Any health insurance tips for snowbirders?

Stormy Eyes wrote:
Here is some info posted by somebody on another forum. Food for thought...
" In another 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."

If you are in reside in both states, you might be able to but coverage in either state or both.

Does your TX location offer a policy with nationwide coverage? If not, any chance you would consider wintering in Florida? Florida Blue does offer some policies with nationwide coverage networks in 2017. Never know about future years, of course.

I would think long and hard before I would choose my insurance on parsed phrases. While your "intent to reside" will probably get your insurance coverage issued and normal medical conditions covered, what happens should the unthinkable occur and you develop a multi-million dollar medical condition? You can bet the insurer is going to triple check their obligations. If you give them a foothold to challenge coverage, you might find yourself fighting to get coverage for your treatment. That would be a pain if it was coverage to get your home's roof replaced or your car repaired, but it can be life threatening if your heart transplant is delayed because insurance is disputing coverage. You could even win the battle but lose the war if your condition deteriorates. Personally, I only gamble with things I can afford to lose and my health insurance isn't among those things.