Problems with South Dakota Health Insurance for Full Timer's

[mrbarkley]

I have been advised insurance companies in SD are excluding full-time RVER's who have only a mailing service as a residence address from obtaining health insurance. Does anyone know anything about this or have you run into this problem? I have been advised both Sanford and Avera Insurance companies will require a permanent address and will NOT accept a PMB as such. Sanford Insurance cancelled my insurance last year (without notice). I was able to reapply through the Marketplace (Healthcare.gov) and became insured by Avera insurance who had an out of network provider service. I have been advised my Avera insurance will be cancelled effective December 31st because I am a full time rver.

If anyone can help me out with this I would appreciate it.

Thank you - Ellen

[nancyjerry]

We have the mailing service in Florida. Used ACA last year and got a notice our plan was no longer available but we were switched to a 'comparable ' plan automatically UNLESS a we chose and re applied for a different plan. Their new rate for the plan they wanted to switch us to, was 83% higher.
So we hunted and found a policy that really is ridiculous, in that, how or better yet, WHO is picking up the tab....we are paying < $400 for both of us a month, with a $500 deductible and $500 out of pocket!!!!
You have to use the Silver plan to get the highest subsidies.
Our plan 'costs' $1100 a month, but we are getting $900 in subsidies!
Nuts, but it's paying off BIG time for us.

Hubby had rotator cuff surgery then had blood clots and the plan has paid off big time.
Thanks Obama, but all my working nieces and nephews are paying for me 😞
Nancy

[UnionMan354]

rubycreekted wrote:

JimM68 wrote:
My understanding (which could be wrong) is that SD problems are last years problems.

Would love to hear some real info.

We changed our residence to SD last December. We have been trying to enroll in a Medicare part F Blue cross plan in SD to replace our BC plan in MI we currently have. NO LUCK. We have to either stay with the MI plan or accept a higher cost Humana plan or a AARP plan as BC requires proof of stick and brick residence. We will stay with the Michigan plan another year and see what shakes out.

Ted

Hi Ted,
"No Luck" Did you go thru the Exchange, a Website (ehealthinsurance), an independent Insurance Broker, or what? Did they tell you about the Sticks & Bricks requirement/proof or did you enroll then you were contacted by BCBS? Who do you use for your mail forward address? Lastly, if you already changed your state of residence to SD, how can you keep the MI plan or does state or residence not matter?

[BarbaraOK]

UnionMan354 wrote:
So what keeps other state insurance companies (ie. TX/FL) from enacting the same 'mailing service as a residence' restrictions!?

As some of you may already know United Healthcare GoldenRule is pulling out of South Dakota as of Dec 31, 2014. Been with them for the 8+ years we have been on the road fulltime. Had National coverage and HSA qualified. Now basically no good options, Unbelievable.

Well in Texas the Escapees have a pretty good record at lobbying the legislature to ensure that the Escapees address is a legal PHYSICAL address.

Barb

[rubycreekted]

JimM68 wrote:
My understanding (which could be wrong) is that SD problems are last years problems.

Would love to hear some real info.

We changed our residence to SD last December. We have been trying to enroll in a Medicare part F Blue cross plan in SD to replace our BC plan in MI we currently have. NO LUCK. We have to either stay with the MI plan or accept a higher cost Humana plan or a AARP plan as BC requires proof of stick and brick residence. We will stay with the Michigan plan another year and see what shakes out.

Ted

[Nolan]

Clicky

[2gypsies1]

Check out the full-timing forum at iRV2.com. There is lots of discussion on this. Bottom line - if you're not elibible for Medicare, South Dakota is not for you.

[mrbarkley]

Appreciate everyone's interest in obtaining Health Insurance in SD. Here is the response I received today from my agent regarding my insurance company (Avera)'s policy regarding Full Time RVers in SD. See below:

Hi Everyone, again I want to thank you all for your business, your patience and allowing me to keep you informed via group email, I would appreciate a reply email to this email so I know this info has been received.

latest info from Avera management as of 11/18/2014

If you have an Avera policy that was purchased on the Marketplace, you will be able to keep this coverage in 2015, however , claims will not be covered, at in network benefits unless the services are for urgent or emergent services.

So things like Preventative Medicine, durable medical equipment & maintenance chiropractic treatments will not be covered as in network benefits, again their words are only network benefits for urgent or emergency services.

Your polices will have their full benefits if used at in network providers in SD."

To put it bluntly, if you want to see your doctor in another state for your annual physical and routine stuff, you just have to pay him/her out of pocket and not file a claim - that's what I will be doing. If you have a heart attack while staying in a state other than SD, you will be covered because that would be considered Urgent/Emergency care. There is a nationwide network that you can use.

I suggest you just check out the network to make sure you can find a doctor/hospital in the area you will be staying that is part of the network. Your insurance company will be able to give you the website. I found many in Florida and my doctor in NC is also in the network should I elect to have a heart attack while visiting NC..... Most hospitals and emergency facilities are in the network. I am looking forward to turning 65 in 2.5 years and then I won't have to worry about these things!!!! Thanks Ellen

[Fulltimer50]

mrbarkley wrote:
Thanks for the feedback. I turned 62 this year so Medicare is a few years away. My SD agent called last week to inform me that I would be getting a cancellation notice from Avera by the 15th of Nov. Mail is late this week with holiday, should get it tomorrow.

I would be interested in hearing what their reasons are for cancelling.
I find it hard to believe that they can cancel just because you are on the road a lot.

[lbrjet]

Texas and Florida have way more people living in them which translates to a much lower full time RV percentage of the population than SD does. Since insurance is priced at the state level, it is much more difficult to price policies accurately when a bunch of your potential clients never spend any time in the state. I would be more worried about the Feds taking away your domicile status than Texas or Florida.

[UnionMan354]

So what keeps other state insurance companies (ie. TX/FL) from enacting the same 'mailing service as a residence' restrictions!?

As some of you may already know United Healthcare GoldenRule is pulling out of South Dakota as of Dec 31, 2014. Been with them for the 8+ years we have been on the road fulltime. Had National coverage and HSA qualified. Now basically no good options, Unbelievable.

[2gypsies1]

I would highly suggest that you switch your domicile to Texas or Florida. Here's a post from today from a fellow full-timer under Medicare age. She has done a lot of research on this topic. It was posted on iRV2 full-timing forum. Good luck!

--------------------------------------------------------------

Health Insurance Exchange 2015 (pre-Medicare Fulltimers)

--------------------------------------------------------------------------------

Ok folks, open enrollment is just about to start. You can shop exchange plan rates now on HealthSherpa. I've been playing around on the site looking at our options (PPO plans only) and want to start a thread to share results. Please NO politics.

https://www.healthsherpa.com

-> Rates vary a lot by state, as expected. SD (Avera) offers the cheapest PPO plan of the "big 3" RV states (TX, SD, FL), but the we still don't know if they will accept fulltime RVers in 2015. Latest word (last month) was "no", but they may be reconsidering. Kyle told me today that he is still waiting on a final word from them (expected sometime this week). Even if Avera accepts RVers they may not offer care (except emergency) outside of SD.

-> Subsidies vary a lot by state and zip! This was a surprise to me. TX is actually the 2nd cheapest state EXCEPT if you qualify for subsidies. Subsidies are significantly higher in FL.

Here's some numbers for 2 people (mid 40's) with and without subsidies. This is for PPO plans only:

SD Exchange (zip 57106 Minnehaha County)
Avera Bronze PPO 6200 ($6200 deductible) $492
Subsidy $60,000 level = $107 ==> $385
Subsidy $50,000 level = $186 ==> $306
Subsidy $40,000 level = $306 ==> $186

FL Exchange (SKP Bushnell zip 33513)
Assurant Bronze PPO 001 ($6000 deductible) $622/mo
Subsidy $60,000 level = $177 ==> $445
Subsidy $50,000 level = $256 ==> $366
Subsidy $40,000 level = $376 ==> $246

FL Exchange (St.Brendans Isle zip 32043 Clay County)
Assurant Bronze PPO 001 ($6000 deductible) $634/mo
Subsidy $60,000 level = $221 ==> $413
Subsidy $50,000 level = $300 ==> $334
Subsidy $40,000 level = $420 ==> $214

TX Exchange (SKP Livingston zip 77351)
BCBS Bronze PPO 006 ($6000 deductible) $584/mo
Subsidy $60,000 level = $71 ==> $513
Subsidy $50,000 level = $150 ==> $434
Subsidy $40,000 level = $270 ==> $314

I have yet to look into plan details (out of network caps etc.) so I have more work to do...but this is a preliminary landscape look.

Nina
__________________
12 paws, 40 feet and the open road
http://wheelingit.us

[mrbarkley]

Thanks for the feedback. I turned 62 this year so Medicare is a few years away. My SD agent called last week to inform me that I would be getting a cancellation notice from Avera by the 15th of Nov. Mail is late this week with holiday, should get it tomorrow.

[jorbill2or]

There is a lot of discussion on this and it is a REAL problem .. If you aren't aware you will be as they are dumping these as they find them. many Full timer blogs are full of information on this with many waiting to find out what this year will bring and planning a move to Florida or Texas. if you are pre medicare you have a problem. As I understand it there are plans that will cover you in SD but Not while you are travelling. ( kind of a problem unless you stay in SD )

[JimM68]

My understanding (which could be wrong) is that SD problems are last years problems.

Would love to hear some real info.