Selecting a Domicile -- It's All about Counties

[Zulu]

For those full timers (or soon-to-be full timers) who are pre-Medicare . . .

Selecting a Domicile -- It's All about Counties.

[BasicRV]

Thanks for the tips!

[Velos]

Thanks for posting good info.

[Kirk W]

Zulu, that is a great link but it left me wondering if the authors got permission of the site that was taken from to publish their materials? Not my issue but for them I hope that they did. Here is a link for County Health Rankings webpages, from the Robert Wood Johnson Foundation. Both sites are quite interesting! The county rankings page lists all 50 states.

 

Thanks!

 

Now a good project for someone is to find what states have the best and least expensive health coverage and also accept the use of a mail service for driver's license and vehicle registration.........

[trostberg]

Amen

 

 

Now a good project for someone is to find what states have the best and least expensive health coverage and also accept the use of a mail service for driver's license and vehicle registration.........

[saydiver]

For those full timers (or soon-to-be full timers) who are pre-Medicare . . .

 

Selecting a Domicile -- It's All about Counties.

I'm going to assume you wrote the article, since you have the same website link in your signature. In your article you say, "None of the 67 Florida counties offer PPO ACA plans." That's not true!!!!! If you're going to publish an article, please make sure the info in it is accurate. For FL your info is definitely incorrect!!!

 

As I have mentioned several times in this forum, FL BCBS Blue Options and Blue Select plans are a combination EPO/PPO (PPO/EPO) and not just an EPO. They are EPO in-state and PPO out-of state and do cover both in-network and out-of-network providers. Some counties in Florida do not have Blue Select plans.

 

I have PPO coverage with the 1419 FL BCBS Blue Options ACA plan for when I'm out of state and it covers both in-network and out-of-network providers. It's available both on-exchange and off-exchange. The healthcare.gov site just says the FL BCBS 1419 plan is an EPO plan, but it's actually both and if you click on 'Learn More About This Plan' and scroll down, you'll see where it say 'Yes' to National Provider Network. Here's a link to the 2016 1419 plan PDF from FL Blue's website and it clearly shows on the PDF that it's a PPO/EPO plan. It also shows the PPO logo on my insurance card.

 

http://www.bcbsfl.com/DocumentLibrary/SBC/2016/1419.pdf

 

Sue

[Zulu]

Zulu, that is a great link but it left me wondering if the authors got permission of the site that was taken from to publish their materials?

 

What "materials"?

[Zulu]

I'm going to assume you wrote the article, since you have the same website link in your signature. In your article you say, "None of the 67 Florida counties offer PPO ACA plans." That's not true!!!!! If you're going to publish an article, please make sure the info in it is accurate. For FL your info is definitely incorrect!!!

 

I'm glad you're happy with your FL ACA EPO plan and that it gives you what you need, but I stand by my statement -- there are no FL ACA plans that are classified as PPOs.

[Yarome]

'Yes' to National Provider Network.

 

You might want to check more in to that. "'Yes' to National Provider Network." does 'not' necessarily equate to a PPO and out-of-state out-of-network coverage. It also may not mean that out-of-state providers within their own network will have the same levels of coverage as an in-state network provider.

 

It sounds more like a national tiered provider network plan to me. If so, then it's missing the one thing that makes a PPO a PPO and Zulu's info seems to be holding water.

[Kirk W]

What "materials"?

That interactive map is actually coming from the site owned by Robert Wood Johnson Foundation. They used a link to supply it and if the foundation does give use rights to share it, I was thinking of spreading it about the Escapee community. If you look at it, they seem to have solid information on every state, as well as a wealth of other health care related information.

[Zulu]

That interactive map is actually coming from the site owned by Robert Wood Johnson Foundation. They used a link to supply it and if the foundation does give use rights to share it, I was thinking of spreading it about the Escapee community. If you look at it, they seem to have solid information on every state, as well as a wealth of other health care related information.

Right. I correlated their rankings for several common domicile states with 2016 ACA exchange plan costs and options in these states . . . in brief, if you domicile in a state's Top 25% "healthiest" counties, you're more likely to get lower costs and more options than if you reside in one of the Bottom 25% counties.

[saydiver]

Zulu and Yarome,

They are not classified as PPO, because they are not PPO for BOTH in-state and out-of-state, which I already mentioned, but they are PPO for out-of-state and have access to the Blue Card program and 'Yes' to National Provider Network concerning BCBS plans does mean the Blue Card program.

Look at the document I posted in the link in my post above. In the top right hand corner you will see it says PPO in addition to EPO.

 

Here's a link to the info on the Blue Card program:

 

http://www.bcbs.com/already-a-member/coverage-home-and-away.html

 

That PPO logo with the PPO inside the suitcase is on my health insurance card, which means I have access to the Blue Card program both nationally and worldwide.

 

Still don't believe me that FL Blue Select and Blue Options plans can use the Blue Card program, then read Kyle's statement about Florida Blue Select and Blue Options plans where he says the same thing:

 

"ON Exchange most counties will have Florida Blue (not Florida Blue HMO–that’s a different company) as an option. Florida Blue has Blue Options (PPO/EPO), Blue Care (HMO), and Blue Select (PPO/EPO). Each of these plans utilizes different networks inside Florida but with the Blue Options and Blue Select, when traveling outside of Florida you can utilize the Blue Card program. This program allows you to see doctors in the national and worldwide networks."

 

This above statement is quoted from the following document:

 

https://www.rverinsurance.com/uncategorized/rver-guide-to-2016-aca-open-enrollment/

[Zulu]

They are not classified as PPO, because they are not PPO for BOTH in-state and out-of-state, which I already mentioned, but they are PPO for out-of-state and have access to the Blue Card program and 'Yes' to National Provider Network concerning BCBS plans does mean the Blue Card program.

 

I get what you're saying, but I used the ACA classification.

[saydiver]

It doesn't matter and I don't care how the ACA classified it. Without a further explanation that the Florida Blue Options and Blue Select plans are actually combo plans, like Kyle has in his article, you're misleading people into thinking they can't get PPO benefits when traveling out of state, if they sign up for a FL Blue Options or Blue Select plan and that is simple not true.

 

 

[Yarome]

Zulu and Yarome,

 

Thanks for the info. I'm no authority on insurance policies available in FL, nor do I want to be. I just said Zulu's info seems to hold water due to all of the recent articles where Florida Blue has been quoted as saying they will no longer be any PPO's available in Florida in ACA marketplace. Or others being quoted as saying their new EPO's are substituting their PPO's. It doesn't affect me in the slightest.

 

~ Safe Travels

[saydiver]

 

Thanks for the info. I'm no authority on insurance policies available in FL, nor do I want to be. I just said Zulu's info seems to hold water due to all of the recent articles where Florida Blue has been quoted as saying they will no longer be any PPO's available in Florida in ACA marketplace. Or others being quoted as saying their new EPO's are substituting their PPO's. It doesn't affect me in the slightest.

 

~ Safe Travels

 

It's obvious neither one of you are an authority on health insurance, so please quit trying to confuse people even further.

 

I haven't seen any articles saying that about Florida, Texas, yes, but not Florida and it really doesn't matter what an article says. It only matters what the policy says and it clearly say PPO and 'Yes' to National Provider Network (Blue Card). While I've been out of the health insurance business for many years, I do have 28 years experience with a BCBS and can still read a policy.

[saydiver]

PS. For everyone trying to make a decision about health insurance, please don't take my word for it. It's best if you talk to a licensed agent, like Kyle who understands health insurance for the full-timer, to explain what is available for a Florida resident, before making such a huge decision.

[jbh]

FWIW we've been using our Florida Blue Select EPO/PPO in Georgia and Texas since Obamacare began. It's listed on the exchange as EPO but the card itself says PPO.

[Zulu]

It doesn't matter and I don't care how the ACA classified it. Without a further explanation that the Florida Blue Options and Blue Select plans are actually combo plans, like Kyle has in his article, you're misleading people into thinking they can't get PPO benefits when traveling out of state, if they sign up for a FL Blue Options or Blue Select plan and that is simple not true.

 

Boy, did you miss the point of my blog.

 

Here's my point . . .

 

Previously you said you have a 2016 FL BCBS 1419 BlueOptions ACA plan, right?

 

In Florida's Monroe county (ZIP 33037), for a 63-year-old female with no subsidy, that 1419 plan will cost $1,077 per month.

In Florida's Holmes county (ZIP 32425), for a 63-year-old female with no subsidy, that 1419 plan will cost $718 per month.

$4308 yearly price difference. Same plan. Same State. Different County.

 

 

For me . . .

 

In Arizona's Mohave county (our domicile county), my wife's 2016 plan will cost $1,134 per month.

In Arizona's Pima county, the same plan costs $578 per month.

$6672 yearly price difference. Same plan. Same State. Different County.

 

 

So for RVers, moving to a new location -- a "healthier" county -- should be considered.

[saydiver]

No, I didn't miss the point of your blog and I agree with what you said!

 

You still left out vital info, which could affect someone's decision on where they decide to domicile, because you obtained that info from a third party site, rather than each carrier's site.

[Yarome]

I haven't seen any articles saying that about Florida, Texas, yes, but not Florida and it really doesn't matter what an article says.

 

I'm not going to search out every article, but as reported by Health News Florida... and it 'is' a fact that if you go to the ACA marketplace, as Zulu reported, you will not find any FPO offerings from FloridaBlue. FloridaBlue itself call that particular plan a "hybrid EPO". That's ALL Zulu said as a general guide for the U.S. It's ridiculous to expect any one person to be an expert on every on or off market offering by every company or entity across the entire United States.

 

Take the info for what it's worth, but laying it on Zulu is out of line.

 

'nough said.

[saydiver]

Pointing out where her article is incorrect or leaves out very important details is not out of line. Anyway I'm out of here, so you and Zulu can continue to post incorrect info.

[lb311]

I have a lot of professional experience in the healthcare industry and just switched my domicile from Illinois to Florida precisely to get the Florida Blue's EPO/PPO plan, as it is the only one I found to still offer a broad nationwide network of "in-network" providers, as well as continuing to offer a cap on out-of-network out of pocket costs). Zulu and Yarome are correct that these Florida plans are not fully 100% PPO plans as their coverage inside the state of Florida is a more limited network (thus the EPO plan name). But outside of Florida, it is very much a traditional PPO plan, and one of the few still left that individuals on the ACA can purchase!

Many 2016 ACA plans might still be calling themselves "PPO" but they're anything but!

You now really need to read each plan's detail page on the ACA site and examine their Summary of Benefits and Provider Directory links, before being able to determine just how much of a traditional nationwide PPO they are.

Some PPO's (such as those in South Dakota) are calling themselves PPO's but are only offering SD providers as in-network. Other plans, such as those being offered in IL, AZ, and many other states next year on the ACA, are still calling themselves PPOs and offering "nationwide networks" but have now stopped capping out of pocket costs for out of network providers. This can expose you to huge, and UNLIMITED, financial risks! Here's an excellent article from the Kaiser Foundation on this new "gotcha" to many of the 2016 PPO plans.

Zulu is absolutely correct that we full-timers have wheels and should be looking at various states, counties, and zip codes to find the coverage that works best for each of us. But be sure to look beyond the health plan's name (EPO, PPO, etc) to determine how comprehensive the in-network providers really are, and how financially protected you might be to unlimited healthcare bills. Make sure you find comprehensive coverage from not just hospitals and primary care providers, but specialists and ancillary services as well (such as anesthesiologists, pathologists, radiologists, etc).

ACA plans are becoming more complicated by the day as insurers look for new ways to turn a profit. I suggest every under-65 full-time RVer start with Kyle's excellent Guide to 2016 ACA plans for the most authoritative information on plans in the "big-3" states (FL, SD, and TX) for full-time RVers.

Lynne

[trostberg]

I have found that WA still has a Blue plan with capped out of network costs. They also have a slightly different resident definition for the health insurance side of things from what I have been told is the federal exchange definition (I have never seen one).

 

"

A Washington resident is someone who currently lives in Washington, intends to live in Washington including someone without a fixed address

, or entered the state looking for a job, or entered the state with a job commitment." They have their own exchange. Still need to plan to file federal taxes for WA (no state income tax) and have a physical address to get a drivers license.

 

[lb311]

Thanks Teri-- that's great information to know about WA if my Florida Blue ever changes their plans. I've got 11 more years before I can get Medicare, so will likely be State/County domicile hopping in future years if the ACA plans keep changing so drastically from year to year.

 

Lynne