Health coverage when you study in another state

Studying in another state can change how your health coverage works day to day. Before you move, check the plan networks, Medicaid rules, marketplace options and emergency coverage described here.

Checking your plan's network

Health plans build their networks around a region, and that region may stop at your home state's border. An HMO or EPO plan may cover only emergencies outside its area, while a PPO plan often pays for out-of-network care at a higher cost to you.

Some insurers belong to national networks that give access to doctors in other states. Call member services, give the city where your school is, and ask which local doctors, urgent care clinics and pharmacies are in network.

Emergency care away from home

Federal law requires most plans to cover emergency care at in-network cost sharing, even at an out-of-network hospital, and without prior approval. The No Surprises Act also limits surprise bills for emergency care and for some care at in-network hospitals.

Follow-up care after an emergency returns to the network rules, so ask the plan where to go next. Keep copies of any bills and notices in case you need to question a charge.

Before you move

• In-network clinics near campus
• Your plan's rules for care outside its area
• Where Medicaid will cover you, if you have it
• The nearest urgent care and emergency room

Medicaid across state lines

Medicaid coverage belongs to the state that enrolled you, and routine care in another state is usually left out. Emergencies are often treated differently, so ask your state agency how it handles them.

Depending on state rules, a student may be able to apply for Medicaid in the state where they attend school. Contact the Medicaid agency in that state and ask how it decides residency for students.

The marketplace and the move

Moving to or from the place you attend school can count as a qualifying life event for a marketplace Special Enrollment Period. Students can often choose whether to apply in their home state or the state where they study, so ask the marketplace which applies to you.

Plan networks differ by area, so a marketplace plan bought at home may have few providers near campus. Compare networks in both places before you choose.