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21 minutes ago, Barbaraok said:

Individual policies are not controlled by the state like DL, vehicle registration, taxes, voting, ease of establishing residency, etc.  that’s what makes a state friendly for full timers.  

Barb, if you can't get decent health insurance in a state ("RV friendly" or not), then all those other things you mentioned are eclipsed.

Edited by Zulu

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5 hours ago, mreid99 said:

I'd like to apologize to Wizard&Oz, I thought this forum was for helping one another. This thread went a pissing/bicker match. 

 

Quite frankly I am here to learn and I am disappointed to see this thread heading down the toilet, if I wanted that I would have  gone to another website.

Agreed. Thank you for your apology and I guess I will continue my quest looking elsewhere for helpful tips and advice. 

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10 hours ago, mreid99 said:

I'd like to apologize to Wizard&Oz, I thought this forum was for helping one another. This thread went a pissing/bicker match. 

 

Quite frankly I am here to learn and I am disappointed to see this thread heading down the toilet, if I wanted that I would have  gone to another website.

This bickering is not the norm for folks on this forum.  Most postings ARE helpful.  

 

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On 3/3/2019 at 10:05 PM, Wizards&OZ said:

Anybody using RVHealth.com? What's your opinion on the services provided? Have you used Telemedicine before and what are your thoughts on it? 

I believe there have been some topics on this forum in the past about RVHealth.com.  You might want to search this forum for the word "RVHealth" and see what comes up.  

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On 4/6/2019 at 4:34 AM, mreid99 said:

I'm a year away from retirement, I'll have no medical coverage from 57 to 62. I am very interested in learning more about who and how to obtain healthcare coverage. I know we all have different needs, but there isn't hardly anything that I have found that's helpful.

There has been quite a few topics on this forum about health insurance over the last several years.  You should get quite a few hits by searching for "health insurance" or "healthcare".  

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One thing about searching forums.  Searches tend to bring up a bunch of hits a person has to wade through to find the specific info one needs.  It is a bit of a pain sometimes.  

On the other hand, it takes time and a fair amount of effort for those who do reply to questions to give more than 1 line responses.  Some times I think people asking questions don't stop to realize the time and effort that goes into detailed responses. 

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7 hours ago, Wizards&OZ said:

I guess I will continue my quest looking elsewhere for helpful tips and advice. 

I think that you might find it worthwhile to give it more time. With a group as large as Escapees there are always occasional spats but even then most members do mean well. I'd hate to see you give up on us so quickly. And remember that not everyone who posts on these forums is a member of Escapees. 

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15 hours ago, mreid99 said:

I'd like to apologize to Wizard&Oz, I thought this forum was for helping one another. This thread went a pissing/bicker match. =

Quite frankly I am here to learn and I am disappointed to see this thread heading down the toilet, if I wanted that I would have  gone to another website.

Since you essentially hijacked the OP's post with a much more general question, this is pretty ironic.

I don't know how long you've been on RV forums, but people "bicker" about pretty much everything -- from 12V vs 6V batteries, Ford vs Chevy . . . you name it.

Health insurance is a much much much more complicated issue. It's no wonder people feel so strongly and disagree. What's the matter with that? Remember, we're all becoming crusty old farts. Sometimes salty to the max.

If you can separate the wheat from the chaff, you received some great information in this thread. For example, OP's question was pretty much answered by Kyle Henson in post #5:

RVHealth is a telemedicine plan only. A telemedicine plan (which gives you 365/24/7 access to doctors via phone/video) plans are a wise choice for RVers to have but of course can not replace health insurance. 

Kyle is a health insurance expert. Even though I have some issues with Kyle, I bought my Medicare Supplement through him. I trust him implicitly on some issues. Others, not so much.

My schtick is know your source of information.

Both my wife & I started RVing in our early 60s . . . we started with a nationwide BCBS plan through COBRA, signed up for ACA plans which got us through her cancer, and now we're on Medicare. When I was on an ACA plan, I did a boatload of research on health insurance, in particular every ACA PPO plan in every county of every state (if you're counting, that's over 3,000 counties). It took months. However, I wouldn't recommend most of the ACA info on my own web site now because it's out of date like RV Dreams. (On a side note, WheelinIt also has a lot of health insurance info, but they're living in Europe now, so that wouldn't be my go-to health insurance info site either.)

Finally, I'd guess that most of us on this forum are on Medicare or military health insurance. So many may have never purchased health insurance or some time has past when we did. You should be aware of a person's situation when they give you advice. It matters.

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I am sorry but there are a lot of grumpy old men on this forum. There are also some very nice helpful people. Health insurance is a tough topic and people have lots of opinions. In my other life I was a CEO for a company with 500+ employees and I had to provide health insurance. There is no cheap way of doing that! I stayed on for two years so that I could take our health insurance plan to a self funded plan. We had United Healthcare for about 7 years because no other company wanted to insure us to many females and any other excuse they could find. We were paying a little over $900 per month per employee and we had two good years and United still wanted a 10% increase. When I pointed out that we had only spent 62% of premiums on health care over the past two years they said yes but the ACA was the cause. We had a very good plan, PCP $5 visit and specialist $35 visit. It was a 90% / 10% plan with total $3,000 out of pocket before it went to 100%. I was able to keep the same plan with monthly cost of $700 by self funding. First two years the company saved more the $650,000. All we did was to buy reinsurance for large claims and anything over 125% of premiums. So even if we had a bad year we were limited to 125% of the $700 monthly cost which is still less the $900+ per month that we were paying. Good Luck.

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The cost for ACA plans vary substantially from state to state and even by location within each state.  Shopping around could save a lot but it is still expensive.  I know many people who would like to retire but can't work the high cost of health insurance into an affordable plan.  This is a wide spread problem and if a reasonable plan is available I'm sure a lot of people would be interested.

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18 hours ago, Zulu said:

Barb, if you can't get decent health insurance in a state ("RV friendly" or not), then all those other things you mentioned are eclipsed.

I guess that would depend upon whether you think a majority of fulltimers are trying to get individual policies or are covered through employers, Cobra, military, medicare.   The number of RV Fulltimers + individual insurance needs is very small in comparison with the whole health insurance spectrum - to expect that any health insurance company is going to offer something just for RVers is wishful thinking.

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1 hour ago, Barbaraok said:

The number of RV Fulltimers + individual insurance needs is very small in comparison with the whole health insurance spectrum - to expect that any health insurance company is going to offer something just for RVers is wishful thinking.

I don't expect insurance companies to do that. I do want Escapees to repeat my health insurance research for those under 65 -- that is, check what nationwide ACA policies are available in every state.

Edited by Zulu

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22 hours ago, Barbaraok said:

Individual policies are not controlled by the state like DL, vehicle registration, taxes, voting, ease of establishing residency, etc.  that’s what makes a state friendly for full timers.  

All insurance is state-regulated.  Companies cannot sell across state lines.  Individual policies most certainly depend on the state (actually, the COUNTY) one is domiciled in.

Moreso than registration, taxes, etc., if one is pre-Medicare and buying an individual policy, the cost and policy coverage often usurps any of those other concerns since it is often the single highest expense someone in the pre-Medicare, individual-plan-purchasing situation can have.

Edited by mkc

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12 hours ago, mkc said:

Moreso than registration, taxes, etc., if one is pre-Medicare and buying an individual policy, the cost and policy coverage often usurps any of those other concerns since it is often the single highest expense someone in the pre-Medicare, individual-plan-purchasing situation can have.

Back in the day, people usually automatically ruled out any state with a state income tax, but I think that given the cost of pre-Medicare individual health insurance, a state with an insurance plan that has appropriate coverage should definitely be in the running even if it has a state income tax.  Now, that state may not be as easy for fulltimers as one of the big three, but at this point, if I needed individual health insurance, I wouldn't rule out any state just because of a state income tax.

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22 hours ago, Blues said:

Now, that state may not be as easy for fulltimers as one of the big three, but at this point, if I needed individual health insurance, I wouldn't rule out any state just because of a state income tax.

I think that a great deal of what has made TX, SD, & FL such strong leaders in the domicile discussion has been the cost of moving there being low. I was fortunate in that we had health insurance provided for us by my previous employer when we hit the road, but that is becoming a very rare benefit. There have always been a significant number of fulltimers who kept their state of origin as domicile, but we mostly hear about those who change. The reality is that many of those who choose one of the "big 3" states do so with no intention of ever living in the chosen state, even though a strict reading of the laws indicate that to be part of your legal domicile. If I were planning to go on the road today with the need to buy my own health coverage, I would probably look to FL first and to my state of origin. 

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Since the type of insurance offered in a particular state changes every year, it is hard to make health insurance options your primary reason for picking a domicile.   I think you should have some expectation to have to return to the state of domicile just in case that is required for whatever reason as state regulations or inspections and licensing could change.   Since I primarily spend my time as far away from FL as you can be, it just doesn't seem the best option for me and everyone will be different.  

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14 hours ago, trostberg said:

Since the type of insurance offered in a particular state changes every year, it is hard to make health insurance options your primary reason for picking a domicile.

First, for the ACA, where you actually reside is what matters, not your domicile. To "move" under the ACA, you use the SEP (Special Enrollment Period) to change insurance. Here's a SEP FAQ.

This is where someone chimes in with "But I'm a full timer, I never know where I'll be staying." Well, if you're never in FL and have a FL ACA plan, good luck if you need major medical. You may have some explaining to do.

 

"it is hard to make health insurance options your primary reason for picking a domicile"

I can only guess that you've never had serious health issues or if you did, you weren't on the ACA. Let me give you an example of why it might be a really really good idea to change ACA plans.

We had an AZ ACA plan but were working for several months in CA. We should have changed to an CA ACA plan, but at the time we were unaware of the ACA SEP provision. So since our AZ health plan only covered us in state, we had to make a long drive back to AZ several times for my wife's chemotherapy.

Edited by Zulu

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Question 3 on the SEP FAQ sounds a lot like establishing domicile in your new location:

"For the purposes of § 155.305(a),”intends to reside” means that an applicant has a present intent to reside where he or she is living, and intends to remain in the Exchange service area where he or she is seeking coverage.

Individuals visiting an Exchange service area for a transitory purpose, for example, to attend to a business matter, obtain medical care, or for personal pleasure, do not have a present intent to reside, and do not meet the residency requirement for Marketplace coverage for the Marketplace service area they are visiting."

Edited by Lou Schneider

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2 hours ago, Lou Schneider said:

Question 3 on the SEP FAQ sounds a lot like establishing domicile in your new location:

It's not. It's for people moving among multiple locations.

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On 4/14/2019 at 12:59 PM, Zulu said:

This is where someone chimes in with "But I'm a full timer, I never know where I'll be staying." Well, if you're never in FL and have a FL ACA plan, good luck if you need major medical. You may have some explaining to do.

I suppose the explanation could be that you're never in one place long enough to get health insurance there, so you used your domicile as the default.  After all, the intent of the ACA is for people to have health insurance, and if using your domicile is the only way to do it, then what else are you supposed to do?
 

Quote

We had an AZ ACA plan but were working for several months in CA. We should have changed to an CA ACA plan, but at the time we were unaware of the ACA SEP provision. So since our AZ health plan only covered us in state, we had to make a long drive back to AZ several times for my wife's chemotherapy.

 

By your reasoning, your claims should have been denied because you were getting insurance in a place where you weren't residing.  In fact, you were visiting there solely to receive medical care, which the FAQ says is forbidden. 

The bottom line is that the ACA was written without any thought to people moving around any more than snowbirds do, who alternate between residences, and are told they can pick one to have health insurance throughout the year, or they can change each time they move (and are warned that deductibles reset if they change).  For traveling fulltimers, it would seem they have the same choice--they can pick one place to have health insurance throughout the year, or they can change when they move.  For most of them, it's impractical and often impossible to change each time they move, so they use one of the options given to showbirds and choose the one place, and the obvious choice in that case is their domicile. 

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3 hours ago, Blues said:

I suppose the explanation could be that you're never in one place long enough to get health insurance there, so you used your domicile as the default.  After all, the intent of the ACA is for people to have health insurance, and if using your domicile is the only way to do it, then what else are you supposed to do?

I get a lot of these questions. Contact the ACA.

 

3 hours ago, Blues said:

By your reasoning, your claims should have been denied because you were getting insurance in a place where you weren't residing.  In fact, you were visiting there solely to receive medical care, which the FAQ says is forbidden. 

I guess you missed that part where I said we were working in CA. So we were residents.

 

3 hours ago, Blues said:

The bottom line is that the ACA was written without any thought to people moving around any more than snowbirds do . . .

And I see a lot of this kind of rationalizing . . . that is, since this law doesn't seem to cover my situation or it would be difficult for me, then I can do what I want. BTW, the ACA SEP is there for people who move. You move a lot? Contact the ACA for advice.

Edited by Zulu

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16 hours ago, Zulu said:

I guess you missed that part where I said we were working in CA. So we were residents.

No, I didn't miss that.  In fact, it was the basis of my statement that you had health insurance in a place where you weren't residing (Arizona, while being California residents), and were traveling to your "health insurance state" to get medical treatments.  So you were doing the same thing as you're telling other people they can't do.

 

Quote

And I see a lot of this kind of rationalizing . . . that is, since this law doesn't seem to cover my situation or it would be difficult for me, then I can do what I want.

Not difficult.  Impossible. 

You have to apply for insurance by the 15th of the month before you want your coverage to start, and if you're using a SEP, you have to have documentation supporting your move.  Suppose you're in Montana on the 14th and plan to arrive in Wyoming on the 3nd of the next month but aren't sure where you're going to stay, and then you're going to head for Colorado on the 20th .  How should you handle the health insurance so that you're covered the entire time? 

I sure seems to me that it's literally impossible to arrange it to have "local" health insurance in that case. 

How would you accomplish it? 

 

Quote

BTW, the ACA SEP is there for people who move. You move a lot? Contact the ACA for advice.

I did.  I said I will be traveling all over the country for an extended period, not staying in any one place for any particular time, and what should I do about health insurance?  The rep consulted someone and came back and said I should keep the plan I have.

It's no different from the advice given to snowbirds--you can keep your plan while you're living in that other place if that works for you, or you can switch plans for the time you're in the other place, but are cautioned that your deductible and out-of-pocket maximums will reset if you do.

Traveling fulltimers are just snowbirds writ large.  But there aren't enough of them for lawmakers to actually consider them when noodling out details, and there's no lobbyist to bring us to their attention.  Just because their particular situation isn't mentioned in an explanatory document doesn't mean the law doesn't cover them.

The purpose of the ACA is for people to have affordable healthcare.  Maybe high premiums and deductibles affect whether the "affordable" part is fulfilled, but the cornerstone of the ACA is making health insurance available to everyone.  It would be contrary to the purpose of the ACA to have a situation where there's no health insurance available to someone just because he travels too much to change his insurance every time he resides somewhere new, or where even if he could figure out how to do it would have his deductible and out-of-pocket maximum reset every month.

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3 hours ago, Blues said:

. . . you had health insurance in a place where you weren't residing (Arizona, while being California residents), and were traveling to your "health insurance state" to get medical treatments.  So you were doing the same thing as you're telling other people they can't do.

We were "residents" of both AZ and CA. I said I wished I had known about SEP when we were in CA because I would have changed to a much better CA ACA plan.

 

3 hours ago, Blues said:

. . . if you're using a SEP, you have to have documentation supporting your move. 

How do you know this?

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5 hours ago, Blues said:

and if you're using a SEP, you have to have documentation supporting your move. 

Blues is correct. Under the new Special Enrollment Confirmation Process implemented in June 2016 you have to submit documentation to support your SEP eligibility within 30 days of submitting an application. 

https://www.healthcare.gov/coverage-outside-open-enrollment/confirm-special-enrollment-period/

https://www.healthsherpa.com/blog/documents-special-enrollment-period-verification-sep/

https://www.cms.gov/newsroom/fact-sheets/fact-sheet-special-enrollment-confirmation-process

 

 

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