Near retirement - health insurance

We are just now establishing domicile in Florida. We are waiting for our bank to send us a statement so we can get driver's licenses. We got our address through Good Sam Mail Service in Crestview. Currently, our motorhome is registered in Florida.

We are fulltimers - have been for 6 months. Florida has no income tax and rv tags are fairly cheap, depending on what they were in your previous state. We are coming from a fairly high tax state (Maryland) so Florida seems very cheap to us.

We will be paying about $1200 more per year for health insurance but saving about $3500 a year in income tax. Car/motorhome insurance is about 2/3s of what it is in our area of Maryland (DC suburbs) so we will save another $600 there.

We really wanted to declare residency in South Dakota - it is so easy! But, once we crunched the numbers, we would actually pay more for adequate health insurance than we would save in taxes. Nevada and Texas were about a wash - there was a little profit in getting residency there but it was offset by other issues such as vehicle registration or inspection. Tennessee was definitely the best state over all, but they make it difficult to get residency and it wasn't worth the hassle.

dahkota wrote:
We purchased a silver level plan directly from Blue Cross. We found the plan through the exchange but it was easier to go direct as we knew we would not qualify for a subsidy. Our plan is about 1/2 the cost of our COBRA option and has a national network, which our previous plan did not.

The cost of health plans varies widely by state and even by county. The two cheapest states (of the ones I investigated) were Maryland and Tennessee. For us, both were under $300/month/person for a silver plan with a $1500 deductible and max out of pocket of $5000.

We looked at all the typical fulltimer states for their health insurance costs. South Dakota, our first choice for residency, was extremely expensive and had no true national networks. Texas and Nevada were also expensive (over $500/person). Tennessee was very cheap but it is hard to establish residency. So we have settled on Florida. The monthly cost is under $400/month/person with a $5000 max out of pocket.

We are pretty healthy people, only visiting the doctor twice per year for checkups for our pre-existing conditions (free in all plans). So, we are considering a plan with a lower max out of pocket but higher deductible. For us, the max out of pocket is most important when looking at health plan costs (i.e. Monthly premium X 12 + max out of pocket = maximum yearly cost. Our current plan works out to $8312 per year if we hit the max out of pocket. We found many plans with a yearly cost over $12000 per year in the same situation).

Most people focus on the deductible, which makes sense if you visit the doctor frequently but your charges don't reach your max out of pocket. In our case, because we don't see the doctor unless it is a major medical event, the max out of pocket is more important. We have funds set aside to cover both of us to our max out of pocket for two years. Meeting deductible requirements will come out of that.

It takes some work but it really is in your best interest to find the best plan for your situation. Understand how you use medical care today so you can predict for tomorrow. In some cases, a high deductible/low cost plan would be best. In others, a low deductible/high cost plan will work best. In the end, you should look at total out of pocket costs for a year of coverage if you are looking for the best "bang for your buck."

Hi Dahkota - I guess we never considered FLA as our domicile. We too are healthy and only visit the doctor once a year for our checkups. I've got a couple of questions if you don't mind.

R U fulltimers and if so where in FLA do you call home....i.e your domicile?

How R the other taxes that you pay in state....i.e state and vehicle taxes and others? Did U ever compare the cost of your other taxes in savings to health care costs in other states to see if you could save money?

Who do U use for mail forwarding?

-paul

We purchased a silver level plan directly from Blue Cross. We found the plan through the exchange but it was easier to go direct as we knew we would not qualify for a subsidy. Our plan is about 1/2 the cost of our COBRA option and has a national network, which our previous plan did not.

The cost of health plans varies widely by state and even by county. The two cheapest states (of the ones I investigated) were Maryland and Tennessee. For us, both were under $300/month/person for a silver plan with a $1500 deductible and max out of pocket of $5000.

We looked at all the typical fulltimer states for their health insurance costs. South Dakota, our first choice for residency, was extremely expensive and had no true national networks. Texas and Nevada were also expensive (over $500/person). Tennessee was very cheap but it is hard to establish residency. So we have settled on Florida. The monthly cost is under $400/month/person with a $5000 max out of pocket.

We are pretty healthy people, only visiting the doctor twice per year for checkups for our pre-existing conditions (free in all plans). So, we are considering a plan with a lower max out of pocket but higher deductible. For us, the max out of pocket is most important when looking at health plan costs (i.e. Monthly premium X 12 + max out of pocket = maximum yearly cost. Our current plan works out to $8312 per year if we hit the max out of pocket. We found many plans with a yearly cost over $12000 per year in the same situation).

Most people focus on the deductible, which makes sense if you visit the doctor frequently but your charges don't reach your max out of pocket. In our case, because we don't see the doctor unless it is a major medical event, the max out of pocket is more important. We have funds set aside to cover both of us to our max out of pocket for two years. Meeting deductible requirements will come out of that.

It takes some work but it really is in your best interest to find the best plan for your situation. Understand how you use medical care today so you can predict for tomorrow. In some cases, a high deductible/low cost plan would be best. In others, a low deductible/high cost plan will work best. In the end, you should look at total out of pocket costs for a year of coverage if you are looking for the best "bang for your buck."

From my retirement at 60, up to 65 I purchased a private, individual policy from BCBS based on a national PPO network. Other than the constant increases in the premium, I never had any issues getting good care all over the country.
Thankfully I turned 65 the year Obamacare was implemented and never had to deal with the current mess.
Healthcare insurance options differ significantly from state to state. Your choice of domicile state may be driven by health care over all other issues. Private Healthcare insurance limitations is the one disadvantage to SD domicile.

West Beachhouse wrote:
Just wondering how you manage health insurance while traveling nationally if not subsidized by Medicare, Medicaid or a retirement system (such as government employee, teacher, military etc).

TechWriter wrote:
I've used COBRA, but when it runs out, I'll use a plan from www.healthcare.gov or www.ehealthinsurance.com until Medicare.

Good choices above for research, but I wouldn't use COBRA. I'd also look at this site, http://rverhealthinsurance.com

We're slowly working with Kyle on our health insurance. We are in our 50's and plan to go fulltime next year. We figure our premiums will be in the $700 a month range. The out-of-pocket is what kills you, so make sure that money is tucked away if needed. Look at the in and out of network costs as well as if the provider has a good country wide network.

Your home state will play a big roll in your health insurance also. Our plan is either SD or Texas. We're hoping that SD catches up with other states on providing health insurance for "Fulltime RVers". Make sure that your insurance provider understand that you plan on fulltiming. Feel free to PM me if you have additional questions.

-paul

You will need to find a health plan that provides national coverage. Many of the plans that are available through healthcare.gov have very restrictive networks and may only pay for emergencies out of network so look carefully. DW and I don't qualify for Medicare yet and our premium is $1161 a month for the two of us with substantial deductibles.

West Beachhouse wrote:
Just wondering how you manage health insurance while traveling nationally if not subsidized by Medicare, Medicaid or a retirement system (such as government employee, teacher, military etc).

Some people have big bucks.

I've used COBRA, but when it runs out, I'll use a plan from www.healthcare.gov or www.ehealthinsurance.com until Medicare.