IMPORTANT INFORMATION FOR EXPATS
Most Insurers Will Terminate U.S. Coverage When You Move Abroad
This subject is going to continue to be a topic of ours for some time to come. The topic of moving abroad while maintaining your U.S. Domestic coverage while you are living outside the United States is one of the most misunderstood and confusing subjects for out-bound U.S. Citizens. In a nut shell the problem that primarily exists is that people are trying to maintain their U.S. coverage in order to comply with the mandate from the Affordable Care Act (ACA) and thus avoiding any of its potential penalties.
First I think it is crystal clear that the whole subject of the Affordable Care Act and how it affects each one of us as Americans is so confusing that it can make your head explode. Not to mention the cost. But add to this confusion all the details that are involved in moving to another country and it only gets worse. Most people who are planning to move abroad have a punch list of things that have to happen prior to leaving home. One of those is the issue of maintaining proper health insurance coverage both here in the United States and abroad.
Why Maintain U.S. Coverage?
So why would a U.S. Expat want to pay premiums to an insurer to maintain a U.S. based health insurance plan when the plan to live abroad? Well the two most common discussions I have with clients has either to do with them maintaining compliance with the IRS under the Individual Mandate or because they want to be covered when they return home to the United States for a visit. In both cases you may have a problem and that problem is that your domestic certificate of coverage does not allow you to live outside the service areas and still be able to maintain that coverage. So if you move abroad to say London for the next two years and London becomes your resident address – you no longer qualify for the coverage in what was previously your home state.
Most certificates of coverage state that you must notify the insurer of any significant changes in your eligibility and the number one thing listed is almost always a change of address. For example if you live in Los Angeles, California and you are insured with Anthem Blue Cross and you move to London (not vacation there) you have 60 days to notify Anthem Blue Cross that you have moved and they will terminate your domestic policy. It is that simple. It is ultimately YOUR RESPONSIBILITY TO CHECK INTO THIS! Before you get set on keeping your domestic coverage you need to make sure if keeping it is even an option so CALL YOUR INSURANCE CARRIER and ask for a current copy of the CERTIFICATE OF COVERAGE AND READ IT! Then pick up the phone and speak to a supervisor if you can to make sure you understand your options – if any.
Another reason people try to keep their domestic insurance is that they think it is the least expensive way to guarantee coverage if and when they visit the United States or when they return home for good. Most people do not even realize that there are International plans such as the GeoBlue Xplorer Premier for Expats plan that gives them the option to maintain global coverage even when in the United States – and with no restrictions either. Obtaining International Health Insurance that properly meets the needs of your family can be a bit tricky but not so much that you won’t be able to fully get your head around the subject. Companies like GeoBlue have hands down the best International Health Insurance options for the out-bound U.S. Expat. But before you purchase you need to make sure you are crystal clear as to how your domestic coverage will fit in if at all.
Why All The Anxiety About ACA Coverage?
Much of the anxiety today is driven by the unknown. So many people think that no matter what they do they are still required to maintain an ACA Compliant health plan that meets the ACA’s definition of Minimum Essential Coverage. This may or may not be the case depending on your definition of living abroad. If for example you are planning to move abroad with little intention of returning to the United States and if you are outside the United States for 330+ days per year or more – you are not even subject to the requirements of the ACA. The most expensive coverage you will pay for is coverage that includes service within the United States. Adding this option can almost double your international premium costs over electing to have global coverage minus the U.S. For many this is more than sufficient as they do not plan to visit home much at all. There is no reason to maintain an ACA Compliant plan because once the insurance company finds out you have moved they will more than likely terminate coverage anyway.
What About A Returning Expat to the U.S.
One of the safety nets that exist today for the U.S. citizen that returns home from living abroad is that when you move home your return creates what is called a Qualified Life Event. This event creates a special enrollment window in which you can elect to enroll in a ACA plan within your service area regardless of the annual Open Enrollment Period. The caveat is that the effective date of your new policy will be based upon your enrollment date. This enrollment date may leave you vulnerable depending on the effective date given to your new policy. So you could be uninsured for a period of time assuming you are Johnny On The Spot and complete your enrollment within days of your return.
GeoBlue Xplorer Select for Expats
It is important to understand that you need to be aware that when you move abroad there are International plans available to expats that are designed to cover you abroad but not in the United States. This is because these plan types allow – no require you to keep your domestic plan in place while living abroad. Plans like the GeoBlue Xplorer Select is just on of those plan types. The GeoBlue Xplorer Select plan is a major medical plan for out-bound expats from the United States. One of the advantages of this plan is that if you have a current ACA Compliant health plan you are eligible for simplified underwriting and all pre-existing conditions are covered while abroad. The important thing to note here is that you MUST MAINTAIN underlying domestic coverage or your Xplorer Select plan will be terminated. So what you end up with is your domestic plan covers you while you are in the United States and the GeoBlue Xplorer Select plan covers you everywhere else.
The trick to all of this is finding a domestic plan that will not terminate your coverage for moving outside the service area. This is a topic that you need to pay attention to as virtually everyone you talk to has no clue as to what happens to your existing coverage if you move abroad. Even is you contact your insurer you may not get the correct answer so it is imperative that you ask the right questions and make it clear to them that you are moving outside the United States for an extended period of time. If you are working for a company that is considered a large group your plan may be able to be kept active while gone. But you need to be sure and ask the right questions when you contact them AND as always READ your certificate of coverage.
If you are on an individual plan then more than likely if the insurance company finds out that you have become an expat they will terminated your plan as you no longer meet the eligibility requirements. Trust me this is an area that is so gray and you can get different answers from different people. But moving abroad is really no different than moving to another state in that if you move from one state to another and the insurance company finds out that you have moved out of state – they will terminate your coverage. So before you move abroad thinking your domestic plan is in force and all is ok do your homework.
We will post many new articles about this subject in the weeks and months to come. There are significant risks of being misinformed and you should seek out the best possible advice you can in order to make an informed decision. But trust me – it is not easy getting the right answer and in many cases your head will explode with all the “I don’t know” responses. Moving abroad can be an exciting and rewarding time in your life. But finding out after the fact that you may have lost coverage without you even knowing it could be a bad thing.
I have been a health insurance broker for more than 30 years now and all I do now is focus on International Health Insurance products for Expats and short-term travelers. This one single subject is the most frustrating part of my job – which is finding the truth in all of this. I think that part of the lack of knowledge is that the Metal Plans from the Affordable Care Act are only in their second year and much of this is changing all the time. I no longer represent domestic insurers and one of the reasons is this very subject. I can never get a straight answer – but my best guess is that in the current high claims, low profit environment that they now operate in you can be pretty sure that if they can wiggle out of a large claim because of that fact that you moved abroad without notifying them you could face a situation where claims could be denied and your paid premiums refunded.
Get A Quote and then Call me (307) 690-0427 or email your questions to “email@example.com”. I will do my best to help guide you to the proper channels within your domestic insurance company so you can find out exactly what is required of you should you decide to move abroad. We have other great expat products that meet different needs so finding the right match is important to be sure. If you are ready to tackle this topic – remember – we are here to help.