Health Insurance

[stormysmom]

Hello,

My husband is of Medicare age, put I am not. I had to change my already in place Anthem BC/BS because of Obamacare. I went from a PPO to an HMO. NOW, I learn that when we are in Florida for 5 or 6 months, I cannot visit an MD, except for emergencies. Any suggestions on a different insurance company and plan that can "travel" with me?

Any snowbirds or workampers out there that might point me in the right direction?

Thanks.

[tatest]

stormysmom wrote:
Thanks for all your input. I could've kept my BC/BS but not the same plan. The policy that was offerred to me would've cost about $700.00 a month. Not a possibility. I will explore the websites that were suggested. Thanks to all.

There's the rub. The coverage is available, but not a price you like. When I retired early (7 years before Medicare for me, 8 for my wife) I was able to retain "pay anywhere" 80/20 coverage with $5000 deductibles and $25,000 out of pocket caps, but it jumped from about $400 a month for my share to $1200 in retirement, going to $1600 before I went on Medicare, back down to about $900 for the year it was just covering my wife. Premiums go up with risks (age) and care cost exposures.

We rebudgeted, putting more money into medical insurance than into food and housing, because we wanted to cover risks for care that might be needed for travel. Basically, most of our budget became travel costs and medical insurance costs, that's what my wife wanted to do with my retirement. Before it was all over, we essentially got those insurance premiums back as medical care, because she cost the insurer more than $800,000 the last three years she was covered.

This is something ACA doesn't really fix, as global medical insurance coverage is a luxury beyond the scope of what is seen as "need" but if your lifestyle makes it a need, I don't know of a way of getting around paying the premium.

That $700 a month at your age will likely double before you reach Medicare age, and then the closest supplemental coverage, usually 'N' if they continue to allow it, will likely bring your Medicare+ premiums to more than the $300 you are now paying to the HMO.

Specific insurers and plans for Virginia? I don't know, I haven't shopped insurance in that state, but I'm sure it is not going to cost you any less in Virginia than it cost me 10 years ago in Oklahoma, and you probably won't like the price, since my experience is that $700 a month looks pretty good for a PPO plan with reasonable deductibles and at least 50/50 out of network coverage. You can expect to almost double that to get out of PPO into "traditional" coverage.

[stormysmom]

Thank you.

[travelalot2some]

When I applied for insurance through the NY health exchange, I was given many options. I reviewed each to compare with the COBRA that was much more than we could afford, even short-term. If you reside in a state that has a healthcare exchange, you can contact your local navigator to assist you. It might through a local county agency. In my area the information is on NY health exchange website.

When I had questions about the coverage I called the company. Yes, there are many HMOs because they are supposed to contain costs but they are not necessarily the best plan for everyone. Each individual has different needs, ours includes very significant pre-existing conditions.

It is not a one size fits all, nor should it be. We have a deductible and even with that our cost is still significantly less than, but comparable to, the COBRA. When we wintered in Florida I was sick and went to Urgent Care. I paid the cost of approximately $125.00.

Insurance premiums and healthcare costs have increased for years, and not because everyone has access to healthcare. I remember a time back in the 80's when the premium for BCBS increased by 45%!!

Good luck with your search.

[stormysmom]

Thanks for all your input. I could've kept my BC/BS but not the same plan. The policy that was offerred to me would've cost about $700.00 a month. Not a possibility. I will explore the websites that were suggested. Thanks to all.

[Big_Katuna]

I agree that an Independent agent that represents several companies is your best bet.
Ours saw the motorhome and recommended plans that were seamless nationwide.
She said the only two are United and Assurant. We already had Assurant but got a much better plan under ACA.

We have been self employed for 20 years. The ACA has made a huge difference for us.
Over 11 million people now have insurance. Ours has gotten better for less money for three years.

We are very thankful for the ACA.

[Bumpyroad]

are these cooperatives regulated the same as other "normal" health insurance companies? I heard on the news this morning that 500,000 (or 700,000 don't remember which) people who originally signed up for Obamacare have dropped it.
bumpy

[tjfogelberg]

Check with an independent insurance agent who specializes in health insurance. Because insurance agents are licensed by the state, you'll want one located in your domicile.

Ask about an HSA qualified plan. This offers the best tax advantages.

Todd

[wildtoad]

Many If not most of the plans offered in the private market have to meet the standards as set by the ACA. They are also not allowed to underwrite the policies other than for smokers or age. As a result they severly limit the networks and out of state coverage. Mine provides coverage out of network on an emergency basis only. It's expensive, has high deductibles, but does prevent me from going broke from a medical emergency.

Don't get sick out of network/state or be prepared to pay.

[dahkota]

According to a post, the membership was around 3000 in October 2013.
Liberty Healthshare is one of only 5 approved ministries because the ministry had to exist before 1999, a rule of ACA.
For the first year, pre-existing conditions are not covered and are covered at a reduced rate for the next three years of membership.
Just like regular health insurance, your claim can be denied.
their website states that last month, they paid out $104K in claims.
They are not rated with the BBB because they did not submit requested information.

If this works for people it could be a great alternative. For me, with life threatening pre-existing conditions (currently in remission) I cannot take the risk.

[blangen]

Bumpyroad wrote:

blangen wrote:
We side-stepped Obamacare all together with Liberty Health Share

Cadillac of plans for both of us for $350 per month total.

Just for the record... no affiliation whatsoever with these folks. We're just happy Obamacare side-steppers.

although I admire Obamacare side-steppers, I am a little leery of the communal health coverage. wait till a bunch of extremely expensive events hit the group. How many people is the group composed of?
bumpy

How many members? Don't have a clue but it is nationally available. I'm guessing they are doing very well as they are one of just a few that claim to be "approved" ACA alternatives. In my opinion, I don't see a difference between them and insurance companies.... other than they're considerably cheaper. Interesting that you would think an insurance company is any more stable (if hit with large bills). After all, these are all just "pools" of managed risk. I don't see a difference.

Edit added: Actually, to be fair, let me clarify... we have never submitted a medical bill to them. We use them for catastrophic needs should they ever arise. For all the little stuff, we pay cash and usually get a much reduced rate. So... I'm not telling you how wonderful they are... just that they exist as an alternative to the ACA. Lots of info on the website.

[Bumpyroad]

blangen wrote:
We side-stepped Obamacare all together with Liberty Health Share

Cadillac of plans for both of us for $350 per month total.

Just for the record... no affiliation whatsoever with these folks. We're just happy Obamacare side-steppers.

although I admire Obamacare side-steppers, I am a little leery of the communal health coverage. wait till a bunch of extremely expensive events hit the group. How many people is the group composed of?
bumpy

[blangen]

We side-stepped Obamacare all together with Liberty Health Share

Cadillac of plans for both of us for $350 per month total.

Just for the record... no affiliation whatsoever with these folks. We're just happy Obamacare side-steppers.

[dahkota]

For a large national network, you need a PPO rather than an HMO. BCBS offers them in many states, including Florida and Virginia. I have mine in Maryland but can use it across the country. While my plan is a result of the ACA, I purchased my plan directly from BCBS. It was the same price and, since I didn't qualify for subsidies, faster and easier. Check ehealthinsurance.com for various plans and pricing.

[WyoTraveler]

I'm surprised Anthem BS/BS doesn't cover you. I had it for several years before medicare. When I was out of area I couldn't just go in for routine things like a physical. Could always go in for medical problems. I now carry it as a secondary to medicare and it was transferred from CA to WY. Takes a little longer to get approved. Must be filed in WY then sent to CA but never a problem.

[TucsonJim]

Are you sure about the "emergency" portion of your policy. I tried to buy a new policy under the obamacare provisions, but I could not find one that would pay for emergency care outside of network.