Final answer:
An insured individual leaving their primary coverage area to seek medical care typically needs to obtain prior approval from their insurer. This process is in place to ensure coverage and limit issues such as moral hazard and adverse selection in the health insurance market.
Step-by-step explanation:
When an insured person leaves their primary area of medical coverage and seeks medical care elsewhere, the most common action required is to obtain prior approval from their insurer for the medical service. This ensures that the services provided will be covered under their insurance plan and mitigates issues such as moral hazard and adverse selection. It is not typically required to obtain approval from the NAIC, take a physical examination prior to leaving, or sign a liability waiver from the insurer before receiving medical care.
The Patient Protection and Affordable Care Act (ACA or Obamacare) has played a crucial role in broadening health care coverage, including ensuring coverage for individuals with preexisting conditions and establishing the individual mandate. However, healthcare policies and requirements may vary depending on the insurer and specific health plans, including fee-for-service systems and health maintenance organizations (HMOs).