Health Insurance Part 1
Choosing your state
Finding affordable health insurance with good coverage can be a big stumbling block to hitting the road. There is no simple answer. There is no way around doing your own research to see which state and policy is right for you. Your search will be compounded by the fact that each state regulates insurance companies so you’ll find great variance in prices, coverage and consumer protections. Costs will vary too, based on factors like your age, type of coverage, state of your health and any preexisting conditions.
Immediate solutions
If you will be losing coverage with your former employer, you have a few options to consider.
- COBRA: You may be eligible for COBRA coverage. You can continue coverage under your current policy for 18-36 months by paying the entire premium, which cannot exceed 102% of the cost of group coverage. Some states mandate continued coverage for a longer period of time. Get information at their Web site or order brochures at 800/998-7582.
- Conversion: Convert your group policy to an individual policy. Some states require health insurance companies to do this without consideration of any preexisting conditions, though the premium may be more expensive or coverage less.
- Medicaid: States provide Medicaid to low-income families who meet income guidelines. Each state sets their own eligibility requirements so it is worth checking into if your income will drop.
- Open enrollment: Check to see if your state has an open enrollment period for HMOs. You must be accepted regardless of preexisting conditions. (Not all states require this.)
Choose your state
One advantage of full-time RVing is that you can choose your domicile, or legal tax home. Health insurance coverage could be an important factor in this selection. Where you have health insurance coverage should be a state where you plan to spend some time each year and you will get your annual checkups. You would return to this state if you have a condition or illness that needs treatment.
You will need an address in this state. One RV couple had been insured in Oregon. When they began full-timing, the company willingly billed them through their mail forwarding service in another state. Several years later, when filing claims for an illness, the company declined coverage, saying the couple no longer had an Oregon address. The couple was able to rectify this but make sure you have an address you can use. On the other hand, Kaiser, an HMO in California and other states, told Sharon, another RVer, that extensive travel was not issue as long as they came back for checkups and treatment. (Emergency treatment is covered in a non-Kaiser facility.)
There are a number of resources that can assist you in comparing states and seeing what is available.
- AARP Web site has a section on health insurance. "Health Insurance Options for Midlife Adults" can be ordered from them or viewed at the Web site. Here you can find some basic information and definition of terms.
- Agency for Healthcare Research and Quality has some excellent articles on choosing a health insurance plan, explains terms and provides questions to ask. See their Web site. Look under Health Plans.
- Georgetown University Web site allows consumers to check laws for each state. Consumer guides for each state may be viewed online or printed out.
- National Committee for Quality Assurance (NCQA) has useful information and accredits and rates health insurance plans by state. You can search by state or zip code for plans, see their rating, and link to that company’s Web site. See their Web site or call 1-888-275-7585.
To obtain coverage rates, many companies use insurance brokers. Choose an independent broker that does not charge any fees except perhaps a small setup fee when you actually select a policy. A broker can save you some leg work by identifying companies that provide coverage as well as allowing you to compare rates.
Universal Health Insurance
Two states now have universal health care coverage: Massachusetts and Vermont. Residents of those states may qualify for their programs.
In Massachusetts, every individual is required to have health insurance. They are working to connect employess who are not covered with affordable plans. Massachusetts also subsidizes health insurance costs if your income does not exceed certain limits: about $29,000 for an individual, $40,000 for a couple and $60,000 for a family of four.
Vermont's approach is different. For uninsured residents, they offer Catamount Health. There is a cap on out-of-pocket expenses.
Check the company
Make sure the company is regulated by your state. An out-of-state company may not be. Some RVers join an association to obtain coverage, but be extra careful taking this route. See the article on association policies before purchasing.
Check the company’s A.M. Best rating. The company should tell you what it is if you ask and the agent probably also has that information. However, doublecheck at the A.M. Best Web site for any updates.
Check with the state insurance regulatory body. Contact information for each state can be found at the Georgetown Web site.
Is the company covered by state insurance laws?
Part 2 of this article will cover evaluating health insurance policies and coverage. Part 3 will provide some ideas and resources for those with no health insurance or for reducing costs before your deductible is met.