US Health Insurance for Domestic Cruising?

[Chotu]

This would apply to people doing the great loop, as well as transiting from the east coast to the West Coast and vice a versa.

What are people doing for health insurance when you don’t have a fixed permanent address? Or at least, when you don’t spend any time in your state of residence?

I have been running into some problems because that way everything is set up now, you have to stay within a given state in order to use health insurance services. This doesn’t work well for travelers.

Has anyone found a solution?

[GordMay]

I suspect that you're SOL.


Allowing Purchases of Out-of-State Health Insurance
“Insurance firms in each state are protected from interstate competition by the federal McCarran-Ferguson Act (1945), which grants states the right to regulate health plans within their borders. The result has been a patchwork of 50 different sets of state regulations and the cost for an insurer licensed in one state to enter another state market is often high...
... A number of state legislators have been interested in whether some states allow or facilitate the purchase of health insurance across state boundaries or from out-of-state regulated insurance companies. NCSL's state health insurance research and tracking shows a slowly growing number of states—at least 23 as of fall-2017—and state legislators considering this idea during the past ten years.
The result includes enacted laws in six states, and filed bills not passed in at least 17 others. As of late-20y17 none of the six states was known to actually offer or sell such policies and no consumer has purchased a policy..."
☞ http://www.ncsl.org/research/health/...purchases.aspx

Insurance Across State Lines
☞ https://www.ahip.org/wp-content/uplo...StateLines.pdf

[john61ct]

In practice the law does not recognize nomadic existence between states, you always have a domicile residence, if you don't choose it proactively then when needed a judge will assign you one.

If you choose your legal residence address for the purpose of health care or other services, then it behooves you to learn the providers' requirements and structure your travels to remain in compliance.

Many states are strict, and prosecute behaviour that they perceive as fraudulent.

[sailorboy1]

you get a plan for your State and if you have to go to the doctor for a regular type of thing you go to an urgent care and pay the $10 or whatever copay. Or if you are in a plan that has a big enough network you go to a doctor in it.

The urgent care is less trouble and it's cheap as long as you thought of that when selecting your plan

[RobinScurr]

I am retiring the end of this June and dealt with this. The pension plan has several options for health insurance, but only Blue Cross Blue Shield is accepted outside of my state. As I plan on leaving my state, it was natural choice.

[Nickodemus]

We also use Blue Cross and Blue Shield, but you have to make sure you sign up for one of their plans that allows third party providers. Very often you have to pay up front and then submit the bills afterwards, but we've never had a problem with this, even when we needed medical care in the Bahamas. Just call first to get approval. I'm sure their plans vary from state to state. Our "residence" is in New York.

[briggsj]

Check you Christian Medi-Share. It's cost sharing, not traditional insurance. I've had it for 2.5 years. Love it. 61 yrs old and pay 371 a month.

[john61ct]

Can Jews, Buddhists, Hindu's & Muslims join?

[sagablu]

Originally Posted by RobinScurr

I am retiring the end of this June and dealt with this. The pension plan has several options for health insurance, but only Blue Cross Blue Shield is accepted outside of my state. As I plan on leaving my state, it was natural choice.

This! Check with the local Blue Cross affiliate and see if they offer a plan that uses the EPO network. This will provide you with national access and emergency care outside the US. Avoid the Pathways network, usually state specific.

The problem you may have is that unless you can prove loss of coverage from another plan, you cannot enroll into any individual plan until the National open enrollment. The enrollment period starts in December for a January 1st effective date. If you do have a loss of coverage, when you contact the local Blue Cross let them know this is a "special enrollment, loss of coverage" You will also need to request the proof of loss from your prior insurance carrier.

[briggsj]

john61ct,

it is a private organization for Christians. I suppose Jews, Buddhist, Hindu's and Muslims can create their own cost savings health plans.

[RickG]

We are with a national carrier, United Healthcare, with our domicile at 411 Walnut Street, Green Cove Springs, FLorida (St. Brendans Isle). Works for us. I travel back to former home area monthly since I am still working, so I mostly use my existing medical and dental providers. My lady has not seen the same provider two times in a row - no problem.

When we make the jump to living primarily overseas we will use IMG insurance. This plan has worked well for my expat employees.

Cheers, RickG

[Russ]

You all seem to be referring to an HMO health network plan
From the web

Most Blue Cross Blue Shield members can rest easy since Blue Cross Blue Shield coverage opens doors in all 50 states and is accepted by over 90 percent of doctors and specialists. And if your extended travel plans take you abroad, you can ensure you have access to quality care through GeoBlue.

For certain any true emergency condition would be covered. Routine care is what I think you’re discussing. They are assuming you have a residence state in the first place. Most insurers these days, ditto banks car insurance etc will demand a proof of residence.
This latter problem has been discussed elsewhere and the insurers are getting more demanding

The suggestion re St Brendans May be the way to go.

[john61ct]

Originally Posted by Russ

They are assuming you have a residence state in the first place.

Might seem a semantic nit pick, but as mentioned, if you are legally resident in the US, then you do indeed have a legal domicile state or territory.

For high-value taxpayers, it can actually take a fair bit of effort to extricate yourself from the clutches of a high-taxing jurisdiction.

Just getting on a boat or RV and starting to travel around outside your previous state does not necessarily do the trick.

You need to explicitly set yourself up as legally domiciled in a new jurisdiction, and again, for high-value taxpayers it may well behoove you to consult professionals to ensure you do so properly, or you may well get some surprise tax bills.

Especially if you still have business ties, family or property still in your previous jurisdiction.

And yes SBI is a great provider, as is Escapees.

Note that your **mailing address** can be a completely separate, frequently changing location, no one cares about that as long as you have a stable and legally sound residential address.

Also tangential to private unsubsidized health insurance, but recipients of medicare / medicaid, veterans, disability or other state benefits should check with their domicile regulations as to the legal effect of being out of state for long periods, it does happen that people lose some eligibilities without even being aware of such issues.

[sagablu]

Originally Posted by Russ

You all seem to be referring to an HMO health network plan
From the web

Most Blue Cross Blue Shield members can rest easy since Blue Cross Blue Shield coverage opens doors in all 50 states and is accepted by over 90 percent of doctors and specialists. And if your extended travel plans take you abroad, you can ensure you have access to quality care through GeoBlue.

For certain any true emergency condition would be covered. Routine care is what I think you’re discussing. They are assuming you have a residence state in the first place. Most insurers these days, ditto banks car insurance etc will demand a proof of residence.
This latter problem has been discussed elsewhere and the insurers are getting more demanding

The suggestion re St Brendans May be the way to go.

The key word there is "most". Many of the plans on the individual ( non-business) market use narrow networks and do not provide national coverage. You have to make sure that you purchase their regular full network with the "Blue Card". that provides the National access. Not Pathways or Essential. Some states may have different names. Again, the business market is very different, the individual market is much more restrictive.

[Montanan]

Originally Posted by john61ct

Can Jews, Buddhists, Hindu's & Muslims join?

Hell yes, or no!