Getting Coverage When Your Family Lives in Multiple Locations
If you or part of your covered household don't live in a plan's coverage area all year (for example, you spend the winter in a different state or you have a child attending college out of state), there are some things to consider when enrolling in a health plan.
You must select coverage based on your primary residence. You're required to enroll in a plan that's in the ZIP Code of this residence, even if you own a second home in a different part of the country. When you contact Via Benefits Insurance Services to enroll, one of our licensed benefit advisors* can help determine your primary residence.
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
Selecting a Health Plan
When selecting a plan, consider whether the plan has a narrow network of doctors, such as an HMO (Health Maintenance Organization) or EPO (Exclusive Provider Organization). These plans may require you and everyone else on your plan to see doctors and facilities within its provider network. HMO and EPO plans, while often the right choice for coverage, only cover you out-of-network in case of emergency. Plan types that have coverage outside of the network include Preferred Provider Organization (PPO) and Point of Service (POS).
Where available, consider choosing a PPO or POS plan that includes out-of-network benefits for the secondary location. Be advised, costs are higher when receiving services out of network.
If you're concerned about the level of out-of-network coverage, ask a benefit advisor about additional solutions, like short-term medical or additional benefits plans.
It can be challenging to select a plan when you or your family members live in multiple locations. Our benefit advisors can assist you in choosing a plan that fits your needs and budget. Call us at 1-866-322-2824 to speak with a benefit advisor and discuss coverage options for your multi-resident household.
*Our licensed benefit advisors specialize in health insurance for retirees. They go through annual training and certification to ensure they can help you make an informed and confident decision.