What to look for in an insurance plan when you live in 2 different places
Living in two different places can often involve a lot of juggling. It can also present some challenges when it comes to health insurance coverage. For example, you want to be sure you have coverage no matter where you’re living. So, whether you have homes in two different states — or spend a lot of time abroad — you’re probably wondering: Do I need two different insurance plans?
It all depends on your situation. “Having double insurance makes almost no sense most of the time,” says Noor Ali, M.D., a physician and the founder of Dr. Noor Healthcare Advisor. So, if one health insurance plan is the way to go, how do you make sure you’re covered no matter where you are? Read on to find out — as well as what to do if you leave the country.
Choose a PPO plan if you live in 2 places inside the United States
If you live in two different states or frequently travel within the country, you may want to sign up for a preferred provider organization (PPO) plan. A PPO plan gives you more nationwide options for providers and health care services. That means you’re able to use your health insurance no matter where you are.
It’s important to make sure the providers you’re seeing (and the care you’re getting from them) is in your plan’s network. That way, you’re getting the full benefits of the plan, including lower out-of-pocket costs.
“PPO refers to the type of network, not the type of insurance plans,” Dr. Ali says. “That’s a common confusion. You can get the plan from anywhere. But PPO refers to the network of doctors you can use with your policy.”
That’s different from a health maintenance organization (HMO) plan. HMO coverage is typically limited to the state or even county where you sign up, so you need to use the providers and services that are included in the HMO plan. In many cases, once you leave your plan’s service area, you typically have to pay the full cost of care. The only exception to this rule is emergency care.1
Understand your plan’s emergency coverage
If you have an accident or medical event that threatens your health (like a car crash or a heart attack), you can’t be denied emergency care because of insurance status — no matter where you are in the country.2
In fact, a recent federal law, The No Surprises Act, protects you from unexpected, out-of-network bills for emergency services. If your health insurance covers emergency care, you can’t be charged more than your network cost-sharing for emergency medical services. That means no matter where you are in the country, you pay your network cost-sharing for emergency care (as if you were back home).3
Get an additional plan if you travel outside the United States
In general, United States health insurance plans don’t carry over to other countries. Once you leave the United States, you’ll need additional protection so you can get medical care if needed while you’re abroad.
The best way to do that is to get a travel health insurance plan. You might be familiar with travel insurance, which can protect you if your flight or cruise gets canceled or delayed. A travel health insurance plan can help cover costs in case you get hurt or sick and need medical care.4
Travel health insurance is especially useful if you have a health condition. It’s also helpful if you’re planning on doing something adventurous, like hang gliding or scuba diving. And, it might be a good idea to get travel health insurance if you plan to stay in another country for more than 6 months.4
Before you decide on a travel health insurance plan, you may want to consider the following:
- Check with your current health insurance plan to see if they cover emergencies when you’re out of the country. Then check to see if your plan has exclusions for preexisting conditions or certain activities.4
- Make sure your plan covers accidents and illnesses. “Most policies are blanket accident and injury policies, which means they’re going to cover you if you get hurt,” says Dr. Ali. “But you want to look for a plan that also covers illness, because that’s where you’re probably going to incur more of the bills.”
- Shop around, even if your health plan covers overseas travel. There are companies that specialize in travel insurance, including health plans. It’s important to find one that fits your needs at the right price.
Depending on the benefits in your plan, you’ll likely pay upfront for the cost of any medical care you may need overseas. You’ll then get reimbursed through the travel insurance when you return home, adds Dr. Ali. Be sure to check the plan’s policy before you decide to go ahead with it, and keep your receipts if you need reimbursement. Dr. Ali suggests looking at the available options in both places you live. Then decide what plan covers the providers and services you might use the most.
Asking the right questions and choosing the best plan for your lifestyle can help give you peace of mind no matter where you are.
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