Although enjoying the full-time RVing lifestyle may come with some trying moments, most former and current full-timers I’ve talked to think it’s a blast. My husband and I love everything about it except for one thing: the limited health insurance options for full-time RVers like us who are too young for Medicare. Unfortunately, these options are dwindling as the Affordable Care Act’s open enrollment season kicks off this month.
Last summer, those of us with individual health insurance policies were stunned when major providers like Blue Cross Blue Shield of Texas announced it is dropping all PPO (Preferred Provider Organization) plans for individual policy holders, blaming rising costs of medical care and provisions of the Affordable Care Act. In Texas alone, nearly 400,000 people will be affected, not just full-time RVers.
This is a huge game-changer for younger full-timers because we must rely on PPO plans should we need medical care. With my PPO plan I could see doctors anywhere in the U.S. as long as they were in the company’s network of providers. PPOs always cost more but they were worth it because lower-priced HMO plans require members to get treated in their home state if they want coverage, and force them to have an assigned primary care doctor who acts as the gatekeeper to all medical care. Most importantly, these gatekeepers tend to restrict access to premium and experimental care because HMOs are so focused on cost-savings.
And now sadly, the good old days are over according to insurance brokers like Kyle Henson of RVer Insurance Exchange. “It’s just getting worse for RVers,” he bluntly told me in a recent phone call. This was not what I hoped to hear, but Henson went on to explain that in 2016, HMOs will be the main (if not only) option for full-timers who need health insurance coverage.
For nomads like me, HMOs are our worst nightmare because they require us to be in our home state for treatment. Although these plans will cover a critical care emergency room visit outside a member’s home state, the plans come with huge restrictions.
Think It Can’t Happen to You?
I can’t help but laugh at the irony of this situation because I used to gripe about our high-deductible policy that I never hoped to use—and now I’m yearning for it. After all, it was better than no insurance at all. A while back when I made friends with a younger full-timing couple whose health concerns showed me just how important it is to have good coverage, I vowed to sign up with a better PPO in 2016.
These friends are a perfect example of how beautifully a PPO policy fit into the full-timing lifestyle. They started full-timing in their early 40s and within a few years were hit with several health conditions, including heart surgery and a cancer diagnosis. I won’t disclose their names to protect their privacy but what I can tell you is that they are not unhealthy people. Both are fit, outdoorsy and health-conscious—and they still needed major medical care. Did that stop them? Nope! That’s because during their 17 years on the road their PPO plan gave them access to the best care in the country. From a knee surgery by an acclaimed orthopedic sports doc in Vail, Colorado, to cancer treatment at a leading research institution in Arkansas, their full-time RVing lifestyle and PPO plan enabled them to see the best physicians, take their home on wheels wherever they needed care, and be as comfortable as can be during some tough treatments and recoveries.
After learning about the health challenges my friends experienced, I’m no longer willing to gamble on our health or our finances by enrolling in an insurance plan with a five-digit deductible. I’m done playing around with meager insurance coverage and want to balance a high-deductible HMO plan with better access to care outside my home state. Thankfully Henson explained that for full-timers like me, this is totally doable. Here’s how:
Telemedicine is a dues-based program that bridges the care gap between a minor and major health issue. It gives members Internet, email and phone access to healthcare providers who can possibly provide care, diagnose or prescribe medications for minor health conditions—all without ever having to walk into a waiting room. Telemedicine is especially handy for full-timers like me who prefer camping in remote locations far from any real clinics. I sure could have used it last season when I had to wait five hours to see a doctor in the only low-cost health clinic for 100 miles in any direction. The Telemedicine Program is open to anyone regardless of age, health condition or home state. Rates are as low as $12.95 a month.
Metal Gap Plans
Metal Gap Plans, which are offered through Henson’s company, are a way to bridge the money gap when you have a high-deductible health insurance plan. By paying a specific monthly premium based on your age and zip code, you receive cash payments to help pay your deductible if a covered illness or accident happens. This could come in handy if you need out-of-state care that costs less than your HMO deductible.
The Metal Gap plans have varying levels of cash coverage depending on the nature of the injury or accident. Plan restrictions don’t seem too unreasonable either and you can use your payments for health care or whatever you choose. It’s also a “guaranteed issue” plan, which means you can’t be turned down based on your health history. The major problem I see with the Metal Gap plan is that if you max it out and you require additional, more extensive care through your HMO plan, you’ll still have to meet your deductible.
Riding It Out
As I write this article on September 29, Henson warned me that the only thing we can expect for full-timer’s healthcare coverage in 2016 is that PPO plans will go away and all existing plans will have a rate increase. He also stressed that switching home states is not the answer to avoiding this major change. The health insurance industry is extremely unpredictable right now and nobody knows which direction companies will go in 2016 or beyond. “We just have to ride this train out and see where goes,” he said.
This lifestyle has all sorts of advantages, but unfortunately getting excellent health care wherever you want it is no longer easy. The major thing to remember is that you still need good care and there are ways to get it. As things evolve I’ll be sure to keep you posted in my weekly RVLife.com blog, “The Full-Timing Nomad.”
Rene Agredano is a self-employed freelance writer, jewelry designer and animal advocate. Since 2007 she’s traveled with her husband and three-legged dog while chronicling their full-timing life on the road at LiveWorkDream.com.