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We've only made it 10 days into 2016 and the restrictions imposed by BCBS's HMO have us pulling our hair out. We are full-timers and use the Escapees mail forwarding service and thus have a Livingston address. When we signed up for health insurance through the marketplace, we only had 7 options, all BCBS HMO's. Since we are new Texas residents, we didn't have an established Primary Care Physician (PCP) so BCBS assigned us one in Livingston. However, we are now in Kerrville, 5 hours away, and DW needs to have some tests performed. BCBS told us we would have to a referral from our PCP before they would pay for us to see another doctor in the network. Our PCP's office told us they won't do a referral when they've never seen us first. BCBS allows us to switch our PCP but only effective the first of the next month (after they approve the change). We've contacted physicians in the Kerrville area to see if they are accepting new patients with BCBS HMO insurance and, although they are listed on the BCBS website, they no longer belong to the HMO.

 

Our second issue has to do with out-of-state medical treatment. We knew when we signed up for the HMO that the HMO insurance would only pay for emergency room treatment when out of state. Now we see in the BCBS handbook that even this is only true if you are traveling outside of Texas for short periods of time (less than 90 consecutive days).

 

We entered the full-timer lifestyle with the expectation that we would travel throughout the US. Now, the limitations caused by the HMO are causing us to fear leaving the Livingston area. I'm curious how other Texas full-timers under the age of 65 are dealing with these issues.

Phil and Jan Gordon

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We entered the full-timer lifestyle with the expectation that we would travel throughout the US. Now, the limitations caused by the HMO are causing us to fear leaving the Livingston area.

 

Unfortunately, you have picked one of the worst domicile counties -- Polk County, TX -- to purchase ACA on-exchange health insurance.

 

196 of the 254 TX counties do not offer PPO plans. The 58 TX counties that do offer PPOs are from carriers Scott & White Health Plans (55 counties) and Allegian Health Plans (3 counties). However, I'm not sure if either of these two carriers have out-of-state networks.

 

Depending on how many years you have left before Medicare, I'd suggest changing domiciles -- getting out of TX.

 

Check out FL . . . Escapees FL mail service is based in Sumter County. This county offers EPO plans that have some important PPO benefits. For example, this is the least expensive Bronze EPO from Florida BCBS -- BlueSelect 1452. BTW, the 1452 plan is offered in 32 other FL counties and Sumter offers one of the least-expensive 1452 plans. For example, in Miami-Dade county the same plan costs about 36% more than what you would pay in Sumter.

 

Also, every NV, AL, and LA county offers BCBS PPO plans.

 

Always check the health care options for your domicile county.

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We under 65 and use Liberty Health Share. Don't matter what doctor or state we go to. Unless you get a substantial subsidy with ACA it is not very affordable anyway. And the limitations with doctors is too burdensome for us.

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I "moved" to FL last month precisely for the reason of getting a decent BCBS nationwide plan at a very good subsidized ACA cost. I did the Escapees - FL Home thing where my legal address is Bushnell, FL, but mail is all handled by Escapees Livingston. Here's a blog post I did on my domicile-changing experience. You do not need to bring your vehicles with you to become a FL resident. You can literally fly there, get your driver's license and license plates, and fly home.

 

Deal with BCBS HMO (or pay out of pocket) for your immediate health needs, but when you're ready to fix this issue, remember that any time you change your legal address to a new state, it is an ACA "qualifying event" that allows you to change insurance plans at any time during the year.

 

While Liberty Health Share (and other Christian ministry health plans) might help you avoid paying the IRS penalty for not having health insurance, remember that these plans are NOT health insurance (and not regulated in any way by state insurance boards)-- you are literally at the mercy of the other co-op members to help pay your bills. If they help you out, all is fantastic. But if they don't, you alone are fully responsible for the bill. It might be worth the risk for super-healthy folks with no chronic or pre-existing health issues, but not a risk I was comfortable taking as a recent cancer survivor.

 

Lynne

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Thank you for the replies. I wish I had known how inadequate the insurance would be when I incurred the cost to move my domicile to Texas last fall. Since I am only 61 and my wife is 56, we are a long way from being eligible for Medicare and will need to come up with a better solution than the Texas BCBS HMO plans. It's becoming clear that another change in domicile may be necessary. Barring any medical crisis this year, I will probably live with the current bad situation until next fall when it's clearer what the the 2017 plans will look like and what impact the Presidential election will have on the ACA.

Phil and Jan Gordon

2016 DRV Mobile Suites 38 RSB3

2015 RAM 3500 Long Horn DRW / Crew Cab / Long Bed / 6.7 Cummins Diesel / 4x4 / AISIN / 4.1

B&W 3600 Companion hitch

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196 of the 254 TX counties do not offer PPO plans. The 58 TX counties that do offer PPOs are from carriers Scott & White Health Plans (55 counties) and Allegian Health Plans (3 counties). However, I'm not sure if either of these two carriers have out-of-state networks.

 

I switched to a Scott & White PPO plan in Texas. It does not have an out-of-state network. So "moving" to a different Texas county might get you a PPO; that would be a little better than an HMO (no referrals required), but it's still completely inadequate for a fulltimer, and tantamount to not having insurance at all.

 

There are other states that have PPOs with national networks, but Florida is the only one I know of with well-established mail forwarding companies. It would be possible to find a way to do it in another state, but it's not going to be a plug-and-play situation like it is with Florida (or South Dakota, for people over 65 who therefore don't need health insurance).

 

But the health insurance situation in Florida could very well change for 2017, so "moving" to Florida will give peace of mind only until next November.

 

The irony is that I used to think I had a real advantage being a fulltimer because it would be so easy to "live" wherever the best medical care I needed was--a luxury not available to most people, who have to stay near home. Then overnight, my situation went from great health care options to ones that don't work for me at all.

 

 

That is why others on this forum told me to do standard Medicare with a supplement policy.

Then all you have to find is medical providers that take Medicare wherever you are. Good Luck

 

In his original post, the OP specified that he was under 65: "I'm curious how other Texas full-timers under the age of 65 are dealing with these issues."

 

 

I myself wish this ACA would go away like the bad dream it has been for me!

 

People with pre-existing conditions would disagree with your assessment. And I'm not sure exactly how your comment is intended to help the OP with his very serious dilemma.

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There are other states that have PPOs with national networks, but Florida is the only one I know of with well-established mail forwarding companies. It would be possible to find a way to do it in another state, but it's not going to be a plug-and-play situation like it is with Florida (or South Dakota, for people over 65 who therefore don't need health insurance).

There are mail forwarding services all over. They may not be as-good-as or as-inexpensive-as the Ecapees mail service, but other mail services abound.

 

Weigh your options -- saving $10s or $100s using Escapees mail service or saving $100s or $1000s on a good full timer health plan.

 

 

But the health insurance situation in Florida could very well change for 2017, so "moving" to Florida will give peace of mind only until next November.

You bet -- the health plan/prices/options could all change again next year . . . and the year after . . .

 

So you might have to move a lot.

 

 

The irony is that I used to think I had a real advantage being a fulltimer because it would be so easy to "live" wherever the best medical care I needed was--a luxury not available to most people, who have to stay near home. Then overnight, my situation went from great health care options to ones that don't work for me at all.

Look at this a different way . . .

 

If you're a full timer, you at least have the option to change domicile.

 

If you're stuck in a S&B, you really don't have that option.

SKP #79313 / Full-Timing / 2001 National RV Sea View / 2008 Jeep Wrangler Rubicon
www.rvSeniorMoments.com
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There are mail forwarding services all over. They may not be as-good-as or as-inexpensive-as the Ecapees mail service, but other mail services abound.

While there are mail forwarding services in many states, there are not that many states that will accept one as your legal address for things like driving licenses, vehicle registrations and insurance. It might be important to make sure of that before you move your domicile.

Good travelin !...............Kirk

Full-time 11+ years...... Now seasonal travelers.
Kirk & Pam's Great RV Adventure

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While there are mail forwarding services in many states, there are not that many states that will accept one as your legal address for things like driving licenses, vehicle registrations and insurance. It might be important to make sure of that before you move your domicile.

 

Which states won't?

SKP #79313 / Full-Timing / 2001 National RV Sea View / 2008 Jeep Wrangler Rubicon
www.rvSeniorMoments.com
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Which states won't?

Most states do not and this has been discussed many times. If you want a discussion of that, may I suggest that you start a new thread as this is wandering rather far from the subject of the thread?

 

We entered the full-timer lifestyle with the expectation that we would travel throughout the US. Now, the limitations caused by the HMO are causing us to fear leaving the Livingston area. I'm curious how other Texas full-timers under the age of 65 are dealing with these issues.

Good travelin !...............Kirk

Full-time 11+ years...... Now seasonal travelers.
Kirk & Pam's Great RV Adventure

            images?q=tbn:ANd9GcQqFswi_bvvojaMvanTWAI

 

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Same issue with no PPO'S as we are under Medicare age so like Glenn we went with Liberty Healthshare and now pay $300 per month for coverage nationwide.

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