State Residency and ACA (Obamacare) Health Plans

[Zulu]

In a previous thread, someone asked what he needed to do to establish residency in Oregon in order to sign up for a BCBS (Blue Cross Blue Shield) health plan on the ACA (Affordable Care Act or "Obamacare") health exchange.

Some people responded by saying Oregon requires that a person reside in the state 6 months, that you'll need a permanent address, etc, etc.

This is just not true. Furthermore, it's not true for any state.

State residency requirements are NOT the same as ACA residency requirements.

One more time . . .

State residency requirements are NOT the same as ACA residency requirements.

How do I know? From Recent Guidance About Marketplace Residency Requirement and Special Enrollment Period When Moving (Jan 2016), but the details are spelled out in this ACA Residency FAQ from the Department of Health and Human Services.

 

The FAQ reads like it was written for RVers. Some FAQ paraphrased excerpts:

 

Q1: What is the residency requirement for Marketplace coverage?

In order to be eligible for Marketplace coverage, an individual must be a resident of a state (note that it doesn't say "domicile")

(1) where he or she is living; and

(2) where he or she “intends to reside” (including without a fixed address)

Q3. What does “intends to reside” mean?

That an applicant has a present intent to reside where he or she is living, and intends to remain in the state where he or she is seeking coverage.

Note that someone visiting a state for a transitory purpose, for example, to obtain medical care, do not meet the residency requirement for Marketplace coverage for the Marketplace service area they are visiting.

Q7. Is there a waiting period before an individual can become a resident?

No, there is no waiting period associated with the residency requirement.

Q8. If an individual moves, does his or her residence change for the purposes of Marketplace coverage?

If an individual moves to a new Exchange service area (i.e. state) and meets the requirements as explained in Question 1 above—with respect to the new location, then the individual will meet the Marketplace residency requirement in the new location.

Enrolled Marketplace consumers must report any and all moves to the Marketplace within 30 days by calling the Marketplace Call Center at 1-800-318-2596.

Q9. Does an individual’s residence change when he or she leaves a state temporarily?

No.

 

Q11. If an individual travels between homes in different states throughout the year, where is an individual’s residence for the purposes of Marketplace coverage?

If an individual leaves his or her primary home to visit a secondary home for a short duration, the departure will be considered a temporary absence, and the individual will remain a resident of the service area of the primary home. During that time, the individual will not have an “intent to reside” in the location of the secondary home and will not meet the Marketplace residency standard for that location.

 

In contrast, if an individual has two primary homes where he or she spends time for an entire season or other long period of time, then the individual may live and intend to reside in both locations. In such situations, the individual may establish residency in either or both locations.

 

Finally, repeat after me:

 

State residency requirements are NOT the same as ACA residency requirements.

 

[Greg Schoenberg]

Great research. Thank you!!!

 

So essentially a person can change domiciles, or be in the process of changing domiciles, and acquire ACA health insurance right away? Q1 (2) and Q3. Therefore, if a person requires nationwide coverage and lives in Washington (where there are no ACA nationwide plans), they can acquire an address in Oregon, buy a suitable plan, and as logistic permits, complete the domiciling process (voter registration, DMV, etc.)

 

So right?

 

Greg

[saydiver]

Great research. Thank you!!!

 

So essentially a person can change domiciles, or be in the process of changing domiciles, and acquire ACA health insurance right away? Q1 (2) and Q3. Therefore, if a person requires nationwide coverage and lives in Washington (where there are no ACA nationwide plans), they can acquire an address in Oregon, buy a suitable plan, and as logistic permits, complete the domiciling process (voter registration, DMV, etc.)

 

So right?

 

Greg

 

Of course they can. I never said you had to wait 6 months and neither did the FAQs. The six months was not to get domicile, but to maintain domicile, if you didn't meet the other requirements.

 

Now look at questions 9 and 11. You can be gone temporarily or for a short duration? Do you honestly think that means a year or more?

[Greg Schoenberg]

Of course they can. I never said you had to wait 6 months and neither did the FAQs. The six months was not to get domicile, but to maintain domicile, if you didn't meet the other requirements.

Now look at questions 9 and 11. You can be gone temporarily or for a short duration? Do you honestly think that means a year or more?

No....I don't think it means a year or more. But that's the beauty of Oregon. It has terrific summers with low humidity. It's not a sacrifice to return there on an annual basis.

 

Greg

[Kirk W]

. It has terrific summers with low humidity. It's not a sacrifice to return there on an annual basis.

That is an opinion which may not apply to everyone. Many an RV fulltimer chooses to stay out of their state of residence for longer than OR allows. Some of us have medical reasons that force us to return to the location at least annually, but even then there could be times that one stays out longer. Even though we live with medical issues, we were once out of our domicile state for 17 months, due to a family emergency.

[Pat & Pete]

A further example : We likely won't get back to our domicile for another 3 years .

[saydiver]

That is an opinion which may not apply to everyone. Many an RV fulltimer chooses to stay out of their state of residence for longer than OR allows. Some of us have medical reasons that force us to return to the location at least annually, but even then there could be times that one stays out longer. Even though we live with medical issues, we were once out of our domicile state for 17 months, due to a family emergency.

 

A lot of states have requirements that you have to become a resident after six months. I know Florida does. Yes, you had a good reason to be gone, but does having a valid reason mean you can ignore state and federal residency rules? Likely not.

[saydiver]

A further example : We likely won't get back to our domicile for another 3 years .

Exactly my point. A lot of full-timers possibly are not meeting the #9 and #11 ACA residency requirements.

[saydiver]

Q11. As far as having two or more primary homes in different states, are you allowed to have a policy in each state with each being a partial year? A lot of people in FL have two or more homes in different states. They spend winters in FL and summers up north or elsewhere. I can't imagine keeping this straight with multiple insurance companies. I have enough billing issues with FL Blue, without adding additional complexity.

[Kirk W]

 

A lot of states have requirements that you have to become a resident after six months. I know Florida does. Yes, you had a good reason to be gone, but does having a valid reason mean you can ignore state and federal residency rules? Likely not.

One of the reasons that TX, SD, & FL have become so popular as fulltimer domicile states is the fact that none of them have any time requirement for residency and no requirement for you to return to the state except for driver's license renewals and at least TX only requires that on alternate renewals. If FL now has some time requirement for residency, would you supply a link to that regulation, and perhaps quote it here for us? Also please explain the federal residency rules and supply a link to those. Are you saying that there is some federal law that requires you to spend time in some particular state or your state of domicile? Since I am completely in the dark about this, please enlighten all of us.What federal code is this and where can we locate a copy of it? I am pretty sure that no such code exists, or have always believed that.

[Greg Schoenberg]

Q11. As far as having two or more primary homes in different states, are you allowed to have a policy in each state with each being a partial year? A lot of people in FL have two or more homes in different states. They spend winters in FL and summers up north or elsewhere. I can't imagine keeping this straight with multiple insurance companies. I have enough billing issues with FL Blue, without adding additional complexity.

 

I'm in the same boat. Two different homes in two different states. It would be a nightmare switching back-and-forth with insurance companies. This is why coverage is critical for us.

 

Greg

[saydiver]

One of the reasons that TX, SD, & FL have become so popular as fulltimer domicile states is the fact that none of them have any time requirement for residency and no requirement for you to return to the state except for driver's license renewals and at least TX only requires that on alternate renewals. If FL now has some time requirement for residency, would you supply a link to that regulation, and perhaps quote it here for us? Also please explain the federal residency rules and supply a link to those. Are you saying that there is some federal law that requires you to spend time in some particular state or your state of domicile? Since I am completely in the dark about this, please enlighten all of us.What federal code is this and where can we locate a copy of it? I am pretty sure that no such code exists, or have always believed that.

 

Did you actually read what I wrote? I said "A lot of states have requirements that you have to become a resident after six months." Do I know people who stayed in FL longer than six months and didn't become residents? Yes. Did they get in trouble? No, as far as I know.

 

True about what you're saying about TX, SD, and FL(except if you stay here over 6 months), but federal ACA requirements apparently are different. The ACA regs say you can be gone temporarily or for a short duration. Go back and read #9 and #11 from Zulu's post.

 

Here's the info for Florida:

 

Florida law requires that you get a Florida drivers license within 30 days of becoming a resident of Florida. You are a resident if you do one of the following:

• Enroll your children in a Florida public school
• Accept employment
• Register to Vote
• File for a homestead exemption
• Reside in Florida for more than six consecutive months

http://www.dmvflorida.org/moving-to-florida.shtml

http://www.stateofflorida.com/drivers-license-requirements.aspx

 

 

[Zulu]

Q11. As far as having two or more primary homes in different states, are you allowed to have a policy in each state with each being a partial year? A lot of people in FL have two or more homes in different states. They spend winters in FL and summers up north or elsewhere. I can't imagine keeping this straight with multiple insurance companies. I have enough billing issues with FL Blue, without adding additional complexity.

I'm in the same boat. Two different homes in two different states. It would be a nightmare switching back-and-forth with insurance companies. This is why coverage is critical for us.

If you read all of the answer to Q11, then you read that "if an individual has two primary homes where he or she spends time for an entire season or other long period of time, then the individual may live and intend to reside in both locations. In such situations, the individual may establish residency in either or both locations."

 

In essence, you could cherry pick a health plan -- select the best health plan available in one of your residency locations. Then stay with that plan in all you residence locations.

 

I think picking one residence health provider is better than multiple provides and switching providers in each residence location.

 

Why?

 

Two reasons:

(1) One of your residence health plans is probably better than your other residence plans.

(2) I think your health plan's deductible and out-of-pocket max reset when you start a new plan. This could be a big, big deal.

 

Remember, all of this applies to ACA health plan residency requirements.

[Zulu]

A further example : We likely won't get back to our domicile for another 3 years .

 

If you have an ACA health plan based on your domicile residence and you believe that you can keep that ACA health plan while you're away from your domicile for 3 years, then I have a bridge to sell you.

[Pat & Pete]

 

If you have an ACA health plan based on your domicile residence and you believe that you can keep that ACA health plan while you're away from your domicile for 3 years, then I have a bridge to sell you.

 

I bet you do ...

 

No ACA plan here .

 

I thought I was simply firming Kirk's example . Maybe I should have read more deeply ?

[Zulu]

 

I bet you do ...

 

No ACA plan here .

 

I thought I was simply firming Kirk's example . Maybe I should have read more deeply ?

 

My bad. People are talking about both state and ACA residency -- almost in the same breath. It's easy to get them mixed up.

[saydiver]

 

If you read all of the answer to Q11, then you read that "if an individual has two primary homes where he or she spends time for an entire season or other long period of time, then the individual may live and intend to reside in both locations. In such situations, the individual may establish residency in either or both locations."

 

In essence, you could cherry pick a health plan -- select the best health plan available in one of your residency locations. Then stay with that plan in all you residence locations.

 

I think picking one residence health provider is better than multiple provides and switching providers in each residence location.

 

Why?

 

Two reasons:

(1) One of your residence health plans is probably better than your other residence plans.

(2) I think your health plan's deductible and out-of-pocket max reset when you start a new plan. This could be a big, big deal.

 

Remember, all of this applies to ACA health plan residency requirements.

 

 

1. Somehow I have a hard time believing you can just arbitrarily choose one state over the other, especially if you spend only a few months in one of the locations.

2. In the past I've seen carry-overs concerning deductibles, but you're right, it's probably not possible anymore.

[Pat & Pete]

 

My bad. People are talking about both state and ACA residency -- almost in the same breath. It's easy to get them mixed up.

 

No worries . All in a days surfing . Sometimes the waves get a little choppy .

[Zulu]

1. Somehow I have a hard time believing you can just arbitrarily choose one state over the other, . . .

 

You don't have to believe it. Those are the rules.

 

 

. . . especially if you spend only a few months in one of the locations.

 

This is an entirely different question -- minimum residency time (if there is such a thing). Best to call the ACA help line and ask "If I stay in a location for ___ months, can I use this (or "do I have to use this") as a residence for ACA purposes?"

[saydiver]

 

No worries . All in a days surfing . Sometimes the waves get a little choppy .

 

Yes, it is confusing, but even when talking about ACA residency requirements to get ACA insurance, you can't just ignore state residency requirements.

[Smitty77_7]

Well, as it seems to be so often, confusing and sometimes conflicting laws and regulations, has really made it mandatory for us all to keep our "That Was Easy!" button handy:)!

 

I know at least two couples, and one other person too, that have over three Escapees Coop's and or Rainbow lots. Two of them have Washington Evergreen and Arizona North Ranch. The other person has Oregon Timber Valley in Sutherlin, JoBo in Aquanga California, and finally a place at Rainbow Plantation in Summerdale Alabama (Though last time I visited ran into him, he was thinking about a park model on one of three locations, probably Alabama, to cut back on the longer drives with his Fiver.)

 

So three potential states to choose from for him, and two for the others. Funny, one couple retained AZ, and I believe the other couple with higher income, chose Washington.

 

Real simple world we live in....

Smitty

[Greg Schoenberg]

1. Somehow I have a hard time believing you can just arbitrarily choose one state over the other, especially if you spend only a few months in one of the locations.

2. In the past I've seen carry-overs concerning deductibles, but you're right, it's probably not possible anymore.

Regarding number two. I have not seen an individual policy with deductible carryovers. Likely a thing of the past I'm afraid.

 

-Greg

[Greg Schoenberg]

[quote name="Smitty" post="871141" timestamp="1479085083"

 

So three potential states to choose from for him, and two for the others. Funny, one couple retained AZ, and I believe the other couple with higher income, chose Washington.

 

Real simple world we live in....

Smitty

 

I spend much of the year in Arizona. Sure not seeing me advantages of domiciling here. Income tax, high sales tax, and really cruddy health insurance choices. I'm holding on to my Washington residency long as I can.

 

Greg

[Luke1]

What type of health insurance do full time RV'ers get that follows them state to state?

 

I am new to living and travelling in my RV full time and the health insurance I currently have (BCBS in Palm Beach County, FL) requires me to be in that county for any medical treatment other than emergencies.

 

Looking for another plan that I can use anywhere just in case.

 

Luke1

[Kirk W]

I am new to living and travelling in my RV full time and the health insurance I currently have (BCBS in Palm Beach County, FL) requires me to be in that county for any medical treatment other than emergencies.

t sounds like you must have one of the HMO plans. What you will want is the PPO type with coverage and network providers in all states. You should be able to locate one in FL.