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Hospital
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Emergency
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Urgent care facility
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Pharmacy in Pine, Arizona
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So you want to retire to the
open road in your RV. Thousands of people do it every year,
and few would trade this stimulating, mobile lifestyle for
the jobs they left behind. But what about health insurance?
Some retirement packages include
continuing health coverage but, sadly, most do not. In fact,
many retirees who were once covered are now in a bind as the
rising cost of health insurance is forcing many companies
to drop coverage for retirees or raise the rates to unmanageable
amounts.
So if you want to travel, what
do you do? Postpone your dream? Continue to work until you
are eligible for Medicare? And what if you have a pre-existing
medical condition that makes obtaining a policy almost impossible?
Here are some considerations to keep in mind.
Before you quit your job.
If you are currently employed and have health insurance, don't
quit before making plans for coverage after retirement. You
may be eligible for a conversion policy, or you may need to
keep your current coverage to qualify for an individual policy,
especially if you have a pre-existing condition.
- Best option: Convert to a high-deductible
individual policy as soon as you can; that way you'll still
be covered when you leave your job. At the same time, set
up a tax-deductible Health Savings Account. This is where
you will stash the cash you will need for out-of-pocket
expenses and other things like dental and vision expenses,
which may not be covered by your new health insurance.
- Another option: Continue
your current coverage under the Consolidated Omnibus Budget
Reconciliation Act of 1985 (COBRA).
COBRA coverage is expensive, but it has an important benefit:
Once your continuation coverage is exhausted, you are protected
under the Health Insurance Portability and Accountability
Act (HIPAA), which, among other things, requires states
to offer some type of coverage with no exclusions for pre-existing
conditions to individuals who have accepted and exhausted
COBRA coverage. Check your state to see how it works.
- If you are within a year of reaching Medicare
eligibility, investigate short-term policies. They might
not cover a pre-existing condition, but they will be less
expensive than a COBRA policy while still giving some peace
of mind.
Once you are in the market for a policy, proceed
carefully. You do not want to be turned down. A rejection
by an insurance company will be recorded in your permanent
record with the Medical Information Bureau (MIB), a central
database shared by some 600 life insurance and health insurance
companies, making it more difficult or impossible to get coverage
from any other company. A good independent health insurance
agent can help you determine if you will be accepted or can
help you withdraw a submitted application if it looks like
it will be rejected.
Now would also be a good time to call the Medical
Information Bureau (866-692-6901) to find out what's in your
record. Some entries may be incorrect or could be rewritten
more favorably, affecting both your rate and your coverage.
You can receive one free report each year.
Choosing your domicile. Domicile is the
place where a person has his or her permanent legal home.
A person may have several residences, but can have only one
domicile. Full-time RVers can choose their domicile. Since
states vary tremendously in the regulation and pricing of
health insurance, you may wish to consider insurance coverage
when choosing your domicile.
Two good resources for researching state insurance
regulations are "The New Health Insurance Solution,"
a book by Paul Zane Pilzer (see especially Appendix A), and
"A Consumer Guide for Getting and Keeping Health Insurance"
from HealthInsuranceInfo.net.
Pilzer's book also covers residency requirements.
Note that two states, Massachusetts and Vermont,
have recently enacted universal
coverage, and other states are watching those experiments
closely.
Choosing a policy. There is no one-size-fits-all
health insurance policy and no easy way to find a policy without
doing a lot of research. Use the resources mentioned in the
sidebar and talk to other RVers. If you have special circumstances,
or can't understand all the fine print, then locate an independent
agent. Some general advice applies to everyone.
1. While you are researching the particular
rules and protections in your state on HealthInsuranceInfo.net,
check out the records of the insurers operating in the state.
Also find out about financial assistance -- you may qualify.
2. Check out the report cards issued by the
National Committee
for Quality Assurance, which rates health insurance
policies that have been accredited by the organization.
3. Use an online search site like eHealthInsurance.com
to compare plans and get quotes. But be wary of sites that
request your name and address or other personal information
before providing a quote; they may not deliver online quotes
and instead sell your personal information.
4. Even if you don't have special circumstances, consider
using an independent agent, i.e. one who represents a number
of different insurance companies. An independent agent can
tell you which companies are reliable and help you with
the application process.
As for particular policy features, consider
the following:
- Cost of premium (though
cheapest may not be the best
- Lifetime limits ($5 million
minimum)
- Coverage not subject to
the deductible (e.g., well visits)
- Co-payments
- Coverage when traveling
(not all insurers will cover you in every state)
- Exclusions
What about pre-existing
conditions? People who have pre-existing medical conditions
have the most trouble finding coverage. Many states allow
insurers to exclude these conditions, charge exorbitant rates
for them or refuse coverage altogether. "The New Health
Insurance Solution" is an excellent resource for RVers
in this situation. Here are some key points from the book:
Remember, HIPAA ensures the
portability
of health insurance if you lose or change your job, regardless
of pre-existing conditions. Certain conditions must be met,
however, so do your research before leaving or retiring from
your workplace.
Five states -- New York, New
Jersey, Massachusetts, Maine and Vermont -- are "community-rated,"
meaning that your health and age do not affect the size of
your premiums.
- Many states maintain a special
insurance pool to cover high-risk individuals. A high-risk
policy will be more expensive than a regular policy, but
at least you will have coverage. In some cases, you need
to be HIPAA-eligible to qualify for the policy.
- A few states have annual
open-enrollment periods during which you can get coverage
no matter what your health history is. Check the reliability
of the insurance company if possible.
- Couples should consider
separate policies if one person is substantially older or
has a pre-existing condition. In a few states, however,
the lower-risk person can be added to the high-risk policy
for less than the cost of a separate policy.
- If your retirement income
will be low, you may qualify for Medicaid or for special
state programs and assistance. In some states your income
can be more than $30,000 and you can still qualify for help.
What about working on the
road? I'm a big proponent of working on the road, both
for extra cash and for the interesting people and experiences
you'll encounter; in fact, I've written a book on the subject
(see Resources). Road jobs don't often provide health insurance,
but a few do. Kelly Services, an agency for temporary workers,
offers health insurance through a third-party vendor. You
can easily transfer your records from one Kelly location to
another as you travel. Contact local Kelly offices for information.
AARP's
National Employer Team includes some employers -- Home
Depot, for example -- who extend benefits to seasonal workers
who work in two different locations. Home Depot also provides
some benefits to part-time workers.
Companies looking to recruit
older workers sometimes offer benefits as an enticement. Yuma
Regional Medical Center in Yuma, Ariz., for example, hires
health care specialists during the busy winter months when
the city almost doubles in size. The benefits include health
insurance for workers who work long enough; they also include
flexible schedules, housing and mileage allowances.
Two last things
- Be cautious about joining
an association just to obtain health insurance. If the underwriter
is based in state other than your own, it may fall under
different regulations in your state and not offer you as
many protections as you think. Check your state's regulations
at HealthInsuranceInfo.net.
- Medical discount cards are
not health insurance. Some cards, like those issued by Costco
and Wal-Mart, are legitimate, but many cards are worthless.
Check with your health care providers to see how much discount
you will get and whether you can get the same or better
discount for paying cash without the card.
Health insurance is critical
to your well-being and your peace of mind on the road. Yes,
it will take some work to sort out what coverage you need
and how to get it, but when you are out traveling in your
RV, seeing all the sights North America has to offer, you'll
know it was well worth it.
Jaimie
Hall-Bruzenak
5/9/08
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