Navigating Out-of-State Health Care: A Guide for ACA Beneficiaries

If you’ve recently moved to a new state, you may be wondering how to access quality health care. The Affordable Care Act (ACA) offers several provisions to ensure that you can continue receiving the medical attention you need, even if you’re living away from your primary care providers.

Out-of-State Telehealth Services
Telehealth appointments allow you to consult with your healthcare professionals remotely, using video conferencing technology. During the COVID-19 pandemic, the ACA temporarily expanded telehealth coverage to allow patients to receive care from providers licensed in any state. Although this waiver has expired, some states, such as New York, have implemented permanent telehealth laws. You should check with your insurance provider to confirm if telehealth services are covered for out-of-state providers.

In-Person Medical Appointments

If telehealth is not an option, you can still travel to your parents’ state for in-person medical appointments. Your ACA health insurance should cover these appointments as long as the provider is in-network. You may need to pay a higher out-of-pocket cost if the provider is out-of-network, so it’s best to check with your insurance company beforehand.

Medication Refills

If you require regular medication refills, you can have them sent to a pharmacy in your new state. Most insurance plans contract with national pharmacies, so you should be able to pick up your prescriptions at any location. However, controlled substances may require a separate approval process, and you may need to fill them at a pharmacy in your parents’ state.

Tips for Getting Out-of-State Health Care

Contact your insurance provider to verify coverage for out-of-state services.
Check if telehealth services are available from your current providers or if you can establish care with new providers in your new state.
If necessary, make travel arrangements to attend in-person appointments in your parents’ state.
Consider the cost of out-of-state care and whether you need to pay higher out-of-pocket expenses.
Communicate with your healthcare providers regularly to ensure that your medical needs are being met.

Navigating out-of-state health care can be challenging, but with careful planning and communication, you can ensure that you continue to receive the quality medical attention you deserve. If you have any questions or concerns, don’t hesitate to reach out to a licensed保険agent for guidance.