FT RVer under-65 2018 Healthcare insurance options

[Stripe34]

My concern with EPO for us as full time RVers is this:
“EPO stands for "Exclusive Provider Organization" plan. As a member of an EPO, you can use the doctors and hospitals within the EPO network, but cannot go outside the network for care. There are no out-of-network benefits.”

[Stripe34]

This might be interesting, from Escapees: “Healthcare for RVers with Theda Moseley
Tuesday, October 24th 10:00am CST ”
Off this page:
https://zoom.us/webinar/register/WN_...Q-Kzr8tXcl-Obg

[TechWriter]

Originally Posted by Stripe34

My concern with EPO for us as full time RVers is this:
“EPO stands for "Exclusive Provider Organization" plan. As a member of an EPO, you can use the doctors and hospitals within the EPO network, but cannot go outside the network for care. There are no out-of-network benefits.”

That's the same for a PPO, too. There is NO provider that pays for every health care doctor or facility. You are always using a network.

[saydiver]

Originally Posted by Stripe34

My concern with EPO for us as full time RVers is this:
“EPO stands for "Exclusive Provider Organization" plan. As a member of an EPO, you can use the doctors and hospitals within the EPO network, but cannot go outside the network for care. There are no out-of-network benefits.”

If you're talking about FL Blue's PPO/EPO plans, they are both an EPO and a PPO and yes both are considered networks. FL Blue's(BCBS) BlueSelect and BlueOptions plans are considered an EPO instate and a PPO when one is traveling out of state. Nowadays how a plan is classified is not as important as it once was. What's important is 1. if the plan offers a nationwide network of providers and hospitals and 2. if the nationwide network coves most of the doctors and hospitals in the US. FL Blue's BlueSelect and Blue Options EPO/PPO plans meet both points. BCBS calls their network the BlueCard program and it covers over 90% of the doctors and hospitals in the US.

FL Blue has their 2018 rates online.

When selecting a plan Blue Options plans have a larger instate EPO network than Blue Select plans. Blue Select plans also have some restrictions on labs, DME and a few other ancillary services.

[TechWriter]

Originally Posted by saydiver

FL Blue has their 2018 rates online.

It looks like premiums have increased about 17% from last year.

[computerguy]

Originally Posted by TechWriter

It looks like premiums have increased about 17% from last year.

Mine is up 21.7% if I keep the same plan.

[saydiver]

Originally Posted by TechWriter

It looks like premiums have increased about 17% from last year.

The further south you go in FL, the higher the rates. DH's rate increase is 20% and FL Blue is our only option in our county.

[Gannet]

We went off COBRA and onto a BCBS FL ACA plan a year ago. Before we did that, I checked doctor availability within the BCBS provider directory at a number of random locations nationwide. It appeared to me that pretty much any doctor or facility that accepted BCBS anywhere in the country was available to us. Second, I compared rates for the zip codes of the primary Florida mail services: Escapees, St. Brendan's Isle, and MyRvMail. We found the lowest rates in the county of MyRVMail, and domiciled there, although the one for St. Brendan's was about the same. We found a new Primary Care physician in Pensacola, so we don't have to go deep into Florida to get our checkups. We got our prescriptions through Walgreens, but were surprised to find that a few states have either no or very few Walgreens. When we get our new scrips next week we'll handle them through Walmart - they are everywhere. We did have to use an Urgent Care facility and an orthopedist in a state far from Florida. The insurance was accepted, but of course the deductible ate our money. We were able to get lab work pretty much anywhere with Quest Diagnostics, and that was covered. All in all, it has all worked ok for us so far. A year and a half until Medicare, which will actually be quite a bit more expensive than our subsidized ACA plan - but then we can shift our domicile out West if we want. YMMV, IANAL, etc.

[saydiver]

Originally Posted by Gannet

We went off COBRA and onto a BCBS FL ACA plan a year ago. We got our prescriptions through Walgreens, but were surprised to find that a few states have either no or very few Walgreens. When we get our new scrips next week we'll handle them through Walmart - they are everywhere. We were able to get lab work pretty much anywhere with Quest Diagnostics, and that was covered.

I'm assuming you have a Blue Select plan since you mentioned Quest Diagnostics for lab work? Are they the Pathology/Labs Exclusive Provider again for 2018?

Prescription Drug coverage is also subject to the Exclusive Provider Provision. I know WalGreens is the Exclusive Provider. Have you checked with FL Blue to see if WalMart is also listed as an Exclusive Provider? If not, I believe your claim will be denied.

[saydiver]

Originally Posted by Gannet

A year and a half until Medicare, which will actually be quite a bit more expensive than our subsidized ACA plan - but then we can shift our domicile out West if we want. YMMV, IANAL, etc.

Florida has some of the highest Medicare supplemental rates in the country. Click on the link to find out what Medicare Supplemental plans are available by county and their rates.

https://apps.fldfs.com/mcws/CWSSearch.aspx

[TechWriter]

Originally Posted by saydiver

Florida has some of the highest Medicare supplemental rates in the country. Click on the link to find out what Medicare Supplemental plans are available by county and their rates.

https://apps.fldfs.com/mcws/CWSSearch.aspx

Excellent link! Got one for SD?

[saydiver]

Originally Posted by TechWriter

Excellent link! Got one for SD?

I briefly looked on SD's Dept of Insurance website, but didn't find anything and then did a search and found the following:

SD DOI - SERFF Premium Rate Review Public Portal

The data is there, but not in an easily searchable database like FL provides and looks like it will take some time to search through all the documents. Clink on Medicare Supplement, then Submission Date twice to get the latest plan documents.

[Stripe34]

Wish there was easily accessible information for the pre-medicare group. It seems very fragmented.

[oatmeal]

Originally Posted by Stripe34

My concern with EPO for us as full time RVers is this:
“EPO stands for "Exclusive Provider Organization" plan. As a member of an EPO, you can use the doctors and hospitals within the EPO network, but cannot go outside the network for care. There are no out-of-network benefits.”

About the "there are no out-of-network benefits" part...

It depends on the policy. Some EPOs do provide out-of-network coverage; the Florida Blue policies I've looked at do. The EPOs that have only a local network and are actually more like an HMO (only without referrals required for specialists) often provide no out-of-network coverage at all.

For example, some Florida counties have Ambetter policies available on the exchange. But look carefully--Ambetter has only the local network, and no out-of-network coverage at all, but just looking at the results in an online search at healthcare.gov, that wouldn't be apparent. So if you have Ambetter and are outside the local network during your travels, it's the same as if you have no health insurance at all, except in the case of an emergency.

If out-of-network coverage is provided (like some Blue Cross policies), it will have a separate deductible, and that deductible will be higher than the in-network deductible. But it will at least be some coverage if you require treatment in an area where there's no in-network provider, or if you inadvertently receive services from an out-of-network provider (like assisting your in-network provider with surgery). What I find appealing about out-of-network coverage is that there's an out-of-pocket limit, which could keep me from racking up bankruptcy-causing medical bills.

Originally Posted by Stripe34

Wish there was easily accessible information for the pre-medicare group. It seems very fragmented.

Actually, the pre-Medicare group that requires a nationwide network for individual health insurance doesn't really need it because there are so few choices, especially if you're on the exchange.

If you're looking for a state where you can get a health insurance policy with a nationwide network, on the exchange, and easily establish residency, then it's Florida. I have yet to see any better option mentioned by anyone; Texas and South Dakota don't work for this group.

If you're currently a resident of a different state, it would be a good idea to investigate insurance in that state to compare it to Florida. Or if you have family members in another state and you could use their address as your residence, so establishing residency in that state wouldn't be a big hassle (but be aware that it might have a provision that requires your actual presence in that state for a certain period of time), check the insurance options in that state. You run the risk of that family deciding to move, of course, but that will vary among people.

Of course there are other considerations in picking a state for your domicile, like a state/city income tax, the cost of vehicle registration, general friendliness to nomads domiciling there, etc. But for someone under 65 who needs individual health insurance, the availability of health insurance should be the first thing you look at, and most people circumstances will limit that to at most a very few states.