Purchasing Out of State Health Insurance Question

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RooseveltG
Posts: 705
Joined: Sun Sep 07, 2008 2:56 pm
Location: The Rust Belt

Purchasing Out of State Health Insurance Question

Post by RooseveltG »

Does anyone know if you are required to purchase health insurance in your own state. I spend 6 months in 2 different locations and the health care premiums in the state where I am not a resident are lower than the state where I am a resident. I would prefer to purchase the less expensive out of state policy.

Thanks in advance for any opinions.

Roosevelt.
cubedbee
Posts: 312
Joined: Tue Aug 04, 2009 11:13 am

Re: Purchasing Out of State Health Insurance Question

Post by cubedbee »

You are only allowed to purchase Qualified Health Plans (sold on the Exchange) in the state in which you are a resident

From Section 1312 of PPACA
SEC. 1312. <<NOTE: 42 USC 18032.>> CONSUMER CHOICE.

(a) Choice.--
(1) Qualified individuals.--A qualified individual may
enroll in any qualified health plan available to such
individual.
f) Qualified Individuals and Employers; Access Limited to Citizens
and Lawful Residents.--
(1) Qualified individuals.--In this title:

[[Page 124 STAT. 184]]

(A) In general. <<NOTE: Definition.>> --The term
``qualified individual'' means, with respect to an
Exchange, an individual who--
(i) is seeking to enroll in a qualified health
plan in the individual market offered through the
Exchange; and
(ii) resides in the State that established the
Exchange (except with respect to territorial
agreements under section 1312(f)).
http://www.gpo.gov/fdsys/pkg/PLAW-111pu ... ubl148.htm

From a practical purpose, I think this extends to off-exchange because of the way geographic rating works. A carrier in a given state must file geo factors for all the geographic regions in that state (the regions themselves were decided by state regulators and approved by CMS). If you are from out-of-state, that's not one of the filed geo regions for that carrier so there is no approved rating factor to use. Only if you apply with the zip-code of the cheap state will they be able to give you a quote...
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Topic Author
RooseveltG
Posts: 705
Joined: Sun Sep 07, 2008 2:56 pm
Location: The Rust Belt

Re: Purchasing Out of State Health Insurance Question

Post by RooseveltG »

The real question for those who split time between states, is whether one needs to purchase insurance in the state where they are residents.

I also "live" in my non official residence state half the year, pay property taxes and see physicians there.

Roosevelt.
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