Health insurance for someone that tends to wander

[safari]

I am FIRE and have private health insurance. I no longer maintain a home in my erstwhile hometown (I just rent an apartment-hotel/extended stay hotel room when I am there), although I still consider it home and spend, on average, about 5-6 months a year there. The rest of the time I am travelling or living part-time abroad. My health insurance premium has skyrocketed over the past few years and the few times I have gone to the doctor it has almost always been when I was away from home so I just paid out of my own pocket and didn't get any reimbursement.

Does anyone know of any health insurance that would work for my lifestyle? Suggestions? By the way, a year ago I was thinking about an HSA and I am now taking another look.

[lazygood4nothinbum]

i was concerned about extended travel as well. my insurance company sales guy told me i'd get reimbursed 75% out of network after high (hsa plan) deductible with no coinsurance or copay. seemed reasonable, hope it works out that way.

would be interested in you posting more information about your roving lifestyle as i'm considering something similar in the future. my favorite childhood holloween costume was the hobo. just some dirt on my face, some old clothing and a sack tied to the end of a stick. i don't see why that shouldn't be my lifestyle now.

[Meadbh]

I'm not sure if this might work for you, but.....

I have a corporation that has me as its sole employee. The corporation has recently set up a Personal Health Services Plan using a trust company. When the employee (me) incurs expenses for ANY health care (anywhere in the world) that is recommended (not necessarily prescribed) by a licensed healthcare practitioner (not necessarily a physician), I can send the bills to the trust company, with a corporate cheque for the corresponding amount plus a premium. The corporation therefore pays the bill, which becomes a corporate expense, and is tax deductible.

So if I decide to have a breast augmentation in Thailand, or need a course of physiotherapy in Lithuania, it will not be free, but it will be a corporate expense. My plan also has travel insurance, which covers medevac to my home country.

[safari]

i was concerned about extended travel as well. my insurance company sales guy told me i'd get reimbursed 75% out of network after high (hsa plan) deductible with no coinsurance or copay. seemed reasonable, hope it works out that way.

Yes, I think that might work out reasonably well when in another state, but I'm not sure how well it would work if in another country. It seems that all health policies I have seen are anchored to a particular state and their network of providers that they cover at the higher rate are only in that state.

would be interested in you posting more information about your roving lifestyle as i'm considering something similar in the future. my favorite childhood holloween costume was the hobo. just some dirt on my face, some old clothing and a sack tied to the end of a stick. i don't see why that shouldn't be my lifestyle now.

As an example, this year I travelled in Morocco for almost a month, travelled in France for about 2 weeks, a couple of weeks on a road trip in the States, spent about 4 months in Vancouver, BC, spent one month in Japan, and travelled for one month in Thailand. Last year was similar, but I went to Ecuador, Germany, Austria, Switzerland, Hungary, and Italy plus spent several months in Vancouver. I have travelled a lot for more than 20 years, but after RE I have been doing even more of it.

I tend to be "home" for irregular intervals of a few weeks to a few months at a time. I used to have a house, but it just tied me down so I sold it several years ago. After that I had a few apartments, but I got tired of all the hassle of moving in, a few months later moving out, getting utilities turned on and off, etc.. Staying at an apartment-hotel is very convenient for periods of short periods, say less than 3 months. That is usually long enough for me to be here anyway. The downside is that they can get pretty expensive, although if your stay is longer than 30 days there is no hotel tax. The one I am staying at now is raising their rates on 1/1 and then *again* on 2/1.

[safari]

I have a corporation that has me as its sole employee. The corporation has recently set up a Personal Health Services Plan using a trust company.

That might work, but it sounds like it is way too much hassle for me! I have trouble just keeping my records and getting my income tax return filed each year!

[Meadbh]

Originally Posted by safari

That might work, but it sounds like it is way too much hassle for me! I have trouble just keeping my records and getting my income tax return filed each year!

Actually, very little hassle was required. To set this up, I met with one agent, filled one form, and wrote one voided cheque. No ongoing administration costs. They suggest I submit bills once yearly.

http://www.olympiatrust.com/about.php

[mykidslovedogs]

Originally Posted by safari

I am FIRE and have private health insurance. I no longer maintain a home in my erstwhile hometown (I just rent an apartment-hotel/extended stay hotel room when I am there), although I still consider it home and spend, on average, about 5-6 months a year there. The rest of the time I am travelling or living part-time abroad. My health insurance premium has skyrocketed over the past few years and the few times I have gone to the doctor it has almost always been when I was away from home so I just paid out of my own pocket and didn't get any reimbursement.

Does anyone know of any health insurance that would work for my lifestyle? Suggestions? By the way, a year ago I was thinking about an HSA and I am now taking another look.

Sorry I didn't comment earlier. Have been busy with the holidays...

First - May I ask what carrier you are using for your private policy? Blue Cross and Blue Shield has a worldwide network, so If you are with them, you should have some network coverage abroad. Here is the link to their worldwide coverage info....

http://www.anthem.com/wps/portal/ahp...onal%20Members

If you are not with Blue Cross and Blue Shield, I would recommend keeping your current coverage and supplementing with a travel policy when you travel. Multinational Underwriters International Citizen Economy is a good plan for people who travel 6 or more months out of the year, and the coverage is fairly inexpensive... Here is a link to get info:
The good thing about supplementing with a travel policy is that the travel policy pays the providers, and you are not required to pay upfront and then be reimbursed at an out of network level like you would be on your existing stateside plan. I hope this info. is helpful to you.

https://www.worldtrips.com/quotes/

Another thought would be to drop your stateside plan altogether and go strictly with an international policy (like MNUs international citizen plan. The only problem with this thought is that if you were to develop a pre-existing condition while abroad, it would be hard for you to get back into the private market again in the U.S. when you decide to cut down on your travels.

Happy travels, and happy new year!

[Meadbh]

Ah, our resident Insurance Specialist, MKLD, is here!

[Trek]

I still carry personal health insurance through Blue Cross Blue Shield. It offers some coverage just about anywhere in the world. It even covers me in Estonia, though I've never used it there and I have to go to a certain medical center. I pay $1800 annually for 80/20 coverage (in the U.S.)

I'll shortly drop it in favor of private health insurance in Estonia through a Swedish provider that gives me access to 48 privately run medical centers throughout Central and Eastern Europe. It'll cost me $540 annually and provide 100% coverage.

[safari]

May I ask what carrier you are using for your private policy?

Thank you for your excellent post and good info! I am using BCBS since 1999.

I usually purchase travel health insurance when I travel. I guess my frustration is that I have been paying more and more (up about 1000% in 7.5 years) and the rare times when I could make use of it I am not at home so just pay out of my own pocket. I am healthy and rarely go to the doctor, except for a physical exam every couple of years. More and more I am thinking an HSA would be better for me.

The increase in premiums is just unbelievable to me! A high deductible HSA will cost double what my fairly good policy cost when I got it in 1999.

Multinational Underwriters International Citizen Economy is a good plan for people who travel 6 or more months out of the year, and the coverage is fairly inexpensive.

I'll take a look at that. Thank you!

[mykidslovedogs]

If you are travelling more than 6 mo. out of the year and are very healthy, I'm thinking a higher deductible/more of a catastrophic plan is probably a good idea. Why pay for the extra benefits if there is no need for them? It's not hard to make a plan change to a higher deductible. A simple letter of request to your insurance carrier is all it takes. You might need to call them to get quotes on some alternate plans, first. Or, if you get a broker, they will do all that work for you, and then all you'll have to do is sign the letter of request.

[vic]

Check out some of the European carriers. They are well regulated and can't kick you out once you become too expensive for them.

This following is fairly expensive but it does not seem to have a restriction on citizenship (some countries will not insure non-citizens or certain nationalities). Hospital coverage is 2203 euro with a 1050 euro deductible for ages 45-59 (1322 euro with 8000 euro deductible). You can add some extra stuff for non-hospitalization treatment or meds etc..

http://www.joho.nl/verzekeringen/doc...ms_eur2005.pdf

Vicky

[kramer]

There is a possibilty, but I am not sure you are a good candidate for it because I think you spend too much time in the US.

But you could base your health insurance in another country, and then purchase travel insurance when you travel to the US. There are some policies that will cover you anywhere in the world but the US that are based in Thailand, for instance. There are also true worldwide policies. In some cases, for non-emergency care, you may need to return to the country of origin of the insurance policy.

This strategy works best if you are living primarily in one non-US country, and only return to the US for visits. The travel insurance covers you for all emergency care up to a fairly high limit, including in the US. This is what foreign travelers (should) purchase when they travel to the US. There are web sites to sign up and you input the exact dates of your visit, coverage can typically be had for around $100/month, but it is age dependent.

This has the obvious drawback that if you decide to live in the US in the future more than a few months a year, you need to get true health insurance there. And you are screwed if you develop a pre-existing condition that might need to be treated on an emergency basis.

Overall, I think in your situation, I would go with a high deductible US-based policy, one that counts payments when you are in a foreign country towards the deductible. I believe the HSA rules include these sorts of payments, I did check once.

Kramer