Getting Coverage When Your Family Lives in Multiple Locations
If you or someone in your household does not live in your plan’s coverage area year-round, such as spending winters in another state or attending college out of state, there are important factors to consider when choosing a health plan.
You must enroll in coverage based on your primary residence. Even if you own a second home in another part of the country, you must select a plan available in the ZIP Code of your primary residence.
When you contact Via Benefits Insurance Services to enroll, one of our licensed benefit advisors* can help you determine which residence qualifies as your primary residence and review the coverage options available to you.
The criteria for determining your primary residence may include:
Address on file with the Social Security Administration
IRS address (where you pay taxes)
Voter registration address
Mailing address
Time spent at each location per year
Choosing a Health Plan
When choosing a health plan, it's important to consider the plan's provider network. Some plans, such as Health Maintenance Organizations (HMOs) and Exclusive Provider Organizations (EPOs), have narrower networks and generally require all covered family members to receive care from doctors and facilities within the plan's network. While these plans can be a cost-effective coverage option, they typically only cover out-of-network care in emergencies.
If access to providers in multiple locations is important, you may want to consider plans that offer out-of-network benefits, such as Preferred Provider Organizations (PPOs) and Point of Service (POS) plans. These plan types generally provide greater flexibility, but services received outside the network usually cost more than in-network care.
If you're concerned about out-of-network coverage, a benefit advisor can discuss additional options that may help meet your needs, including short-term medical plans or supplemental benefits.
Choosing coverage can be especially challenging when family members live in different locations. Our benefit advisors can help you evaluate your options and find a plan that fits your healthcare needs and budget.
Call 1-866-322-2824 to speak with a benefit advisor and explore coverage options for your multi-residence household.
*Our licensed benefit advisors receive annual training and certification to help Medicare-eligible retirees make informed decisions about their health coverage needs.