Multi-State Health Plans

Everything You Need to Know About Multi-State Health Plans

If you travel out-of-state often, you may want a multi-state health plan through the Health Insurance Marketplace. Most plans are regional, so consider a multi-state plan even if you only plan to travel between two states.

What is A Multi-State (MSP) Plan Program ?

The multi-state plan program was created under ObamaCare (the Affordable Care Act) to provide an additional coverage option for travelers in the Health Insurance Marketplace. Typically health coverage is regional, so multi-state plans are a must for those who travel often.

A multi-state plan is one that has been approved to participate on the health insurance Marketplace by a federal government agency, the U.S. Office of Personnel Management (OPM). This is the same agency that administers the health plan for federal government employees. – You can learn more about multi-state plans from OPM.Gov or KFF.Org.

Who Can Get a Multi-state Health Plan?

If you live in a  state that offers multi-state health plans, anyone with access to the Health Insurance Marketplace can get one. They are not only for Federal Employees.

In 2015 there are multi-state plans in 35 states and the District of Columbia, but by 2017 ObamaCare requires that all 50 states have multi-state plans.

What Providers Offer Multi-state Plans?

In 2015, multi-state plans are offered through the Blue Cross Blue Shield Association and by Consumer Operated and Oriented Plans (CO-OPs).

How Do Networks Work with Multi-state Plans?

Some multi-state plans offer regional or national provider networks and will reimburse as “in-network” care rendered by providers in other states, but others may not. This information should be provided in the description of the multi-state plan’s features on your state’s health insurance Marketplace.

It’s very important to understand your plans network, you should not expect care options to be consistent between states. Be aware of out-of-network coverage cost sharing and limits.

Are Multi-state Plans More Expensive?

In general a multi-state plan isn’t more expensive. However, the cheapest marketplace plans will often be local HMOs (without multi-state options. In this way, the cheapest multi-state option will often cost more than the cheapest marketplace plan. Comparing one PPO to it’s similar MSP, you may find the multi-state options to have a lower price-tag due to competition of the large network.

Specific cost sharing will very for each covered benefit depending upon your plan and network.

Can I get cost Assistance on a Multi-State Plan?

These plans work just like regular Marketplace plans and are eligible for cost assistance.

Multi-State or PPO?

In some states PPO’s cover you out of state, in others only a multi-state plan will. Again it’s important to check networks and coverage limits of any plan you buy.