Getting health insurance is one of the most challenging things you need to set straight before living in an RV full-time. This topic can get very confusing because there are a lot of things you need to know. It can get even more complicated for you if you’re shifting from a desk job with employee insurance benefit to a self-employed full-time RVer. But, worry not because we’ll break things down for you in this post.
How do full-time RVers get health insurance? Full-time RVers can get health insurance through the Health Insurance Marketplace, other private health insurance companies, health care sharing ministries, short-term health insurance, and fixed benefit and indemnity based health insurance.
Simple as these answers may sound, most insurance plans are not very wallet-friendly. So, you need to do serious research if you’re looking for more affordable plans. This is very crucial because insurance policies depend on your state domicile, your income, and your current health condition. Some even go through lengths like hiring an insurance broker to make things easier. However, if you’re here to do it on your own, below are the things you need to know.
Introduction to Health Insurance
Why do RVers need health insurance?
Health insurance basically provides you financial protection for unexpected and, often, expensive medical procedures. Of course, health insurance also covers basic doctor/hospital visits and the corresponding prescription drugs and medical devices you may have to use. This can be very beneficial when you’re on the road and you have to be prepared for any major expense you will have to make.
Before, there was even a penalty for not having health insurance. In 2018, this amounted to $695 per adult or 2.5% of the yearly household income, whichever was higher. For plans starting in 2019, however, this fee no longer applies. Still, you should take note of this because today, there are some states that charge you if you don’t have the required health coverage.
Some Terms You Need to Know
Learning about insurance and the proper plan for you can quickly get messy if you don’t understand the terms. So, let’s get a brief introduction to them before getting into the specifics.
The deductible is the amount you’ll have to pay out of your own wallet before your insurance company covers the remaining balance. So, if you have a $2,200 annual deductible, you’ll have to pay that amount for covered medical services before the insurance kicks in.
The premium is basically your payment for having the insurance coverage. Plans have different options so you can pay for this monthly, quarterly, semi-annually, or even annually.
- Copay (or Copayment)
The copay is the fixed fee you have to pay for when you get covered services like doctor visits and prescription drugs. This can apply alongside the deductible and is usually not counted as part of it. Basically, it’s the amount you’ll have to pay outright when you go see the doctor.
Related to copay, coinsurance is another cost-sharing method that insurance companies follow. This is usually calculated as a percentage of the total bill and can be applied after you’ve paid the deductible. The higher the coinsurance, the bigger your share.
- Out-of-pocket max
Simply, this is the maximum amount of money you have to pay “out of your pocket.” Consequently, this is the sum of the deductible, copay, and coinsurance. Once you reach this total, the insurance company covers the rest of the cost. So, if you have a $20,000 bill, a $5,000 deductible, 20% coinsurance, and an $8,000 out-of-pocket max, you have to pay $5,000 then your 20% share in the remaining balance. You stop paying once the total reaches $8,000!
To sum up this section, different plans can have different cost-sharing options. For example, while some plans use both copays and a deductible plus coinsurance, other companies don’t necessarily follow this structure. In fact, some plans offer services like checkups at no cost at all. Remember that other amounts you pay for like copays, coinsurance, and premiums don’t usually count towards your deductible. Copays, however, may be considered in some plans so keep an eye out for that.
Thus, as an RVer you need to determine which combinations are right for you. For instance, if you’re healthy and won’t be requiring much services, you might want to go with a plan that has a high deductible and low premiums. Otherwise, you might want to go with the opposite, with a low deductible and high premiums. Either way, choose where you can save more.
What is considered when you apply for insurance?
When you apply for insurance, companies look at different things before they give you coverage and when they calculate your premium. The first factor is usually age. Companies expect that younger people generally need fewer services compared to older people. This is why premiums for the latter can go up to 3 times more than the amount for the former.
Next, your location can also play a role. This is because depending on the state you’re in, living conditions like local rules and the cost of commodities can differ. Third, how you take care of your health condition is also a factor. For example, if you’re a tobacco user, you can be charged a higher premium than those who don’t smoke.
Lastly, the type and amount of coverage heavily dictate the premium. The less the coverage, the lower the premium (i.e. high deductible plans). If you’re getting a plan for the whole family, that can also cost a lot more than individual plans.
What is the Affordable Care Act?
I’ll try to keep this part a bit more RVer-friendly. What should you know about the Affordable Care Act (ACA) more popularly known as Obamacare? The ACA actually made way for more accessible insurance plans because of its advocacy to increase access to healthcare. This is actualized through the Health Insurance Marketplace where people can choose from numerous plan options.
Through the ACA, you can also qualify for subsidies which help you pay for your monthly insurance premium. More importantly, the ACA prohibits insurance providers from charging more premium for your pre-existing conditions. This way, ACA-compliant insurance companies cover current health conditions and cannot take advantage of your medical history.
Types of health insurance plans for RVers
Marketplace (ACA) and Non-marketplace (Non-ACA)
As mentioned, you can purchase policies in the Health Insurance Marketplace. Being ACA-compliant, this is commonly where people first look for insurance plans. But, these plans usually don’t have a nationwide network nor are they affordable if you don’t qualify for a subsidy. Also, you can only apply for marketplace plans during their open enrollment period from November 1st to December 15th. More importantly, since they have to abide by ACA’s rules, the plans cover pre-existing conditions.
Non-marketplace insurance plans, on the other hand, are more affordable. They also have more options to purchase plans with nationwide networks. Pre-existing conditions, however, are not covered and there may be some health requirements. Lastly, unlike marketplace policies, you can apply for non-marketplace plans all year round.
HMOs and EPOs
Health Maintenance Organizations (HMOs) and Exclusive Provider Organizations (EPOs) provide for plans that usually don’t allow out-of-network use. This can be very disadvantageous to RVers that don’t plan on staying in one area. So, if your plan is to jump from one state to the next, these types of plans may not be for you.
Simply, all you have to remember is that if you purchase HMO and EPO plans, you won’t get your benefits unless you go to healthcare providers that are in the network. Just imagine being in the middle of nowhere and looking at your list of providers that are miles away. Clearly, this is not a good option for RV-wanderers.
Preferred Provider Organizations (PPOs) plans are more recommended to RVers. This is because they provide healthcare options both in and out of the network. More importantly, when you purchase these plans in some states like Florida, you can avail of a nationwide PPO plan. This is the best type of health insurance policy that an RVer can get.
In other states like Texas, they also have nationwide PPO plan options. However, these plans are not ACA compliant like the ones in Florida. Furthermore, although your benefits might be lower in out-of-network healthcare services, it’s still helpful to have these benefits to lower your expenses. Also, PPOs generally have much wider networks compared to HMOs and EPOs.
How do full-time RVers get health insurance?
Health Insurance Marketplace
How can you buy plans in the Marketplace?
When you enroll for an insurance plan in the Marketplace, one of the things you need to check is if you can qualify for premium tax credits. This basically means that if your income is low, you can correspondingly get lower monthly insurance payments. All of these can be done online when you enter details like your household information for your Marketplace application.
Simply, you are designated according to your income and household size. With these details, you are ranked against the federal poverty level for your category. If your income is between 100% and 400% of this level, you can get the credit. What’s another benefit for an RVer like you who needs to budget is that you have the choice of applying all or some of the premium tax credit to your monthly insurance payment. Thus, if you use less than the amount allocated for the premium tax credit, it can be redeemed as a refundable credit. Such is especially useful when you are filing for taxes.
If you are purchasing plans in the Marketplace, take note that some states have their own “healthcare exchanges.” Thus, the “federal” Marketplace will link to the state-specific exchange where you can get quotes and purchase policies. Some of these states are California, Colorado, and Nevada.
What are the types of plans in the Marketplace?
One of the mandates of the ACA is to designate plans in the Marketplace into “metal” categories. These are described below.
For this plan category, you split the costs by paying 40% while the insurance pays 60%. This plan provides for the lowest amount of monthly premiums. Correspondingly, this means that the deductible is higher. You will have to pay a lot before the insurance kicks in! Thus, this is good for unexpected and major expenses like injuries. You will have to shoulder routine medical procedures but on the brighter side, the premium is low.
The cost-splitting set up for this plan is 30-70. This plan is recommended for those who also qualify for cost-sharing reductions or “extra savings.” Such is also determined during the application period and can only discount your payments if you get the “moderate” or silver plan.
The cost-splitting set up for this plan is 80-20. With high monthly premiums in this plan, you can expect that you have a low deductible. Thus, if you expect to get more healthcare services, this plan is a great match.
The cost-splitting set up for this plan is 90-10. Evidently, this has the highest monthly premium but also the lowest deductible. This plan is perfect if you are getting a lot of medical care and if you can afford the high monthly payments. With the platinum plan, the usual case is that you won’t have to pay for anything else aside from the premium.
Private Health Insurance Companies
As mentioned above, you don’t necessarily have to get plans through the Marketplace. Much like the licensed agent you deal with in ACA-compliant companies, you can also hire an insurance broker to find private health insurance companies for you. If you don’t want to spend for convenience, you can call the companies yourself to get your quotes or look them up online. Usual companies are Blue Cross, Blue Shield, and United Healthcare. Take note, however, that because these plans are not ACA-compliant, you have no premium tax credits or other savings.
Health Care Sharing Ministries
What are health sharing ministries?
Health sharing ministries are faith-based organizations that pool funds to pay for a member’s medical bills. Thus, when you make a claim, members chip in to cover your healthcare. So to speak, this isn’t really an insurance plan where you have to pay a monthly premium. This can then be an affordable alternative.
The disadvantage of health sharing ministries
However, some are discouraged from pursuing this option. This is because these ministries require you to adhere to their faith and attend religious activities regularly. Sometimes, you even have to get a pastor’s signature to qualify. If you go with the Liberty Health Sharing Ministry (which doesn’t have any faith requirement), the downside is it is unlikely that you’ll get your claim when it comes to it.
Short-Term Health Insurance
What is short-term health insurance?
Short-term health insurance is basically getting insurance for a fixed period of time. This is perfect for specific situations. For example, when you are shifting to full-time RV and you don’t have a state domicile yet; or when you are waiting for benefits you can get from the government (i.e. waiting to qualify for a subsidy).
Fixed benefit and Indemnity Based Health Insurance
What is fixed benefit and indemnity based health insurance?
This type of insurance does not cover all types of healthcare services. Basically, with this type of policy, you are paying for a fixed fee for a predetermined list of medical expenses. Thus, this is commonly used as a supplemental option.
Things to consider in choosing a plan
Price, Health Condition, and Coverage
So for a quick recap of the points we’ve taken up so far, here are some things you should take note of when choosing a plan. Of course, the price is always something you have to look into. If you are qualified for subsidies, go to the Marketplace. Otherwise, you might find cheaper options through brokers.
Next, you also have to consider your health condition. Will you be needing constant healthcare services? Following that, what is the most beneficial amount of deductible for you? As mentioned above, there is really a wide range of insurance plans you can choose from. These have different cost-sharing structures as well. So choose, what is best for both your wallet and your health.
Third, you have to consider the coverage of the insurance plan. Thus, taking your state domicile into the equation is a very important detail. This is because, like the states which have their own “Marketplace,” your state dictates the types of insurance you can take. So, although Florida, South Dakota, and Texas may be the best choices taxwise, health insurance options can also be something you can weigh in when you register your state domicile.
Other Steps You Will Take
When purchasing health insurance, you can also consider other measures you will take. This will make your estimates more accurate and give you a clearer picture of the healthcare services you will need. To give you an idea, some RVers actually administer self-testing and other preventative care. This is done through telehealth which is basically having a doctor diagnose you online and even give you prescriptions when the need arises.
Travel to Canada
As a full-time modern nomad, you may have plans to go out of the country like RVing to Canada. One thing you have to note is that not many insurance plans, as you’ve read earlier, offer wide coverage much less international coverage. Thus, U.S, health insurance plans are generally not accepted in Canada. So, you have to purchase a separate travel insurance or have your health savings account ready.
To end, getting health insurance can be a very time-consuming task especially to those who are starting from zero. However, the time you spend picking the right plan can save you thousands of dollars in the future. Thus, be patient, do your research, and live a worry-free life on the road!