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Old 09-10-2019, 09:28   #1
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Health Insurance for Cruisers

I am sure this question has been asked several times - but I suspect the answer for US citizens is dynamic given the current awful state of our medical/health insurance industry.

I am looking to provide health insurance next year for myself, my wife and son. I am 58 years old and retired last year. I had great coverage while employed, but this went away when I retired. At first, I continued the coverage through COBRA which was way too expensive and I found that it provided no coverage outside the US. Last year, we made a transatlantic trip on our boat and I took out repatriation insurance with DAN. This seemed like a very reasonable cost and I figured we could pay locally for any minor care needs. In 2020, we plan to cruise to the Bahamas again, but then continue up the east coast of the US. I will likely take out a DAN policy again, but need to address US health care. From what I have found so far, open enrollment under Obama care does not seem to be open yet; and some private policies seem close to worthless (in terms of cost versus real benefit). Christian Healthshare looks like it could be an option worth considering.

I feel there must be other cruisers out there that have found a reasonable solution to bridging the gap in the US until age 65. Maybe the only solution is to cruise outside the US? I welcome any reasonable suggestions.
Neil
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Old 09-10-2019, 11:54   #2
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Re: Health Insurance for Cruisers

We use imgglobal.com for employees who are US expats living outside the country. Within the US, ACA healthcare exchanges work; You could have a qualifying event based on change of address or wait until November 1 to enroll for 2020.

Good luck!

Cheers, RickG
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Old 09-10-2019, 17:08   #3
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Re: Health Insurance for Cruisers

We use our home state’s health exchange (Obamacare) and have DAN for repatriation if necessary. Open enrollment starts on November 1st. There are variations in cost and plans with each state, so do your research carefully.
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Old 09-10-2019, 17:30   #4
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Re: Health Insurance for Cruisers

Open enrollment periods are more flexible when you have a significant life change, such as moving to a new location. So you might be able to get in early. Either way, enrollment starts in Oct, as I recall.

Look carefully at the insurance options available under ACA plans in your state and county. How much is covered outside of your direct area varies greatly between policies.

Also, check your annual taxable income. To qualify for the subsidized plans you need to fall between a minimum and maximum income range. Fall below it and you drop into Medicaid, which is not useful for a cruiser.

Also, consider what you are trying to insure. Many seem to think of health insurance as prepaid medical. We ensure to protect our assets from a large cost. We direct pay for all the little stuff.
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Old 10-10-2019, 09:37   #5
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Re: Health Insurance for Cruisers

Quote:
Originally Posted by Ndavies View Post
I am sure this question has been asked several times - but I suspect the answer for US citizens is dynamic given the current awful state of our medical/health insurance industry.

I am looking to provide health insurance next year for myself, my wife and son. I am 58 years old and retired last year. I had great coverage while employed, but this went away when I retired. At first, I continued the coverage through COBRA which was way too expensive and I found that it provided no coverage outside the US. Last year, we made a transatlantic trip on our boat and I took out repatriation insurance with DAN. This seemed like a very reasonable cost and I figured we could pay locally for any minor care needs. In 2020, we plan to cruise to the Bahamas again, but then continue up the east coast of the US. I will likely take out a DAN policy again, but need to address US health care. From what I have found so far, open enrollment under Obama care does not seem to be open yet; and some private policies seem close to worthless (in terms of cost versus real benefit). Christian Healthshare looks like it could be an option worth considering.

I feel there must be other cruisers out there that have found a reasonable solution to bridging the gap in the US until age 65. Maybe the only solution is to cruise outside the US? I welcome any reasonable suggestions.
Neil

I'm kinda fortunate to have VA care.. Back in '72 i snuck in the navy with a bad back.. was guarding the shores of Athens.. no vietcong got into Athens on my watch... with that there are va facilities statewide, st. john's, puerto rico, phillipines.. I'm good!
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Old 10-10-2019, 10:27   #6
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Re: Health Insurance for Cruisers

National Health Care US is worthless offshore. Nonetheless, you are required to have it if you are in the US more than 60 days/year. This means that the Bozos in charge mandate you have it AND travelers insurance and also DAN depending on what you find. We elect to have only NHS with DAN and arrange all annual doctor visits back to back when we plan to be in the US (hurricane season). Paying out of pocket for island care is way less than additional insurance. We have only seen a Caribbean doctor once in three years. For a disaster, go to the US.
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Old 10-10-2019, 10:58   #7
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Re: Health Insurance for Cruisers

Quote:
Originally Posted by RickG View Post
We use imgglobal.com for employees who are US expats living outside the country.

Good luck!

Cheers, RickG
We have a catastrophic plan through IMGglobal too. 5k deductible (2.5K outside US) for two people aged 37 at $135 a month. But we haven't used it, so have no idea of its true worth.

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Old 10-10-2019, 17:48   #8
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Re: Health Insurance for Cruisers

Quote:
Originally Posted by Nicholson58 View Post
National Health Care US is worthless offshore. Nonetheless, you are required to have it if you are in the US more than 60 days/year. This means that the Bozos in charge mandate you have it AND travelers insurance and also DAN depending on what you find. We elect to have only NHS with DAN and arrange all annual doctor visits back to back when we plan to be in the US (hurricane season). Paying out of pocket for island care is way less than additional insurance. We have only seen a Caribbean doctor once in three years. For a disaster, go to the US.
There is no penalty for not having health insurance in the US. You might have to find some other 'fact' to dislike government.

Like you, we pay out of pocket while cruising most of the year. That does not make having US insurance worthless offshore. We are insuring our assets from a large health expense. The big expenses are often the long term treatments and multiple hospital stays. If the time came, we would do these in the US under insurance.

For those suggesting international, travel type insurance for cruisers, be careful to read the policy terms. These are unregulated policies that are not required to meet the minimum cover of ACA plans. Many of them have competely unreasonable pre-existing conndition exceptions. Their definition of pre-existing condition can be pretty broad, like anything you did or should have seen a doctor for. Many also have unreasonable incident/lifetime caps.
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Old 11-10-2019, 05:27   #9
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Re: Health Insurance for Cruisers

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Originally Posted by Paul L View Post
For those suggesting international, travel type insurance for cruisers, be careful to read the policy terms. These are unregulated policies that are not required to meet the minimum cover of ACA plans. Many of them have competely unreasonable pre-existing conndition exceptions. Their definition of pre-existing condition can be pretty broad, like anything you did or should have seen a doctor for. Many also have unreasonable incident/lifetime caps.
Of course, reading the policy is a must. I can speak from experience for IMG. We had an employee working from Antigua, Guatemala. His spouse had a history of neck issues from a car accident. She needed her cervical vertebrae fused. The best surgeon for that was in Mexico City. IMG paid for travel for two and the procedure. He is a runner and needed Achilles’ tendon surgery. Their two daughters had the usual healthcare needs. Out of pocket expenses were less than $100 per year.

The cost of IMG for the family of four was $748 per month. They moved back to the US in July and I’m paying $2,100 per month for their United Health Care medical insurance. One of their kids had a bug that was not responding to treatment. They took her to an out of network specialist who diagnosed her with Giardia. Their out of pocket cost for one visit was over $500.

So, yeah, I like IMG for expats.

Cheers, RickG
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Old 11-10-2019, 06:27   #10
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Re: Health Insurance for Cruisers

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Originally Posted by RickG View Post
Of course, reading the policy is a must. I can speak from experience for IMG. We had an employee working from Antigua, Guatemala. His spouse had a history of neck issues from a car accident. She needed her cervical vertebrae fused. The best surgeon for that was in Mexico City. IMG paid for travel for two and the procedure. He is a runner and needed Achilles’ tendon surgery. Their two daughters had the usual healthcare needs. Out of pocket expenses were less than $100 per year.

The cost of IMG for the family of four was $748 per month. They moved back to the US in July and I’m paying $2,100 per month for their United Health Care medical insurance. One of their kids had a bug that was not responding to treatment. They took her to an out of network specialist who diagnosed her with Giardia. Their out of pocket cost for one visit was over $500.

So, yeah, I like IMG for expats.

Cheers, RickG
IMG offers a reasonable life time maximum cap, along with a pretty restrictive pre-existing conditions limits. Most cruisers looking for insurance are 40+ meaning pre-existing conditions are just a reality.
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Old 11-10-2019, 19:28   #11
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Re: Health Insurance for Cruisers

For US readers Carefully engineered withdrawals from. Taxable 401k can put you right where you need to be for affordable ACA coverage. Be careful the math has to be correct

As far as evacuatiin coverage, the US powersquadron has partnered with DanUSAfor evac insurance

As a side note. Us Power squardron is a really solid org
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Old 16-10-2019, 08:16   #12
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Re: Health Insurance for Cruisers

Thank you everyone or the feedback. I am going to check out IMG, and we do already have a DAN policy. From a first look at information I have found on ACA plans - they are not real good if you plan to travel. Christian Healthshare could be an option, but I would like to hear from anyone that has actually used it.

Thanks again!
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Old 16-10-2019, 09:43   #13
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Re: Health Insurance for Cruisers

Doesn't really matter if my ACA plan is good out of the US. It's basically free and there for "major medical" if out of the country. When paired with inexpensive health care in the non US world and evacuation plans if it definitely worth having.

BTW wife fell a couple of weeks ago here in the US and broke her shoulder. So far that's only cost us about $340 with our free subsidized ACA
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Old 16-10-2019, 19:01   #14
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Re: Health Insurance for Cruisers

Not sure if this is same as referred to in other posts above, but Gowrie Group offers a “Jackline” program for international cruisers. Sounded like a good deal, though you have to be out of the U.S. to use it: https://www.gowrie.com/Marine-Insurance/IMIS.aspx
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Old 16-10-2019, 19:12   #15
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Re: Health Insurance for Cruisers

Not sure if this is same as referred to in other posts above, but Gowrie Group offers a “Jackline” program for international cruisers. Sounded like a good deal, though you have to be out of the U.S. to use it: https://www.gowrie.com/Marine-Insurance/IMIS.aspx
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