Going full time: questions purchasing health insurance on marketplace

[jcooper]

We are going full time in about 2 months. We have a home in Virginia which we are keeping for now and VA drivers license. We will mostly be in Texas for my husbands job and will use escapees for mail service there. We will eventually buy land in Texas  and switch everything over eventually.  Can we buy insurance on the marketplace for Texas without switching our drivers license? Do they make you send in a copy of drivers license for proof? 

[Zulu]

The ACA is concerned where you actually reside. Contact the ACA for info.

[Mike.gibble]

Zulu is correct.  Health Insurance companies care where your permanent residence is and what your drivers license says.  Also, please let me know if you'd like to review health insurance options.  RVer's need good nationwide coverage so they don't have to worry.

[Mike.gibble]

It also looks like the federal government is going to open up a "special enrollment" period due to the current health pandemic. My home State of Maryland has already done so for those who do not have insurance.

[Blues]

On 3/20/2020 at 7:54 AM, Mike.gibble said:

Zulu is correct.  Health Insurance companies care where your permanent residence is and what your drivers license says. 

Actually, Zulu says that it's not your permanent residence/domicile that counts, but where you're physically located.  This has been discussed at great length in previous threads, and Zulu's conclusion is that fulltimers can't base their ACA insurance on their domicile, but hasn't offered a solution for people who travel fulltime and can't meet the requirements to get a different plan each time they change location, never mind the burden of resetting deductibles and out-of-pocket limits each time a person gets a new policy.

[Kirk W]

9 hours ago, Blues said:

conclusion is that fulltimers can't base their ACA insurance on their domicile,

Which is exactly what we did and and what all of the fulltimers I know have done, to the best of my knowledge.

[Zulu]

On 3/22/2020 at 7:25 PM, Blues said:

. . . Zulu's conclusion is that fulltimers can't base their ACA insurance on their domicile, but hasn't offered a solution for people who travel fulltime and can't meet the requirements to get a different plan each time they change location, never mind the burden of resetting deductibles and out-of-pocket limits each time a person gets a new policy.

Blues is incorrect. You can use your domicile address for ACA health plans if you actually spend "some time" there. On the other hand, if you use a state "in name only" as a domicile as many RVers do, then you may have "issues" with your ACA health plan when you most need it.

• "some time" = no clear definition, but if you think stopping in to your domicile to get your driver's license, and then leaving for the rest of year is enough time in state for the ACA, good luck. If staying in your domicile for a time is too much of a "burden" for you, then roll the dice.
• "in name only" = a "paperwork" domicile. What Escapees used to encourage until they got savvy. Now Escapees recommends that you actually spend some time in your domicile state.
• "issues" = you need major medical treatment and your health insurance company finds out you don't actually reside in the state you claim. Good luck.

Also, you don't have to get a different health plan each time you move. Blues is misinterpreting this Health & Human Services (H&HS) SEP FAQ on the ACA which addresses what to do if you travel to different locations. Read this FAQ for yourselves.

Finally, Blues claims I haven't offered a solution for full timers. I sure have -- plan to spend some time in that state you claim as a domicile. Apparently, Blues just does not want to spend quality time in his domicile, so he's been misconstruing what I and the H&HS SEP FAQ have said to fit his travel needs.

[2gypsies]

I'd love to know how many have had issues with ACA by using their domicile address and not spending time there but instead, travel.  Anyone out there had problems?

[Kirk W]

2 hours ago, Zulu said:

On the other hand, if you use a state "in name only" as a domicile as many RVers do, then you may have "issues" with your ACA health plan when you most need it.

I am wondering if you could point to some of those people who have had problems? Is there someone that you can have come on the forums to tell such a story, or is this just what you conclude could happen? 

[Zulu]

4 minutes ago, Kirk W said:

I am wondering if you could point to some of those people who have had problems? Is there someone that you can have come on the forums to tell such a story, or is this just what you conclude could happen? 

Not the ACA, but two people we know with Medicare supplements had to switch states when their supplement providers found out they were not actually living in the states they claimed.

And one more . . . a AZ couple we know who liked their CA doctors so much that they used their daughter's address as their address so that they could keep their Kaiser CA insurance. This worked fine for years. The couple went to CA every year, checked into a hotel, and saw their doctors. Hunky dory. Until they needed extensive treatment this year. They now have to stay at expensive hotels while the hubby undergoes treatment. Oh, and it's way too late for them to switch back to AZ health insurance.

Good enough, Kirk?

[whj469]

When I go to the doctors, labs or anything medical I must show my drivers license and insurance card. I am not sure what they would say if I had an out of state license?

[Jaydrvr]

1 hour ago, whj469 said:

When I go to the doctors, labs or anything medical I must show my drivers license and insurance card. I am not sure what they would say if I had an out of state license?

I can't see where that's in any way relevant. Whenever I show my driver's license it's just for identification and almost always out of state. The (usually) young employee checking it does no more than glance at it, and I can't imagine why they would bother to care.. As long as they get their paycheck. Jay

[2gypsies]

5 hours ago, whj469 said:

When I go to the doctors, labs or anything medical I must show my drivers license and insurance card. I am not sure what they would say if I had an out of state license?

They don't say anything.  Why would it be different than being on vacation?

[Kirk W]

19 hours ago, Zulu said:

Good enough, Kirk?

Clearly it is good enough for you. Since I don't have a dog in this fight, it doesn't matter to me and it wasn't me who questioned your opinion. I only know what we experienced and we never had any problems but we did keep our primary care physician in the same state as our domicile. We did have many occasions to visit doctors along the road with no problems from Medicare or our Medigap but most of that was prior to the ACA. I asked for documentation in an effort to clarify because I would like to be sure that we are sharing accurate information. 

[Kirk W]

15 hours ago, Jaydrvr said:

Whenever I show my driver's license it's just for identification and almost always out of state.

I have always thought of it as making sure you are who your insurance is covering, but I'm not so sure that they wouldn't ask if the D/L address and the insurance plan didn't match? On the other hand, none of my health related cards have my address on them so............🤔

[Blues]

21 hours ago, Zulu said:

Not the ACA, but two people we know with Medicare supplements had to switch states when their supplement providers found out they were not actually living in the states they claimed.

Not the ACA, so not pertinent here, not to mention the fact that the vast majority of traveling fulltimers are on Medicare, presumably with supplements, and they don't report any problems. 

Regardless, apparently these people you mentioned were living somewhere where they could get a supplement based on where they're actually residing.  That's not the case for a traveling fulltimer who changes location too often to meet the requirements to get a plan in those various locations.

 

21 hours ago, Zulu said:

And one more . . . a AZ couple we know who liked their CA doctors so much that they used their daughter's address as their address so that they could keep their Kaiser CA insurance. This worked fine for years. The couple went to CA every year, checked into a hotel, and saw their doctors. Hunky dory. Until they needed extensive treatment this year. They now have to stay at expensive hotels while the hubby undergoes treatment. Oh, and it's way too late for them to switch back to AZ health insurance.

This has nothing to do with what a traveling fulltimer who has a plan with a nationwide network faces.  In fact, it's the opposite.  These people live in Arizona but chose to have a plan that would cover them only in California.  Turns out they needed more care than they anticipated, which is annoying and costly for them, but Kaiser is still covering them.

That has nothing in common with traveling fulltimers who pick a plan with a nationwide network.  In fact, it shows that even in an obvious case like the one you present, where the people actually live fulltime in one place where they could/should get health insurance and choose to use a bogus address to get a policy elsewhere, the insurance company won't have any issue at all providing extensive care.

That's great news for traveling fulltimers.  It's nice to be able to fall back on the fact that basing their insurance on their domicile is the only practical option, but apparently that's not even necessary, based on the example you gave.

 

[Mike.gibble]

Kirk, you are correct.  The asking for the driver's license is simply to verify that the insurance card matches the identification card (driver's license or ID).  Health insurance cards typically do not show the person's address on them.  The medical facility just needs to know where the bill is going and how to handle the visit based on the coverage.