You can do what many cruisers do. Sign up with a mail forwarding
service. You'll then have a Personal Mailbox (PMB) which can be used as your
health care insurance "home" address, a billing address for credit cards, address for your financial, banking and investment services, Medicare, Social
Security, the IRS, etc.
If you sign up with St Brendans Isle in Green Cove Springs,
Florida, you can legally establish "domicile" there and become a
Florida resident with all that implies (driver
license, voting in state and federal elections). Florida is a good choice since it has no state
income tax, no tax on investments, no death
taxes, and no property tax on your
boat. The only catch is that you cannot reside in another state for over 1/2 year, which really isn't an issue for long term
offshore cruisers or ex-pats like us. We've lived outside the US part time for eight years, and full time for over five years, and have found this arrangement, along with the ability to handle
health care transactions and financial matters over the
Internet be ideal. Aetna covers us here in
Nevis on their "out of network" reimbursement scale.
SBI scans our mail envelopes and we can choose to have them sent to us via USPS International mail or via FedEx, or to have SBI open the mail, and scan the contents which we can then download to our computer for a small additional fee. We find this a lot better than imposing on
family members or friends to be our "mail drop" in the States.