State based health care insurance

goboatnow · Oct 18, 2015

Curious what liveaboards do about state based health insurance when everything seems to be based on your physical address, whether or not you actually live there. We're currently ID residents, living in CA for the winter, moving on to points north when the weather gets warmer. All insurance options I look at revolve around what state I live in. Well, I don't/won't really live in any one particular state. We can be residents of any state but will probably chose one without state income tax.

What have other members experienced?

Thanks

caltexflanc · Oct 18, 2015

When we were cruising full time I maintained my Texas citizenship by belonging to a mail forwarding service, Escapees. We had private insurance through Blue Cross of Texas and had no issue seeing doctors and hospitals all up and down the east coast. The problem arises with things like jury duty if you are registered to vote, and if car registration needs proof of inspection, which Texas now does, or you need to go renew your driver's license in person, which Texas didn't before, but asked me to this go around.

DavidM · Oct 18, 2015

I think but am not sure that you must purchase insurance in the state where you maintain your legal residency. But if you pick the wrong carrier then most of your usage will be out-of-network and will be expensive.

My wife's private insurance is in NC with Blue Cross. Fortunately they have a national network of providers and if she goes to one while out of state it will be covered as in-network. But some state's Blue Cross systems doesn't work that way, so you are limited to in-state providers to be in-network.

So pick your state and your carrier carefully. Makes you long for a single payer, national insurance system like Medicare doesn't it -

.

David

Larry M · Oct 18, 2015

djmarchand said:
I think but am not sure that you must purchase insurance in the state where you maintain your legal residency. But if you pick the wrong carrier then most of your usage will be out-of-network and will be expensive.

My wife's private insurance is in NC with Blue Cross. Fortunately they have a national network of providers and if she goes to one while out of state it will be covered as in-network. But some state's Blue Cross systems doesn't work that way, so you are limited to in-state providers to be in-network.

So pick your state and your carrier carefully. Makes you long for a single payer, national insurance system like Medicare doesn't it -.

David

Good points. We're Washington State residents, travel full time and are insured with have Blue Cross. 20 months ago I had an MRI performed, out of state, by an out of network provider. More out of pocket paid by us and it didn't go toward our deductible for in network. Last year I had a knee replaced in Florida and Blue Cross paid everything once we reached our deductible and they negotiated with the providers since they were in network. Before we have any services done, we call Blue Cross and verify that the provider is in network. We are also covered for emergency services when out of the country on vacation.

goboatnow · Oct 18, 2015

We are also covered for emergency services when out of the country on vacation.

Who do you use for out of country emergency insurance?

I'll check with BX. Thanks

BandB · Oct 19, 2015

The key is to check the networks of insurers when choosing. Typically if you get a PPO with a national provider you'll be covered well. Now, the book or file you get initially won't include out of state providers, but you can often ask them for one for the area you're in at the time. When we first moved to Florida, we were both covered by NC policies and continued to be under Cobra briefly. However, we were able to get a listing of network providers in our area and get care.

Phil Fill · Oct 19, 2015

We have Unitedhealth thru AARP. We live 5 months on the boat in The Puget Sound Washington, and travel 7 months around them US on the land yacht. Seems to be accept in all states. We have not travel out of the US.

BandB · Oct 19, 2015

Phil Fill said:
We have Unitedhealth thru AARP. We live 5 months on the boat in The Puget Sound Washington, and travel 7 months around them US on the land yacht. Seems to be accept in all states. We have not travel out of the US.

Do you have a medicare supplement or medicare advantage plan? I ask because the supplement is accepted anywhere, but the acceptance of advantage plans is very much a regional situation. There are parts of the country where most doctors accept them but then other areas that the majority of doctors do not. In South Florida they're easily accepted.

Phil Fill · Oct 19, 2015

BandB said:
Do you have a medicare supplement or medicare advantage plan? I ask because the supplement is accepted anywhere, but the acceptance of advantage plans is very much a regional situation. There are parts of the country where most doctors accept them but then other areas that the majority of doctors do not. In South Florida they're easily accepted.

Social Security with suplement plan. Social Security paid 90+ %, so Unitedhealth paid very little. Next year I am going on Regence 0 premium plan were Regence process the claim four Social Security and recieves a fee from them, and Walgreen has a prescription plan that year premium is 20 dollar a year and co pay cheaper also.

CVS and Walgreen are nation wide. We use Walgreen. So suplemental premium is 0 dollar compared to 162 dollars/month, and subsiption 20/year compared to 45dollar per month with co pay cheaper. Save about 2000.00 per year with max out of pocket 1, 000.

Our insurance broker special is Medical and medicare plans.

BandB · Oct 19, 2015

Phil Fill said:
Social Security with suplement plan. Social Security paid 90+ %, so Unitedhealth paid very little. Next year I am going on Regence 0 premium plan were Regence process the claim four Social Security and recieves a fee from them, and Walgreen has a prescription plan that year premium is 20 dollar a year and co pay cheaper also.

CVS and Walgreen are nation wide. We use Walgreen. So suplemental premium is 0 dollar compared to 162 dollars/month, and subsiption 20/year compared to 45dollar per month with co pay cheaper. Save about 2000.00 per year with max out of pocket 1, 000.

Our insurance broker special is Medical and medicare plans.

Medicare pays 80%, Supplement pays 20%.

As to your $0 premium medicare advantage plan, I must warn you, it will not be as widely accepted. There are areas of the country you will find very few doctors or hospitals willing to accept it. On the west coast they're widely accepted. In NY and in South Florida the same. In much of the south and southwest though, doctors do not participate. You need to carefully look at the coverage where you'll be traveling.

goboatnow · Oct 19, 2015

One problem I see is that everyone, including health insurance brokers, kind of tweak out when you tell them you have no real physical location/address and are on the move. Makes it 'interesting '

BandB · Oct 19, 2015

goboatnow said:
One problem I see is that everyone, including health insurance brokers, kind of tweak out when you tell them you have no real physical location/address and are on the move. Makes it 'interesting '

You do have a state of residence and your physical address may be something like a relative's house or St. Brendan's. Then you just tell them you travel a lot.

Phil Fill · Oct 20, 2015

goboatnow said:
One problem I see is that everyone, including health insurance brokers, kind of tweak out when you tell them you have no real physical location/address and are on the move. Makes it 'interesting '

We use our son street address. All of the payments are set up for automatic withdrawl, so not much mail. While we lived aboard we had a PO box and used the marina address. All of our medication for verification is still the marina adress. Also email and text is becoming more popular. Our smart phones is the only thing we use. :socool:

caltexflanc · Oct 20, 2015

goboatnow said:
One problem I see is that everyone, including health insurance brokers, kind of tweak out when you tell them you have no real physical location/address and are on the move. Makes it 'interesting '

That's why we used Escapees in our situation. They give you a unique physical address. Never had any issues or tweaking out whatsoever with health or auto insurance folks. Actually, Blue Cross of Texas actively solicited and advertised to Escapees members, who are 99% RV'ers. You just need to buy the right policy, we did, and it worked out great for us. They were happy to take our money, too.

BandB · Oct 20, 2015

caltexflanc said:
That's why we used Escapees in our situation. They give you a unique physical address. Never had any issues or tweaking out whatsoever with health or auto insurance folks. Actually, Blue Cross of Texas actively solicited and advertised to Escapees members, who are 99% RV'ers. You just need to buy the right policy, we did, and it worked out great for us. They were happy to take our money, too.

Same as St. Brendan's. You can get a driver's license with that physical address, register to vote, use it for anything requiring a physical address. There is even a declaration of domicile you can file with the county there.

I'm assuming Escapees gives you a Texas address and residency? I understand they do Texas, Florida and South Dakota.

tallswede · Oct 20, 2015

So pick your state and your carrier carefully. Makes you long for a single payer, national insurance system like Medicare doesn't it -

.

David[/QUOTE]

Actually, makes me long for the days when if you needed routine medical care, you afford to pay out of pocket. If you had something more serious, BlueCross/BlueShield was accepted everywhere. Oh, and many doctors made house calls. All this was before Medicare/Medicaid and all the other gigantic corps. got ahold of things. Sigh. This was as recently as the 1960's.

Kevin

BandB · Oct 20, 2015

tallswede said:
So pick your state and your carrier carefully. Makes you long for a single payer, national insurance system like Medicare doesn't it -.

David

Actually, makes me long for the days when if you needed routine medical care, you afford to pay out of pocket. If you had something more serious, BlueCross/BlueShield was accepted everywhere. Oh, and many doctors made house calls. All this was before Medicare/Medicaid and all the other gigantic corps. got ahold of things. Sigh. This was as recently as the 1960's.

Kevin[/QUOTE]

Well, as I wasn't alive for the 60's then I don't have the longing for the good old days.

You mention housecalls, well housecall physicians are actually coming back into availability and popularity, especially with seniors.

caltexflanc · Oct 20, 2015

BandB said:
Same as St. Brendan's. You can get a driver's license with that physical address, register to vote, use it for anything requiring a physical address. There is even a declaration of domicile you can file with the county there.

I'm assuming Escapees gives you a Texas address and residency? I understand they do Texas, Florida and South Dakota.

Yes, as mentioned, it was just like actually living in Texas in all legal and commercial respects. I chose them since we were already Texas residents before selling the house and moving onto the boat. Also as noted, the biggest hassle was dealing with jury duty but Polk County was very understanding.

State based health care insurance

goboatnow

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caltexflanc

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DavidM

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Larry M

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goboatnow

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BandB

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Phil Fill

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BandB

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Phil Fill

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BandB

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goboatnow

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BandB

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Phil Fill

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caltexflanc

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BandB

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tallswede

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BandB

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caltexflanc

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