Health insurance on the road

[retiredtraveler]

I am sure this has been discussed before so if so I apologize for asking again. Neither my wife or I are old enough to get medicare so we purchase our plan here in our home state of CT. We generally spend 6 months in the south and the rest here. Due to some ongoing health issues our doctor demands we seek medical help in the south to monitor the situation. The problem is that our plan does not cover anything except emergencies once outside of our state. How do others deal with this?
Thanks in advance.

[johnhicks]

So you're suggesting we can just pick the best zip code?

[TechWriter]

westernrvparkowner wrote:
BCBS still offers PPO plans in Montana, but I know for a fact they have discontinued all PPO plans in Texas.

That's not true.

Using www.healthsherpa.com, look up the BCBS plans available for the 73301 Zip Code (Travis County, TX).

You should find 9 PPO plans (Bronze, Silver, and Gold) offered from Scott & White Health Plan.

By contrast, check the health plans available for 77351 (Polk County, TX where a lot of RVers call home). No PPOs, right?

If you're a full-time RVer under the age of 65 who has to purchase a health plan, selecting a domicile has become more complicated since the passage of the ACA ("Obamacare").

It's not enough anymore to just pick a domicile state . . . you need to pick the best Zip Code to reside in that state.

Regardless, I'd check out the Escapees Insurance Site which is designed for RVers.

westernrvparkowner wrote:

State to state it's the Bubba Gump of coverage, you never know what you are going to get.

Again, not true . . . unless you think BCBS is the be all end all health care provider.

If you have a Consumer Reports on-line account, you can access the NCQA Health Insurance Plan Ratings. For example, here are some of the TX plan ratings.

[Skid_Row_Joe]

Big Katuna wrote:

Big Katuna wrote:
United and Cigna have national plans.

We have been paying for our own insurance for twenty years.

While not cheap, the ACA has saved us money and we get better coverage, lower deductibles.

I would recommend finding a reputable agent that carries many lines.

When I said this, I had not learned of the changes from 2015 and 2016.

United and Cigna have discontinued their national PPO policies.

Deductibles have gone up, esp for out-of-network.

There are national plans, but they are in network.

The best we have found is a Humana POS (point of service) National. $4000 pp deductible. HSA compatible. About $1500/mo, a little less than this year but we had lower deductibles and more co-pays.

As long as you have your heart attack near a Humana network facility, you will be covered after your deductible. The network in FL is pretty good; Shands, Mayo, Orlando Regional, etc. Humana has one of the largest nationwide networks.

Out of network deductible is fairly gruesome; $16K pp.

All your annual diagnostic stuff is covered per ACA.

It seems all the ACA does (and it is not insignificant) is remove the lifetime cap, make policies available to those who were previously un-insurable, and require preventative tests paid for.

Pre ACA we had to pay for every office visit, every test, rates were higher, deductible about the same and we had a two million life time cap which we had eaten away at about half.

While affordable, it is not cheap. Should be called slightly better than it used to be for some people.

If the ACA is repealed, we will both be un-insurable.

I'm sure our wonderful leaders will get it sorted out by the time I hit 65

Given your very high premiums, I would guess that your deductibles are very low, or, your income is rather high, to the extent you do not qualify for a subsidy.

When you turn 65, you won't have to worry about whether or not there is an ACA in place. You'll automatically go on Medicare, or, Medicaid - whichever one you qualify for, you will be covered.

[Big_Katuna]

Big Katuna wrote:
United and Cigna have national plans.

We have been paying for our own insurance for twenty years.

While not cheap, the ACA has saved us money and we get better coverage, lower deductibles.

I would recommend finding a reputable agent that carries many lines.

When I said this, I had not learned of the changes from 2015 and 2016.

United and Cigna have discontinued their national PPO policies.

Deductibles have gone up, esp for out-of-network.

There are national plans, but they are in network.

The best we have found is a Humana POS (point of service) National. $4000 pp deductible. HSA compatible. About $1500/mo, a little less than this year but we had lower deductibles and more co-pays.

As long as you have your heart attack near a Humana network facility, you will be covered after your deductible. The network in FL is pretty good; Shands, Mayo, Orlando Regional, etc. Humana has one of the largest nationwide networks.

Out of network deductible is fairly gruesome; $16K pp.

All your annual diagnostic stuff is covered per ACA.

It seems all the ACA does (and it is not insignificant) is remove the lifetime cap, make policies available to those who were previously un-insurable, and require preventative tests paid for.

Pre ACA we had to pay for every office visit, every test, rates were higher, deductible about the same and we had a two million life time cap which we had eaten away at about half.

While affordable, it is not cheap. Should be called slightly better than it used to be for some people.

If the ACA is repealed, we will both be un-insurable.

I'm sure our wonderful leaders will get it sorted out by the time I hit 65

[Skid_Row_Joe]

Big Katuna wrote:
Spent some time looking on the healthcare.gov site today.

We are paying about $1800/mo this year but the plan is being terminated.

Looks like we can get a Platinum plan with much lower copays and deductibles for about the same price.

It appears most of the plans are national plans.

I have questions, so I am going to call them tomorrow and/or talk to my agent, who is also a healthcare.gov navigator.

We are both 62.

Thanks for this, BigKatuna. I'm hoping for a similar outcome going forward into the 2016 health insurance coverage decision/dilemma during open-enrollment time this year.

[UnionMan354]

Yeah know how you feel. My wife & I have always carried health coverage; including 9yrs with UnitedHealthcare after going full-time RVing. Then the ACA starts, so they dropped all policies and pulled out of the entire state(12/31/2014). So for 2015 we get with insurance brokers and shop around to find basically only 1 real carrier option(off exchange) that offered an HSA qualified plan with nationwide coverage at Double the premium$, higher deductible, and lower coverages than we had previously. With no choice we go with that. NOW, we just get a notice in the mail that our 2016 premiums are going up nearly 50% more with even slightly higher mandated deductibles! And we haven't filed nary a health claim(praise God). 'Affordable' Unbelievable...

Robert & Shelly
Full-timing Class of 2006

[Skid_Row_Joe]

jorbill2or wrote:
Very True ! The only difference is the employer in many cases is a for profit Business and can raise prices to cover the cost if they want to increase coverage . for the govt its "raise" yours and my taxes .. they don't sell any products to raise prices on.
Also in my case if we are lucky and make over 35 ? grand a year the subsidy is ZERO so I have to pay 15-+ grand making my true income on that mythical 35 now 20. The great equalizer I guess!! If I made 25 I'd be subsidized and only pay 4 grand leaving 21 grand Humm? I ran those numbers last year .. Not sure about this year.

As pointed out already on this thread - your premiums are based on your age, AND your income after expenses. This is the Gov't plans, not open for interpretation. It's really pretty easy - if you're unhappy with your premiums, either make more, or, less income! Many of us pay $0 zero out-of-pocket for our Gov't.-mandated healthcare plans. It's not that hard to research. Really, it's not!

[jorbill2or]

BarbaraOK wrote:

I would venture that your income is low enough that you receive a subsidy ..the govt ( taxpayers ) are making up the difference in the true expense .. It's still there you just aren't paying it. I certainly don't begrudge you that , just that you need to be aware of the true cost that those over a certain income must really pay

Same as when people are working and never really see what their employer pays, just what they pay.

Very True ! The only difference is the employer in many cases is a for profit Business and can raise prices to cover the cost if they want to increase coverage . for the govt its "raise" yours and my taxes .. they don't sell any products to raise prices on.
Also in my case if we are lucky and make over 35 ? grand a year the subsidy is ZERO so I have to pay 15-+ grand making my true income on that mythical 35 now 20. The great equalizer I guess!! If I made 25 I'd be subsidized and only pay 4 grand leaving 21 grand Humm? I ran those numbers last year .. Not sure about this year.

[Skid_Row_Joe]

westernrvparkowner wrote:
You are getting a government subsidy for your plan. My plan with the $1400.00 premium is a PPO Silver Plan with a $5000 deductible and a maximum out of pocket of $6500 per person. It does cover the first three doctor visits, lab tests with a 20% copay and drugs are tiered with a copay. I am probably going to move to a PPO Bronze plan because I will save nearly $450 a month, but we will no longer have any drug coverage or lab coverage. The deductible will increase, and the copays for covered events will also increase. Just an FYI, the cheapest Gold Plan available to me is $1857.00 per month. As for age, both my wife and I are Sub 60, by a few years.

Your premiums are based on your income. This is mandated by the Gov't. If you'all are 65 or over, your drug prescriptions out-of-pocket are capped @ a $2,500.00 annual maximum per person. In the meantime, prescriptions are dirt cheap when you're with an ACA sponsored healthcare plan. I suggest you shop and buy your BCBS Plan through the dot gov website. It's way cheaper. Unless you've got ongoing medical issues, Bronze is what makes most sense to the well-heeled set of folks.

[Big_Katuna]

Spent some time looking on the healthcare.gov site today.

We are paying about $1800/mo this year but the plan is being terminated.

Looks like we can get a Platinum plan with much lower copays and deductibles for about the same price.

It appears most of the plans are national plans.

I have questions, so I am going to call them tomorrow and/or talk to my agent, who is also a healthcare.gov navigator.

We are both 62.

[BarbaraOK]

I would venture that your income is low enough that you receive a subsidy ..the govt ( taxpayers ) are making up the difference in the true expense .. It's still there you just aren't paying it. I certainly don't begrudge you that , just that you need to be aware of the true cost that those over a certain income must really pay

Same as when people are working and never really see what their employer pays, just what they pay.

[jorbill2or]

dahkota wrote:

retiredtravelers2013 wrote:
I am sure this has been discussed before so if so I apologize for asking again. Neither my wife or I are old enough to get medicare so we purchase our plan here in our home state of CT. We generally spend 6 months in the south and the rest here. Due to some ongoing health issues our doctor demands we seek medical help in the south to monitor the situation. The problem is that our plan does not cover anything except emergencies once outside of our state. How do others deal with this?
Thanks in advance.

We have a PPO plan that offers a national network through BCBS.

It is November, so you now have a chance to sign up for a new plan.

A new option for us this year is an EPO/PPO plan, which I am looking into. One must have a "preferred provider" but one also has access to a larger, nationwide PPO network.

I see the prices people post here on the boards: $1200 for two, $1800 for two, per month, and I wonder what kind of gold plated no deductible plan you all have. Our current plan is going from $550/month for two to $600/month. But we are also a year older than last year(do many people consider that prices rise as you age?).

To figure out the most cost effective plan, I take the max out of pocket $ and add it to the total premiums. This year, the number was $9850 per person. I could pay $800/month/person for a gold plan but since the max out of pocket is still $6500 my outlay would be $16100/year. Seems a waste of $6000 for the same result.

I would venture that your income is low enough that you receive a subsidy ..the govt ( taxpayers ) are making up the difference in the true expense .. It's still there you just aren't paying it. I certainly don't begrudge you that , just that you need to be aware of the true cost that those over a certain income must really pay

[fla-gypsy]

It is a complete nightmare and strangely I think that was intentional.

[westernrvparkow]

dahkota wrote:

retiredtravelers2013 wrote:
I am sure this has been discussed before so if so I apologize for asking again. Neither my wife or I are old enough to get medicare so we purchase our plan here in our home state of CT. We generally spend 6 months in the south and the rest here. Due to some ongoing health issues our doctor demands we seek medical help in the south to monitor the situation. The problem is that our plan does not cover anything except emergencies once outside of our state. How do others deal with this?
Thanks in advance.

We have a PPO plan that offers a national network through BCBS.

It is November, so you now have a chance to sign up for a new plan.

A new option for us this year is an EPO/PPO plan, which I am looking into. One must have a "preferred provider" but one also has access to a larger, nationwide PPO network.

I see the prices people post here on the boards: $1200 for two, $1800 for two, per month, and I wonder what kind of gold plated no deductible plan you all have. Our current plan is going from $550/month for two to $600/month. But we are also a year older than last year(do many people consider that prices rise as you age?).

To figure out the most cost effective plan, I take the max out of pocket $ and add it to the total premiums. This year, the number was $9850 per person. I could pay $800/month/person for a gold plan but since the max out of pocket is still $6500 my outlay would be $16100/year. Seems a waste of $6000 for the same result.

You are getting a government subsidy for your plan. My plan with the $1400.00 premium is a PPO Silver Plan with a $5000 deductible and a maximum out of pocket of $6500 per person. It does cover the first three doctor visits, lab tests with a 20% copay and drugs are tiered with a copay. I am probably going to move to a PPO Bronze plan because I will save nearly $450 a month, but we will no longer have any drug coverage or lab coverage. The deductible will increase, and the copays for covered events will also increase. Just an FYI, the cheapest Gold Plan available to me is $1857.00 per month. As for age, both my wife and I are Sub 60, by a few years.

[dahkota]

retiredtravelers2013 wrote:
I am sure this has been discussed before so if so I apologize for asking again. Neither my wife or I are old enough to get medicare so we purchase our plan here in our home state of CT. We generally spend 6 months in the south and the rest here. Due to some ongoing health issues our doctor demands we seek medical help in the south to monitor the situation. The problem is that our plan does not cover anything except emergencies once outside of our state. How do others deal with this?
Thanks in advance.

We have a PPO plan that offers a national network through BCBS.

It is November, so you now have a chance to sign up for a new plan.

A new option for us this year is an EPO/PPO plan, which I am looking into. One must have a "preferred provider" but one also has access to a larger, nationwide PPO network.

I see the prices people post here on the boards: $1200 for two, $1800 for two, per month, and I wonder what kind of gold plated no deductible plan you all have. Our current plan is going from $550/month for two to $600/month. But we are also a year older than last year(do many people consider that prices rise as you age?).

To figure out the most cost effective plan, I take the max out of pocket $ and add it to the total premiums. This year, the number was $9850 per person. I could pay $800/month/person for a gold plan but since the max out of pocket is still $6500 my outlay would be $16100/year. Seems a waste of $6000 for the same result.