In 2015 I wrote a pretty lengthy article on South Dakota health insurance for pre-medicare RVers. You can review that article for the full story but here’s a recap:
From 2012-2014 I had a low cost, high deductible plan that would cover me in case of emergency only, everything else I paid out of pocket. My emergency fund was large enough to cover the deductible.
Starting in 2015, the Affordable Care Act (more commonly known as Obamacare) changed the health insurance scene for full-timers dramatically. Everyone over 30 now had to have full insurance – high deductible plans didn’t meet the requirements – or pay a penalty.
Because of my income level (around $20,000 last year) I qualify for a subsidy that makes the Bronze level ACA plans on the Marketplace historically similar in cost to what my high deductible plan use to be before the ACA, and theoretically I also get a free wellness checkup every year. I say theoretically, because I’d need to go to South Dakota for that checkup and I don’t spend much time in that state. My plan covers emergencies out-of-state (part of the ACA law), but other care (including post-emergency) needs to be done in SD, which isn’t very nomad friendly.
Of the three big full-timing residency states (Florida, South Dakota, Texas), only Florida has ACA plans that provide nation-wide coverage (Florida Blue), which for those of you who are thinking of hitting the road in the near future, is definitely something worth taking into consideration when making your domicile state decision. There’s no guarantee that Florida will continue having this option in the future – 2016 saw the removal of these kinds of plans in many states – for 2017 they still do. If I had health issues and required regular medical care, I’d probably “move” to Florida for this reason, but as I am still, thankfully, in good health, I can’t justify the cost it would take to switch residency states at this time.
It’s also worth pointing out that ACA plans are not the only option. For people who make over about $47,500, there is no subsidy, and the cost of a plan can be pretty extreme. 2017 opens up the possibility of joining a medical cost sharing group as a viable option as it’s now ACA exempt, but it’s important to realize that this isn’t actual insurance, there is no guarantee of payout.
For those new to the RVer health insurance scene, Kyle over at RVerInsurance has a very informative article that goes over all the options for next year, and I highly recommend it: http://www.rverinsurance.com/2017-health-insurance/. I was in e-mail communication with Kyle in 2015 when all of these changes were taking place and he helped me a lot with figuring out what my options were.
And yes, if you’re not getting insurance through a job, you probably do want to sign up for an ACA compliant plan instead of going without. It makes better financial sense for those who are on a budget and don’t have a high income. In 2015 the penalty for not having health insurance was cheaper than the least expensive bronze plan, so many RVers chose to just take the penalty. Starting in 2016 though, the penalty for not being insured went up to $695 per adult or 2.5% of your annual income, whichever is higher. For my income level, it’s cheaper to pay for the insurance.
Which brings me to what I signed up for for 2017.
My Avera 5000 Bronze level plan (what I had for this year) is still available next year, and after checking the details I decided to renew it. The out-of-pocket cap for this plan is a lower amount than my emergency fund, it’s the second cheapest option for South Dakota. At 32 years of age, with an expected 2017 income of $22,000, I’ll be paying $18 a month for this plan. Yes, you read it right, $18. There’s been an increase in insurance rates for 2017, my plan rose by about 20% (without the subsidy it would be about $360 a month, ouch!), but the government subsidy increased too to more than cover the difference (I paid $52 per month in 2016, my last year with a high deductible plan in 2014 was about $60).
For many people, applying on the Marketplace website is a quick and painless process, but it’s never worked for me as the software doesn’t recognize my mail forwarding address in South Dakota as a residential address, so they can’t confirm my identity. I always end up having to call and talk to a real person to sign up, and in 2015 I almost didn’t have insurance for January 1st as Avera didn’t accept me as a SD resident initially and I had to make extra phone calls to get it set up, but since then it’s gone much smoother. The call time last year was 26 minutes, this year it was only 15 minutes – practice makes perfect.
All in all, it only took a couple hours this year to research options, place the call, and get insured for next year – not bad at all.
Edit 12/2/16: Health insurance is a rather hot issue right now with several different camps of belief and a lot of strong feelings. It’s good that these kind of topics get discussed as that is how knowledge is gained and compromises are reached. I’d just like to kindly state that while sharing an opinion is fine, this blog is not the place for full-out political arguments – there are other blogs, forums, and communities out there made for that. Thank you.
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I’ve survived another Black Friday/Cyber Monday weekend at Amazon, it was a pretty crazy few days as usual with the conveyors running full tilt and everyone (particularly outbound functions) in full rush mode. Yesterday I was assigned to a work station right next to one of the big elevators that carries product up and down between the four floors and it was a madhouse. This week saw 11 hour days for the work-campers here in Haslet Texas, but there is no fifth day for my shift which has me a little bummed. Even the pickers working the outbound side of operations don’t have a fifth day this week for our shift, I think staffing continues to exceed need.
Only three more weeks to go! If there’s no overtime that last week, my last day will be December 20th, otherwise it’ll be the 21st (officially it’s the 23rd for all of CamperForce, but that falls on my weekend).