May I apply for an ACA plan and not live in that area of service? The ACA (Affordable Care Act) has caused U.S. States from allowing only those who are residing in their State to have their coverage. The issue is an eligibility concern. We looked at sample policies from Michigan, California, New York, Illinois and Florida under various U.S. domestic insurance plans. They all included residency termination clauses. We recently saw a Florida member terminated when living in Singapore due to the residency issue. The service area is increasingly important because it is a qualifying event trigger within 60 days of moving to a new service area. Generally this “old plan” generally says you terminate after 60 days of leaving their area and it is all legal.
Here is part of an article from GeoBlue (also called GeoBlue) talking about this type of situation. Good Neighbor provides GeoBlue career medical insurance for those residing outside the U.S. You may view one of those GeoBlue international medical insurance investments here at https://www.goodmissionaryinsurance.com/geoblue-navigator-insurance-missionaries/.
Is Retaining an ACA Compliant Domestic Health Plan a Viable Alternative?
In an effort to avoid the penalty, some expats have gone abroad with domestic plans that harshly restrict overseas coverage. This has resulted in increased financial burden and unexpected out-of-pocket expenses because of significant benefit gaps. Additionally, the expat was forced to deal with the inconvenience of managing issues with an insurer thousands of miles away: in a different time zone, with no understanding of the local health care or the relationships necessary to secure trusted care. Coverage and network problems aside, most individual health insurance policies explicitly require that you meet the ongoing eligibility criteria for the policy. Eligibility hinges upon being a resident or living in the plan service area. Definitions can vary but if you no longer reside, live or work in the service area your coverage typically terminates after 60 days or based on the last billing cycle in which your eligibility changed. Excerpts from a sample policy of a popular health insurer located in California are illustrated below and reflect eligibility; change of address and policy termination language.
Who is Eligible for Coverage
To be eligible for membership as a Subscriber under this Agreement, the applicant must:
- Reside in the Service Area;
Notice of Changes
The Subscriber is responsible to notify us of any changes that will affect his or her eligibility or that of Dependents for services or benefits under this Agreement. We must be notified of any changes as soon as possible but no later than within sixty (60) days of the event. This includes changes in address,…
Termination of the Member
Unless prohibited by law, the Member’s coverage will terminate if any of the following occurs:
- The Member no longer meets the eligibility requirements for coverage under this Agreement.
Effective Dates of Termination
- If the Member moves outside of the Service Area, or the Member is not located within the Service Area, coverage terminates for the Member and all covered Dependents at the end of the billing period that contains the date the Member failed to meet any of the conditions above regarding the Service Area. IMPORTANT: Termination of the Agreement automatically terminates all Your coverage as of the date of Termination, whether or not a specific condition was incurred prior to the Termination date.
This language underscores the necessity to consider buying a robust insurance policy that adequately protects you when you move abroad. The expense of the shared responsibility payment is minimal when you consider the alternative of finding yourself injured or ill overseas, and uninsured. For assistance understanding your options, contact your Agent.
Please call one of our licensed agents at Good Neighbor Insurance at 866-636-9100 or locally here in Arizona at 480-633-9500 with any questions. You may also reach us via email at . Have an amazing and safe travels as you serve others!