Pre-Medicare Insurance, travel nearly full time

[BarbWire]

Advice/clear-headed thinking needed, please!

I am 60, and do not qualify for ACA subsidies, so can shop off-marketplace. I use almost no health services.

I do not maintain a fixed abode (nearly full time traveler), but have the option of two addresses to use in TX: one in Polk County and one in Williamson County. My insurance options are either a dreadful HMO from BCBS (either county) or Oscar Health in Williamson county. Neither one has any out-of-network max/stop-loss.

Neither gives me "non-life threatening" health coverage so any time I am away from my home network (ie, almost all the time) I am vulnerable for unexpected health care costs. If I fall off my bike in VT and have a big 'ol gaping gash that requires 18 stitches but is not life threatening, the BSBC call center person said it would not be covered. (In fact, BCBS TX will implement a new policy on June 3 that all ER visits are the upfront financial responsibility of the insured, unless in later review BCBS-TX decides that it really was an emergency and chooses to cover some expenses.)

Alas, I miss the national network PPOs of yesteryear!

QUESTIONS:

1. faced with this, what do y'all do for medical coverage (not necessarily life threatening emergency) within the US when you travel?

2. same question for international travel.


Thanks

 

[MBAustin]

Have you talked with a health insurance agent to confirm that these indeed are your only choices?

For international travel, most travel insurance policies have medical coverage, some more than others. You can compare at a site like http://insuremytrip.com.

 

[omni550]

Advice/clear-headed thinking needed, please!

I am 60, and do not qualify for ACA subsidies, so can shop off-marketplace. I use almost no health services.

I do not maintain a fixed abode (nearly full time traveler), but have the option of two addresses to use in TX: one in Polk County and one in Williamson County. My insurance options are either a dreadful HMO from BCBS (either county) or Oscar Health in Williamson county. Neither one has any out-of-network max/stop-loss.

Neither gives me "non-life threatening" health coverage so any time I am away from my home network (ie, almost all the time) I am vulnerable for unexpected health care costs. If I fall off my bike in VT and have a big 'ol gaping gash that requires 18 stitches but is not life threatening, the BSBC call center person said it would not be covered. (In fact, BCBS TX will implement a new policy on June 3 that all ER visits are the upfront financial responsibility of the insured, unless in later review BCBS-TX decides that it really was an emergency and chooses to cover some expenses.)

Alas, I miss the national network PPOs of yesteryear!

QUESTIONS:

1. faced with this, what do y'all do for medical coverage (not necessarily life threatening emergency) within the US when you travel?

2. same question for international travel.


Thanks

For Q.2 - There was a recent thread here within the last couple of months on travel insurance for international travel.
(I'd research the link for you, but my laptop is on the fritz ATM. My tiny old tablet makes researching difficult.)

omni

 

[BarbWire]

Have you talked with a health insurance agent to confirm that these indeed are your only choices.

I haven't found an agent/broker in Polk County; most agents have dropped health. Still searching in Williamson County for an agent that handles health other than short term policies.

For Q.2 - There was a recent thread here within the last couple of months on travel insurance for international travel.
(I'd research the link for you, but my laptop is on the fritz ATM. My tiny old tablet makes researching difficult.)

Ah, thanks -- I"ll look for that thread.

 

[kite_rider]

We are in a similar situation that you are in. At least now you don't have to worry about paying the individual mandate penalty if you don't buy an ACA policy. If you truly are healthy and don't have any pre-existing conditions, you might consider buying a short term medical policy. They are much cheaper than ACA plans, but are pretty crappy policies. Now, you can get them for a full year rather than the 3 month limit that use to apply.

During one year in the past, we took the kids out of school for a year and traveled internationally. We were able to buy a pretty good travel medical policy for much less than the local ACA policy. Back then you could get out of the individual mandate penalty if you could show that you were out of the country for a period of 11 out of 12 months. So that worked for us.. As already stated, insuremytrip.com is a good place to shop for that.

 

[dcoy]

BarbWire: I have a USA friend who travels non stop, 365 days/year. Does not own a place, is constantly on the move. I asked him the same question last week. He responded with:

"Medical insurance is a real hassle for me - since I need to just buy a personal policy and pay full price - its not cheap. The one way you can save money is eliminate standard US coverage - and only have emergency coverage in the US- the problem with that is 2 things - 1 if something goes wrong while I'm in the US then it will be covered but only until I can get better enough to fly back to HK and continue any further treatments there (staying int he US for treatment is not an option) and 2 if I want to have any "elective" treatment in the US (ie go there for some sort of serious surgery, therapy etc that is not a good option overseas) it would not be covered at all - Id have to get the treatment elsewhere in the world. So if you are prepared to be OK with using medical services outside the US you can get decent policies but I'm not prepared to do that yet myself. I use Aetna but there are lots of other providers and plans".

 

[BarbWire]

Thanks, @kite_rider and @dcoy.

This is frustrating indeed. I have not found an agent in either Texas county who has policies that offer reasonable coverage, regardless of price. At this point, I am inclined to buy the least expensive policy and assume that I am essentially self-insuring for my medical care for the next four years.

I usually don't spend more than 6 months of the year outside the US -- and that spread over a couple of trips. It is ironic that when I have trip medical insurance I have better medical coverage than I do in the US.

Of course, what happens to the insurance markets in 2019 is totally up in the air, with the repeal of the individual mandate. Sigh.

 

[zinger1457]

Since you're in good health I assume you will probably shop for a HDHP. Even if your heath insurance covered you it's likely most if not all of the cost for minor injuries while traveling will end up as out of pocket cost anyway. I've ran into minor medical issues a couple times while traveling and just went to the local clinic and paid cash. Not very popular here but maybe look at one of the healthshare ministry plans, I'm pretty sure they will cover you anywhere.

 

[BarbWire]

For sure -- I've had a bronze HDHP for the past several years. The HSA contribution is a small bit of salve on the premium wound.

And the little bit of health care I've had -- other than the covered vaccinations -- I have paid cash for. In fact, my chiropractic doc stopped dealing with insurance entirely three years ago -- it wasn't worth the hassle for his office staff. And he says that he lost very few clients; those who have insurance that covers chiropractic understand and are willing to file their own claims.

My out-of-pocket "in network" is capped at about $7,000 per year, and I've budgeted that. I would like to find a policy that has a max for "out of network" because not only do you run into OON away from your home network, but even at your home base, out-of-network is inevitable. For example, my current individual insurance (in FL) has in-network emergency rooms and hospitals, but notes that there are no ER docs, radiologists, pathologist or anesthesiologists in network. Huh? That's where an OON max becomes critical.

Regarding healthshare ministries -- philosophical mismatch. But thanks for suggesting -- all ideas welcome..

I've been looking at insuremytrip -- thanks to all for the suggestion. I also need to study the referenced thread. Maybe I should spend most of 2019 out of the USA....

 

[kite_rider]

Let us know what you find Barb. I feel like I've spent *way* too much of my life's time looking for health insurance and reading the fine print. Most of my friends have Megacorp insurance, ACA, or they just don't care about the details; so it's hard for me to find people to compare notes with.

I don't know what you like to do when you travel, but my idea of early retirement is kite surfing, mountain biking, backcountry skiing, and paragliding. Once you actually find health insurance, you might discover that half the things you do are *not* covered.

For international travel, I've been using the International Medical Group (IMG) Patriot International plan with the 'Adventure Sports Rider'. This policy seems to cover my needs and has the best price. Never had a claim, so I don't know how good this plan actually is. Would love to hear from anyone else who has feedback about IMG.

Regarding short term medical (non ACA) in the US, try to find an insurance broker that carries National General Short Term Medical Plans. I had this policy once a while back and found that they were very affordable and the 'in-network' care was vast - covered most all of the country. Part of Aetna. I had one claim with them (Urgent Care visit) and it was while I was travelling in Southern California. They paid promptly and the negotiated rate with the Urgent Care facility was much lower than I feared. However, they have fine print that excludes hang gliding and 'similar' things; so I figured they would not cover a claim related to paragliding. Because of this, they don't fit my needs; but may be something for you to explore.