When you move to a different county or in from another state or out of country, that gives you a special enrollment period to get or change health insurance. See below for details.
10 CCR California Code of Regulations §6504 Special Enrollment Periods
(9) A qualified individual or enrollee, or his or her dependent, gains access to new QHPs [Qualified Health Plan – Insurance Companies] as a result of a permanent move. into a new county or the USA and new coverage [free quotes] is available you can get new healthcare coverage, without waiting for the annual open enrollment as you qualify for a Special Enrollment (Main Page) as provided by law in:
CFR §155.420 Special enrollment periods
(7) The qualified individual or enrollee, or his or her dependent, gains access to new QHPs as a result of a permanent move;
NEW RULE!!
4.2017 Federal
(7) … and—
(i) Had minimum essential coverage as described in 26 CFR 1.5000A-1(b) for one or more days during the 60 days preceding the date of the permanent move.
See also CA Insurance Code §10965.3 (d) (1)
CA Residency Guidelines Franchise Tax Board Publication # 1031
CMS Fact Sheet 5.6.2016 – Must have prior coverage – can’t move just to get coverage.
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Email us if you have any questions and we can consult and help you enroll with year around service at no addtional charge. The Insurance Companies pay us to help you.
Blue Shield CALIFORNIA RESIDENCY DEFINITION
A resident of California is an individual who
(a) has not established a permanent residence outside of California and
(b) intends to reside in California for at least 180 days of the year following his or her effective date.
These requirements apply whether an application is submitted during open enrollment (OE), or under a special enrollment period (SEP).
These requirements also apply to newborn babies and their parents. For example, if an expecting couple from New York is on vacation and the baby is born in California, the parents are not considered residents of California and the baby is therefore not eligible for a Blue Shield plan. This is because (for practical reasons) the residency of the parents or legal guardians determines the residency of the infant. These requirements apply whether the parents or legal guardians reside outside of California or outside of the country. Regarding surrogate mothers, unless she is claiming parental rights, her residency is irrelevant to determining the residency of the infant. Instead, the residency of the parents or legal guardians is what is important.
Applicants for Blue Shield coverage under a SEP must verify California residency by submitting two examples of documentation from Blue Shield’s SEP checklist. In addition, applicants seeking coverage under an SEP for a permanent move must have had coverage at some point during the 60 days prior to their moving to California. [Citation Needed]
Required Proofs to show you moved
Blue Shield Simplified Guide for Open Enrollment and Proofs for moving
INFANTS & DEPENDENT CHILDREN (applying solo):
Birth Certificate of the child (Hospital, County, or Government issued only) OR Supportive documentation confirming the adoption or legal guardian status (as applicable)
SCHOOL AGED CHILDREN (applying solo):
School Enrollment Record from the former state California School Enrollment Record (school aged child)
ADULT APPLICANTS & FAMILIES:
Verification of recent address change, such as a utility billing statement, rental agreement, or mortgage statement from the previous residence and at least one of the following:
Current utility billing statement confirming the California address
Lease or renter’s agreement
Monthly mortgage statement
Notify Your Covered CA about Your New Address
If you moved this year or are planning to move, you probably have a list of organizations to notify about your new address – like the U.S. Postal Service, utility companies and even the IRS. If you get health insurance coverage through Covered CA , you should add one more important notification to your list: your Marketplace.
If you are receiving advance payments of the premium tax credit, it is particularly important that you report changes in circumstances, such as moving to a new address, to the Marketplace. There’s a simple reason. Reporting your move lets the Marketplace update the information used to determine your eligibility for a Marketplace plan, which may in turn affect the appropriate amount of advance payments of the premium tax credit that the government sends to your health insurer.
Reporting the changes promptly will help you get the proper type and amount of financial assistance. Getting too much premium assistance means you may owe additional money or get a smaller refund when you file your taxes. On the other hand, getting too little could mean missing out on monthly premium assistance that you deserve.
Other changes in circumstances that you should report to Covered CA or us if you appoint us as your agent include:
- an increase or decrease in your income, including lump sum payments like a lump sum payment of Social Security benefits
- marriage or divorce
- the birth or adoption of a child or other changes affecting the composition of your tax family
- starting a job with health insurance
- gaining or losing your eligibility for other health care coverage
Many of these changes in circumstances – including moving out of the area served by your current Marketplace plan – qualify you for a special enrollment period to change or get insurance through the Marketplace. In most cases, if you qualify for the special enrollment period, you will have sixty days to enroll following the change in circumstances. You can find information about special enrollment periods by clicking the link, scrolling down to our ask a question section or using the red email us button at the bottom of your screen.
Links & Resources
Temporary Plans – if you missed Open Enrollment – or are traveling
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If you qualify for tax credits - subsidies and want them in advance (Pros-Cons) of filing your taxes click on "Health On Exchange" - Covered CA, illustrated below.
This website and are individual consultation are provided to you FREE of Charge! We are paid by Covered CA and/or the Insurance Companies to help you. When you fill out the Covered CA ONLINE Application, just appoint us as your agent under Find Help in the Upper Right Hand Corner so that we get paid for helping you. Click here for screen shots for more detail of how to do it. If you prefer, you can pay us a consultation fee in lieu of appointing us as your agent, for educational services only.
You can then see all the quotes on the exchange, showing the Cost Share Reduction - Enhanced Silver if available, subsidy - tax credit amount and your net premium. If you click "Off Exchange" you will see more plans and companies which may have larger provider lists. Scroll down for more screen shots.
Then click on "View Plan Details" - "View Doctor's & Providers" - to compare and get more information. Please note that the quote engine does not show enhanced silver, but shows silver at 70%. Check our chart for the better silver coverage.
Learn more about the right to change plans when Silver Level Enhanced Changes
To apply, click on apply now or use the links in the right hand column, ON THIS PAGE, but it will have you redo the quote for that specific company. The price is the SAME, no matter if you use us, go direct to Covered CA or the Insurance Company, as mandated by law! If applying through Covered CA, be sure to sign the form to appoint us as your agent. It's not all the easy to figure out how to do it on their website.
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Exceptions to Individual Mandate
I’ve been out of the country since April 1 and plan to continue to be out of the country until at least Sept 1.
My healthcare plan is $235.28 per month which seems both expensive and pointless while I’m out of the country since there are very little benefits abroad.
Is it possible to get a retroactive refund on my healthcare for these months and cancel the policy until I’m back in the states?
I doubt that your 6 month stay out of country changes anything with your residency.
So, if you cancel coverage, I don’t see how you would qualify to get coverage when you come back to USA.
There are travel policies that you can get.
Here’s our page on coverage out of country. Do NOT take our summary as Gospel. Read your Evidence of Coverage!
$235/month sounds very low. Must be a bronze plan for a young person. Get quotes here.
Don’t forget, if you get hurt, sick, ill, kidney disease, cancer, etc. outside the USA, you can always come back and get follow up treatment here. How much does chronic care treatment cost?
Blue Shield Proofs Required:
I lived overseas last year and this year, I was in the US in January for 3 weeks, left and came back last month and moved back
Sounds good to me, we just need to have the proofs that you are a new resident in CA. The proofs are listed above and on the Blue Shield simplified guide page 5 # 12. Email or bring to our meeting as many as you can get.
I’m a US Citizen along with my wife and children. We have been living in China the past two years.
1. How do we get Health Coverage when we come back to the USA?
2. How do we get a 1095 A or B so we can file our taxes?
3. What’s this you said on the phone about an exemption?
1. When you will come back, if it’s not Open Enrollment, you would qualify for a Special Enrollment CFR 155.420 (d) (7) as it’s a move to a new region. Get FREE no obligation quotes here.
2. You don’t need a 1095 A, as your exempt from the mandate and not being in the USA – Service Area, you wouldn’t qualify to buy coverage.
3. File form 8965 to show that you are exempt from the mandate. Links and instructions are on this page.
Citizens living abroad and certain noncitizens—
You were:
A U.S. citizen or a resident alien who was physically present in a foreign country or countries for at least 330 full days during any period of 12 consecutive months;
A U.S. citizen who was a bona fide resident of a foreign country or countries for an uninterrupted period that includes an entire tax year; Learn More – 8965 Instructions