No options left for pre-Medicare health insurance in SD for fulltime RVers

[Greg Schoenberg]

Originally Posted by saydiver

A very large percentage of the population doesn't need nationwide coverage. You may need the coverage, but full-timers are a very small segment of the population. Eliminating networks and requiring nationwide coverage for everyone would mean rates would skyrocket for people who don't need that kind of coverage.



Sue

Actually Sue, I do not know of a PPO plan in my states, Oregon and Washington, who do not offer a nationwide network. I suspect the plans in South Dakota are deliberately screening out the full timer population, believing them to be higher than average risk.

Greg

[datrbone8]

Originally Posted by saydiver

A very large percentage of the population doesn't need nationwide coverage. You may need the coverage, but full-timers are a very small segment of the population. Eliminating networks and requiring nationwide coverage for everyone would mean rates would skyrocket for people who don't need that kind of coverage.

Sue

I don't know if that is true. Everyone seems to love Medicare and that is pretty much a nationwide system. It really doesn't make sense that coverage should vary in availability, quality and cost simply due to where one makes their home

[Smitty77]

Originally Posted by Greg Schoenberg

Actually Sue, I do not know of a PPO plan in my states, Oregon and Washington, who do not offer a nationwide network. I suspect the plans in South Dakota are deliberately screening out the full timer population, believing them to be higher than average risk.

Greg

Before I became a Full Timer, I traveled for work quite a bit. Millions of people travel weekly for their jobs. And this is cross state, and sometimes cross countries too.

So, it is more than just us small amount of RV'ers that need solid PPO with extensive networks.

Best to all,
Smitty

[saydiver]

Originally Posted by Smitty77

Before I became a Full Timer, I traveled for work quite a bit. Millions of people travel weekly for their jobs. And this is cross state, and sometimes cross countries too.

So, it is more than just us small amount of RV'ers that need solid PPO with extensive networks.

Best to all,
Smitty

Yes they do, but they're also employed and likely have group health insurance through their employer.

Sue

[saydiver]

Originally Posted by datrbone8

I don't know if that is true. Everyone seems to love Medicare and that is pretty much a nationwide system. It really doesn't make sense that coverage should vary in availability, quality and cost simply due to where one makes their home

Sure it does, because the cost of living differs around the country, so health care costs do too.

Medicare is heavily subsidized. $1200 a year in premiums does not even come close to covering the average medical cost of someone over 65.

Sue

[Barbaraok]

Originally Posted by saydiver

Sure it does, because the cost of living differs around the country, so health care costs do too.

Medicare is heavily subsidized. $1200 a year in premiums does not even come close to covering the average medical cost of someone over 65.

Sue

Sue,

You're forgetting all of the money that we all pay into Medicare while we are working. So not heavily subsidized, more like we pay ahead for care we will all need later.

Nor did you include the 20% deductible that we all pay under Part A and Part B - which is why most also get a supplemental policy to cover those deductibles.

Barb

[saydiver]

Originally Posted by Barbaraok

Sue,

You're forgetting all of the money that we all pay into Medicare while we are working. So not heavily subsidized, more like we pay ahead for care we will all need later.

Nor did you include the 20% deductible that we all pay under Part A and Part B - which is why most also get a supplemental policy to cover those deductibles.

Barb

I didn't forget it...

"One of the biggest misconceptions about Medicare is that it is self-financed by current beneficiaries through premiums and by future beneficiaries through payroll taxes. In fact, payroll taxes and premiums together covered only 52 percent of Medicare's costs in 2013. General federal revenues from U.S. taxpayers made up most of the difference."

See Budget Explainer: Medicare | pgpf.org

Sue

[saydiver]

Originally Posted by Greg Schoenberg

Actually Sue, I do not know of a PPO plan in my states, Oregon and Washington, who do not offer a nationwide network. I suspect the plans in South Dakota are deliberately screening out the full timer population, believing them to be higher than average risk.

Greg

Smitty believes all plans should offer nationwide coverage. I was just pointing out that most people, who need an under 65 individual health insurance policy, probably don't need nationwide coverage, which would cost them more.

South Dakota was screening out full-timers long before ACA. Health insurance was the primary reason we became Texans in 2008.

I agree nationwide coverage is higher than average risk, which is why some states don't offer PPOs or if they do, the plans costs more, as well they should for the higher risk.

Sue

[Davdeb1]

As many of you know, I just looked at many plans for my wife. I only looked at the ppo and pos plans. Many of them said "nationwide coverage but not one said multiple states plans. I methodically checked zip codes for areas I might be. I used zip codes of major metropolitan areas. Not one hit outside my Ohio area. BUT...... at least we can get insurance.
My point is, just get insurance in your home state if you can. Its a crap shoot if you are unlucky enough to need medical attention outside your coverage area. But having a tough time getting insurance in your " chosen" home state tells me, find another one.
Paul and Nina are very intelligent and competent people who are trying to give advice to anyone thinking of using SD as a home state. If you have other insurance from a group or employer, or you are a Vet or have some other plan fine. If you have to buy your own, this is probably not the state for you.

[saydiver]

Originally Posted by Davdeb1

As many of you know, I just looked at many plans for my wife. I only looked at the ppo and pos plans. Many of them said "nationwide coverage but not one said multiple states plans. I methodically checked zip codes for areas I might be. I used zip codes of major metropolitan areas. Not one hit outside my Ohio area. BUT...... at least we can get insurance.
My point is, just get insurance in your home state if you can. Its a crap shoot if you are unlucky enough to need medical attention outside your coverage area. But having a tough time getting insurance in your " chosen" home state tells me, find another one.
Paul and Nina are very intelligent and competent people who are trying to give advice to anyone thinking of using SD as a home state. If you have other insurance from a group or employer, or you are a Vet or have some other plan fine. If you have to buy your own, this is probably not the state for you.

A multi-state plan is for a family with members residing in different states.

Sue

[saydiver]

PS to multi-state plans and a PM.

Yes, a multi-state plan can work for full-timers/snow birds too, but not all multi-state plans are nationwide currently, but will be within the next few years according to the following article:

OPM Multi-State Plan Program Fact Sheet

When I looked at a TX multi-state plan last year it wasn't nationwide, but I haven't checked it out this year to see if all states are included.

Sue

[Smitty77]

Originally Posted by saydiver

Smitty believes all plans should offer nationwide coverage. I was just pointing out that most people, who need an under 65 individual health insurance policy, probably don't need nationwide coverage, which would cost them more.

South Dakota was screening out full-timers long before ACA. Health insurance was the primary reason we became Texans in 2008.

I agree nationwide coverage is higher than average risk, which is why some states don't offer PPOs or if they do, the plans costs more, as well they should for the higher risk.

Sue

My comment about national was more that once ACA started, I felt it should have provided 'national' coverage. IMO, since I can't get a PPO as an RV'er in SD - ACA is not 'national' in it's rules and regulations.

I see and understand your concern that costs could be higher to those who may not need a PPO plan. IMO, that is no difference then some of the other items regulated that must be included as coverage. Many would not choose to pay for some items in an open market, but they have no choice.

It was a start, but many parts are out of balance. For example, the theme of this thread is one 'No options left for pre-Medicare health insurance in SD for full timers'. And that still seems 'out of balance' to my way of thinking.

But we all have our own view, and as seen, any given sentence can be taken and used to argue multiple sides of the topic!

Best to all,
Smitty

[Barbaraok]

I'm not sure I understand why a multi-state plan wouldn't be good if the states involved encompassed places where you would travel part of the year. Are you needing to see physicians/hospitals every month of the year? We see our physicians once a year and every once in a while may need to visit a 'doc in the box' or an emergency room. Most insurance will cover you for emergency treatment if you are traveling on vacation, etc.

Barb

[saydiver]

Some people have non-emergency medical conditions which require them seeing a specialist, rather than a 'dr in a box', more often than once a year, so they may have drs in multiple places. I know we do.

Sue