Content of the material
- Employer-Sponsored Health Insurance
- Claim reimbursement examples
- Know your rights under the Balance Billing Protection Act
- 5 Questions About Out-of-State Medical Insurance
- 1. Are You Covered?
- 2. What Counts as an Emergency?
- 3. Is Urgent Care Covered?
- 4. What Is Covered Under Emergency Care?
- 5. How Do You File a Claim?
- Insuring College Students or Grown Children Under 26
- Travel Insurance
- Medicare Advantage
- Can you still be on your parents insurance when out of state?
Employer-Sponsored Health Insurance
If your employer transfers you to another state, you’ll likely stay on their sponsored plan, providing it has a complete network in the new city. If it doesn’t, the employer might find you a new, accommodating plan.
Claim reimbursement examples
The claim reimbursement examples (PDF) has examples of average submitted charges and allowances for commonly billed voluntary out-of-network services. Actual charges and costs may vary. Follow the steps on this page to obtain a price estimate for any planned out-of-network covered services.
Know your rights under the Balance Billing Protection Act
Coverage of emergency services and prior authorization requirements for non-emergency surgical or ancillary services performed at in-network facilities. Learn more.
5 Questions About Out-of-State Medical Insurance
Before you leave on your trip, contact your insurer and ask these questions:
1. Are You Covered?
Ask your insurer whether there are any local service providers at your destination that will cover you under your plan, and ask whether any states are restricted. Will the plan cover all states?
2. What Counts as an Emergency?
Your health insurance plan might cover emergencies, but each insurer has its own idea of what is an emergency. A lot of people end up paying for expenses when the insurer decides that the case was not an emergency. Ask for the exact definition. It will help you decide whether you need to buy supplemental coverage, like health or medical travel insurance.
3. Is Urgent Care Covered?
Ask whether urgent care facilities are covered or only emergency rooms. You don't want a claim denied for going to the wrong place.
4. What Is Covered Under Emergency Care?
Ask what additional coverage is included in the emergency medical care for you and your family. For instance, if you are going to a remote spot, you may want to know about services like air ambulances.
5. How Do You File a Claim?
Find out how claims payment works:
- Which documents will you need?
- Will you have to pay in advance and request reimbursement?
- Find out whether there are forms for out-of-network physicians' claims.
Insuring College Students or Grown Children Under 26
You can cover your adult children who attend college in another state under your healthcare plan. It is important to verify if your student will be able to find in-network medical providers nearby. Some insurers have agreements with companies in other states. Otherwise, you may need to look into a separate plan.
If you're going to spend part of the year in another state and are concerned about having coverage for more than just emergencies, you might want to consider a domestic travel medical policy—or an international travel policy, if you're living overseas for part of the year.
These plans are less expensive than individual major medical coverage because they’re more limited.
They typically don’t cover pre-existing conditions, and they come with caps on the total benefit amount that the plan will pay. However, they can provide additional peace of mind depending on the circumstances.
If you opt to keep the individual major medical plan or Medicare Advantage plan that you purchased in your home state, supplementing it with a travel policy will offer additional protection beyond the emergency-only coverage that you're likely to have with your existing coverage—without switching to an entirely new major medical policy each time you move.
In most areas of the country, Medicare Advantage is an alternative for Medicare beneficiaries who would prefer to receive all of their Medicare coverage in one plan, offered by a private insurer.
However, Medicare Advantage plans have provider networks that are more limited than the nationwide network of providers who accept Original Medicare. Medicare Advantage plans use managed care, which means they can be HMOs, PPOs, (etc.), and the scope of the network varies from one plan to another.
If you're enrolled in a Medicare Advantage PPO, you'll have some coverage for out-of-network care, although your costs can be significantly higher than they would be if you remained in-network.
There are also certain Medicare Advantage plans that are specifically designed for people who live in more than one place, but they're not available in all areas.
If you have or are considering Medicare Advantage coverage and you're also thinking about splitting your time between homes in more than one state, you'll want to carefully read the fine print. Talk with the Medicare Advantage insurer to see how you'll be covered when you're outside of your home state.
Can you still be on your parents insurance when out of state?
Children are eligible to stay on their parents' health insurance until age 26, regardless of where they live. However, if you live in a different state from your parents, you may find that their coverage network doesn't fit your needs in a different location. If that's the case, you may want to explore your own coverage options.