Another in a series of Q&A columns answering consumers questions about the Affordable Care Act.
About 130,000 Americans pick up and move somewhere else every single day, the U.S. Census Bureau estimates. And guess who are among the most mobile? We itchy Californians.
Perhaps youre wondering what moving around has to do with Obamacare. Quite a lot, actually.
Your health plan options and prices vary by geography, and the Golden State is chopped into a whopping 19 regions. Los Angeles is so large that it accounts for two regions, and that doesnt even include the Inland Empire or Orange County.
Today, Ill tell you what happens to your coverage when you travel or move, and whether youll be able to see a doctor when youre in Boise, Berlin or even Berkeley.
Q: I am considering enrolling in one of the Covered California plans. How will my coverage work if I am traveling out of state or out of the country and need medical care?
A: Im adding one other part to Suellens question: What happens when traveling within California? As I mentioned above, health plans sold on the open market and through our health insurance exchange, Covered California, vary by region. That means not all plans are sold in all regions. In fact, some have a very limited geographic reach, including the Chinese Community Health Plan and the Contra Costa Health Plan, both in the Bay Area.
So, if youre traveling within the state and need care, it depends on who your insurer is and what kind of network of doctors and hospitals it offers. If, say, you have a Kaiser plan, you can visit an in-network Kaiser doctor or hospital outside of your region and have the costs covered.
If, however, your insurers network doesnt extend to your travel destination, you will only be reimbursed for emergency and urgent care services, not routine services, says Lizelda Lopez of Covered California.
When youre traveling outside of California, your insurer doesnt matter: You are only eligible to have emergency and urgent medical services covered.
None of our plans have out-of-state networks, Lopez says.
By the way, this isnt necessarily new. Earlier this year when I visited the East Coast, I got a scary infection that needed immediate attention. I called my insurer first, which directed me to choose from specific ERs and urgent cares. I dutifully complied, but still had to fight to get my urgent care visit covered.
Lopezs advice? Wherever youre visiting, do what I did and double-check with your insurer to find out if a provider is covered. My advice: Be prepared for a fight afterward.
Q: What happens if an individual moves from one state to another after signing up for a plan? Ill be living in California for the first few months of 2014, but theres a definite chance I may be moving to Washington. Will it be possible to transfer my plan to a different state partway through the year?
A: Once again, Im adding another part to Johns question that may sound familiar: What if you move within California?
The answer also may sound familiar: It depends on your insurer. If you have a plan that also is offered in your new locale, you keep that plan. If you want to change it, youll have to wait until the next open-enrollment period.
If you cant get the same plan in your new hometown, youll be eligible for a special-enrollment period and can sign up for a new plan.
And now, back to Johns question. If you move to another state, you will need to enroll in a new plan through that states exchange or buy on the open market. If that state doesnt run its own exchange (Washington state does), you would use the federal exchange, healthcare.gov (if it ever gets to working right).
Moving to another state also triggers a special enrollment period, so youd be able to choose a new plan immediately.
Q: What about American citizens living in another country such as Sweden, where health insurance is covered? Why should I be required to have health insurance in the states when I dont even live there?
A: As most of you know, Ask Emily is geared toward a California audience. But that doesnt stop people from writing from all corners of the country.
And, it turns out, from all corners of the world.
I have received questions similar to Arties from readers in New Zealand, Thailand, Malaysia and Australia.
The answer depends on how long you live abroad during a calendar year. According to the Internal Revenue Service, U.S. citizens who live abroad for at least 330 days within a 12-month period dont have to comply with the Obamacare insurance mandate, which requires most Americans to have health insurance as of Jan. 1.
That also means you wont have to pay a tax penalty for not having insurance.
You dont even have to be insured in your country of residence, like Artie is, to get out of the insurance requirement, the feds say.
In other words, if you dont want to trigger the mandate, try to keep your annual trips back home to under five weeks each year!
Questions for Emily? Email her at AskEmily@usc.edu. The CHCF Center for Health Reporting partners with news organizations to cover California health policy. Located at the USC Annenberg School for Communication and Journalism, it is funded by the nonpartisan California HealthCare Foundation.