Health Insurance on the Road

[johns10]

My wife and I will be full-timing soon but have not yet been able to find appropriate health insurance for her that could be utilized anywhere we might be. Can anyone suggest a carrier that deals with this situation? We are not yet eligible for Soc. Sec. so we need a regular plan. I will be using the V.A., so it's just for her.
Thanks.

[Clay L]

My wife and I will be full-timing soon but have not yet been able to find appropriate health insurance for her that could be utilized anywhere we might be. Can anyone suggest a carrier that deals with this situation? We are not yet eligible for Soc. Sec. so we need a regular plan. I will be using the V.A., so it's just for her.
Thanks.

We started out using BC/BS, but they insist that you are physically in your domicile state for half of the year (at least they do in NH and SD). That was a problem for us since we are full timers.
I now have Medicare but my wife doesn't.
She now uses Assurant Health.
They turned out to be cheaper than BC/BS and don't have the half year requirement.
She has not had any claims yet so can't comment on that.

Their web site is http://www.assuranthealth.com/corp/ah/

[Ned]

Private health insurance is available from many companies, but it isn't cheap.  If you are eligible for any group plans through any organizations, you can keep the cost down somewhat.  Escapees has an affiliated insurance plan that is typical.  As fulltimers, you should join the Escapees if you haven't already.  The insurance is just one of the many benefits that the SKPs offer the fulltimer.

[johns10]

Ned--

Do you use a plan thru Escapees?

[Ned]

We did originally but found a better policy several years ago through the NASE (National Association for the Self Employed).  However, as of this month, we're now both on Medicare.  Check out any organizations you belong to for the availability of group health insurance.

[John From Detroit]

Well, I have a retirement plan (BC/BS) that covers me everywhere I go.

I also have MASA (Medical Air Services Association) to get me home in the event of a disaster.  I can provide referalls if you like but there are eligibility requirements..   Or at least I think they are.  They do not market to "The Public" only to selected segments (IE: They market to members of Thousand Trails) and they only accept so many applications per year.

But unlike many insurance companies they cover 100% of your medical transport costs starting with 9-1-1, and unlike most other programs you call 9-1-1 first.  Many companies want you to call them and they arrange the initial transport.  MASA you can call from the hospital if you wish.  (DO call A.S.A.P. but they recognize that time is... Life insurance payments.  Spend 10 minutes on the phone with some HMO bean counter getting an ambulance that arrives 30 minutes later and you may be dead on arrival.  Spend 1 minute on the phone with 9-1-1 and 2 minutes waiting for the ambulance (One place I camped I could see the ambulance garage from my campsite) and you arrive alive.. .MASA would prefer you arrive alive.

Oh, MASA will also pay a professional driver to drive your rig home,  They pay his wages, Fuel, food and hotel lodging, The only thing they do not pay for is pet food, you have to keep at least a week's worth in the rig for the pets.  They will pay him to FEED the pets though.

[Ron]

When we retired may group policy provided by the company I retired from covered us both and still does cover Sam as she is not yet on Medicare and I am now. 

I second Neds recommendation about joining the Escapees.  I recommend joining Escapees then the FMCA if you have a motorhome.  I do not recommend Good Sam, unless you like junk mail,  or any campground memberships.

FMCA provides many benefits at no additional cost to the membership including medical evacuation.

I recommend checking out the medical plan available through the Escapees.  We have never needed such a plan so I cannot give you any details but it would be a good place to start looking.

[fredethomas]

You mention you have VA.  Does your past military service allow Tricare?  There are several types provided by DOD.

[Jeff]

What plans are available to you are a direct function of your domicile. SD offers three plans, one required being in SD 6 months a year, the second was a PPO with no out of network benefits, and the third was Assurant whom we are covered by.

Our problem with Assurant was that they put a 1-2 year pre-existing condition on every symptom Sue and I had seen a doctor about in the past year or two.

[Wendy]

Ned, do you have supplemental insurance to the Medicare? I've got Medicare but am also on Mike's GEHA. Anything Medicare doesn't cover, GEHA does. I've thought often about switching Mike's plan to single rather than family and taking my chances with just Medicare.

Wendy

[Ned]

Wendy, we're on a Medicare Advantage plan, so no need for the supplement.  The downside is our provider is in Phoenix, so there could be logistics problems if we need treatment when not in that area.

[Clay L]

Ned, do you have supplemental insurance to the Medicare? I've got Medicare but am also on Mike's GEHA. Anything Medicare doesn't cover, GEHA does. I've thought often about switching Mike's plan to single rather than family and taking my chances with just Medicare.

Wendy

Wendy, if you get off the family plan I would reccomend a supplement. It's amazing how much Medicare doesn't cover.
You may already know about this - the Medicare web site has a link to a site that has info on available insurance companies in each state along with costs.

[Pierat]

Have you checked out AARP plans? I haven't used them, but heard some good things.

[ArdraF]

I've thought often about switching Mike's plan to single rather than family and taking my chances with just Medicare.

Wendy,

I agree with Clay.  I wouldn't do that if I were you.  You really need to have a Medicare supplement because what Medicare pays to providers is pitiful.  Example:  My last regular doctor visit was billed at $140, of which Medicare approved only $92.23.  Of that amount Medicare paid $73.78 and AARP paid $18.45.  If I didn't have the supplement I would have had to pay the other $18.45.  With a major illness or accident, that could be disastrous!  Remember my broken elbow up in Eugene?  That was about $11,000, including three surgeries and the physical therapy.  Medicare and Blue Cross paid it all.  And my broken wrist was around $3,000, including one surgery and physical therapy.  So you don't want to be caught short for the unexpected big things.

Our supplement is now AARP Health Care Options.  We had Blue Cross/Blue Shield until last year when most of our local provideers got so fed up with them that they decided to no longer accept BC/BS.  Whatever you do, avoid those HMOs that have a limited network because they may not cover you if you're out of your home area (only specified local doctors are in their network).  We originally went with Blue Cross because of our traveling and, perhaps most important, knowing we could go to any doctor anywhere in the country if we ever need a specialist.  You can't do that with HMOs.  So far we're happy with AARP and know we'll be covered anywhere.

By the way, when we lived in Calfornia we had the Kaiser Foundation HMO which took good care of us for many years, including a couple of times when we were out of the country and needed emergency care.  Kaiser is the only decent HMO in my opinion because it is the ONLY one in which the doctors make the decisions as to what care the patient needs.  All the other HMOs have the bean counters making medical care decisions and I wouldn't give you a plug nickle for any of them.

ArdraF

[Wendy]

I probably wouldn't give up Mike's GEHA family plan unless I found something that would supplement my Medicare for less money. And it sure is nice that I never pay anything for medical (Medicare pays primary, GEHA pays any leftovers). It's just irritating to pay the "family plan" rate when there's only 2 of us. I think I'll get a quote from AARP for Medicare supplement for me and see if it saves any money.

$11,000 for your elbow? Ouch (in more ways than one). I'll be sure to try not to fall out the motorhome door.

Wendy

[Clay L]

Have you checked out AARP plans? I haven't used them, but heard some good things.

That is who I have and so far it has been great.

For example; I often caught myself trying to fall asleep while driving. My wife said I snored and quit breathing for long periods at night, so I went to our family doctor. He prescribed a night with an oxygen monitor and based on the results referred me to  a specialist in sleep disorders. That doc prescribed an overnight sleep study and based on that, prescribed a CPAP machine for me.

The total cost was something over $3500 as I recall and my out of pocket expense was zero.

PS. The result? No more snoring and no more naps while driving or during the day on the couch.

[Marsha/CA]

Tim and I don't qualify for medicare just yet and we don't have coverage from his prior employers so.....we pay our own premiums and have BC/BS.  We chose the PPO plan so that we would have coverage all over the US and could choose our doctors.  When we went to CAnada last year, I called and they sent a special ID card showing we had coverage.  It costs us a real pretty penny for our coverage.  We also have a $5K deductable.  We've set it up so that we pay for the little things and the big things are covered in order to keep our costs down. 

I tell ya what was such an eye opener.  We would go in for something small like a doctor's visit.   The bill would be $100.00.  The doctor would submit  the charge to BC/BS.  BC/BS "contracted amount" for the service was $40.00, so that is the amount we would be responsible for.  The poor soul who didn't have any insurance would be paying the full $100.00. 

Something is sure out of whack when it comes to insurance.

Marsha~

Marsha~

[Ned]

We saw that all the time with our medical insurance.  Our final amount for some charges would often be half or less than the billed amount and almost always was significantly less.  Although it didn't come close to the premiums, the insurance did save us a lot of money on our out of pocket expenses.  As in your case, we treated it as catastrophic insurance with a large deductible.

[KodiakRV]

...We would go in for something small like a doctor's visit.   The bill would be $100.00.  The doctor would submit  the charge to BC/BS.  BC/BS "contracted amount" for the service was $40.00, so that is the amount we would be responsible for.  ...

I think that is typical nowadays.  I suspect it enables the doctor to have a big tax write-off against uncollected expenses...

[Ned]

A write off against unrealized income doesn't save any taxes.  No income, no tax, and no savings.

[KodiakRV]

A write off against unrealized income doesn't save any taxes.  No income, no tax, and no savings.

Wouldn't it be considered a business loss?

[Ned]

You can't deduct as a loss money you never received.  If it was billed and accounted for as income, then the adjustment could be taken against the booked income, but I doubt that they do accounting that way in a medical office, but rather book the adjusted amount.  In any case, tax is only paid on the amount realized so there is no tax advantage to be had.

[Jeff]

We have been with Assurant for two months and have not incurred any medical expense. With our previous insurer who worked through the Beech Street Network all claims went to Beech Street and they negotiated the lower charge and then we paid our share of the charge, deductibles, etc as Ned described.

Does anyone have Assurant and do they work in the same way since they are not a PPO? The agent we have in Sioux Falls says to just save the receipts until we reach our high deductible and then submit them all? As I think about it i was going to wait until we incurred an expense and then call Assurant but I am going to call Monday.

[Marsha/CA]

Jeff,

I don't know anything about Assurant.  But BC/BS informed us right at the onset to present our card for all services and to wait and pay the bill after the medical provider and insurance company were involved.  That way, we get the lower contracted price and they have a record of eveything that is going on.  We keep records, but it's nict to know that BC/BS has the info also.

Marsha~

[Ned]

If you have to submit your receipts after you've paid for the services, you aren't getting the benefit of any network discounts and will be paying full price up to your deductible.  If you don't reach your deductible in a year (we never came close) then you'll be paying a lot more than you should.

[Jeff]

If you have to submit your receipts after you've paid for the services, you aren't getting the benefit of any network discounts and will be paying full price up to your deductible.  If you don't reach your deductible in a year (we never came close) then you'll be paying a lot more than you should.

Marsha and Ned:

I realize the procedure that was why I asked if anyone had Assurant. I will check with them tomorrow if I don't get distracted with ferries, glaciers, etc.

[ArdraF]

$11,000 for your elbow? Ouch (in more ways than one). I'll be sure to try not to fall out the motorhome door.

Wendy, the $11K was when I fell off the ladder cleaning the outside of the MH.  The elbow was complex.  First surgery to repair and put in titanium plate with 8 titanium screws.  Second surgery to clean scar tissue out of the ulna canal and shave off "funny bone" so I could bend my arm.  Third surgery was to remove plate and screws so I could further bend my arm for complete recovery.  Moral of the story is don't break ANYTHING! 

For those who are not yet on Medicare, here's what you're in for when you reach Medicare age.  With most Medicare-supplement plans including our old BC/BS and our current AARP the procedure is that we present all our cards to the medical provider.  The provider then bills Medicare who sends both us and the provider the paperwork showing what is allowed and paid.  The provider then submits a bill for the balance to the supplemental carrier and they send us both paperwork showing what they paid.  In theory, we won't owe anything unless Medicare disallows a procedure.  If Medicare disallows a payment then the supplemental also disallows it.  Sometimes we get a bill from the medical provider, but we never pay it until we get paperwork from both Medicare and AARP because getting a refund is harder than waiting.  It's usually been paid by the time we call the provider anyway.  There's a huge amount of paperwork involved and it can get pretty ridiculous.  My paperwork file from the elbow is about an inch thick.  And people wonder why health care costs so much!

Speaking of the elbow reminds me of something else.  The RV insurance paid the first $5,000 because it happened while I was working on the motorhome.  After it was all over with and we saw how much it cost we upped our RV insurance medical portion to the maximum.  We had no clue the RV insurance would pay any of it until we were at the hospital and they asked how my accident happened.  As soon as we mentioned the RV the lady said they would be the first to pay and BC/BS would be second (I wasn't yet on Medicare).  The RV insurance paid the first $5,000 without any hassle at all, so make sure your vehicle medical coverage is at the maximum. 

ArdraF

[Wendy]

With most Medicare-supplement plans including our old BC/BS and our current AARP the procedure is that we present all our cards to the medical provider.  The provider then bills Medicare who sends both us and the provider the paperwork showing what is allowed and paid.  The provider then submits a bill for the balance to the supplemental carrier and they send us both paperwork showing what they paid.  In theory, we won't owe anything unless Medicare disallows a procedure.  If Medicare disallows a payment then the supplemental also disallows it. 

Sometimes this works the opposite way....paperwork goes to the other insurance carrier first, then to Medicare. Depends on who's considered the "primary" carrier. And that can depend on whether or not your spouse is employed or retired. As Ardra says, don't pay anything until you get all the paperwork from all the carriers. When Mike retired, Medicare and GEHA spent 6 months arguing over who was primary for me. They both ended up paying their portion eventually but I hate to think what I would have had to do to collect from either one if I had paid the doctors up-front. Also, don't take "no" for an answer....keep arguing with them. Sometimes it works, sometimes it doesn't, but it's worth a try.

Wendy

[Alaskansnowbirds]

Wendy,

You've mentioned in the past that you are ex-military. Can you get any coverage through them?

[Wendy]

Wendy,

You've mentioned in the past that you are ex-military. Can you get any coverage through them?

Just the things any veteran can get at the local VA clinic/hospital. I was medically discharged but it was a hereditary eye disease so I don't get any special benefits.

Mike, on the other hand, has a service connected disability so he gets preferential treatment at the VA clinics.

Can't complain, I retired at age 25 and I do get social security disability. And, hey, Oklahoma and Arkansas give half-off camping at state parks if you're 100% disabled.

Wendy
Lake Eufala State Park, Oklahoma