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Old 11-12-2020, 07:26 PM   #1
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2021 Health Insurance

I am looking into a health insurance policy for 2021 on the ACA and it is primarily good for in-network services in about 25 covered states. Several states are not on this companies list of in-network locations, which I am looking to travel in during 2021. I am aware that an emergency room type visit would be covered, but what about after they move you out of an emergency room, or some other medical event that would not be an emergency?? To cover that concern and potential large dollar outlay, I am thinking about getting a health insurance accident policy to cover the out of network areas, should something happen and we would need coverage.

I am curious what others that are PRE-Medicare age do about coverage while RV'ing and not in-network areas?

Thanks in advance.
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Old 11-13-2020, 06:59 AM   #2
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I pick an insurance with wide area coverage, such as Blue Cross with their "traveler" program included with most of their plans.
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Old 11-13-2020, 04:47 PM   #3
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Be glad you're not in Ohio. Zero plans with coverage outside of your home area, except for "emergencies" whatever that definition is.

My wife just had to go on ACA so she got a medical-only travel plan for the winter through Allianz.

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Old 11-16-2020, 11:07 AM   #4
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Originally Posted by HolmRVQuest View Post
I am curious what others that are PRE-Medicare age do about coverage while RV'ing and not in-network areas?
Many traveling fulltimers choose to domicile in Florida because Florida Blue offers EPO (not HMO) plans that have access to the Blue Cross nationwide network of providers. That's important to them because they need to have coverage for routine care (non-emergency) while they're traveling.

For people who live in a fixed place (where they receive routine care) and are vacationing away from there, they probably just rely on whatever emergency coverage their health insurance policy provides, if they think about it at all. And I'd be surprised if they go even deeper, like you did, and wonder what happens when the emergency "ends," which to me is a very big deal.

BTW, what ACA plan did you find that has coverage in 25 states? That might actually work for someone if they were planning to be traveling in those states anyway.
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Old 11-16-2020, 11:32 AM   #5
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I pick an insurance with wide area coverage, such as Blue Cross with their "traveler" program included with most of their plans.
Can you provide some details about this? I couldn't find anything about a "traveler" program.

I did find an "Away From Home Care" program that Blue Cross offers, but all that does is allow an HMO member to "transfer" to a different Blue Cross HMO if he will be out of his own HMO's area for more than 90 days. Like a college student who's on his parents' plan and is attending college in another state.

Or maybe you're talking about their BlueCard program, where an HMO member can get non-emergency care while outside the HMO area if he first gets a referral from his primary care physician?
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Old 11-16-2020, 11:43 AM   #6
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Rates are reaching an insane level. The least expensive plan in our state for two people (ages 61 and 82) is over $1700 a month with a $17,000 deductible. We walk the ACA premium support cliff line each year, juggling investment income to keep it under the cutoff. . I truly don't know what working people who make just over 4 times the poverty level ($68,900 for a couple filing joint return) a year are supposed to do. No way they can afford the premiums and pay the deductibles should they actually have a medical crisis. Thankfully we have sufficient financial assets to pay should the worst happen, but should it be a long-term medical event we would be forced to liquidate all our investment into cash equivalents to show minimal income and qualify for subsidies. Dang shame there is a system in place that actually discourages maximizing investment income.
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Old 11-16-2020, 11:53 AM   #7
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Be glad you're not in Ohio. Zero plans with coverage outside of your home area, except for "emergencies" whatever that definition is.

My wife just had to go on ACA so she got a medical-only travel plan for the winter through Allianz.
What Allianz plan did she get? I looked at Allianz's website, and the only medical coverage I could find was for emergencies, which she should already have with her ACA plan.
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Old 11-16-2020, 11:55 AM   #8
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Rates are reaching an insane level. The least expensive plan in our state for two people (ages 61 and 82) is over $1700 a month with a $17,000 deductible. ... Dang shame there is a system in place that actually discourages maximizing investment income.
This has nothing to do with the OP's question. Maybe you could find a more appropriate place to share your thoughts?
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Old 11-16-2020, 03:09 PM   #9
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What Allianz plan did she get? I looked at Allianz's website, and the only medical coverage I could find was for emergencies, which she should already have with her ACA plan.
https://www.allianztravelinsurance.c...cy-medical.htm

The ACA definition of "emergency" only concerned the duration of the "emergency" per the companies we talked to. So if you broke your arm the ER visit is covered but that is when the "emergency" usually ends. Your subsequent orthopod visit to have it set and a cast applied is not considered an "emergency". We talked to HealthMarkets and AON and they both used that example.

The Alianz definition was more broad. It covered illness and injury as well and they currently have lifted the pandemic exclusion for COVID. We called them and worked with an employee. As their exclusions say, it is not intended for regular appointments.

From the emails we exchanged, in no particular order:

Me, about a requirement to show we had commercial carrier tickets, which almost no one does nowadays: "She started the app and we read the PDF of coverage. Page 12 contains this global exclusion. We are driving our own vehicle on this trip, not taking a commercial carrier so there are no ďtravel carrier ticketsĒ."

Him: "You do not have to have travel carrier tickets if you are driving yourself but we would need to see something showing the dates of the trip (rental property start & end dates, etc.). Hope this answers your question but if not Iím glad to call you back. "

Me: "So at the time of any claim, we would be submitting our campground reservation receipts or invoices since thatís all we would have? If so, that will work."

Him: "That is correct. "

Me: "Last questions. This travel plan will cover someone in the USA who is on ACA, right? If so, how does any coordination of benefits work? Iím guessing any ACA coverage would be the primary insurance and the travel insurance would be secondary?"

Him: "Our medical coverage is primary if you need it to be, it can be used as secondary if you choose but if you need it I would probably just come directly to Allianz."

If you're considering it, call them and have them email you the PDF. Then email back an forth with your questions. If nothing else, their answers could get you relief for a denied claim or maybe a premium refund.

HTH,

Ray
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Old 11-16-2020, 10:42 PM   #10
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We have ACA. Forget travelling...for us, OUR OWN COUNTY HOSPITAL is out of network. That's with BCBS. I lost my doctor of 25 years earlier this year when his practice couldn't negotiate a contract, and went out of network.



I've been trying to figure out what to do, but just signed up again for insurance that is basically worthless. If we lived 7 miles away (over the county line), we'd have one of BCBS's best available plans under the ACA (Blue Advantage).


One thing I have have seen referenced several places and Q&A's -- when travelling (or for us, even at our "home" hospital) an ER visit might not be covered as an emergency, if you only THOUGHT it was an emergency, and went out of an abundance of caution. Say you think you are having a heart attack, and are rushed to the ER. Turns out it was heartburn or whatever. Guess what? Not covered.



That Allianz travel insurance sounds interesting, I will give it some research. Especially on further-ranging trips. Most of our trips are shorter and within a 2 or 3 state area, but well outside of our ACA coverage area (about 1/10 of our state).



I am considering going with one of the christian heathcare cost-sharing organizations as a supplemental/backup plan. I probably wouldn't trust them as my sole insurance though (but it might be better than ACA overall).
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Old 11-17-2020, 12:37 AM   #11
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I've been looking over the United Healthcare "Health Protectorguard" fixed indemnity hospital and doctor insurance. It is designed more as a supplement to another plan, like ACA, and pays fixed amounts per doctor visit, test, day in hospital, etc.


I ran some quick numbers, and for my wife and I (mid-50's) a mid-range plan would run 670 a month. Based on our medical visits this year (over 7k out of pocket before hitting deductible), including a couple of ER visits, it would have paid out around 5-6000 bucks so far in 2020.



So, at a total annual cost of 8000, it would (this year) have potentially paid me 6000 direct, and would at least have had something better than the weak ACA emergency-only coverage when traveling (and in my home county).


There are no good, or cheap, options.


(We did attempt in 2018 and 2019 to shop for a regular insurance plan outside of the ACA...prexisting conditions (but nothing major, stuff like HBP) nixed that).
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Old 11-17-2020, 11:35 AM   #12
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Allianz before Covid-19 was a good option but with our travel insurance for trips this year they changed their policies after the fact and we were denied coverage and lost thousands of dollars.



For the next couple of years it is very risky to get sick and need to be admitted to a hospital. Hospitals have always killed thousands of patients each year with medical mistakes (and nosocomial infections) and the out of control coronavirus has made it worse. One out of six patients being hospitalized for Covid-19 are either medical workers or members of their families which shows how out of control the situation is in the USA with our politicians deciding to let God sort it out.



Prior to medicare we always set aside $24,000 to have available for medical emergencies in addition to paying $24,000 for medical insurance. Pre Covid-19 we could also travel to other countries where costs are much lower. I paid 400 Euros to have a procedure done on my hands in Germany as an U.S. citizen. I had the second round of treatments done in California and the bill was over $17,000 and my co-pay was $4,000.



We have universal health care for our politicians and the people working for the military but everyone else is on their own.
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Old 11-17-2020, 01:44 PM   #13
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One out of six patients being hospitalized for Covid-19 are either medical workers or members of their families
Can you give a credible link to this statement?
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Old 11-18-2020, 08:32 AM   #14
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Allianz before Covid-19 was a good option but with our travel insurance for trips this year they changed their policies after the fact and we were denied coverage and lost thousands of dollars.
https://www.allianztravelinsurance.com/covid-19-faq.htm

Am I covered if I need emergency medical care because I become ill with COVID-19 while on my trip?
Travel insurance does not generally cover medical claims due to COVID-19 in most states. However, in response to the public health and travel crisis that is currently occurring, for a temporary period, we are accommodating claims for emergency medical care expenses a customer incurs due to becoming ill with COVID-19 while on their trip.* This accommodation applies to plans currently in effect. Please refer to our Coverage Alert before purchasing another plan.

We urge any customer who has a medical issue while traveling or needs help to call us. We are assisting customers 24/7/365 who wish to change their travel plans, need travel assistance, or would like to file a claim. Our assistance team is ready to help all of our customers who need help while traveling, such as locating medical facilities or rebooking transportation. You can also use our self-service options on this website. We review every claim based on its unique facts and circumstances and are happy to answer any questions you may have.


I obviously have no idea what happened to you but if they denied coverage and now cover it, I'd be calling and asking for coverage.

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Prior to medicare we always set aside $24,000 to have available for medical emergencies in addition to paying $24,000 for medical insurance. Pre Covid-19 we could also travel to other countries where costs are much lower. I paid 400 Euros to have a procedure done on my hands in Germany as an U.S. citizen. I had the second round of treatments done in California and the bill was over $17,000 and my co-pay was $4,000.
Sorry, I'm not following. If you're on Medicare, depending on whether you selected Original Medicare with a good Medigap supplement or a Part C "Medicare Advantage" plan, how did it not cover COVID?

Where would Allianz travel insurance kick in rather than Medicare? Did you select a high-deductible HMO "Medicare Advantage" plan? It kind of sounds like that.

I'm trying to be sure we've covered all of our bases to try and keep something like that from happening. Thanks in advance for anything you can share.

Ray
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