With Covid behind us, we started a new search for decent full-time RVers health care. Sadly, we came up with nothing.
The Sorry State of Full-time RVers Health Care Coverage Options
Full-timing is a hot RV trend right now. Too bad health care options for full-time RVers isn’t. I mean who wants to think about premiums and plans when your heart is bursting with wanderlust? If you did, you may not even want to hit the road. I’m not even sure I would right now. Here’s why:
Over the years of being on the road, I’ve watched heath insurance plan selections whittle away:
- Preferred Provider Plans (PPOs) used to give national coverage. But they’re almost impossible to find today. According to Slate, PPOs are disappearing because consumers want cheap rates. Health insurance companies responded, and nixed pricier PPO plans.
- Health Maintenance Organizations (HMOs) are the main form of coverage for most Americans. These plans are cheap, and sometimes subsidized thanks to the Affordable Care Act. But they restrict you from getting care across state lines. So do Exclusive Provider Plans (EPOs). Neither type of plan will cover you for anything but an “emergency” if you happen to be out of your home state. Guess who gets to define “emergency”? Yep, the company. Ah, the spirit of capitalism is alive and well in health care, isn’t it?
- Florida is the only state with PPO plans. If you’re a resident, you can get national but pricey coverage through Blue Cross.
Recently, Escapees held a helpful discussion about Healthcare Options for Pre-Medicare RVers. I was surprised they could fill an hour with information that lead to my conclusion: there are no good full-time RVers health insurance options for anyone under 65. It’s still worth a watch so you understand the terminology:
Making the Most of a Bare Bones Health “Plan”
When Jim and I got Covid, I was terrified it would send us to the hospital. We didn’t need to go, thankfully. If we did, our plan would not cover us because we are not currently in our domicile state of Texas.
While we were sick, we used our Dial Care plan (formerly known as Teladoc). We made two calls at two different times, and two MDs coached us through Covid symptoms. Their suggestions prevented an expensive urgent care clinic visit that would have provided the same information at about 100 times the cost of our $15 monthly plan.
And thank dog we didn’t need to use our MASA Assist pre-paid life flight plan.
I recently dug around to find a better health insurance plan, and quickly learned that it doesn’t exist.
There are No Good Options for Young Full-time RVers Health Care
This problem is so much more than a ‘cost-of-lifestyle’ drawback.
Whether you are full-timing or rooted, almost every legitimate health insurance plan offered to Americans, employed or self-employed, requires the policy holder to be in-state and in their provider network to receive care–unless you happen to be in a situation that meets the company’s definition of “emergency.” If you are, you’ll be lucky to get one night in the ER and a few tests covered. The rest is up to you and your bank account.
Short-term and “limited indemnity” health insurance policies are not real health coverage.
Meanwhile many health insurance brokers are selling what appears to be health plans on various websites targeted to RVers. But what I’ve learned is their products amount to glorified payday lending loans. Members pay a monthly premium to companies with slick brochures that hide the essence of their plans: limited reimbursement-based coverage with low payment thresholds and annual/lifetime caps.
Stay away from these so-called “plans.” They are unregulated, deceptive, expensive, and rarely live up to their promise. Just read the 2020 Brookings Report, “Fixed indemnity health coverage is a problematic form of “junk insurance.” Or read the dozens of reviews on websites like ConsumerReport.com or Yelp reviews.
Progressive states like Washington, Vermont, Massachusetts and California (states that have their own highly successful health care marketplace exchanges) do not allow these “plans” to be sold to their residents. That should tell you something.
What about health sharing ministries?
Another unregulated health “plan,” HSMs are even more ambiguous and scammy than short-term and indemnity plans. While waving the banner of religious freedom, these plans look as shiny as the greedy glint in a TV preacher’s eye. But dig down and you’ll see they can pick and choose who, what, and how they cover health claims, leaving many members out in the cold when they need to rely on it for a hospital bill.
Many of these entities mimic the marketing, structure and language of ACA-compliant health insurance plans — but offer none of the protections, said JoAnn Volk and Justin Giovannelli, researchers at the Georgetown University Center on Health Insurance Reforms.. see “‘Sham’ Sharing Ministries Test Faith Of Patients And Insurance Regulators”
The reality is, few if any Americans are covered by their health insurance plans once they cross state lines. Unless you want to change your residency to Florida (we do not), there are no good health care plan options for RVers who are not Medicare age.
From Cost-of-Lifestyle to Costing Us Our Lifestyle, It’s Time for a Change
Some day soon, Jim and I will gather the courage to get our annual check-ups and access preventive care on the road. Meanwhile, we need to do something now to avoid a medical bankruptcy.
Some have asked, “Why not just move to Florida?” Well, for one, we just don’t feel like making the trek to a place we aren’t particularly fond of. But the main reason is because there is nothing stopping Blue Cross from ending PPOs in that state too. Texas had PPO plans through Blue Cross when became residents in 2009. It’s only a matter of time before PPOs end in Florida too.
We are making plans to switch our domicile to a state that’s closer to our usual RVing routes along the West Coast or in the Rockies–just in case we encounter a need for ongoing medical care. Oregon and Colorado are at the top of our list, followed by Washington and then California.
As I mentioned in my last post, changing domicile is causing a huge inconvenience and upheaval in our traveling life. But we know this is the smart thing to do in an age where medical bills cause over 500,000 Americans to file bankruptcy each year. In the wealthiest nation on earth, this should not be happening. Something needs to change.
If you’re new to full-time RVing, I hate to burst your bubble with this depressing news. Full-time RVers health care plans are not a fun topic. But the longer you’re on the road, the more you age, the greater chance you’re going to need real health care coverage. How you’ll get that medical care and not go broke is something to consider before you’re headed down the point of no return in a health care calamity.
13 thoughts on “Full-time RVers Health Care Options are a Sick Joke”
Not surprising abt Kaiser-it’s a US empire corporation; hence, hustlers and hucksters. Profiteering off of the sick and infirm.
👉do not allow these “plans” to be sold to their residents👈
What do you mean by this comment?
They offer it, but that’s it…you can’t buy it?
If you are a resident of any of the states that ban those “plans”, the company cannot legally sell one to you.
Rene, thats exactly why I don’t bother with eating kale!
But on a more serious note I have to say, unlike Maya’s experience with Kaiser, mine has been excellent. I was born into the Kaiser system and believe they have vastly improved their general standard of care over the years. That is not to say they are without issues, they are not. In some cases they had to be sued to improve and their mental health care is still woefully lacking. But what large health care system is perfect? I think with any health care system you have to be a strong advocate for yourself by educating yourself and being persistent in demanding the care you need. I have complex medical issues and, with my current health care team of specialists, feel I am very well taken care of. I did have to be proactive in choosing my doctors, if I am not happy with one I fire them. My mom and dad were also with Kaiser and, although sometimes we had to fight for it, always received excellent care as well. I have definitely heard the horror stories though, and I am so sorry Maya, that you and your family all had bad experiences with Kaiser! But I am sure one can hear the same kinds of stories with any health care provider.
Thanks, Codie Rae. I was born into Kaiser as well and only stopped using them within the last decade. I’m glad you had a great experience, but that’s just not what I’ve seen both for myself, with patients I took care of, and by people in the chronic illness community who are trying to get the help that they desperately need. Some of us have it hard enough just trying to function day-to-day without having to argue with our doctors to provide proper care. I’ve consistently gotten the best care from anywhere other than Kaiser, but particularly with access to top-rated teaching hospitals.
Of course, every healthcare system has problems. But I think when you combine care with insurance into one bundle, things get too muddled and it’s too easy for the people in charge to cross lines in order to save a buck. I saw similar things happen when Cigna started opening up its own care centers.
Luckily, Rene and Jim are in a position where they have other choices than Kaiser, which is why I’m strongly recommending that they look at other options.
Although not directly related to your post…should you ever need to have blood tests done, avoid using your insurance if possible. There are a number of states that allow direct-access testing without a doctor’s order and you can save a bundle. Check out Sonora Quest website to see the tests you can order. As of 2015, states permitted to perform direct-to-consumer testing: AK, AR, AZ, DE, DC, IN, IA, KS, LA, MN, MS, MO, MT, NE, NM, NC,ND, OH, OK, SD, UT, VT, WA,WV, WI, TX, VA. Also, through some kind of loophole, you can legitimately order blood tests through this website. You pick a specific lab and tests you want done and the blood work order is mailed to you. Results are emailed to you. Website: https://www.healthtestingcenters.com/
We have used both Sonora Quest and Health Testing Centers since we started RVing nearly 13 years ago.
And for folks young enough, Under 37, I believe, consider a hitch in the Armed Forces. 1. It’s patriotic to support the country that supports you, and 2. There’s the VA everywhere in the US. And unlike a few reports most of the VA care is really “top notch” .
Thanks for the suggestion David. I’m pretty envious of friends who have served and are now enjoying the benefits like great health care. Thank you for your service.
The VA angle may not work for most people enlisting. If you retire from the military, are disabled while in, or serve during a war, it probably will. If you only serve for 1 or 2 terms during relative peacetime, you have to be means tested. The amount of income that they allow to be eligible is below the poverty level. I served in the early 80’s, and am not eligible. Also, retired teacher – not a multi-millionaire.
Howdy! Informative post. Thank you. Not sure how close you are to Medicare age, but regardless, have you looked into Kaiser Permanente? Although I am VA insured, my wife is with Kaiser in California. Prior to retirement, we were both with Kaiser. Kaiser “campuses” are one stop shops: hospital, ER, labs, doctors offices, specialties, etc. And possibly of interest based on a comment you made in your post, although Kaiser is not in every state, they ARE in California, Colorado, Washington and Oregon. And although you can’t use all services of Kaiser from state to state, you can access certain things. For instance, my wife needed a prescription filled in Colorado. California doctors, Kaiser or otherwise, can’t prescribe in another state. But Kaiser in Colorado was able to telemedicine with my wife, write the prescription and she picked it up local to where we were boondocking. ER visits would be accessible and maybe other things as well.
Hi Ed! Well, I’ve got 13 years to Medicare age, and Jim, 10. Thank you for suggesting Kaiser. Yes they are a great HMO, one of the few out there. My parents have been members for years and it’s super convenient having everything in one spot. Being that they are a non-profit, premiums are relatively affordable and they really do seem to have the patient’s best interests in mind too. I know they’re in CA but it hadn’t occurred to me that they are in all the states on our list, thanks for pointing that out, we seem to be on the right track.
Be careful about Kaiser. Actually, they are NOT a non-profit; they are not-for-profit. There is a difference. Non-profits must operate for the benefit of the public at large. A not-for profit does not have this requirement.
They have had a lot of problems over the years, like getting their rights to do kidney transplants revoked due to incompetency and negligence. As a not-for-profit, all revenue is supposed to go back into the operation of the business, but there has been some intermittent evidence that they are actually skimming off profits.
The state of New York kicked them out decades ago because they refused to meet the state minimum standards. Also, someone who used to work there in their clinical research division said that when you become a member, you basically agree to allow them to review all your medical data for research purposes (observational, retrospective studies only).
I also have a special dislike for them because their carelessness nearly killed my mom and brother when she had pregnancy complications, they permanently damaged my brother’s hand when he was seen there for an accident. Not to mention that it took them nearly 4 decades to diagnose me with a condition I was born with.
Lastly, if they don’t have the specialists to see you in one of their facilities, they often refuse to refer you out to people who could help you, because it comes out of their bottom line. I could tell you more stories as well. I know some people swear by them, but if you have any type of complex medical conditions, they tend to fail big-time. I would never go to them in an emergency…I’d rather have to pay off medical bills for the rest of my life and go to a better hospital.
Oh Yikes! Thank you for the enlightenment, Maya. It’s much appreciated. Knowing your background I take what you are saying very seriously. I didn’t know any of those things and will definitely keep all of it in mind when we get to the point of choosing a plan.