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Old 04-18-2022, 05:03 PM   #43
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BC Buck, you mentioned EPOs a couple of times, and I can't tell if you're automatically disqualifying them or not, and are looking only for PPOs. However, the Florida Blue plans that many fulltimers use are EPOs, not PPOs. And they do provide out-of-network coverage (separate deductible, etc., but it exists, while many policies these days don't provide any out-of-network coverage at all (which is kind of scary to me)).

As for a nationwide network, here's the Summary of Benefits and Coverage for a Florida Blue plan that's available on the Obamacare Exchange:
http://www.bcbsfl.com/DocumentLibrary/SBC/2022/1419.pdf

Notice that it says "PPO/EPO" up in the right corner, but on the list of plans on the Exchange website, the only choices in Florida are EPO and HMO. I have no idea why it's called an EPO in one place and a "PPO/EPO" in another.

But I'd say that in looking for a policy, the thing to always avoid is an HMO, and if it's an EPO or PPO, investigate further.

Notice that in the Summary of Benefits and Coverage I linked to, there's no mention of a nationwide network. So how do you know it provides access to Blue Cross's nationwide network?

The sure-fire way is to look at the lower right corner of a Florida Blue member's card: if there's a logo that is a suitcase with "PPO" in it, that signifies that the plan is part of the "Blue Card" program, which is another term for the Blue Cross's nationwide network.

But you get the card only after you sign up for the plan. Before that point, the way I was tipped off that there's access to a nationwide network was by reading reports from people on forums like this that they've used their Florida Blue EPO plan all over the country, using providers in the BCBS nationwide network.

That's one reason using Florida Blue is a solid idea--it's a known thing. For any other state, I'd want to see something in the plan documents verifying that it provides access to the Blue Card nationwide network for routine care--not just emergency or maybe urgent care.

But be aware that Florida Blue offers Blue Select plans and Blue Options plans. From reading everything I can find, I have gathered that the Blue Select plans have a smaller network in Florida than Blue Options plans. If you're planning to spend time in Florida, it might be wise to get a Blue Options plan, to be sure you have access to Blue Cross's larger network in Florida. If you're not going to be spending time in Florida and really just want access to the Blue Card nationwide network, Blue Select will operate just like Blue Options in that respect, although there might be some issues with payment for lab fees with Blue Select plans that aren't there with Blue Options plans. I haven't been able to figure that one out completely. And Blue Select plans are cheaper than Blue Options plans, so there has to be some sort of difference between them.

And one other thing I'll point out is about using the Escapees Florida domicile. Most of the other mail-forwarding companies (and maybe even all of them) receive your mail at their location in Florida and hold it there for you until you ask for it to be forwarded. Escapees doesn't do that.

Instead, the Florida address their customers use is just a mail drop (I guess you'd call it), and all mail that arrives there is sent to the Escapees location in Texas, and when it arrives at their location in Texas, that's when it's processed for the individual customers, and held there until the customer asks for it to be forwarded.

The customer pays a per-piece fee for each item that is received at the Florida address, which is why they tell you to use it only for official documents that require a Florida address, like driver's license, vehicle registration, etc. As far as I know, your mail is never separated from all the rest of the mail while it is in Florida--that happens only once it arrives in Texas and joins all the other mail that is sent by individual senders to people who use the Texas address.

I've always been a little squeamish about using an address in Florida only for things that require a Florida address, while having to have a Texas address where my mail actually ends up, and is the only place it can be forwarded to me from. As far as I know, this arrangement has never caused a problem, and I'm sure people will say they've never had an issue with it.

But there are many Florida mail forwarders who do everything in Florida, which to me makes for a cleaner domicile; you have only one address, and it's in Florida.
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Old 04-18-2022, 05:23 PM   #44
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Aetna and United Healthcare have PPOs that are nationwide or nearly so. Blue Cross/Blue Shield (aka Anthem) too. It's been quite awhile since I turned 65 so not sure of who has that sort of non-Medicare policy these days, but my Aetna Medicare Advantage plan has something like 20,000 doctors "in network".

Exactly this. Stay away from EPO and find a good PPO or HMO that will cover you out of network. Aetna and Blue Cross/Blue Shield are both reputable companies that will provide a broad range of coverage. It isn't cheap, but no plan will be. Good luck in your search.
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Old 04-18-2022, 05:43 PM   #45
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I've always been a little squeamish about using an address in Florida only for things that require a Florida address, while having to have a Texas address where my mail actually ends up, and is the only place it can be forwarded to me from. As far as I know, this arrangement has never caused a problem, and I'm sure people will say they've never had an issue with it.

But there are many Florida mail forwarders who do everything in Florida, which to me makes for a cleaner domicile; you have only one address, and it's in Florida.
You can be sure that lawyers have cleared the way for Escapees. They definitely do things legally.
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Old 04-19-2022, 05:33 PM   #46
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It's been quite awhile since I turned 65 so not sure of who has that sort of non-Medicare policy these days, but my Aetna Medicare Advantage plan has something like 20,000 doctors "in network".
This is not a Medicare discussion (although for some reason people always insist on bringing Medicare into pleas for help with obtaining appropriate health insurance on the individual market). But since you brought it up, I'll point out that Medicare Advantage plans are generally not recommended for traveling fulltimers because of their local-only networks. There are exceptions, but the general wisdom is that Medicare beneficiaries who travel fulltime should avoid Medicare Advantage plans, and go with what people know will work, based on experience--original Medicare, possibly with a supplement.

As for having 20,000 doctors in your network, there are over 1,000,000 doctors in the United States; your doctors represent 2% of that population. Presumably the vast majority of your 20,000 doctors are in your Medicare Advantage plan's local coverage area, leaving very few, if any, scattered around the country.

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Stay away from EPO and find a good PPO or HMO that will cover you out of network.
This is terrible advice.

If a person takes it, when he's looking for policies on the Exchange, he won't even look at the Florida Blue EPOs, which are the gold standard for traveling fulltimers because many people have reported successfully using them for routine care all over the country, and if you carefully read the actual policy, you'll see how and why it works.

I've never heard of any HMO that is successfully used by a traveling fulltimer for routine care all over the country. As for PPO plans on the Exchange website, if you dig a little deeper, you'll find that they are likely to have only a local network, which is unsuitable for a traveling fulltimer.

It's easy to say, "Aetna [or whoever] is known for having a big network--get a plan from them." But saying that without any specifics doesn't really help.

For one thing, employer-provided plans are different from plans that individuals like the OP can get. And even among ACA plans that are available to individuals, they vary greatly depending on the state, and even the county within a state, and definitely among insurance companies.

With all due respect, if you haven't actually searched for an ACA plan that's suitable for a traveling fulltimer, you have no idea what it's like. The bottom line is that there is a very limited number of ACA plans that will provide the coverage a traveling fulltimer wants, and they are available in only a very limited number of states. Fulltimers in other states simply have no options for a plan that will cover them all over the country, which people who haven't "been there and done that" seem to refuse to believe, but it's true.
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Old 04-19-2022, 05:52 PM   #47
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This is not a Medicare discussion (although for some reason people always insist on bringing Medicare into pleas for help with obtaining appropriate health insurance on the individual market). But since you brought it up, I'll point out that Medicare Advantage plans are generally not recommended for traveling fulltimers because of their local-only networks. There are exceptions, but the general wisdom is that Medicare beneficiaries who travel fulltime should avoid Medicare Advantage plans, and go with what people know will work, based on experience--original Medicare, possibly with a supplement.

As for having 20,000 doctors in your network, there are over 1,000,000 doctors in the United States; your doctors represent 2% of that population. Presumably the vast majority of your 20,000 doctors are in your Medicare Advantage plan's local coverage area, leaving very few, if any, scattered around the country.

This is terrible advice.

If a person takes it, when he's looking for policies on the Exchange, he won't even look at the Florida Blue EPOs, which are the gold standard for traveling fulltimers because many people have reported successfully using them for routine care all over the country, and if you carefully read the actual policy, you'll see how and why it works.

I've never heard of any HMO that is successfully used by a traveling fulltimer for routine care all over the country. As for PPO plans on the Exchange website, if you dig a little deeper, you'll find that they are likely to have only a local network, which is unsuitable for a traveling fulltimer.

It's easy to say, "Aetna [or whoever] is known for having a big network--get a plan from them." But saying that without any specifics doesn't really help.

For one thing, employer-provided plans are different from plans that individuals like the OP can get. And even among ACA plans that are available to individuals, they vary greatly depending on the state, and even the county within a state, and definitely among insurance companies.

With all due respect, if you haven't actually searched for an ACA plan that's suitable for a traveling fulltimer, you have no idea what it's like. The bottom line is that there is a very limited number of ACA plans that will provide the coverage a traveling fulltimer wants, and they are available in only a very limited number of states. Fulltimers in other states simply have no options for a plan that will cover them all over the country, which people who haven't "been there and done that" seem to refuse to believe, but it's true.
Yeah, we use an HMO with nationwide, out of network coverage. We can go anywhere when we’re outside our normal coverage area and we’re covered. You may have your acronyms mixed up. An EPO is an exclusive provider organization, meaning you must get care from someone the EPO has negotiated an agreement with, or they won’t cover it. No provider in your area? Tough luck. You’ll be out of pocket. You might also be thinking of the Florida Blue PPO/EPO. That’s different. You can go out of network with these plans, but the cost is higher. Health insurance is hard and it can be confusing. Read the entire offering before making a choice. Make sure it has the coverage you need in the locations you plan to be. We’ve been lucky, but it takes research into each plan and you’ll need to check and recheck your coverage as you change how you’ll be using it.
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Old 04-20-2022, 12:25 PM   #48
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Yeah, we use an HMO with nationwide, out of network coverage. We can go anywhere when we’re outside our normal coverage area and we’re covered.
Having an HMO that covers non-emergency care outside the HMO's local network is exceedingly rare, because the whole purpose of an HMO is to spend less money by managing enrollees' care. But your HMO seems to be the opposite of that.

And it sounds even than a PPO plan, because as extensive as Blue Cross's nationwide network is, it doesn't include every provider in the United States. But your insurance will cover you no matter who you see and no matter where it is. This would be the holy grail for fulltimers. Even fulltimers who have original Medicare are limited to doctors who accept Medicare patients.

What company and plan do you have, and where is the HMO based? Is it available on the Exchange?
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Old 04-28-2022, 08:41 PM   #49
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Yeah, we use an HMO with nationwide, out of network coverage. We can go anywhere when we’re outside our normal coverage area and we’re covered.
I think maybe you didn't see my previous post.

What company and plan do you have, and where is the HMO based? Is it available on the Exchange?
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Old 04-30-2022, 07:02 AM   #50
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Find a better health insurance broker. Can't stay with your employer's through Cobra?

Cobra is expensive. Brokers make more money by upselling policies.

ACA is probably the best bet.
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Old 04-30-2022, 10:53 PM   #51
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ACA is probably the best bet.
Not if there are no policies on the ACA Exchange that offer a nationwide network for non-emergency care.

I wish dizcom would come back with details on the HMO that covers people nationwide. That would be great for traveling fulltimers--the lower premium that HMO policies usually have, but without being limited to a local network for non-emergency care.
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Old 05-01-2022, 03:19 AM   #52
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I agree with the others who have recommended Medishare. As has been pointed out Medishare is technically not insurance. It is a bill sharing system. When the Affordable Care Act was being debated attempts were made to ban health sharing ministries but in order to get the votes necessary to pass the ACA an exclusion favoring the ministries had to be made. Now, because health sharing is so much cheaper, sometimes 1/3 the cost of ACA insurance, people are flocking to Medishare.

Advocates of ACA insurance will point out that Medishare limits coverage for preexisting conditions. That is true and if you have a preexisting condition it's not for you. They also remind us that Medishare is under no contractual obligation to pay your bills. That is also true. They work on the honor system instead. But I have never heard of any incident where they didn't pay a legitimate medical bill that the member himself wound up paying.
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Old 05-01-2022, 01:26 PM   #53
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Now, because health sharing is so much cheaper, sometimes 1/3 the cost of ACA insurance, people are flocking to Medishare.
And as we all know, if it's cheap, it has to be good.
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Old 05-01-2022, 02:37 PM   #54
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Need independent health insurance.

Not maybe as good , but more affordable up front. Much more affordable. It’s got my DW through the past 5 years. I we actually would have been better off with no insurance as she’s healthy and only annual visits and cheap rxes But one catastrophe is all it takes and it provided “some” comfort that if bad things happen we might get through it. It paid on the things as they said. Maybe months later but it did pay.
Every year we looked to got real insurance quotes….. 1500 plus a month with at least a 5 grand deductible before they paid a dime. The lowest coverage was almost 1 grand with a 10 grand deduct. Gotta do what whatever suits your risk/ $ position. I don’t envy those pre Medicare retirees without coverage that make “good” money. They end up spending it all on healthcare insurance !
The key would be to retire on “mattress” savings until Medicare. Then take the max ACA government subsidy for “free” healthcare as being “ poor” with little “income”. ( mattress money doesn’t count .. only income!) . That might be a good strategy.. who knows.
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Old 05-01-2022, 05:03 PM   #55
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And as we all know, if it's cheap, it has to be good.
It's cheap because all the members pay into it, not like the ACA. Also they have limits on preexisting conditions.

As to whether it's good or not they will pay any legitimate bill anywhere in the country. What could be wrong with that?
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Old 05-01-2022, 06:51 PM   #56
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It's cheap because all the members pay into it, not like the ACA. Also they have limits on preexisting conditions.

As to whether it's good or not they will pay any legitimate bill anywhere in the country. What could be wrong with that?
There was a post earlier that they are a year in arrears in reimbursements. That, to me is a red flag warning of serious financial problems. Seeing that a serious medical event easily runs multiple hundreds of thousands that is a risk I couldn’t afford to take.
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