What if I live in more than one state?

When you have homes in two different states, it may be tricky to decide if you need one health plan or two.
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Last Reviewed: Wed, Jul 29, 2020

Purchasing a new individual insurance plan under the Affordable Care Act can be complicated if you spend a significant amount of time in more than one state or travel frequently. Here’s an overview of points to consider.

If You Live in More Than One State

If you truly split your time between two states, the federal regulations covering plans offered through an ACA marketplace say that you can purchase health insurance in one or both places. This is true as long you spend “an entire season or other long period of time” in your second home.

Keeping insurance in just one state. It’s undoubtedly easier and less expensive to buy and keep health insurance in only one state. If you go this route, you’ll be covered only for emergency care when you are outside of that state. And even in an emergency, charges may swell beyond your insurer’s limits for “reasonable and customary” care, leaving you at risk for a big medical bill in the event of a medical crisis.

Getting insured in two states. If you want to establish residency in both of the states where you live, you can buy a new insurance policy every time you move. That’s possible because your move is considered “permanent” under federal regulations. As long as you were insured in the first state, you’ll qualify for a special enrollment period to buy a new policy in the second state.

However, in addition to giving you a paperwork headache, buying insurance twice each year could turn out to be a very expensive arrangement. For example, your deductible and out-of-pocket max will restart every time you move—and maybe even a third time, if your stay in one state crosses into the month of January, when all plans restart for the calendar year.

Carefully consider your situation and talk with potential insurers—then read policies carefully—to be sure you understand your options, potential expenses, and the true extent of your coverage as you move from state to state.

If You Travel Frequently

An insurance plan that meets the requirements of the ACA should cover you if you have to get emergency care out of state. For other types of care, your coverage will depend on the particulars of your plan.

You may want to read the article, Don't Forget to Pack Health Insurance, from HealthInsurance.org for a deep dive into options for travel health insurance.

Learn More

For more health insurance basics, see What Iowa Residents Need to Know About Obamacare.


Legal Consumer - IowaLaw. Jurisdictional relevance: The content of this article pertains to all US states and counties.
When Are You Legally Required to Report “Life Changes” to the Iowa Health Insurance Exchange?
How To Sign Up for Obamacare in Iowa for 2023