Health Insurance - RV-Dreams Community Forum

Fly Buoy V · RV-Dreams Family Member

Health Insurance

RVDude · RV-Dreams Family Member

A topic of global concern and very personal choices.

First, I’d head over to the RV-Dreams insurance page www.rv-dreams.com/insurance.html.

After absorbing that wealth of knowledge head to www.eHealthInsurance.com for a free side-by-side comparison of a hundred or so plans from a myriad of carriers based on your specific input needs. No cost, no obligation, no hassle. Excellent service. In fact, if you buy through them - I did - they make the application process totally painless and in some cases - like mine - even totally paperless. I can not tell you what a superb experience on this incredibly complex topic they were. No spam, no agents calling just insurance. I can't say enough about my experience with them. They even simplify your first month premium using visa. Afterwards your chosen carrier sends you the bills directly.

From the eHealtInsurance.com choices, I personally picked a plan from the Blue Cross Blue Shield (BCBS) family (Anthem in my home state) as BCBS is practically everywhere in the US and even though they operate as a number of different geographic BCBS entities they will cross-bill your "home state plan" rates into whatever BCBS carrier you use out of your home state. Having said that (and knowing that there is at least one very kewel lawyer involved on this forum) you need to make sure of what your plan actually provides as I am in no way an insurance advisor/broker. Disclaimer, disclaimer, disclaimer. I am sure other carriers provide similar coverage. Having had a United Healtcare plan in my not too distant past, I know exactly what you mean.

The eHealthInsurance.com site is a very helpful tool providing the ideal web experience. Good Luck!

-- Edited by RVDude at 23:55, 2007-01-11

Judy · RV-Dreams Family Member

Just as RVDude said you will have to find a health insurance that will cover you nationwide, for this I also picked Blue Cross/Blue Shield....

southwestjudy & Bob & 2blackdogs

Tim & Robyn · RV-Dreams Family Member

I can't really offer any advice, other than to echo RVDude, but I can say that I am grateful that this is one thing at least that we don't have to worry about at this point. I worked for one of the 'Blues' for 23 years until my job got outsourced - I was hired by the outsourcer to continue doing the same job. At any rate, I was eligible for early retirement from BCBS, so when I transitioned over to the outsourcer I took it. We now have retiree insurance (a PPO) from BCBS with very low premiums (which of course can change), plus coverage under UNH (United HealthCare) from my current employer. When we go on the road BCBS will be our only coverage until we're eligible for Medicare (if it still exists) at which point BCBS will again become the secondary payer.

Even more important though, being over 55, by taking early retirement I was able to roll over my 401k and my defined pension benefit into a retirement IRA, which has been growing at a rate almost three times what the pension benefit would have if I had left it where it was. Of course that meant giving up the guaranteed monthly income for life that the pension would have paid, but I'd rather be in charge of my own destiny. The pension was only earning a paltry 4 percent a year, and with other companies already having defaulted on their pension plans, turning it over to the government to pay 60 cents on the dollar, I didn't want to take a chance on the same thing happening to us.

No doubt about it, though, health insurance is a biggie... but it is for everybody, whether or not they're in a stick house or an RV. Portability, it seems to me, is the issue for fulltime RVers, as well as for more conventional lifestyles. What happens to those folks if they decide to move to another state?

Tim Fansler

Tim & Robyn · RV-Dreams Family Member

One other thing... at least as far as the Blues go it's not hard to find 'network' providers out of state if you have internet access. Every BCBS website has a 'find a provider' link. Since we are in a PPO we do have out-of-network benefits (at reduced rates of reimbursement), but we can certainly stay in-network no matter where we are if we choose. I don't know about other insurers (Aetna, Cigna, Kaiser, etc.), and I was surprised by what was said about UNH. I can't imagine though that they don't have portable offerings. They would be at a competitive disadvantage without them. But I'm only a computer geek, not at all expert on the business workings side of things.

Tim Fansler

Tmcblane · RV-Dreams Family Member

Blue Cross and Blue Shield is what we used while traveling. It has some of the best coverage we could find all over.

jmayleben · RV-Dreams Community Member

The only caution I would have with Blue Cross is that they may not understand the "full time" lifestyle and permanent address thing. Here is Michigan, Blue Cross is a challenge if you don't "live" in Michigan at least 6 months out of the year.

I don't know how they would handle it if you had a Michigan mailing address and simply forwarded your mail to somewhere else. I do know that if you have an out of state mailing address they make it hard to get insurance. As someone else noted, Blue Cross is in almost every state (some have more than one) but they are each a different company, so their rules will probably be different.

I would start by looking at the Blue Cross in the state that you will establish residency in and see where that takes you...

John.

dreamjosie · RV-Dreams Family Member

I struggled with the same issue when I retired (at age 57) and went fulltime. Even though I had been with BCBS through my employer, they declined to quote me for a standalone policy because of a bout of diverticulitis 6 months earlier. They wouldn't even rider it out as a pre-existing condition. I could have taken the COBRA coverage, but since that only lasts for 18 months, I would once again be needing to find insurance before I'm eligible for Medicare, and at 18 months older than I was then, and possibly having unknown medical conditions.

So at the recommendation of my self-employed step-daughter, I got a quote from Golden Rule Insurance. Here's their website: Golden Rule. They have many plans to choose from, and I opted for a high deductible Health Savings Account plan. You can put as much money in the Savings Account as the deductible, which in my case was $2700, and it earns 4% interest. You can pre-load it at the beginning of the year, or monthly along with your premium. If over age 55, you can even add an additional amount which last year was $700. This year my deductible is $2850, and the add-on amount is $800. You can use the money in this account for everything from a bottle of aspirin to over the counter cold pills to prescription drugs to medical bills. Anything related to managing your health. And unlike the HSA's you get through your employer, the money does not have to be used up at the end of the year. It rolls over. You don't have to "use it or lose it".

In my plan, after your deductible has been satisfied with covered medical expenses, all covered expenses are paid at 100%! The monthly premium for me was under $300 a month. They still excluded the diverticulitis as a covered illness, but agreed that after a year or so with no episodes, I could petition them to delete the rider. Since it was for me an isolated incident, I have no problem with it. My policy is a PPO and the company is national; there are "in-network" providers in every state. You can find them easily through their website.

The cost of health insurance, as well as the cost of our truck and rv insurance, was something we considered when deciding whether to keep a Wisconsin address as our official legal residence (which we were able to do through Fred's daughter) or change it to our mail forwarding address (Escapees) in Texas. We found that all our insurance was cheaper as Wisconsin residents than as Texans. Just one more thing to research when choosing a home base.

Jo

RVDude · RV-Dreams Family Member

Just a thought I am reminded of and wanted to share is the notion of keeping ones’ addresses clean. Unfortunately, our great Nation still requires each of us to have a clear and documented domicile. It can be argued that ones’ domicile can be inferred by the intersection of the addresses one uses for - taxes, insurance, RV registration, car registration, property, bank accounts, utility bills, voter cards, etc. Hence, keeping ones’ key legal addresses clean and together might save ugly legal/tax issues downstream. How cleanly each of us interprets/executes this is a personal choice. Again, just a thought. I, for one, have everything in my entire life pegged to one single address which is a mailbox at a “The UPS Store” which is a fully legal "street" address.

-- Edited by RVDude at 20:20, 2007-01-14

Judy · RV-Dreams Family Member

Our address is also the UPS store. When we call and ck on how much mail we have they then ship it to the RV resort we are at, so far that is working well. It is considered a legal address..

southwestjudy & Bob & 2blackdogs

Howard · Host

I'm glad to see so many chiming in on this. Thanks for linking to the information on the RV-Dreams website as that saves some time and space here.

I just want to add a little bit about Blue Cross Blue Shield. We also have Anthem BC/BS. Anthem runs the BC/BS program in nine states and they do have national providers. But as mentioned, not all BC/BS plans are the same.

Though they are not exactly franchises, think of them that way for ease of explanation. BC/BS is sort of like McDonalds with strict basic guidelines, similar same logos, branding, etc., but the owners/managers in each state have quite a bit of leeway in their plans. Not all BC/BS programs have national coverage. And they have a great deal of flexibility in who they insure. For example, the BC/BS plan in South Dakota (a great full-timer home base) has recently denied coverage to full-timers (this does not affect federal employees under a BC/BS plan).

So I just want to reiterate that it is very important to be absolutely sure you will have medical coverage nationwide as some of the plans that seem to be national might only be regional or only state specific. This information is not always made clear by the insurance company, so try to get something in writing as to the geographic area covered by the "in-network" plan. Most will have "out-of-network" coverage, but if you are not clear on this and you spend most of your time in "out-of-network" areas it could cost you LOTS of money later.

And just because you can get BC/BS and nationwide coverage in one state, it does not mean that you can in a new state you select as your home base. If you have to get individual coverage, it is very important to do your homework. If you are not sure of all the questions to ask, just come back here and I'm sure we can put something together.

Tim & Robyn · RV-Dreams Family Member

About Anthem/BCBS: A couple years ago Anthem bought Wellpoint, a California based owner of some of the Blues, and the new company has been renamed Wellpoint, Inc. and the headquarters was moved from California to Indianapolis. They are still using the Anthem name, but at some point that will probably go away. WellPoint is a Blue Cross or Blue Cross Blue Shield licensee in 14 states: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin. They also operate under the name Unicare in some states.

As Howard said, the BLues in each state are all independent licensees of the BCBS name/logo.

The only reason I know anything about this is I worked for BCBS Georgia, which got bought by Wellpoint, which got bought by Anthem, etc., etc., and now I work for the outsourcer who took over their data processing... hopefully retiring from there in one year and nine months!

Tim Fansler

Doncat · RV-Dreams Family Member

I am not fulltiming yet, so I don't know how well it works, but I carry Tricare Prime insurance. I have had this since retiring from the military and it is great around here. Since they assign a primary care physician, I don't know how well it will be on the road. Anyone else have this type insurance?

Old Snipe · RV-Dreams Family Member

Hi, Don.

As a current AD Coastie researching the fulltime RV life, I've read recommendations from retired military folks that have Tricare Standard. Without going into great detail, Standard is a "portable" benefit, not linking you to a particular provider. You can travel without getting into the referral nonsence and the deductable is $150/year or $300 family/year. The deductable only applies if you use medical treatment in that year.

It may not be the best plan for you, but I am leaning heavily towards it. Check it out.

And hey, thanks for your service!

Best Regards from CWO2 Paul Dahl, USCG

Fly Buoy V · RV-Dreams Family Member

WHOA...we're really confused now after reading Howard's post. We currently live in Florida and have Golden Rule through United Healthcare. Does anyone have any experience with this insurance while traveling? AARP offers it, but we got it through an independent agent. We're getting closer to "pulling the plug" on stick-house living but we need to be really confident about this healthcare thing.

Thanks to all who are contributing to this post. I'm absolutely sure we're not the only ones who are trying to make this monumental decision to fulltime but are having trouble sorting out all the loose ends that need to be tied up.

dreamjosie · RV-Dreams Family Member

I have Golden Rule/United Healthcare which I purchased after I left my job/retired to go fulltiming. I am 58 years old. They have many different kinds of plans, so you need to make sure you get a PPO type plan, not HMO. An HMO will tie you into a local network and will not work for traveling. A PPO on the other hand just means you get better coverage/payment when you choose a participating provider. Golden Rule is like BCBS in its national coverage. There are participating providers all over the country. You just go to their website and find one in the area you are in.

mcw50 · RV-Dreams Family Member

Insurance will definitely be your top priority...just make certain you have a PPO plan as has already been suggested. Luckily, as a retired teacher, we had coverage when we started out at age 55, and have kept our legal address in the state where we retired. Costs, however, have risen sharply in the 6 years we have been on the road and we now have a very high deductible. We have used medical facilities all over the US over the last 6 years, using ER and "Urgent Care" facilities when necessary and asking for references from other RVers and campground managers when we had time to do "research" when making other DR appointments. Up to now we have scheduled our travels so that we could have our annual physicals with our original primary care DR in our former home town, but are now in the process of changing to one in "snowbird territory" to make scheduling easier. What we have found is that we all have our individual circumstances and programs and that you need lots of patience to get all the details worked out with appointments, claims, payments, prescriptions, etc. Good luck!

Fly Buoy V · RV-Dreams Family Member

Thanks Jo, Howard, RV Dude and all the rest of you for your input and insight into this insurance thing. It is one of our top priorities and we'll keep monitoring this post for more information.

Janjanjan · RV-Dreams Community Member

I have a PPO through UHC and my husband has a PPO through BCBS. With a PPO, it is critical that you utilize preferred physicians, labs, and hospitals whenever possible. The cost differential is much greater than you might think when you see that in-network covers at 80% and out-of-network covers at 60%. Let me give you a real life example of what that actually means.

Two years ago, I went to an emergency room in the middle of the night when travelling for business. Prior to going in, I called UHC to determine which of several nearby hospitals were in-network and chose accordingly.

My bill for the incident was $4800 from the hospital. UHC's negotiated rate was $896!!!! for the services rendered, and I paid 20% of the $896, or just under $180. Had this hospital been out-of-network, UHC would have paid 60% of their allowed $896, or about $540, but I would have been responsible for $4800 minus $540, or over $4200. $4200 vs $180 is a huge difference. A much bigger difference than you might guess when you see the 60% vs 80% figures. In every case, it is 80% or 60% of the customary and allowed charges, but if the hospital or physician doesn't have a contract with the insurance carrier, they aren't held to this customary and allowed charge.

It is important that you don't pay attention to the claim that many physicians and urgent care facilities make--that they "accept" all insurances. "Accepting" your insurance is very different than honoring negotiated price breaks!