be able to keep your current health insurance plan if the plan’s network still includes the geographic area where you are moving to. Contact your employer and/or your insurance company for details about how your move will affect your insurance.
Because you will lose your health insurance through your employer when you leave your job, you will need to (1) figure out your health insurance options moving forward, and (2) make sure there is no lapse in your coverage. You may be eligible for COBRA, Medicare, or Medicaid, or you may be able to move to another group plan, such as through a spouse or parent.
If you are moving to a new job that offers health insurance, there may be a waiting period of up to 90 days, before you are eligible, so you will need to think about your options to cover that gap.
More information:
If you have Medicare and you recently moved or plan to move, you must update your address by calling the Social Security Administration (SSA) at 800-772-1213.
You can make changes to your Medicare coverage during the open enrollment period from 10/15 to 12/7, each year. But, if you move outside the open enrollment period, certain moves qualify you for a special enrollment period (SEP) to make changes to your Medicare coverage.
Your next steps to update your Medicare plan will depend on where you are moving and what type of Medicare coverage you have:
You can keep Original Medicare no matter where you live in the United States, because Medicare covers any providers across the country who contract with Medicare. As long as you still have Original Medicare, you can also generally keep your current Medigap plan. Except, if you are moving to or from Massachusetts, Wisconsin, or Minnesota, those three states have unique Medigap options. Contact your new state’s department of insurance.
If you are moving to a new address that is in your plan’s service area:
More information:
Medicaid is a federal program, but each state operates its own Medicaid program and can have different rules. This means you cannot transfer your Medicaid coverage from one state to another, and you cannot have Medicaid coverage in two states at the same time. But if you plan ahead, you may be able to get Medicaid in a new state in time to avoid a gap in your coverage. It is important to talk to your health care team to let them know you are considering moving, as they may be able to help with the transfer of your medical care and your Medicaid coverage.
In all states, you qualify for Medicaid if you meet the income and resource (asset) requirements and you meet another category of eligibility, such as having a disability. But details vary by state. So, it is important to learn about the eligibility rules in your new state, because they may be different from where you live now.
Some states offer “expanded Medicaid,” which may make it easier to qualify for Medicaid, because it is available to adults under 65, with a household income up to 138% of the Federal Poverty Level (FPL). Find out if your state offers expanded Medicaid at TriageCancer.org/Medicaid-Expansion. Minnesota and New York also give individuals with a household income between 138-200% FPL access to Medicaid through the Basic Health Program. For expanded Medicaid, there is no asset requirement and you don’t have to meet another category of eligibility.
| Household Size | 138% FPL in 2023 (AK & HI have higher income levels) |
|---|---|
| 1 | $20,120.40 |
| 2 | $27,213.60 |
| 3 | $34,306.80 |
| 4 | $41,400 |
| 5 | $55,586.40 |
| 6 | $62,679.60 |
You should also look to see how Medicaid benefits in your new state compare to your current benefits. For example, your new state may offer more or less optional benefits, such as dental coverage.
To avoid a lapse in your coverage, you should also consider the timing of your move. Because most states end existing Medicaid coverage at the end of the month, the best way to prevent a lapse is to move close to the end of the month, cancel your coverage in your original state, and immediately apply for coverage in your new state. On average, it takes 7 to 90 days for Medicaid applications to be processed by a state.
If you cannot avoid a gap in coverage, you may still benefit from Medicaid. Once you’ve been approved for coverage, you can apply for retroactive Medicaid coverage to help pay for certain health care expenses accrued up to three months before your application date. To qualify, you must have been eligible for Medicaid during those three months, and your state may require additional qualifications for retroactive eligibility. Note: Some states have dropped retroactive coverage (e.g., Arkansas, Arizona, Florida, Iowa, Indiana, Kentucky, New Hampshire).
Once you are ready to apply for Medicaid, you can do so by:
If you are in a position where you need to compare new health insurance options, there are a few key things to consider when picking a health insurance plan:
When comparing plans, it can be tempting to just choose the one with the lowest monthly premium. But, to figure out the total cost for the year, including your out-of-pocket expenses, you have to do some math:
(Plan’s monthly premium x 12 months) + Plan’s out-of-pocket maximum = Total annual cost
For more information, see our Health Insurance Materials & Resources. For help doing the math to pick the right plan for you, download our free Health Insurance Plan Comparison Worksheet.
Last updated: 01/2022
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