mickeleit Posted June 22, 2017 Report Share Posted June 22, 2017 We are now going full timing and trying to determine whether to register in TX or SD through Escapees. We are pre-Medicare (by a few years) and would appreciate any feedback in investigating health insurance coverage/primary doctor in SD or TX prior to establishing our domicile. We want to be covered "out of state", yet I assume our primary doctor has to be in the state of our residency? Might SD have less expensive health coverage, with out of state benefits, or should we just go the TX domicile as there is better health care services/insurance programs in TX, even though we most likely would be utilizing health care services outside of either state? THANK YOU FOR ANY FEEDBACK: Scott & Kristen Mickeleit. www.thepacificsurf.com Link to comment Share on other sites More sharing options...
Zulu Posted June 22, 2017 Report Share Posted June 22, 2017 To be blunt, unless you're "cash flush", you might consider waiting until you turn 65 and can get on Medicare. Here's why -- if you're considering an ACA (aka Obamacare) health plan: Monthly premiums have skyrocketed (as much as 25% in some places) You have less choice (the number of health plans have dropped + "out of state" are difficult to find. There aren't any in SD and TX) It will probably get worse (check the news). Last year I actually looked for "RVer friendly" ACA health plans in every county of every state. Under half of all the states had health plans that might offer nationwide coverage. Generally, these would be BCBS PPO plans -- my analysis. I'm trying to repeat this analysis for the current 2017 ACA plans. Though I've only looked at 5 states so far (AK, AL, AR, AZ and CA), BCBS PPO plans can be found in AK, AL, and CA. However, these aren't your typical full-time RVer domicile states. Nevertheless, if you plan on buying your own health insurance for a couple of years, I would rule our SD and TX. However, FL may still have BCBS EPO plans that have nationwide coverage. Finally, to answer your question about SD and TX health plans. These are the cheapest current ACA plans available (I figured your ages at 63) . . . POLK County, TX BCBS HMO plan: $760 (1 person) $1519 (2 people) MINNEHAHA County (Sioux Falls, SD) AVERA PPO: $818 (1 person) $1636 (2 people) Here's a great site to check for current ACA plans -- www.healthsherpa.com SKP #79313 / Full-Timing / 2001 National RV Sea View / 2008 Jeep Wrangler Rubiconwww.rvSeniorMoments.comDISH TV for RVs Link to comment Share on other sites More sharing options...
mds1 Posted June 22, 2017 Report Share Posted June 22, 2017 mickeleit, I cannot answer your question directly, but have been considering medical coverage over the past two years or so. Nationwide coverage is on it's way out for us who are not Medicare eligible. My own situation is my wife will be Medicare eligible within 9 months of us hitting the road. I'm not sure but am considering using a COBRA benefit for that 9 month period after I leave my job. I have been building up our health savings account as well, hoping to have a stash of cash there for future expenses. For myself, I'll be providing my own health insurance for several years. I'm considering several options right now. One is to start seeing a doctor in my current home state who does not except insurance. This Direct Medical Care plan is an example. As we plan to travel "home" at least twice a year I could see the doctor there for more routine services which are sharply discounted. The doctor also offers medical care online through video chatting. Maybe I could then enroll in a high deductible "catastrophic" plan for more extreme needs. We are looking at Texas as well for coverage, but from what I've been reading Florida is the most likely place to find a possible nationwide coverage plan. I do however worry about handling emergencies and what each plan might offer. Right now, with a lack of nationwide plan coverage options, there is risk here. Not so much for my wife but for me who will have no Medicare coverage. Personally, I'm not going to let that risk stop me from going full time in an RV. For me, it is not an answer to just say work until I'm 65. Fortunately I am healthy today. I suppose if that changes in the next two years before we leave full time, then I might reconsider. Some of the best reading regarding full timer health care can be found on the Wheelingit blog. This would be a good time to get with your state senator as they review the current healthcare bill. Some already are aware there is a very big cap in the plan for those wishing to retire early. I'm not meaning to get political here. We are considering Texas as a domical for many reasons which include it being close to our home state of Missouri where many of our family members live. I'll let you know if I find a plan with nationwide coverage - but doubt that will happen any time soon. I'm making a list of alternatives which include the above mentioned as well as discounted ways for medications, what Mexico offers for dental and vision, what other doctors are out there in Texas (or wherever) who don't except insurance but discount their rates. I'm also considering a plan B in the event of a medical emergency until I could return to my local health care coverage. Frankly, I do not care to donate a life savings to a doctor or a hospital. But would like to be stabilized before returning home. Regardless, it's going to be expensive and a risk in this life style. It's a big topic. Sorry I can't answer about Texas or South Dakota. It will most likely change anyway in the next year. Mark from Missouri Our Future in an RV 2018 Ram 3500 Laramie Dually LB 6.7L HO Diesel Aisin Transmission 4x4 3.73 Gears 2019 Vanleigh Vilano 320GK 35’ fifth wheel 16,000-pound GVWR Link to comment Share on other sites More sharing options...
Kirk W Posted June 22, 2017 Report Share Posted June 22, 2017 Welcome to the Escapee forums! Please feel free to participate in any or our forums as new members are the lifeblood of them. 9 hours ago, mickeleit said: we most likely would be utilizing health care services outside of either state? This is a major problem for younger fulltimers and has been a growing problem for a long time. It is also an issue that seems to be doomed to continue to change in the near future which makes answers very difficult to give. For a long time, the key issues have been where you can use a mail service for a legal address and taxes, but health care is becoming a much larger issue. It is still critical that one is able to get a driver's license, insurance, and vehicle registrations using a mail forwarding service, but traveling without medical insurance of some kind could spell disaster! Good travelin !...............KirkFull-time 11+ years...... Now seasonal travelers.Kirk & Pam's Great RV Adventure Link to comment Share on other sites More sharing options...
trostberg Posted June 22, 2017 Report Share Posted June 22, 2017 I have found North Dakota Blue Cross plan to be one of the best and coverage out of state. I have had good coverage out of state in Wyoming when working at Yellowstone and that disappeared I believe and my good plan in Washington (my legal residence) now no longer covers out of state. I am work kamping this summer in North Dakota and did get coverage here. Your coverage does not have to be in your state of legal residence as long as you can prove you are in the state where your coverage is. You can find the documents needed for proving you are in the state on the ACA web site. Good luck Link to comment Share on other sites More sharing options...
Zulu Posted June 22, 2017 Report Share Posted June 22, 2017 1 hour ago, trostberg said: Your coverage does not have to be in your state of legal residence as long as you can prove you are in the state where your coverage is. You can find the documents needed for proving you are in the state on the ACA web site. Right here. SKP #79313 / Full-Timing / 2001 National RV Sea View / 2008 Jeep Wrangler Rubiconwww.rvSeniorMoments.comDISH TV for RVs Link to comment Share on other sites More sharing options...
trostberg Posted June 22, 2017 Report Share Posted June 22, 2017 Quote There is another list of required documents you have to upload to file once you sign up. Things like utility bill, change of address from post office that shows both new and old address etc Link to comment Share on other sites More sharing options...
Zulu Posted June 23, 2017 Report Share Posted June 23, 2017 3 hours ago, trostberg said: There is another list of required documents you have to upload to file once you sign up. Things like utility bill, change of address from post office that shows both new and old address etc Right here which includes this stipulation: What if I don’t have any of these documents? You can submit one document showing your new address (dated within 60 days prior to your move) and one document at your previous address dated within 12 months after your move. To submit these documents, select “Other” from the drop-down menu. Or, you can submit a letter with the date of your move, your old and new addresses, and the reason you can’t submit documents. The Marketplace will take your letter into consideration. To submit this letter, select “Letter of explanation” from the drop-down menu. SKP #79313 / Full-Timing / 2001 National RV Sea View / 2008 Jeep Wrangler Rubiconwww.rvSeniorMoments.comDISH TV for RVs Link to comment Share on other sites More sharing options...
mickeleit Posted June 26, 2017 Author Report Share Posted June 26, 2017 Thank you all for your insights. Sounds like I need to start my HSA..... Link to comment Share on other sites More sharing options...
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