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BCBS Texas to stop offering PPO Plans in 2016


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It is a good thing that Escapees is letting the insurance companies know that there is a segment of the population that has an issue with just HMO's being offered. RVers are one, but other out-of-state workers are probably another larger group. Unfortunately, I doubt the insurance companies view us as a large enough segment to "care about". I certainly don't expect any revision of this direction of any significance or benefit to fulltimers. My personal situation will require that I go on an HMO until Medicare kicks in. I view it as a "catastrophic" policy as is the current PPO I have. It covers nothing up to the $6800 deductible anyway. IF I have a catasrophic illness it will fall under the "emergency" provisions of the HMO - or should.

 

One might want to look at a transport policy like MASA or Skymed for transport back to someplace in your domicile state if you are on an HMO.

Jack & Danielle Mayer #60376 Lifetime Member
Living on the road since 2000

PLEASE no PM's. Email me. jackdanmayer AT gmail
2016 DRV Houston 44' 5er (we still have it)
2022 New Horizons 43' 5er
2016 Itasca 27N 28' motorhome 
2019 Volvo 860, D13 455/1850, 236" wb, I-Shift, battery-based APU
No truck at the moment - we use one of our demo units
2016 smart Passion, piggyback on the truck
-------------------------------------------------------------------------
See our website for info on New Horizons 5th wheels, HDTs as tow vehicles, communications on the road, and use of solar power
www.jackdanmayer.com
Principal in RVH Lifestyles. RVH-Lifestyles.com

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Paul,

 

No. Health insurance is not a addressed in our Constitution. There would be nothing to change there.

 

Insurance companies are, however, protected from interstate competition by the McCarran-Ferguson Act (1945), which grants states the right to regulate health plans within their borders.

 

A few states have actually signed into law (Kentucky, Georgia, Maine) and Wyoming has enacted a law allowing interstate sales of health insurance. But this all happened around a lot of uncertainty with the ACA and so far insurers are reluctant to venture across state lines.

 

 

That is my point.

Amendment X

The powers not delegated to the United States by the Constitution, nor prohibited by it to the states, are reserved to the states respectively, or to the people.

 

So since insurance is not mentioned in the Constitution, the power to license and regulate insurance companies is left to the states just as is the licensing teachers, doctors and lawyers.

 

Paul

2005 Winnebago Voyage 38J

 

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I may be wrong, but I think many years ago the insurance industry carved up America into separate areas for the sole purpose of not having too much competition with each other. The McCarron-Ferguson act made it so someone in say Maine can't purchase a cheaper plan that might be offered in Idaho. Hopefully that'll change in 2016, and we can get some open competition to drive premiums down.

Fulltiming since 2010

2000 Dutch Star

2009 Saturn Vue

Myrtle Beach, SC

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I agree with Escapees that advocacy is necessary but I really question whether working with Texas is the solution. For the under 65 crowd I think we should be looking elsewhere. Texas has the highest uninsured rate in the country which strains there entire health provider system. If that is not a priority to them, I don't think they will stay up nights worried about early retirees.

 

I also question whether sales of insurance across state lines is any panacea. As said earlier this is already allowed in some states and has little practical impact. This sounds great when politicians throw it out but when you drill down it does not get to the real problems.

http://www.washingtonpost.com/news/wonkblog/wp/2012/10/03/do-health-insurers-even-want-to-sell-across-state-lines/

http://www.healthcarefinancenews.com/news/selling-insurance-across-state-lines-will-more-competition-drive-down-prices%C2'>

 

The biggest problem with traditional competition in the health insurance market is the disconnect between the product sold and the end user. Insurer's are motivated to profit by sending out less money than they take in and that really has nothing to do with the quality of health care provided to the patient.

Dave and Lana Hasper

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The biggest problem with traditional competition in the health insurance market is the disconnect between the product sold and the end user. Insurer's are motivated to profit by sending out less money than they take in and that really has nothing to do with the quality of health care provided to the patient.

Would you be interested in investing your savings in a company that sold insurance for less in premiums than they pay out in claims? Or even one that pays out everything that they take in? Profits are the reason that companies exist and we invest in those which pay us the most in dividends.

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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Absolutely Kirk. I firmly believe in the effectiveness of the free market. My point was not that insurance companies should not make a profit but more that competition amongst insurance companies may not lower prices and actually works to disconnect us from the market.

 

As a random example, prior to the recession Ford did well and was able to refuse a bailout because they made internal reforms and produced a better product for the price point. As consumers, we could shop for cars, examine the quality and look at prices. However, that kind consumer driven competition, is extremely difficult in getting medical care due too the complexity, lack of price information, unavailability of competitors in certain markets and necessary lack of shopping in medical emergencies. BUT with our system we don't even get that far. We shop only for insurance plans, not the medical care, and the insurance companies profit motivation is not that they produce healthy customers at a good economic price point but that they minimize payments to both the health care providers and patients without reference to the care received or provided.

Dave and Lana Hasper

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With more, and more mergers comes less, and less competition among insurers. The ones getting the short end of the stick will the American consumer. I could have sworn someone from up on high guaranteed that premiums would go down...period. So much for that.

Fulltiming since 2010

2000 Dutch Star

2009 Saturn Vue

Myrtle Beach, SC

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Yeah, my premium doubled (well to be accurate it increased 98%). I did get a slight reduction in the target I have to hit before I get ANYTHING covered (including prescription drugs). That went down from 10K to 6K. And now I will have NO policy that I can use outside of my home county area. And I will have to find a Dr. that would take me. In Livingston. What a mess.

Jack & Danielle Mayer #60376 Lifetime Member
Living on the road since 2000

PLEASE no PM's. Email me. jackdanmayer AT gmail
2016 DRV Houston 44' 5er (we still have it)
2022 New Horizons 43' 5er
2016 Itasca 27N 28' motorhome 
2019 Volvo 860, D13 455/1850, 236" wb, I-Shift, battery-based APU
No truck at the moment - we use one of our demo units
2016 smart Passion, piggyback on the truck
-------------------------------------------------------------------------
See our website for info on New Horizons 5th wheels, HDTs as tow vehicles, communications on the road, and use of solar power
www.jackdanmayer.com
Principal in RVH Lifestyles. RVH-Lifestyles.com

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The mergers are only part of the problem. In an article that I recently read, but can't seem to locate now there was a CEO quoted as saying that the company has concluded that current regulations make it impossible for them to sell a health care policy that meets current requirements at a price the customer can afford and still show a profit on it. Many companies have just quietly closed down the health care side of their business.

 

It is very difficult to predict where the health care coverage is going and even more difficult to express an opinion about what should happen, without becoming political in the process. It is really good to have a nonpolitical place to discuss such problems, so I'm glad that is the case since most of us seem to have little impact upon the process anyway. :unsure:

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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Thanks to modern medical advances we are living longer and facing new medical challenges. The average life span is increasing. If health insurance premiums are $500 a month and RX's, dr visits, labs etc exceed that how can insurance companies stay in business?

 

"An ounce of prevention is worth a pound of cure" may be the place to start to curb health insurance costs?

 

This is an old article (2009) from a 60 minutes piece but I think the idea of how the money is spent may still be true?

http://www.cbsnews.com/news/the-cost-of-dying/

 

"Last year, Medicare paid $50 billion just for doctor and hospital bills during the last two months of patients' lives - that's more than the budget of the Department of Homeland Security or the Department of Education. And it has been estimated that 20 to 30 percent of these medical expenditures may have had no meaningful impact."

 

Two things in life are certain "death and taxes" beginning with the end in mind in insurance planning maybe we could come up with some solutions to curb the high insurance costs in the end and improve the quality of life along the way?

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  • If my memory serves me right, I don't recall any insurance company complaining about the ACA. Makes you wonder!!!
  • c u on the road

 

 

Are you serious? As I recall, the insurance companies were blamed for this never getting done in the 40 years it was attempted. They fought it tooth and nail. The ACA hasn't been a benefit for the insurance companies, the medical industry, or the average consumer. It has helped those who couldn't afford insurance (through subsidies) and those who couldn't get insurance (because of pre-existing conditions).

 

ACA was touted as supposed to reduce the cost of health care. I haven't seen it happen yet. Maybe it will someday.

Everybody wanna hear the truth, but everybody tell a lie.  Everybody wanna go to Heaven, but nobody want to die.  Albert King

 

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Yea Harry you are right. Neither the insurance companies nor the pharmaceuticals complained. The one part that they did not like, the public option, was knocked out to get the rest of the ACA passed. The idea behind the public option was that the fed government would offer a national insurance policy in competition against the privates and keep them in check. I don't know whether that would have worked but

 

I think the experience with ACA is going to vary with each state and how that state chooses that state makes. If you are Texas, with the highest rate of uninsureds in the country, and you refuse medicaid expansion, there are going to be cost consequences. The experience in Texas is going to be much different that a state like Mass where the majority of the population is insured. My state of Michigan is more in the middle of spectrum and PPO plans with a national network are still offered at a price thousands of dollars less than I could purchase before the ACA.

 

Those of us under 65 are just going to have to carefully monitor the developments in each state in addition to the national developments, Both the states and federal government are drafting legislation with reference to the majority of the population and overlooking the segment of the population that lives it life on the road. We need to raise awareness of our situation.

Dave and Lana Hasper

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chirakawa insurance companies fought against portions of the ACA, the public option, very hard and won. Post ACA their profits are extremely high and in recent issues like the Supreme Court decision in Burwell you find them supporting the ACA. http://money.cnn.com/2015/01/21/investing/unitedhealth-earnings-obamacare/

 

http://www.nytimes.com/2014/11/18/us/politics/health-law-turns-obama-and-insurers-into-allies.html?_r=0

Dave and Lana Hasper

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Are you serious? As I recall, the insurance companies were blamed for this never getting done in the 40 years it was attempted. They fought it tooth and nail. The ACA hasn't been a benefit for the insurance companies, the medical industry, or the average consumer. It has helped those who couldn't afford insurance (through subsidies) and those who couldn't get insurance (because of pre-existing conditions).

 

ACA was touted as supposed to reduce the cost of health care. I haven't seen it happen yet. Maybe it will someday.

 

Sadly nothing ever gets less expensive. It may go on sale for a short time but the trend is always higher.

 

Seven Economic Rules: http://www.amosweb.com/cgi-bin/awb_nav.pl?s=wpd&c=dsp&k=seven+economic+rules "A set of seven fundamental notions that reflect the study of economics and how the economy operates. They are: (1) scarcity, (2) subjectivity, (3) inequality, (4) competition, (5) imperfection, (6) ignorance, and (7) complexity."

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Thanks to modern medical advances we are living longer and facing new medical challenges. The average life span is increasing. If health insurance premiums are $500 a month and RX's, dr visits, labs etc exceed that how can insurance companies stay in business?

 

"An ounce of prevention is worth a pound of cure" may be the place to start to curb health insurance costs?

 

This is an old article (2009) from a 60 minutes piece but I think the idea of how the money is spent may still be true?

http://www.cbsnews.com/news/the-cost-of-dying/

 

"Last year, Medicare paid $50 billion just for doctor and hospital bills during the last two months of patients' lives - that's more than the budget of the Department of Homeland Security or the Department of Education. And it has been estimated that 20 to 30 percent of these medical expenditures may have had no meaningful impact."

 

Two things in life are certain "death and taxes" beginning with the end in mind in insurance planning maybe we could come up with some solutions to curb the high insurance costs in the end and improve the quality of life along the way?

 

There is no feasible way to provide good economical health care to a population of fat, sedentary citizens. It's not just the seniors either. Go to any high school in America and look at the students. When I was in high school, we had maybe 1 or 2 overweight students out of a hundred. Today, half the students are overweight. Obesity, diabetes, and other related ailments are at epidemic rates.

 

To me, this is the great challenge for our country in the next 50 years...............how to reverse the trend of inactivity and poor eating habits and get people back to a healthy lifestyle. Waiting until people are old and then pumping blood pressure medicine and statins into them is not the best approach, IMO.

Everybody wanna hear the truth, but everybody tell a lie.  Everybody wanna go to Heaven, but nobody want to die.  Albert King

 

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.....

 

Those of us under 65 are just going to have to carefully monitor the developments in each state in addition to the national developments, Both the states and federal government are drafting legislation with reference to the majority of the population and overlooking the segment of the population that lives it life on the road. We need to raise awareness of our situation.

 

In small numbers are voice is but a squeak, to increase our numbers is to join with others that would benefit from individual health insurance ie: independent contractors, sole proprietors, ie mobile repairman, artists, musicians, consultants etc

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It is a good thing that Escapees is letting the insurance companies know that there is a segment of the population that has an issue with just HMO's being offered. RVers are one, but other out-of-state workers are probably another larger group. Unfortunately, I doubt the insurance companies view us as a large enough segment to "care about". I certainly don't expect any revision of this direction of any significance or benefit to fulltimers. My personal situation will require that I go on an HMO until Medicare kicks in. I view it as a "catastrophic" policy as is the current PPO I have. It covers nothing up to the $6800 deductible anyway. IF I have a catasrophic illness it will fall under the "emergency" provisions of the HMO - or should.

 

One might want to look at a transport policy like MASA or Skymed for transport back to someplace in your domicile state if you are on an HMO.

 

 

MASA or Skymed were baked into our retirement budget planning, before we committed to retire. Being able to, when stable, get back to where our love ones and friends are can be an important part of the healing process not just for the person in need, but also a great comfort for the spouse who is supporting you in times of trouble.

 

On the HMO vs PPO angle. I wonder if obtaining a Travel Health Insurance policy is an option? Or, even available in these new ACA times. I know travelers are still able to obtain extra intentional travel insurance, wonder if domestic travel insurance is an option. (Note: For Full Timers that are actually out of their Domicile states the bulk of the time, that may not help. But, we currently are traveling for several months at a time, then returning to our 'vacation home' to heck on family and for the DW to get her gardening fix:)!)

 

For us, we're still waiting to see what my companies Group Retirement Health Care plan will do for next year. We're currently a PPO out of BCBS of North Carolina. As a Fortune 50 corporation, multi states are involved, and all are currently under the BCBS NC (And one other PPO that cost the same, can't recall what it is right now, but think it was Aetna.) Shifting times, so we'll see what happens.

 

I've only 2 1/2 years to go to 65, but the DW is 57, so this will remain an ongoing challenge for us.

 

One option I've been considering, is helping our Daughter get established when the move to the North West in the near future. They're thinking Portland, I've been suggesting Washington for no Income Tax reasons. Perhaps Vancouver, with an occasional trip to Portland for large shopping sprees:)! We're considering pulling forward a bit of her future inheritance and help with a downpayment on a home. We'll sub rent a room from them to establish an address for change of Domicile from SD due to the Health Insurance situation. (More of just a future thought at this time on our part, and I have not researched Oregon vs Washington as far as Health Insurance yet. On the surface, Washington with no Income Tax is a match for SD, which is one of our primary reasons for changing from California to SD. Vehicle Registration and lower Vehicle Insurance costs were another. No idea how Oregon and Washington compare on those fronts, but suspect the no Income Tax savings of Washington would still make that the deicing factor.)

 

Here is a link to BCBS on 'How to get care when you travel':

 

http://www.bcbsm.com/index/health-insurance-help/faqs/topics/getting-care/how-to-get-care-while-you-are-traveling.html

 

Maybe worth the research, and when I get the time, I think I will:)!

 

Best to all,

Smitty

Be safe, have fun,

Smitty

04 CC Allure "RooII" - Our "E" ride for life!

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I just read all the posts for this topic and you all have successfully scared the crap out of me. Just sayin'. I currently have been living in WI with a grandfathered plan as I took a break from the road to help a friend start a business. Yes, it doubled in the last couple years, but it's a PPO. However, next week I am heading back to TX at least for a while and then planned to decide where to volunteer/travel to next. I've been mobile since 2008. I have no usable family options. No kids, one brother in NJ (and we know that's the worst place to domicile) and have no idea where I need to call home to get insurance while I travel. I was going to leave everything as WI for a while, but once I leave the RV park, I have no address I can use here. I had planned to get back on board with Livingston as my domicile until this morning! So, I read lots of discussion but no possible solutions to a single person that travels. Probably a demographic of one, but it's my current life. I'm starting to think that I will have no choice but to get a fixed job again.

 

If ACA lets you change plans if you move, is it even feasible to change plans at each new volunteer location? I'd be changing my insurance every 2-3 months. Is my grandfathered WI plan transferrable to TX if their both BCBS? One is Anthem BCBS of WI versus BCBS of TX, so I'm thinking no.

 

Any suggestions on what I need to do??

Barbara Jones, missing my furry travel companions Reggie and M.E.C.O. (RIP)
2005 Montana 3295RK
2006 Dodge Ram 3500 Diesel Dually Crew Cab LB
http://www.spacetonature.blogspot.com

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Can you use your friends address for Wisconsin? Others, does Florida still offer PPO under the ACA and how would the domicile option be there using an escapees address? Anyone using a Bushnell Fl address and getting ppo insurance under the ACA.

Dave and Lana Hasper

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BPJ, If I were you I would try to work something out for a wisc address since you have some history there. If that did not work I would look at Fl since it is one of the states where others have experience domiciling. If you can confirm Fl offers a PPO plan under the ACA I would look at that as a serious option. Here is a discussion by Technomadia when they made the change. http://www.technomadia.com/2013/02/setting-up-domicile-in-florida-as-a-full-time-rver/ You may also want to check withRV insurance exchange to see if they have any ideas. https://www.rverinsurance.com/

Dave and Lana Hasper

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