ACA plan for snowbirds?

[MichaelB]

But wouldn't BCBS/FL expect that you have treatment for a major illness like cancer be in their network? I would think they might object if all the bills came from outside FL, especially if it is more expensive.

No data or studies to back this up, but I think most people don't travel far away from home to treat major illnesses.

 

[photoguy]

I'm not a snowbird but I have been doing extensive extended travel in the US for the past two years. I have been very happy with a PPO plan from BCBS and had no problem with getting non-emergency care in multiple different states at in network providers.

I wondered if BCBS would look at our usage and question where we were resident. But they never did -- probably from their end we either did not exceed any "thresholds", we look just like consultants who do a lot of travel for work, or maybe our situation is just not that unique.

As noted in post #2 you need to get insurance where you are a resident. If you have some choice in this due to being a snowbird, then you might find that certain states/areas have better plans. For example, while a PPO plan is easy to get in CA, that might not be the case for other locations. Also I've noticed that subsidy amounts could vary significantly by region due to the dependence on the cost of the second lowest silver plan.

 

[Ohio Tealady]

I'm looking for an update on this subject of having ACA coverage in multiple states. My home state only provides a regional HMO for my area. Is there currently a national provider?



Thanks in advance if you can educate me on this subject.

 

[mfposa]

Hello Harley,

We are Florida residents for the majority of a calendar year.

Our experience is the PITA factor is not great at all (notifying healthcare.gov and filing out a new app. Maybe 30 minutes all in. But I was a Navigator, so getting around in the program is easy for me). While the cost differential between a nationwide plan compared to a local plan is worth my time. Additionally, the hard work or PITA is finding the right doctor, which we have now accomplished by revisiting the States we enjoy.

ctbktb

We are struggling with insurance. We are 62 and snow birds. Florida Blue does not cover doctors in our summer home of South Dakota. Neither do the other 2 choices for healthcare for our Florida county. I think this would be ideal.

ctbktb - does the procedure of switching plans to the state you will be living in for the next few months, still work? Someone posted that as of 2016 they didn't think that would work.

I found a BCBS pdf that talks of an "Away from home care" program that allows you to switch your hmo to your new location if you're going to be there a few months:
http://www.bcbsfl.com/DocumentLibrary/SalesCommunications/content/Away From Home Care Brochure.pdf

 

[SecondCor521]

We are struggling with insurance. We are 62 and snow birds. Florida Blue does not cover doctors in our summer home of South Dakota. Neither do the other 2 choices for healthcare for our Florida county. I think this would be ideal.

ctbktb - does the procedure of switching plans to the state you will be living in for the next few months, still work? Someone posted that as of 2016 they didn't think that would work.

I found a BCBS pdf that talks of an "Away from home care" program that allows you to switch your hmo to your new location if you're going to be there a few months:
http://www.bcbsfl.com/DocumentLibrary/SalesCommunications/content/Away From Home Care Brochure.pdf

I'm not ctbktb and also not a snowbird, but you can check out "Changes in residence" for special enrollment periods at https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period. Note the comment about "vacations", although I think snowbirding would likely not be considered a vacation.

It could be clunky to switch back and forth though. Usually you can only start coverage on the first of the month, so you'd either need to time your snowbird transition dates to the first of a month, or have overlapping coverage for the transition months.

 

[MBSC]

Florida Blue does not cover doctors in our summer home of South Dakota...

I found a BCBS pdf that talks of an "Away from home care" program that allows you to switch your hmo to your new location if you're going to be there a few months:
http://www.bcbsfl.com/DocumentLibrary/SalesCommunications/content/Away From Home Care Brochure.pdf

This document says South Dakota does not participate in the BCBS 'Away from Home' program.

https://achieve.lausd.net/cms/lib/C.../active/2021Anthem_Guest_Membership_flyer.pdf

There is also this:

Below is a list of states that do not participate in Away From Home Care® (AFHC®). For states that are covered, please contact Member Services to confirm there is coverage in that county.

States not covered on AFHC® include, but are not limited to: Alabama, Alaska, Idaho, Iowa, Kansas, Mississippi, Montana, Tennessee, Nebraska, North Dakota, Oregon, Puerto Rico, Rhode Island, South Carolina, South Dakota, Utah, Vermont, Washington, West Virginia, and Wyoming.

Source: https://capitalhealth.com/faq-what-areas-are-covered-away-home-care®

 

[Freedom56]

We use a BCBS PPO. These plans are not cheap. We are now paying $1883 per month for two of us for a Bronze PPO with no subsidies. All we get are annual preventive screenings. I can't wait for the day we are eligible for Medicare.

 

[mfposa]

I'm not ctbktb and also not a snowbird, but you can check out "Changes in residence" for special enrollment periods at https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period. Note the comment about "vacations", although I think snowbirding would likely not be considered a vacation.

It could be clunky to switch back and forth though. Usually you can only start coverage on the first of the month, so you'd either need to time your snowbird transition dates to the first of a month, or have overlapping coverage for the transition months.

I saw the requirements. If students can change, why wouldn't people who are going to be in another state for months?

However, after believing that switching plans would work fine, I found another article that pointed out that your deductible, if any, would be reset to 0. They also said that your tax credit may be affected. Not sure why the tax credit would be affected.

 

[mfposa]

This document says South Dakota does not participate in the BCBS 'Away from Home' program.

https://achieve.lausd.net/cms/lib/C.../active/2021Anthem_Guest_Membership_flyer.pdf

There is also this:

That's an amazing find! Too bad you can't switch the BCBS HMO to SD, and other states, since I think the ability to switch HMO home base would have been ideal.

United healthcare has something called tri-term (3 years of coverage) and short term coverage (12 months or less of coverage.) I think every doctor in the US is in that plan. It's NOT an ACA plan. The price is about $950 a month for the tri-term which was what we would pay for an equivalent obamacare plan with $1000 a month tax subsidy coming from you! ( I do not understand how the gov can afford that.)

Since we are 62, the tri-term would have been fantastic. However, you have to be in super good health. I am in super good health. However, I have a blood disorder that hasn't done anything for 10 years and often never does anything. But "blood disorder" is on their list of rejected conditions for the short term plan. The tri-term plan does not list it but they do ask about other conditions that are not in their list. I'll have to list the blood disorder.
I'm sure they'll see it and reject. We'll see. I applied.

One advantage of the short term (12 month) plan is that you can pay the premium all at once and get 18% off!! If I get tri-term, we will put my wife on short term plan for maximum savings.

However, as I'm sure you thought of, doing that opens you up to developing a condition. But if that happens, you could switch to ACA and not travel or take your chances on needing medical.

 

[SecondCor521]

I saw the requirements. If students can change, why wouldn't people who are going to be in another state for months?

However, after believing that switching plans would work fine, I found another article that pointed out that your deductible, if any, would be reset to 0. They also said that your tax credit may be affected. Not sure why the tax credit would be affected.

Good point on the deductible.

Your tax credit almost certainly will be affected, because it is determined, among other things, by the SLCSP, which in turn depends on where you're living (in my case, it's my ZIP code). Everything still works as you would expect, it's just that you'll get multiple tax forms (1095-As) and will have varying entries in the January to December section of your ACA PTC reconciliation on Form 89662.

 

[ctbktb]

Hello mfposa- Sorry, I do not personally know if it still works. We have been insured with Florida Blue since 2018, and given our good health, stopped changing plans mid-stream at that time.

Take care.