Health Insurance On The Road
The mere mention of health care can send the most steadfast person into a dull fog and reduce the weaker to a blubbering mass. Health care and, more specifically, health insurance is an overwhelming issue. There’s literally thousands of options out there and reading insurance contracts requires a strong pot of espresso and a iron-willed attitude.
What Are My Options?
We’re too young for Medicare, and we don’t have any government or military benefits so we needed to find a private, affordable option. The 3 main choices for full-timers such as ourselves are:
- No Insurance – wing it and see what happens
- Traditional Plans – Such as Blue Cross, Blue Shield etc.
- Catastrophic Insurance – an insurance that only covers catastrophic events (really a sub-set of #2 with higher deductibles)
Choosing the Type of Insurance
So, how do you choose what you need? Insurance is a risk assessment. In our case we’re in great physical health, keep tabs on our blood-work ourselves (and know how to read and interpret the labs), don’t have any weight issues and are very conscious of our nutrition and exercise. So, what we needed wasn’t something to cover everyday life, but something to cover the unexpected. We weren’t prepared to go for #1 and in fact I wouldn’t recommend it for anyone. All our research on #2 showed it was too expensive. So, #3 turned out to be the winner.
Exploring Options
Once we decided on the basic idea we were off to research options. By far the easiest and most comprehensive on-line site we found was eHealthInsurance. You enter your state and birthdate and you get a bunch of options. The site will show you the following:
- Plan type = for example network, or PPO
- Deductible = how much you have to pay before the insurance kicks in
- Co-insurance = how much you have to pay once your deductible is used up (usually expressed as a percentage between 0-30%)
- Office visit = how much, if any, you have to pay for each office visit (sometimes called co-pay)
- Lifetime maximum = how much in total the insurance will pay over your lifetime, expressed either per person or total (for the family)
For “catastrophic” insurance you’re only looking to cover the big-ticket items. So, you want a very high deductible, 0% co-insurance and a high lifetime maximum. Basically this means you’re willing to pay for any small-time or regular annual check-ups yourself and use the insurance only if something major happens (major accident, major long-term health issue etc.).
The Final $$
Based on above, we found a plan with $10,000 deductible, 0% co-insurance and $5 million (per person) lifetime benefit that cost $150/month ($1,800/year) total for the both of us combined. If something really bad happens we’ll be paying $10,000 out-of-pocket, but then we’re completely covered. That’s totally reasonable and within our comfort zone.
The deductible is a big factor in the final $$. The lower you want it, the more you’re going to pay so you have to assess if it’s worth the extra moolah for you. Had we gone with a $1,500 deductible we’d be paying anywhere from $350 to $500/month. That means instead of $1,800 per year we’d pay $4,200 to $6,000 per year. We keep a close track of our expenses and in the past 10 years we’ve never used more than $2,000 per year on any medical issue, routine, emergency or otherwise, so it simply didn’t make sense to cough up the extra cash.
For your own case, you’ll have to decide, based on your own health and situation what makes most sense for you and your family. If you have kids or on-going medical issues that require regular attention it may make sense to pay for lower deductible or enter one of the State-sponsored High Risk Insurance Pools . If you’re like us, in good health and just need to cover the “big scare” it probably makes sense to pay less and go for the higher deductible. Look at your history, sum up old expenses and see what makes sense.
If I haven’t put you to sleep by now, I applaud your stubbornness and wish you healthy RV travels for many years to come.
I’m a retired financial planner & insurance agent. I also was a fulltimer for nearly 4 years. I’d like to suggest the following:
Assuming for the moment that you could have paid the higher premium for the lower deductible from cash flow, then take an amount equal to the difference in premiums and put it away in a savings account.
Do this until you have accumulated $20,000 (you each have a deductible, right?). Now you a have 100% self-insured coverage for the 1st $10k each and 100% coverage after the $10k stop-loss deductible. What do you think?
Good advice! What I forgot to mention in the post is that we keep the deductible amount in an accessible “rainy-day fund”. So, we have the deductible $$ available if we need them. We’ve saved up to prepare for this, but for someone just starting out, it would make total sense to put money aside as you go along. You can put the $$ in a regular savings account, or an HSA (Health Savings Account), or other “liquid” places. That way you’re completely covered, no matter what happens. Thanks for the comment 🙂
Oh, and I should mention. For the particular insurance we got the deductable is $10K combined.
Wow. And we were complaining about our $2,000.00 deductible for my husband’s union retirement. I’ll shut up from now on. 🙂
Yeah, a $2K deductable is sweet 🙂
This is a nice, concise, precise post, and I’d like to add it to my healthcare page, if you don’t mind.
I’m wondering about traveling and choosing a state for coverage. If, for example, you use Texas as an official residence state, do you have to go to Texas to use your coverage? If not, what extra do you pay for being out-of-area?
Thanks!
Roxanne
Sure…feel free to link ‘er up!
As for choosing coverage, you do have to pay in your state of residence (just like car insurance) which is why it’s worth shopping around for rates before deciding residency. Once you’ve got the insurance however it covers you everywhere you go. So, we don’t have to go to SD for our care, but can use it anywhere in the US.
Nina
Hi Nina,
We are looking at our insurance options. We are looking at the Coventry Prism 5000 with $10k deductible. The question I have is that it looks like if you are out of network the deductible goes up to $12/24k (individual/family)- is that similar to what you found? We are concerned that the network of PPO providers is very limited geographically.
Thanks for your insights,
Bettina
Yes, the out-of-network deductible is higher, but we’ve found the Coventry PPO network to be pretty good. It’s one of the reasons we went w/ that company -> a pretty solid network. I’d recommend browsing on their site and looking at the network options so you can see this for yourself.
Nina
We are dreaming of the life on the road. Last year I traded our old (I say old, the only NEW camper I ever owned, an ’09 Keystone) 24 ft camper with full slide out living room/dining room for a much older much nicer Holiday Rambler 36 foot motor home with no slides, a ’96 model with nearly 80 thousand miles on her. Both myself and my good wife of 44 years are retired, well disabled, I draw SS and Workers Comp for a line of duty accident on a police department with no other benifits, the wife on SS only. So we have our home paid for but a note on just the motor home and a few (quite a few) credit card bills otherwise pretty clear financially. Problem is though that I am on lots of drugs that keep my 63 year old frame a going, I must have narcotics to quell the pain from the accident, as well as some other drugs to go along with the same problem. Here’s the problem, my Dr.says that in order to now get my narcotics, Obama Care says he MUST personally hand me the script every 30 days for the pain patch, as well as my pain pills. Most of my others I get through the VA, so I figured no sweat, just drop in at a VA hospital nearby and pick up my drugs. NOT According to my VA doc, he says they can mail out my drugs, much as they do now on my request via the internet, however then how do I get them from home, and can the post office forward drugs?? This is our stopper so far, the motor home seems to be in good shape, and this spring we plan several short (less then a month) trips through Montana, North and South Dakota (where I live now, just 137 miles north of Sturgis!)This to shake out the home and get our feet wet so to speak. My question, does anyone know how to get around this drug deal, I would love to shut up this house in the winter and head south before the big snow blows (Started in October last fall – and isn’t over for sure as of yet.)
If you can request to have the drugs mailed to you, then I’d just do that. Mail them directly to wherever you’re staying at the time. Most private RV parks will accept mail, or the local UPS or Fedex office (depending on how they’re shipped) can accept packages too. I’ve used this method for years for personal mail, but admittedly have never tried it with scrips so can’t say if there’s a “gotcha” in there I don’t know about. Perhaps you could “test” this out by having your next set of drugs mailed to an RV park -> go spend the week at one and see if you can get your prescription sent there?
Alternatively if you’re able to get your drugs through CVS or some other nationwide store, then you can do it that way. I know several RV folks who manage their scripts through the nationwide stores -> wherever they go the local store can pull up the script and details.
Some ideas for you, in any case. Hope one of them works.
Nina
Jerry,
I know that this is long after you wrote your question, but I just saw it and will answer you anyhow.
I am retired on disability also, and I also get my medicine from the VA. Being also a full-timer with our motorhome, we do move around and I have changed my address with the VA 5 times this year. I receive Oxycodone and Morphine from the VA and they do send it through the mail where I have to sign for it wherever I am located. if I received this medicine from a civilian doctor they cannot mail the prescription or the medicine as that is against the law; but the VA can mail all medicine to you, even narcotics, which you have to set up and call a special phone number. All you have to do is keep your current address listed with the VA and then when you need refills you just call that number and leave a message that you need a refill and then you will get your medicine around 3 to 5 days later; if you aren’t home then the post office will leave you a note and then you can pick it up at the post office. I’ve been doing this for over 15 years now and it works out fine.
Hope this helps?
Jon
Wow sounds like a possibility at last! Thanks million, I will have to take this up with my VA hospital and see if I can get that set up. Of course I get mine locally at no cost as it’s workers comp, I would probably have to pay the co-pay with the VA but that would be worth it if I could go full timing.
Thanks so much for chiming in with your experience Jon! I’m sure this will be valuable feedback for many folks.
Nina
What about getting prescription drugs while in Mexico. Are they cheaper. Does a Mexican Dr need to see you and write the prescription?
i dont know about mailing drugs but I set up with Traveling Mailbox…they are amazing…about 30.00 a month and everything goes there. I go online and request them to open, hold, forward or shred my mail. once opened I can view it all online and decide whether or not I wan them to forward it or I can just save it as a pdf. as for packages they will accept them and they will forward them. you may want to just ask the question ahead of time. they have several states that you can choose from and you can always go in and physically pick up your package if you want to. pretty cool setup. I am not RVing yet but have been moving around the country alot over the last few years and got tired of hoping my mail would catch up with me. i can go online and put in any address that I want them to forward to. good luck!
Good tips. There are multiple services out there who do this now and it’s common for fulltime RVers to use something like this. We personally use Alternative Resources in SD for mail forwarding. They offer sorting & mail forwarding, but no scanning (yet -> this is coming soon). Escapees in TX is another guy -> again they sort & forward, but have no scanning (yet). St.Brendan’s Isle in FL is another popular guy and they do provide online scanning.
Nina
with the new lawes past this past December 2014 Narcotic perscriptions can no longer be mailed at least in Florida if you are not a VA patient I have a implanted Morphine pump and take vicodin as a breakthough medicationand the only way I can get them is to have my Dr. post date the Perscriptions and he gives me a 3 month supply at a time so I came work my shedule around my medication refills my pump gets filled everey four months and so We just come to Florida evry 4 months but I just found out that I can get my Motphine Pump filled anywhere there is a pain clinic that has the Medtronic refill system so I have been researching these different locations as the pump is computer controlled and and only sone one with the proper Medtronic computer can read and refill the pumps diagnostic settings and dosage as you the individual have no control over the dosaging or refilling it. I used to be on the patch , Oxycontin and several other narcotics until I had this pump implanted and it has worked so successfully I only use the morphine pump and take a vicodin as a supplement for those days where we drive long distances, the other plus is that by having the Morphine pump implanted It dose not effect your driving ability as the Morphine is dripped directly on the damaged area of my spine and I am not drivinhg under the influence and don’t have to worry about the chance of getting a DUI as it is directly dripped into the spinal fluid so I am able to fuction safly for myself and other motorists (my biggest concern) Hope this helps
All fine and dandy for VA patients BUT. I am female 71 with 89 year old stepmother. Have many rare medical problems and get IV infusions every 8 weeks. Have just received diagnosis of breast cancer and say to hell with it. Selling house and traveling throughout the USA. Have 28′ Class A and would like slightly longer with tip outs and twin beds then it’s sell everything and hit the road. If I keep residency here (Oregon) can keep doctors and get IV infusions elsewhere (cost more though). Biggest concern is keeping insurance in my doctor’s network so I can keep coming back for follow ups etc. Is there a site that anyone knows of that specializes in retired women. Have good Social Security and retirement and good savings.
I’d recommend checking in with the folks over at RVerinsurance Exchange. They specialize in RVer insurance. I have no affiliation by the way.
https://www.rverinsurance.com/
Nina
ABSOLUTELY Love to follow you guys! You’re a wealth of knowledge and experience for those “wishing” they could be on the road as well.
On the subject of healthcare, how are you handling it since ObamaNation Care has taken over for those that do not have a healthplan?
We have about a year left and we can’t find anything on minimums required. You indicated that you have a catastrophic plan and that is the preferred route. But with the rules in place, it seems that there is no place for the catastrophic plans any more. Is this true? What are your current experiences?
All of your other expenses seem to be in line with what we have calculated. You don’t have to have $1,000,000 or more packed away in your 401 account. You need (notice this word) to have enough to travel from point A to point B in fuel, put food in the belly (and there are ways to minimize this), and find a place to stay (work camping anybody?). As you have already pointed out, there are plenty of “free” or near free locations nationwide.
We would love to hear your thoughts on the latest in healthcare!
Happy Trails!
Health Insurance has been a roller coaster these past few years, no doubt. Catastrophic Insurance is no longer an option for us and we had to give that up several years ago. I’ve got several posts on what we’ve done (which I’ll link to below), but to cut a long story short we’re currently on an ACA plan in SD. I’m not particularly happy with it since it has zero network outside of SD, but unfortunately our options are very limited in that state. In fact I no longer recommend SD for anyone who is pre-Medicare and needs to buy a plan on the open market (I.e. they are not otherwise covered).
We plan to re-evaluate our whole situation again in November when open enrollment comes around. We will be in FL this winter so if they have any good ACA options there we will probably switch domicile from SD to FL.
If you want to read more detail, you can see all my latest posts on Health Care including the impact of the ACA and what we did this year (and why) in my “Health Care” tab here:
https://www.wheelingit.us/category/health-care-2/
Nina