Medical care when living in 2 places?

[Rex]

We are one year into FIRE and, as you know, life is great.....our plan has us living 7 months in Florida and the remainder in NC.

Our doctors and dentist are in Florida but I recently needed help while in NC. It was not easy and when you need medical care, it's not the best time to be figuring out who and where.

I've thought about establishing a primary care Dr in both places and rotate the annual "wellness" visit each year.....Same with dentist regarding the 6 month visit. But then, that could be a train wreck with duplicate efforts and confusion.....

Is this really an issue? And for those wise folks who've done this before, how do you handle it?

 

[RunningBum]

I kept my primary doctor and dentist in the state I chose as my primary residence. If you ever have to prove to the state of NC that you aren't a residence, it gets tougher if you see a dentist or doctor there for routine visits. I don't know how likely this is, but it's the advice a tax attorney gave a friend of mine in a similar situation, so it's what I followed too.

Maybe see a doctor and dentist in NC once to establish a relationship and explain that you will be doing standard checkups in FL but want a place to go for other situations. I just rolled the dice for 7 years and had one dental emergency I had to take my chances on (and had to sit in the waiting room for 3 hours), and one ER visit which didn't really matter about having a GP.

 

[harllee]

I live 6 months in the middle of North Carolina and 6 months in the mountains of North Carolina. My primary doctor is in my winter home in the middle of NC. When I need medical care for something like a sinus infection when I am in the mountains I go to a nearby urgent care, I have established a relationship with them. So far I have not had a dental issue while in the mountains, if it were an emergency I am sure I could find a local dentist. For a serious medical care I would get transported somehow to my winter home in Chapel Hill, NC where my primary doctor is. I use a pharmacy that has offices in both areas so I could pick up drug refills either place.

 

[MRG]

How will your insurance work? My ACA plan only works in the state I applied in. I'm staring at $1500 in bills that my insurance won't cover(they said no problem when I called).

Private insurance and Medicare are more flexible, I guess.

 

[harllee]

Maybe the OP is on Traditional Medicare which applies in all states.

 

[pb4uski]

We have BCBS and they don't seem to care where we get care. My PCP and who I go to for annual physicals is in VT but I went to an urgent care while in FL with a bad cough and it worked seamlessly. OTOH, DW has been going for her wellness visits in FL since her PCP in Vt left the practice that she was going to.

For us, 10 months to Medicare for DW and 18 months for me... all ok so far.

My dentist is up in VT and last 2 eye exams were in FL. I did crack a tooth while in FL and went to a local dentist to have the jagged edge smoothed. The quoted me $1,900 for a crown and it was $1,400 at home and since I wasn't in pain I waited to have it done here.

 

[RetMD21]

We have BCBS and they don't seem to care where we get care.

MY bcbs plan has big discounts form hospitals and doctors in network but I am unclear on whether I get the discounted rate when out of state. I am thinking probably not but haven't had any reason test it.

 

[Rex]

I'm the OP.

Thanks for the quick info....

My BC/BS insurance is good anywhere in the USA. So far, I've had no issues using it "out of state" and it's all "in-network" as long as I choose properly.

I don't want to cause alarm with my Florida state resident status so I may forgo any formal doctor relationship while in NC.

I do like the idea of working with the local dentist for one of the 2x a year cleanings. That way, I've got a local dentist if needed.

So it would be Urgent Care/ER and a local dentist while in NC and maintain my primary care folks/dentist when home in Florida.

Any other thoughts on this?

Thanks!

 

[karen1972]

What I read of my ACA BCBS was that I could go in other states for Emergencies only which to me implied I would need to go to either urgent care or the hospital...anything else would be treated as out of network. I know they had a web portal to go look up places in other areas if I need it. However, I don't think I'd use it for something I couldn't justify had to be addressed within a few days time as then I'd just wait until I got back to my primary since I'm not sure if they look at coding and would deny the claim as non-emergency.

 

[MichaelB]

We are one year into FIRE and, as you know, life is great.....our plan has us living 7 months in Florida and the remainder in NC.

Our doctors and dentist are in Florida but I recently needed help while in NC. It was not easy and when you need medical care, it's not the best time to be figuring out who and where.

I've thought about establishing a primary care Dr in both places and rotate the annual "wellness" visit each year.....Same with dentist regarding the 6 month visit. But then, that could be a train wreck with duplicate efforts and confusion.....

Is this really an issue? And for those wise folks who've done this before, how do you handle it?

We’ve been doing this for years. It’s a bit of an hassle, but can be managed. If you plan on living between two locations for an indefinite period, it helps to have, in each location, a primary care, any specialist (if you have any chronic condition) and a dentist. There’s nothing worse than looking for a dentist or primary care for immediately availability. BCBS BlueCard network is quite large and most policies have low cost sharing for PCP visits.

In our case the physicians and dentist understand we are seasonal residents, and that’s not an issue for them. We carry the results of blood work with us, just in case.

When you hit Medicare age this does become a bit more of a problem, as Medicare doesn’t pay for visits to your primary care physician unless you are ill or have some condition.Keeping a PCP in each location can get costly.

 

[MichaelB]

Just to clarify, the ACA does not define insurance networks. This is done by the insurance companies, working together with the state insurance regulators. Limiting networks is one way insurers limit healthcare options for users, and it is a bargaining tool for insurers with providers.

Choosing to restrict networks to local providers is entirely an insurer decision, and many employer provided policies are equally restrictive.