How to buy a plan when you live in one state, work in another

I have a permanent address in New Hampshire and have taken a 6 month (or longer) consultant position in Pennsylvania. I am paid through a consulting company but they do not offer health insurance so I am getting individual health insurance. My question is twofold: 1) in what state am I required to purchase the insurance — the state I’m consulting in (PA) or my permanent residence state (NH) and 2) if NH, then how is “in network” and “out of network” handled since I obviously will need to use service providers in PA?

Nomad

Dear Nomad,

On question one: It’s not so much that you are required to buy health insurance by one state or the other.  The Obamacare individual mandate does not start until January 1, 2014.  In any case, you will need to buy health insurance in your home state.

If you want to avoid having to change plans, then go with a national company that offers coverage in both states or offers plan that has no provider network at all.  Plans like these tend to have skinny benefits.  Another option is to go with a plan that is good in New Hampshire, and covers out-of-network services.

This leads in to your second question.  You are allowed to use out-of-network providers, and some plans will pay a lower percentage of the charges.  Some plans pay zero for out-of-network services, so be careful you avoid those.  You also need to be careful when you have a hospital stay.  The hospital may be “in network” but separately billed services (radiology, for example) may not be.

In sum, assuming that you will return to New Hampshire, your best bet is to get a plan that works at home and will pay for out-of-network services during your consulting gig.

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Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.