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How to keep your health insurance when you move to another state

You'll likely need a new plan, but ACA provisions apply nationwide

If you work for a large employer that has business locations throughout the country, you may find that your coverage remains unchanged with your move. But if you buy your health insurance in the individual market, you’ll have to purchase a new plan.

Since individual market coverage is regulated and marketed at the state level, a new plan is needed when you move from one state to another. But prior to 2014, health insurance was often an obstacle for people who wanted to move to a new state.

2022 Guide to ACA Open EnrollmentIn all but five states, individual market coverage was medically underwritten, so people with pre-existing conditions often found it difficult, expensive, or impossible to enroll in new coverage if they were going to need to purchase their own plan (as opposed to getting coverage from an employer, Medicare, or Medicaid).

Many states had state-run high-risk pools, and federal pre-existing condition insurance pools (PICP) were implemented in the years leading up to 2014. But high-risk pools could impose waiting periods for new arrivals to the state, and coverage through the risk pools was often prohibitively expensive and generally had benefit caps that weren’t always adequate.

That’s all a thing of the past, thanks to the Affordable Care Act. In every state, health insurance is guaranteed-issue for all applicants during open enrollment and special enrollment periods — and moving to a new state will trigger a special enrollment period as long as you already had coverage before your move. And the price is the same regardless of whether you have pre-existing conditions. Premiums can vary based on age, zip code, and tobacco use, so you might find that coverage in your new area is priced differently. But if you’re eligible for premium subsidies, the subsidy amount will adjust to reflect the cost of the benchmark plan in your new area.

How do I get new health insurance coverage when I move to a different state?

If you work for a large employer that has business locations throughout the country, you may find that your coverage remains unchanged with your move. But if you buy your health insurance in the individual market, you’ll have to purchase a new plan.

Individual market coverage is guaranteed-issue thanks to Obamacare, but it’s only available for purchase during open enrollment, and during special enrollment periods triggered by qualifying events. Moving to an area where different health plans are available (which includes moving to a new state) is a qualifying event, as long as you already had coverage in your prior location. (This prior coverage requirement took effect in July 2016.)

So you cannot move to a new state in order to take advantage of a special enrollment period if you were uninsured prior to the move. But as long as you had coverage before the move, you’ll have a 60-day enrollment window during which you can pick a new plan – in the exchange or off-exchange – in your new state.

It’s optional for exchanges to allow access to special enrollment periods in advance of a move (as opposed to only after the move has occurred), but there’s no requirement that exchanges offer this feature. So your enrollment period likely won’t begin until the day you move, and the earliest effective date you’ll be eligible for will be the first of the following month. (Normal effective date rules are followed in this case, which means that in most states, you need to enroll by the 15th of the month in order to have coverage effective the first of the following month; this requirement will no longer be used by as of 2022, when they will simply allow coverage to be effective the first of the month after you enroll, regardless of the date you enroll.)

That means you may end up having a gap in coverage, depending on the date you move and how far into your 60-day enrollment period you are when you select a new plan in your new state. You’ll want to find out how your current health insurance plan works in your new state; you may only have coverage for emergencies once you leave the state in which your policy was issued.

Is short-term health insurance available for purchase in your state?If you’re concerned about the possibility of having a gap in coverage, you could enroll in a short-term plan to cover you until your new plan takes effect. Short-term plans are not regulated by the ACA, and they don’t count as minimum essential coverage. But they’re specifically designed to cover short gaps in coverage, and they’re perfect for a situation in which your new plan will be taking effect within a few weeks and you only need “just in case” coverage in the meantime.

A short-term plan can have an effective date as early as the day after you apply, and short-term plans are available in nearly every state. Be aware, however, that they generally don’t cover any pre-existing conditions, and they can also reject your application if you have significant pre-existing medical conditions.

How will my health insurance provider network change when I move to a new state?

Particularly in the individual market, health insurers have been moving towards HMOs and narrower networks. So it’s becoming rare for plans to offer network coverage in multiple states. Be prepared for the fact that you will almost certainly have a new provider network with your new plan.

It’s also important to note that even if your health insurer is a big-name carrier that offers plans throughout the country, it will have different individual market plans in each state. So although you might have a Cigna plan already, and Cigna might also be available in the individual market in the state where you’re moving, you’ll need to re-enroll in the new plan once you move.

And although Blue Cross Blue Shield is a household name in the health insurance market, their coverage varies from state to state. The Blue Cross Blue Shield name is licensed by 36 different health insurance carriers across the country; a Blue Cross Blue Shield plan in one state is not the same as a Blue Cross Blue Shield plan in another state.

Additional resources

You can also browse our extensive collection of state health insurance resources, and details about the health insurance exchanges in each state. If your income doesn’t exceed 138 percent of the poverty level (or even higher, if you’re pregnant or looking for coverage for your children), you’ll want to pay attention to the details about how each state’s Medicaid program works and what you need to know about switching to a new state’s Medicaid program.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.

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1 year ago

How can a young, growing family stay covered / navigate living in CO for half of the year and NY in the other half?

Louise Norris
Louise Norris
1 year ago
Reply to  Lynn

The main problem you’re going to run into is having to prove your residency each time you move back and forth. You can’t have Medicaid from two states at once, so you need to cancel one state’s Medicaid coverage for the other’s to take effect, but you don’t want to do that until you’ve confirmed with the new state that you’re meeting the residency rules.
I would recommend that you contact Health First Colorado (CO Medicaid) and New York Medicaid and explain your situation to each of them. Ask what they will need from you in order to prove your residency, and be sure you understand what you’re going to need to do each time you move in order to stay covered.

1 month ago

It seems the only way to maintain coverage under the ACA is to lie about when you moved. You would need to say you moved before you actually do in order to institute coverage when you need it. This is a gross oversight of the ACA. The reason for this is unclear. Why would anyone lie about moving to pay for coverage that does them no good? Maybe coordinate with the USPS so you can prove you’re moving when you fill out a change of address request or some such.

Louise Norris
1 month ago
Reply to  Les

The special enrollment period for a move is only available if you already had coverage in your prior location. Since coverage cannot start or end mid-month, people who move mid-month typically just keep their old plan in place until the end of the month, and enroll in a new plan in the new area with coverage starting the following month. The old plan might provide coverage only for emergencies in the new area, depending on the network and how far you’ve moved.

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