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Blues

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  1. But the document you linked to specifically addresses people who meet the residency requirement in more than one location. It doesn't make them change health plans when they move to their summer or winter home. Instead, it actually advises them that they should consider whether they would benefit more from choosing a health plan that has nationwide coverage and using it regardless of where they're living instead of changing their health plan when they go from one residence to the other. So no, the ACA doesn't strictly use where one "actually resides," because it allows people who "actually reside" in more than one location to choose which one to use to buy health insurance. And this is in spite of language that says the opposite: In the case of a person who splits his time among multiple residences and seeks health insurance based on one of those locations, he doesn't intend to remain in the Exchange area where he gets coverage, and therefore doesn't meet the residency requirement. Yet the ACA allows him to use that location anyway. Why? Because the goal of the ACA is to provide access to health insurance. In this case, they're actually bending over backwards because for people with a summer home and a winter home, it wouldn't be too terrible to require them to get a different policy in each location, but it would be more burdensome than if they didn't have multiple residences because each time they change their policy, the deductibles and out-of-pocket maximums reset to zero. To avoid this, the ACA allows them to choose to get a policy in a place where they don't actually meet the residency requirement. Now think about a traveling fulltimer with 50 residences a year. If they're going to let someone with two residences do a pick 'em on where to get health insurance, why would they prohibit the same solution for a traveling fulltimer? At least with two residences, it's conceivable that a person can get a different policy for each location, even if it's a hardship because deductibles and out-of-pocket maximums reset each time. But for someone with 50 residences in a year, or even 12 one-month stays in different locations in a year, not allowing him the same option as a snowbird would be tantamount to denying him insurance because even if he could meet the application deadlines, which he can't, his deductible would reset every single month. So what's the solution? Take the same reasoning the ACA uses with snowbirds and apply it to traveling fulltimers. In the case of a snowbird, there are obvious locations to base health insurance, and the ACA allows him to choose from among them. In the case of a traveling fulltimer, there are many many residences, none of which are practical. But there is a place where he receives his mail, also known as his domicile. Why do you keep calling me "Boomer"? Well, sure, living fulltime within the boundaries of a state is an obvious way to get health insurance. But as discussed above, the ACA doesn't actually require it in all cases. Never mind that living within the boundaries of a state is explicitly not what traveling fulltime is about. But okay, be physically present in your home state. Sound advice. So let's get some more advice based on that. At what point can a person travel out of state again, and keep the health insurance from his home state? One week? One month? Three months? A whole year? And then how often does the person have to come back? Every year? Every other year? Once every three years if the previous visit was between 75 and 90 days, but every five years if the previous visit was at least 180 consecutive days?
  2. Did it end up going away on its own?
  3. No That's what I thought. But yet you warn, "He probably won't be caught by the health insurance company as long as he's just paying premiums." I take that to mean there won't be trouble unless he files a claim, even though you don't know of anyone ever having a claim denied on this basis. You wife's friend actually lived in Arizona, and there was no reason for her not to have an Arizona plan. That's not the case for traveling fulltimers, which is who we're talking about here. I assume she goes to California to receive that care, because Kaiser's website doesn't show plans, or even any providers, in Arizona. Again, that's not what traveling fulltimers do. They receive their care where they're living at that moment, using a policy that is based on their domicile because they cannot meet the deadlines and requirements for changing an address and getting a new plan every time they move. No, my justification is that no one has offered any evidence, whether legal or anecdotal, that a person who has a domicile created by using a mail service and uses that domicile to obtain health insurance runs a known risk of having claims denied based solely on having insurance based at that domicile. ETA: The ultimate justification is, what other choice does a traveling fulltimer have?
  4. That's what I thought. And I assume nobody has ever had a problem with the insurance company refusing to pay because the insured didn't actually reside in Livingston, or even intend to reside there, but used the mail service address for domicile purposes, including for Medicare and any Medicare supplement. The OP is in the same situation, only with under-65 health insurance--using a place as a domicile even though he doesn't reside there or intend to reside there. Yet people are issuing warnings that claims will be denied, even though the OP would be doing the same thing people with Medicare and Medicare supplements do--use the mail service address as the domicile. It's true that ACA plans are not Medicare supplement plans, but the underlying issue--where to base the insurance when someone doesn't live anywhere in particular--is the same.
  5. How do you know all claims will be denied? Where do the over-65 Escapees mail service users get their Medicare supplement policies? I always assumed it was Livingston, even though I doubt they see doctors there, especially since plenty of them never go to Livingston. If that's what they do, are their claims denied? And I have yet to hear of any pre-Medicare people who have Blue Cross based on their Florida domicile having claims denied because they weren't in the area where their domicile is. Have you? I would think this would be very important information for the many people who have Blue Cross in Florida in order to have access to a nationwide network. Oscar Health has limited networks, and offers policies in only 15 states, and in those states. And in those states, it appears to be only in major metropolitan areas. Like in Colorado, it's the Denver area only. In Arizona, it's Phoenix only. Plus I'm not positive that a Texas policy would be "valid" in Colorado. I have the same question about Ambetter, which offers policies in several states, and might work for a traveling fulltimer IF the policy from one state works in all the other Ambetter states, but I wouldn't sign up without official word from Ambetter that that's how it works. But even if it does, neither Oscar nor Ambetter policies provide any out-of-network coverage at all. Here's what the Oscar website says about getting out-of-network care:
  6. Actually, the word "tax" hadn't even been mentioned when you posted about people filing fake domicile changes to avoid taxes. Plus, you were talking about people who live in one state trying to claim "residence" in anther state, which has nothing to do with people, like the OP, who don't live anywhere in particular but have to choose a place to domicile. myshipp, your situation is a textbook example of someone who decides to travel fulltime: I'm leaving here, not going back, and will either travel until I die or stop traveling when I find some place I want to settle down. As you noted, you're facing challenges because "the system" isn't set up to accommodate people who are doing that, including taking steps to declare a domicile. The vast majority of people just have a domicile, with no thought whatsoever.
  7. A few years ago, a lady wrote up an account of establishing Florida domicile by flying in and doing it all in one day. For the life of me, I can't find it. I think you in particular may have trouble because you haven't been having mail sent to your Florida address. The reason Escapees doesn't suggest that you have your regular mail sent to the Florida address is that it automatically gets sent to your Texas address, and you pay a separate fee for each piece that gets sent. Not to mention that there's a delay involved. Personally, I've always been a little uneasy about the way Escapees does this, but so far it appears to work. But there are other mail services in Florida that don't involve having the Florida address serve solely as a place to receive only the portion of your mail that relates to your Florida domicile. The address you use for your Florida stuff is the same address you use for everything. But there's nothing stopping you from changing your address for bank statements or credit card bills to the Florida address before you have any connection to Florida. The language you quoted says that printouts of documents are acceptable; I have a street address on the .pdf copies of my bank statements, even though I don't actually get those in the mail. I wonder if you could change your address with your bank, for example, and ask them to generate a statement or other document with that address on it, and look at it online, and print it for use for getting your driver's license. It doesn't sound like the authorities make you bring the actual envelope or anything. And then once you use those documents to get your Florida driver's license, you can change the address back to the Livingston address, to avoid having to pay extra if something does happen to actually get sent. Again, this is an oddity with the bifurcated system Escapees is using that seems to work, but it just seems questionable to me. What you'll find is that for fulltimers, there's a lot of wedging yourself into various categories. Pre-Medicare health insurance is a prime example. The ACA says it's based on where you actually reside, but for traveling fulltimers, it's literally impossible to change health insurance for each place you stay, and I don't use the word "literally" lightly. There are time deadlines and documentation requirements that a traveling fulltimer simply can't fulfill, but nobody thinks that should disqualify them from having health insurance. So they figure out what can work, which is that they get it where their domicile is.
  8. What good pre-Medicare options are y'all finding in Travis County? I looked into it, and all the plans that were on the exchange were either PPOs without a nationwide network or HMOs. What if a person doesn't spend time in any place long enough to apply for and get health insurance associated with that location before heading off to the next place?
  9. The post with the misinformation was from a few days ago, in a thread that drifted into health insurance for fulltimers. The person who posted this said said that under certain circumstances, "going with an HMO might be a good option" for fulltimers, and I think tried to bolster the case by raising doubt about what the nationwide-network PPO plans cover, without any substantiation, or apparently even understanding of how the insurance works. Here's the full comment: http://www.rvnetwork.com/topic/137958-domicile-decisions/?do=findComment&comment=1005298
  10. The following was in a thread that is now closed, so I can't respond to it, but there's misinformation in it that needs to be corrected. This post appears to be saying that out-of-state care would be out-of-network, but that's not the case with a PPO plan from an insurance company that provides its members access to a nationwide network (like Florida Blue, a popular choice among fulltime RVers because members have in-network access to Blue Cross providers across the country). I don't know where the poster got the idea that being outside the state would affect anything for a person who has a plan with access to a nationwide network and chooses a provider from that list. As for authorizations for "expensive" care, has anyone with a PPO plan been forced to get treatment from one particular in-network provider instead of another in-network provider in order for it to be covered?
  11. If it's a service dog that is individually trained to perform a task for a disabled person, why would it be left behind?
  12. No it wasn't. Let's review. You first said: When presented with the notion that it's possible for individual to make informed choices about whether to have various screenings, you didn't say, "Good point--I didn't think of that." Instead, what you said was:
  13. She's doing informed preventive care, weighing the upsides and downsides to her. Just because it's not something you would do doesn't make it an invalid choice.
  14. Just because someone makes a health care choice that you wouldn't doesn't mean it's dumb, never mind really dumb. I was just pointing out that there are people who don't want to have various screenings. I cited some of the issues presented by medical testing because I thought it would lead to an inference that they are making informed choices, and commenters would give their opinions some deference. Obviously I was wrong.
  15. But what about your case of a broken ankle? Or even a heart attack, which could happen to a person in relatively good health? At what point does the covered emergency end, after which the traveler outside his HMO area has no coverage at all? If people want to go with an HMO because they think they will be able to deal with the restrictions on their travel and their choices in follow-up care, that's up to them. But as with everything, I think it should be an informed decision, and like I said, I never have been able to get an answer on when a covered emergency ends, which would be vital information for someone choosing a plan under which their coverage while traveling is only for an emergency. Or it's a decision some people make and then are thankful that they didn't undergo the hassle and expense of unnecessary tests and hassle and expense and mental anguish of false positives and further procedures based on the false positives.
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