Will My Health Insurance Policy Cover Me in Another State?

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When traveling across state lines, you’ve probably wondered, “Will my health insurance work in another state?” The answer to that question is insurance plans cover emergency care at any U.S. hospital, regardless of your policy’s coverage area (the only exception is Hawaii). Therefore, your health insurance will provide you with coverage in any hospital (whether it’s in-network or not) and regardless of your location if a medical emergency is deemed life-threatening. However, there are some limitations. Each health plan comes with a network of specified healthcare providers. When you seek medical care outside this network, you typically shoulder a larger portion of the resulting healthcare costs.

Out-of-state Health Insurance Coverage

Your out-of-state health insurance policy covers only emergencies. Moreover, because there is no precise definition of “emergency,” some insurers may deny claims that they don’t consider true emergencies. Therefore, before you travel out of state, you should have a clear understanding of the kind of emergencies that your insurer covers so that you don’t risk having your claim denied. Also, if you travel a lot or periodically spend a significant amount of time out of state, you should consider getting supplemental accident coverage.

How to Get Health Insurance Coverage When Out-of-state

  1. Supplement Coverage

    Supplemental coverage is essentially an add-on to your existing coverage. With supplemental coverage, you have two options. You can go for additional accident/critical illness coverage that will provide you with money in the event that you get a bad diagnosis or you’re in an accident, regardless of network or location.  This option is ideal if you’re a frequent traveler or if you’re concerned about out-of-network emergency expenses. You can also opt for a hospital-indemnity type of plan that will provide you with money to pay for covered services, including hospital stays, doctor visits, and more, with a nationwide network.

  2. Short-term/ Emergency Health Plans

    A short-term health insurance plan provides you with temporary coverage when there is a lapse in your permanent coverage. It can therefore protect you from costly medical bills resulting from health emergencies. You can qualify for a short-term health insurance plan under certain circumstances, including:

    • Change jobs
    • Attend out-of-state college
    • Waiting for the Open Enrollment Period
    • Lose employer-sponsored coverage
    • Other specific instances
  3. Travel Insurance

    Travel insurance plans can include coverage for unforeseen medical expenses that accrue as you travel. You can tailor your travel insurance policy to ensure it provides you with suitable health coverage during your out-of-state trips.

Key Questions about Out-of-State Medical Insurance

  1. Are You Covered?

    Find out if there are in-network health providers at your travel destination.

  2. What Is Considered an Emergency?

    Each insurance company has its definition of what’s regarded as an emergency. Many people are forced to pay for medical expenses out-of-pocket after their insurer declines their claim because they don’t consider their case an emergency. Getting this clarification will help you decide whether you need to purchase supplemental coverage.

  3. Is Urgent Care Covered?

    Find out if the plan covers urgent care facilities or if it only covers emergency rooms. You don’t want to risk having your claim denied due to not going to the right place.

  4. What Emergency Care Is Covered?

    Find out the additional coverage that’s part of emergency medical care. For instance, you may want to know if your plan covers air ambulances and other emergency services.

  5.  What Does the Process of Filing a Claim Entail?

    You need a clear understanding of the process of filing a claim.

That’s everything you need to know about out-of-state health insurance coverage. Our experts at Hoffman Brown Company will help you find a health insurance plan that provides you with adequate coverage both when you’re in state and out of state.

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