Florid Domicile References?

[katwell]

Hello, Escapees!

My wife and I are looking to retire in the next handful of months and join you all on a nomadic journey. We would like to domicile with Escapees around Bushnell, FL are we are looking for references to businesses that are accommodating to the Escapee lifestyle. We would appreciate any leads to businesses that are aware of – and sympathetic to – the needs of the nomadic community. Examples include:

·      Primary care physicians

·      Dentists

·      Pharmacies

·      Auto insurers

·      Health insurers/brokers

·      DMV locations

·      Banks

·      Estate planners

And so on. What am I forgetting? Is there a better place for this kind of information?

See you on the road!

 

K&M

Edited January 30, 2023 by katwell
Added details

[Kirk W]

Welcome to the Escapees! We are happy to have you with us. Since we had our domicile in TX I can't help with the references, but others who can should be along soon. If you have not already done so, you may want to join the Escapee Facebook pages as they are very active.

Edited January 30, 2023 by Kirk W

[TXiceman]

That is a tall order.  Not knowing anything about income, finances, health, or numerous other things specific to your needs, it is hard to answer very many of your requests.

Best of luck with your adventures.  We have just come off the road after 10 years full time with a Livingston, TX domisle.

Ken

[Anawilliam850]

For information about businesses that cater to the RV/nomadic community in Bushnell, FL and surrounding areas, you can try the following resources:

Escapees RV Club - They have a directory of businesses that cater to RVers, including healthcare providers, insurance, banks, and more.

RVillage - A social network for RVers where you can find information and connect with other RVers who may have recommendations for you.

RV Life - A website dedicated to RV living with articles, resources, and a forum where you can ask for recommendations.

Good Sam Club - An RV club with a directory of businesses that cater to RVers, including healthcare providers, insurance, banks, and more.

You may also want to consider reaching out to RV forums or Facebook groups dedicated to RVers in Florida.

In terms of what you might be forgetting, it's important to have a reliable internet service provider if you plan on working or staying connected while on the road. You may also want to consider the cost and availability of propane and mail forwarding services, which can be essential for some nomads.

[katwell]

Thanks to everyone for the references and kind words.

@TXiceman make a good point that it hard to make a recommendation knowing so little about our situation. In brief, we intend to spend a month or so each winter around Bushnell when we will take care of things like doctor and dentists visits. We’ll likely find ourselves on a BlueCross/BlueShield ACA plan of some kind. We’re fortunate to be in good enough health that an annual physical and infrequent screening procedures should be all we require. That of course won’t be true forever, but we’ll cross that bridge when we get there.

Incidentally, I do see that most community members seem to domicile in Texas and not Florida. We’re inclined to use Florida as a home base because it has far better weather in the winter months and it is closer to family (still out-of-state, but much closer than Texas is).

 

 

[Kirk W]

14 minutes ago, katwell said:

We’ll likely find ourselves on a BlueCross/BlueShield ACA plan of some kind.

As one who has been Medicare eligible for sometime, I don't have recent experience with health insurance plans but most people agree that Florida has the best selection of plans for those who need health insurance than does Texas or South Dakota, the other two choices for health insurance that works while traveling. Just make sure that you make a choice that will allow use in any location that you may travel. A good place to start your research is at healthcare.gov which is the federal site.

As to what state most of us use, most of our mail goes to the Livingston address no matter which state we use so don't let that deter you from choosing Florida. Just follow the directions on the Escapees domicile site and ask here or on Facebook if you should have any questions.

Since you are an Escapee member, I suggest that you visit the club site and look through the Commercial Partners directory for ideas on financial services and also insurance. If someone has a suggestion for one that they use in the Bushnell area I'd probably put it ahead. For RV insurance you will need to get fulltime coverages and I suggest either RV Advantage or Miller Insurance, both with good reputations.

[Blues]

On 1/30/2023 at 11:27 AM, katwell said:

In brief, we intend to spend a month or so each winter around Bushnell when we will take care of things like doctor and dentists visits. We’ll likely find ourselves on a BlueCross/BlueShield ACA plan of some kind. 

A Florida Blue EPO/PPO plan is the obvious and most popular choice.  It provides access to a nationwide network of providers through its Blue Card program.

But be aware that Florida Blue offers "Blue Select" and "Blue Options" plans.  If I were going to be spending time in Florida in addition to traveling around elsewhere, I'd have "Blue Options."  You can see my reasoning here:

https://www.rvnetwork.com/topic/145664-insurance-coverage-in-florida/?do=findComment&comment=1086084

[Fhkw9DPJ8V1g]

We have found that doctors in FL are already used to a transient population given all of the people from the northeast who have been spending "the season" in FL for decades. We have never had a problem with doctors writing prescriptions for the entire year with a follow up yearly. They write a 90 day scrip with 3 refills. Rinse and repeat.

This has worked for my wife who only has one prescription and for me with many. My wife has very few health issues and I have more than a couple of specialists that I see.

We return to FL once a year to make the rounds and see all of our doctors. We are both pre-medicare (soon to change) and use an ACA FL Blue Select plan. As our health needs change so will the time that we spend in state and we may change some things as we approach 65 but for now it works for us.

We've been domiciled in FL and fulltime for well over 5 years.

[katwell]

Thanks to @Blues for the detailed and very helpful analysis; it would indeed be nice to NOT have to travel back to Florida every time I get a hangnail.

Also thanks to @Fhkw9DPJ8V1g -- its sounds like your situation is quite similar to what we're looking to do and it is comforting to hear it is going well.

[Blues]

51 minutes ago, katwell said:

Thanks to @Blues for the detailed and very helpful analysis; it would indeed be nice to NOT have to travel back to Florida every time I get a hangnail.

With a Florida Blue EPO/PPO plan with Blue Card access, finding an in-network doctor when you're not in Florida will be no problem at all. 

Fhkw9DPJ8V1g and wife have successfully used a Select plan for medical care in Florida, but that could be the result of their particular circumstances, like they're getting medical care only in the county where their plan is located (which means Select will have network providers there) and the doctors they like happen to be part of Select's network.

I would suggest that anyone who is considering a Select plan instead of an Options plan (Select plans are cheaper) and is planning to spend time in Florida should read the post I linked to above, to see the possible disadvantages of a Florida Blue Select plan. 

I should add that I have read about dissimilarities between Select's and Options' networks for lab work, but never dug into it to find out the particulars.  It's something to think about, but good luck finding out the particulars.

Actually, I just found a concrete example of the difference between Select and Options networks.  I searched for a Florida Blue plan in Tallahassee, in zip code 32301.  There are Choice plans available there, but Florida Blue doesn't sell Select plans in that area.  So let's see what the Select and Choice networks are like there.

When I did the a "Hospital/Facility" search for Options plan network providers, there were 24 results.  When I did the same search for Select plan network providers there were 15 results, and most of them were ambulatory surgical centers or urgent care centers. 

I don't know anything about the hospitals in Tallahassee, but did notice that two of what sound like major players, Tallahassee Memorial Healthcare and HCA Florida Capital Hospital, are part of the Options network but NOT the Select network.  I confirmed that it wasn't just a search anomaly by going to the link for each facility and seeing the list of plans they accept; both had Blue Options listed and neither had Blue Select listed.

I also did a search for primary care providers and there were 281 in the Options network and 57 in the Select network.

I did similar searches for Bushnell, where Florida Blue does offer both Select and Options plans.  The Select and Options networks there weren't significantly different:  both networks had 8 hospitals/facilities in their network, and Select's network had 146 primary care providers compared to Options' network of 181.  Pretty close.

I see a correlation between whether Select plans are sold in a given area and Select's network size in that area.  If Florida Blue offers Select plans in a given area, the Select network will be almost as big as Options' network in that area.  But in an area where Florida Blue doesn't offer Select plans, Select's network will be significantly smaller than Options' network. 

So it looks to me like if you're buying your Florida Blue plan in the same area where you'll be seeking medical care while you're in Florida, Select probably has a robust network in that area.  But if you're planning to spend time in areas of Florida other than where you buy your insurance plan, it could very well be that the Select network available to you will be much smaller than the Options network--like if you are in Tallahassee. 

And something else to think about:  You might not be planning to have routine medical care in Tallahassee and therefore might not care what the network is like, since emergency care is covered no matter where you are.  But if you had an emergency in Tallahassee and then had to be transferred to a hospital there for further non-emergency care, if you have a Select plan the Tallahassee hospital is going to be out-of-network (the hospitals in the Select network are ambulatory surgical centers). 

And remember that all of this network stuff is only in Florida.  Select and Options plans have access to the same nationwide network of providers under the Blue Card program.  (Although Select might have different coverage/providers when it comes to lab work--I just don't know.) 

That's why I think it might be worth the risk to get a (cheaper) Select plan if you're not going to be spending any time in Florida.  But if you are going to spend time in Florida, you should consider that there are areas of Florida where a Select plan will have a much smaller network than an options plan, and possibly no in-network hospital if you need continuing care after an emergency.

[Fhkw9DPJ8V1g]

On 2/6/2023 at 12:57 PM, Blues said:

Fhkw9DPJ8V1g and wife have successfully used a Select plan for medical care in Florida, but that could be the result of their particular circumstances, like they're getting medical care only in the county where their plan is located (which means Select will have network providers there) and the doctors they like happen to be part of Select's network.

We have always had FL Blue Select since ACA started and we have never had a problem. We are domiciled in Bushnell but we have never seen doctors there. The main reason we chose the Select Plan was to have access to a nationwide network while we're traveling around the country.

In FL we see docs in Tampa, Gainesville and near the Villages. We have never run into a situation where we couldn't see the doc we wanted. They've always been in network.

The select plan has worked out well and has been tested when some bones have needed setting far from FL.

 

[Blues]

15 hours ago, Fhkw9DPJ8V1g said:

The main reason we chose the Select Plan was to have access to a nationwide network while we're traveling around the country.

That's a reason to choose a Florida Blue EPO/PPO plan, but not a reason to choose a Select plan in particular, because access to the Blue Card nationwide network is not unique to Select plans; Options plans have access to the same nationwide network.  Select and Options plans will work the same way when getting a broken bone fixed far from Florida.

But not necessarily while in Florida, because the networks for Select plans and Options plans in Florida aren't the same, and that's why a person who wants coverage both in Florida and while traveling around the country should understand the difference between the Select and Options networks in Florida.

15 hours ago, Fhkw9DPJ8V1g said:

In FL we see docs in Tampa, Gainesville and near the Villages. We have never run into a situation where we couldn't see the doc we wanted. They've always been in network.

That's great, but since the networks in Florida for Select and Options are different, your success with Select is situational.  If you'd been seeking medical care in Tallahassee with your Select plan, the result could be very different, based on the provider searches I detailed above. 

Also, coverage itself is different for Select and Options plans.  I found a Florida Blue provider manual, which illustrates that coverage and networks for Options and Select plans are not the same, and describes the EPO limitations that Select plans have, but Options plans don't.

For BlueOptions:

BlueOptions members have open access to any PPC provider without designating a primary care physician.

Most BlueOptions plans allow members to seek out-of-network services from providers participating in the Traditional/PPS/PHS network. Covered benefits may be reimbursed at a lower non-participating level.

Participating Traditional/PPS/PHS providers are considered out-of-network for PPC members, however, you may not balance bill the member.

For BlueSelect:

BlueSelect members have open access to any BlueSelect provider without designating a primary care physician.

However certain services are subject to an Exclusive Provider Organization (EPO) provision and are only covered when rendered by providers designated by us as the exclusive provider for such service.

Services that may be subject to the EPO provision are:
Behavioral Health
Dental services
Durable Medical Equipment
Home health/home infusion
Laboratory
Medical Supplies
Orthotics/prosthetics
Pharmacy
Vision Services

Participating Traditional (PPS/PHS) hospitals and facilities are considered out-of-network for BlueSelect members, and there is no balance billing protection.

https://www.floridablue.com/sites/floridablue.com/files/docs/Prov-Participation-Plans-Products-ID Cards-UM-Standing-Auth-MASTER2-01-01-2023a.pdf

The EPO limitations are also described in this overview of Select plans:
https://www.floridablue.com/sites/floridablue.com/files/docs/BlueSelect Fact Sheet 2021 IU65 80647.pdf

And finally, here's a description of the various Florida Blue networks:
https://www.floridahealthconnector.com/individuals/florida-blue-provider-network/

The bottom line is that there are differences between Select and Options plans, and most people don't realize that, never mind know what the actual differences are.  The differences will have little or no effect on people who are getting all their medical care outside Florida through the Blue Card program, but the differences could have an effect if getting care in Florida, as the Tallahassee example demonstrates, or if getting a particular service for which Select members have to use only "exclusive" providers, while Options members aren't limited to that subset of providers.

That's what people need to be aware of when choosing between Select and Options, but it's pretty much never discussed.  The focus is always on having access to a nationwide network, which is no doubt important, but the advice needs to drill down further, to alert people who do spend time in Florida that their Select plan will come with a smaller network in Florida as well as some EPO limitations on which providers are covered.