The reason is health insurance. With the Affordable Care Act (more commonly known as Obamacare) swinging into full effect next year, Coventry, my health insurance provider – and the provider for most other pre-retirement South Dakota full-timers – is pulling out of the state.
As a recap, up until now I’ve been on a low-cost, high-deductible catastrophic plan. I paid for my regular health needs out of pocket, and Coventry was around in case an emergency ever befell me. Back in March I wrote about how the health insurance scene was going to be changing. Then in July I got the letter I knew was coming: Coventry would extend my current coverage until the end of this year, but after that I needed to find something else. I opted to wait until closer to the end of the year to start searching for other alternatives, because with so many changes happening in the industry I figured the playing field would look different and perhaps better by November.
Here’s what I’ve found (note: this research was for pre-retirement age RVers, I believe those that qualify for medicare have better options).
If you’re not eligible for a subsidy on your monthly premium, South Dakota is still a viable residency state. Your best option is to go with Assurant.
If you are eligible for a subsidy on your monthly premium, the only one of the three companies on the Marketplace that’ll take full-timers (the other two require you to be in-state 6 months of the year) is Avera.
Wait, what’s this about subsidies and the marketplace? The Marketplace (also called the Exchange) is the the official government website (www.healthcare.gov/) set up specifically for for ACA health plans. Some states chose to set up their own websites, but the three big states for full-timers (Texas, South Dakota, and Florida) all use the healthcare.gov website. This is the site you go to for information on the ACA and to enroll in ACA plans.
Now, as a household of one with a yearly income of less than $46,680, I qualify for a subsidy, so for me it makes sense to enroll in plans on the Marketplace, because I’ll get a lower rate.
“But wait, wouldn’t it still be cheaper to stick to a catastrophic plan than to enroll on the Marketplace?”
Probably yes, but the ACA has changed the rules of health insurance. Everybody needs to have it now, and only folks 29 and under (or those meeting certain hardship exceptions) can enroll in catastrophic plans. I turned 30 back in February, d’oh. All of the full-timers currently out there with catastrophic plans are going to see their plans getting dropped or changed if they’re over 30.
But it’s not all bad news. My taxable income for 2013 was only $16,000. Even if it jumps to $20,000 in 2015, with the subsidy I’d still be paying less per month than I am now, and getting better coverage.*
Okay, so back to Avera and South Dakota. I’d looked on the Marketplace myself this past Wednesday and knew they were my only option, but I didn’t know how good of an option they were. There were muddled reports of full-timers having their insurance canceled after they’d been approved, for not being able to furnish a utility bill as proof of South Dakota residency.
Kyle Henson runs a ridiculously useful website called RVerHI.com (http://rverhealthinsurance.com/) and this guy knows health insurance for RVers. I dropped him an e-mail at 5 am on Thursday morning asking what he thought about Avera, and less than an hour later I had a reply.
Call it serendipity or just plain good timing, but as it turns out, some officials at Avera were just about to have a meeting that day over whether or not full-timers could enroll in their Marketplace plans, and what the coverage outside of the state would be like for those plan holders.
By the end of Thursday I had my answer through RVerHI: Avera is required by the law to offer coverage to full-timers through the Marketplace, as long as they can provide an address that is within the sate, but, starting in 2015 they’d no longer be offering access to their nationwide network.
So what it boils down to for pre-retirement age full-timers who qualify for a subsidy is this: You can get a plan through Avera and remain a South Dakota resident, but you’ll only be able to get emergency care out of state. If you wanted to make use of the shiny new benefits of the ACA (yearly checkups and other preventative care at a reduced cost, not to mention non-emergency treatment), you’ll have to go back to South Dakota to get it. Ewwy.
So what’s a rolling nomad to do?
I cannot tell you what’s best for you, but as for myself, I’m “moving” to Texas next year.
The vehicle registration costs and taxes are similar to South Dakota, and their health insurance options on the Marketplace are way more nomad friendly (and a bit cheaper). However, I won’t be moving at the start of the year. As I’m sure you’ve all figured out by now, Amazon is more than a full-time job and I just don’t have the time and mental bandwidth to pursue changing everything over to Texas before the start of the year when Coventry’s coverage ends. So, I’ll be enrolling with Avera in South Dakota for 2015, and will have the whole of that year** before it comes due again to get my mail forwarding and everything else moved to Texas through the Escapees RV Club.
I’ll be writing more about the steps to becoming a Texas resident next year like I did in 2012 when I “moved” to South Dakota. In the meantime, I hope this information on health insurance changes for South Dakota helps those of you who have, or are thinking of choosing, SD as your domicile state. Have a good week all!
*For the curious, my monthly premium with Coventry was $60 from September of 2012 to 2013. In September of 2013 it jumped to $80 with the new ACA rules creating something of a panic with healthcare providers. My Avera Bronze level (read about the various levels of coverage here) plan at an estimated yearly income of $20,000 is going to be $71 a month. Without the subsidy (if I was making $46,680 or more a year), I’d be paying over $200 a month for my health insurance. That’s a huge difference.
**Open enrollment for the Marketplace started on November 15th and goes until February 15th (December 15th if you want coverage to start by January 1st), but there are events that can qualify you for enrollment on the Marketplace outside of this time frame. I’m about 85% sure as of this posting that moving states counts as one of them, but I’ll be calling or e-mailing and getting an answer from someone to find out for sure and will report back here.
Picture courtesy of Stockmonkeys.com
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