Pre-Medicare Nomads-How do you do manage healthcare??

[Random Painted Highway]

We are several years out before we are eligible for Medicare coverage.  What are middle aged nomads doing for health insurance, i guess i'm middle aged?  From researching, it looks like the best option for us anyway, is the ACA with subsidies.  Not looking for a political discussion, just trying to navigate having health insurance as a nomad.

 

[maki2]

You need to look at plans with nationwide coverage if you are going to be on the road going from place to place. That is going to quickly narrow down your choices.

 

[RVTravel]

https://www.rverinsurance.com/choosing-a-health-insurance-plan/
Health Insurance For RVers

For a lot of people, health insurance is a major obstacle to overcome before deciding to become a full-time RVer. With a little research and planning I don’t see any reason why it has to be a prohibiting factor so long as your expectations are reasonable and your risks are properly managed.

 

[maki2]

Your state in which you have legal residence will have a .gov site for the ACA health insurance plans that are available in that state. From there you will have to start looking at the cost related to your household income and the benefits the various plans offer. Of course watching out to make sure you are covered if you need medical care when out of state.

 

[Random Painted Highway]

That's what i've started doing, looking at plans and seeing about medical care when out of state.  There might be a cost saving to change domicile elsewhere to get better nationwide coverage then where i'm at.  It's hard to forecast what my financials will be for the next year and meeting the minimum threshold to receive some of the premium credits.

 

[bullfrog]

Escapees have good information available for both resident and insurance.

 

[IGBT]

We do ACA with subsidies (although the past 3 years we have had to pay all the subsidies back due to larger than expected gains in stock trading).

It is very tricky to get nationwide coverage.  Our state of Washington doesn't even really have any, which does make me worry about emergencies on the road.  I will be glad when the nation goes to some sort of universal health care system.

 

[Almost There]

I will be glad when the nation goes to some sort of universal health care system.

Should be noted that even in Canada with our 'Universal Health Care' it's not really, really universal. Each province is mandated to manage their own health care system and decide what will and will not be paid for when that provinces' resident receives health care outside of their home province.

Most Canadians aren't even aware of this provision until it hits home, usually because of an out of province urgent health care need. You can buy out of province health insurance which tops up what your home province pays for and it's usually quite inexpensive. Out of country coverage, depending on where you're travelling, can become quite pricey however.

 

[beavergod1]

Been using the ACA Marketplace since the beginning.  Very pleased with it.  Premium is $1850 p/mo.  I pay $41 p/mo and the government picks up the other $1809, and that is on a $45,000 p/yr income.  It is BCBS of Texas, HMO.  It is basically a catastrophic policy, Bronze, with 8000 p/per deductible or 16000 p/fam ded.  My wife ended up taking part of her finger off a few months ago and the total bill was $4800.  I only paid $1300.  I'm not quite sure how that worked, but I'm not complaining.  Did make sure I kept everything in network though.  Free annual checkups, mammograms, and colonoscopies.  They really try to encourage early detection and prevention.  I believe the income limit for subsidies are roughly between $17,000-$68,000 p/yr income...

 

[maki2]

That's what i've started doing, looking at plans and seeing about medical care when out of state.  There might be a cost saving to change domicile elsewhere to get better nationwide coverage then where i'm at.  It's hard to forecast what my financials will be for the next year and meeting the minimum threshold to receive some of the premium credits.

There are various websites that have list of which states have the least expensive insurance rates. 

It is pretty easy to control the minimum amount of income you make unless you have the "Midas Touch"

 

[Random Painted Highway]

There are various websites that have list of which states have the least expensive insurance rates. 

It is pretty easy to control the minimum amount of income you make unless you have the "Midas Touch"

True!  I meant i don't wont my income to fall into medicaid realm, i don't even know what that is, but from what i can tell it looks like $18k here in MT.

 

[maki2]

True!  I meant i don't wont my income to fall into medicaid realm, i don't even know what that is, but from what i can tell it looks like $18k here in MT.

ACA coverage is on an income sliding scale meaning there is a level where the total cost is supplemented by the state or their might still be some assistance if your income is somewhat above that. I only dealt with it for a few months before I turned 65. I did not qualify for 100% coverage so I did end up having a small monthly payment to make. But I did not have to do it all on my own as my income was not all that much above the poverty level.

As to medicaid, you won't qualify for that based only on your on income level. That is a completely different system than ACA or medicare. Do more reading, talk to agents of ACA plans on the phone if you don't understand what you read. Senior centers often have a list of advisers to help with planning what insurance to get and how to prepare for when you do turn 65. That is a free service and it is there because the written advice can be difficult for some people to comprehend.

 

[crofter]

Go online to the marketplace, fill out all the forms, scan any documents to prove what you said in the online forms, and pay for the insurance. After all that, they will mail you an insurance card.

In some states, like Washington, the doctors do not actually accept that type of insurance. So you can get marketplace type of insurance, but you will never get a doctors appointment, and the marketplace insurance does not pay for emergency care. When I lived in Washington I did without medical care, other than paying to get stitched up a few times, and injury care paid for by workers comp.
-crofter

 

[beavergod1]

Go online to the marketplace, fill out all the forms, scan any documents to prove what you said in the online forms, and pay for the insurance. After all that, they will mail you an insurance card.

In some states, like Washington, the doctors do not actually accept that type of insurance. So you can get marketplace type of insurance, but you will never get a doctors appointment, and the marketplace insurance does not pay for emergency care. When I lived in Washington I did without medical care, other than paying to get stitched up a few times, and injury care paid for by workers comp.
-crofter

  I am a retired engineer from a major corporation.  Retired at 56 and have been on Obamacare since it's inception.  With the exception of the higher deductible and being a HMO, it is comparable to what I had working.  It has been a godsend for us early retirees. 
Washington state has its own marketplace exchange.  In Texas we use the federal marketplace exchange.  My wife had glaucoma eye surgery in 15 and an emergency room visit this year for her finger.  In both cases we had no problems getting prompt care with a wide array of doctors, specialistes, urgent care, and hospitals when needed.
There are a number of companies offering insurance on the exchange, ranging from cheap to more expensive premiums.  Some of the networks are indeed very narrow in both doctors and hospitals.  Depends on the company you go with.  We chose Blue Cross Blue Shield of Texas for it's nationwide coverage and vast array of choices in all medical fields and services.
We are currently at my daughters house in Lahaina, Maui for 4 months.  Before coming I checked the network and we are more than adequately covered here and in Oahu if needed.
I can only come to the conclusion that you have never been part of the exchange or you bought one of the cheaper policies that had a very narrow network, and you were disappointed when time came to use it.  To blanketly dismiss something without further research can lead other people astray, though unintentionaly...