Can I buy health insurance from an out of state insurer?

May 4, 2011 10:14 AM

Can I buy health insurance from an out of state insurer? (more)

I posted this thread a few weeks ago, lamenting how I was about to lose my great, cheap CT coverage (Anthem) upon my move to NY, where I could only find spotty and super-expensive coverage. It was explained that "the reason you were able to get relatively inexpensive coverage in CT is that your insurance company saw you as a good risk. In New York, insurance is community rated, meaning they have to offer the same rate to everyone."

I've just been told by a New York physical therapist (who deals with insurance issues all the time) that I don't need to live in a state to get health insurance from an insurer in that state. This rings false to me, but she insisted. Does anyone know the truth?

posted by Quisp Lover to health & fitness (3 answers total)

Ask you state Insurance Commission.
posted by theora55 at 10:35 AM on May 4, 2011

This is not legal advice, and I'm not an insurance expert of any kind, but my understanding is that each state has its own requirements for what is considered "insurance" within that state. They can mandate things like community rating or guaranteed issue, require insurers to cover certain conditions or treatments, regulate rates, and generally decide what kind of insurance can be sold. In order to sell individual insurance to a resident of the state, an insurer must comply with state insurance statutes and be licensed there. So, no, a CT company can't sell its CT insurance to a NY resident unless that insurance complies with NY laws.

What I suspect your PT was talking about was group insurance, in which an employer or some other representative purchases insurance for a larger number of people. There, the laws that apply are those in the state where the group is based. So, for example, I lived for a number of years in NY and had coverage through Blue Cross of MD, because my employer's headquarters were in MD, so that's where they bought insurance for their employees. If you're a member of a group, you get the same coverage offered to all members of that group no matter where you live.

The short answer to your question is no, you as an individual domiciled in NY cannot buy health insurance from a company licensed to sell it in CT but not NY. But your PT is right that many people living in NY have insurance from CT and other states, because they're part of groups based in those states.
posted by decathecting at 11:18 AM on May 4, 2011 [1 favorite]

Thanks for the helpful though depressing information!

My mind's scheming all sorts of ways to have a kinda/sorta CT address in order to hang on to this insurance, but, in the end, I suppose I'd just be giving the insurer ammunition to deny major claims if they ever came up.

I'm not eligible for freelancer or other group insurance. I'm sorta screwed. Oh well. When does Obamacare cut in again? :)
posted by Quisp Lover at 11:27 AM on May 4, 2011