RVer Insurance Exchange’s 2017 (2018 Forthcoming!) Guide to Health Plan Options for RVers
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By now, more than 6 years after the Affordable Care Act (ACA) was signed into law in 2010, most people are familiar with how the ACA works. Rather than summarize all aspects of the Affordable Care Act in this year’s guide we will focus on plan options for RVers. Not much is changing in 2017 from 2016 as far as the ACA rules go. Below are the main ACA changes being implemented in 2017 for individuals and families. If you are looking for a more comprehensive overview of the ACA then you can get that by clicking here and also here (great resource at Kaiser Foundation).
- For 2017, your out-of-pocket maximum can be no more than $7,150 ($6,550 for HSA plans) for an individual plan and $14,300 ($13,100 for HSA plans) for a family plan before marketplace subsidies.
- For 2017, your maximum deductible is the same as the out-of-pocket maximum.
- For 2017 the maximum HSA contribution is $3,400 (+$1,000 for 55+) for individuals and $6,700 (+$1,000 for 55+) for families.
- For 2017 the fees for not having health insurance are the same as 2016 to be adjusted for inflation: 2.5% of household income (up to the total yearly premium of the national average price of a Bronze plan sold through the Marketplace) or $695 per adult ($347.50 per child under 18), whichever is greater. Maximum per person is $2,085. note: using the percentage method, only the part of your household income that’s above the yearly tax filing threshold ($10,150 for individuals, $20,300 for couples) is counted. For more information about the PPACA healthcare law and it’s requirements please visit www.healthcare.gov
NOTE: I am already getting lots of calls from folks asking me for a “Multi-State Plan”. So let me repeat what I wrote in the 2016 Guide about the federal Multi-State Plans (MSP) program…
Multi-State Plans have little to do with a plan’s network and are NOT an indicator of network availability. Here is the official definition of a Multi-State Plan from the federal government: “A Multi–State Plan is a private health insurance plan sold through the Marketplace under a contract between the U.S. Office of Personnel Management (OPM) and an insurance company. OPM is the federal agency that administers health insurance plans for federal employees, retirees, and their families.” Yeah, that’s about it. Pretty boring, huh? Notice it says nothing about coverage across state lines. Our advice is to ignore that identifier on any plan and focus on the plan’s actual benefits and network (PPO vs HMO vs EPO) instead.
2016 was a pretty tumultuous year for health insurance with several insurance companies pulling out of the ACA Marketplace and others severely diminishing their offerings. PPO plans are very hard to find now and even if you do find one it does not necessarily make it a good choice, given the fact that those networks are shrinking as well.
Minimum Essential Coverage (MEC) is the least amount of coverage that is required by Obamacare for an individual to be considered “compliant” and to avoid having to pay the Individual Mandate penalty. All ACA Marketplace plans and most major medical health insurance plans are considered MEC. However, since a lot of us RVers have to look at alternatives to these health insurance plans it is important to know if you have MEC or not. The only options below that are MEC are Option #1 (ACA) and Option #5 (AlieraCare). If you choose Option #2 (CAP), Option #3 (US HEALTH), or Option #4 (HCSM) below you DO NOT have MEC!
Here is a brief overview of the healthcare plan options available to RVers (in no particular order):
Option #1 ACA Coverage
Otherwise known as “Obamacare” this is major medical health insurance like you would obtain from Healthcare.gov or your state’s exchange. These, and only these, are subsidy-eligible plans. It is getting very difficult to find nationwide coverage ACA options. But, if you can, and you have pre-existing health conditions and/or qualify for a subsidy then this is probably the best option for you. There is NO MEDICAL UNDERWRITING with this option.
See if you qualify for a subsidy, get quotes, and enroll in an ACA plan right here. This is our new enrollment platform that is FAST, SECURE, and SIMPLER than going to Healthcare.gov.
Option #2 NEW! Nationwide PPO Cigna-Network Major Medical Plan (ACA-Compliant)
Available as of October 3, 2017: We now offer an off-exchange ACA plan in all 50 states! This plan is not subsidy-eligible and does have some qualification requirements but it is a great option for RVers wanting a Major Medical comprehensive nationwide network plan that is ACA-compliant.
Please go to our dedicated page to view the specific details on this new plan: Click Here!
- Available for November 1, 2017 start date
- ACA-compliant Major Medical Health Insurance
- NOT subsidy-eligible, off-exchange only
- Covers all Essential Health Benefits
- Nationwide Network (Cigna Open Access Plus)
- Available in all 50 states!
- Covers Prescriptions as required by ACA
- Has out-of-pocket maximums as required by ACA
- No maximum benefit limit as required by ACA
- This is a Group Health Insurance Plan
- Simple health questionnaire required to be accepted into group
- Requires primary applicant to be working 30 hrs per week, so not available for fully retired
- Self-employment is okay, Home-business is okay
- No employment verification is required, self-stated question only
- Enrollment is open year-round so you do not need to enroll during Open Enrollment
- Please go to our dedicated page to view the specific details on this new plan: Click Here!
Option #3 US HEALTH (underwritten by Freedom Life Ins Co)
Like Option #2 (CAP) this is an indemnity health insurance plan that does not qualify for ACA subsidies but provides nationwide PPO benefits. Available with this plan is the Premier Med Short Term Rider that gives you a $4,000 deductible and then covers all medical at 100% thereafter until the end of the calendar year. In essence, this one-time use rider upgrades your plan (even in the middle of a medical claim) to a $4,000 maximum out of pocket plan.
This plan is medically underwritten so you generally have to be healthy to qualify and it does not cover pre-existing conditions.
I recommend reviewing the benefits booklet by clicking here before scheduling an appointment with Portia to discuss this option.
Please go here to request details and/or a quote from Portia Lavigne for a US HEALTH plan only or call her at (407) 687-1550.
Please note that this is the only plan Portia is licensed to assist with. Not available in CA, SD, OR, WA.
** You can also schedule an appointment with Portia by clicking here **
Option #4 AlieraCare ** NOW AVAILABLE! **
Perhaps the most unconventional idea here is to drop health insurance and join a medical cost sharing group instead. These faith-based expense sharing programs are not insurance. Instead members directly share unforeseen medical expenses. Members make a fixed monthly sharing contribution. The groups have set up different systems to either reimburse members for their expenses or directly pay providers for the eligible expenses other members incur. By paying only for actual expenses and non-profit admin fees, the costs of these programs can be very attractive.
Here is a short Wikipedia article about HCSMs. There are 5 of them that qualify for the faith-based Individual Mandate exemption. These plans use different terminology than you are used to when discussing insurance so it can be a bit confusing when reading about their programs.
Literally, they directly share costs. There is no “coverage”, like you might expect with insurance. Nor is there a “deductible”. Instead, you must satisfy an “annual personal responsibility” and limits to sharing etc. But in the end they directly share costs. In fact this is how it would have been done by communities historically before health insurance got so big and modern medicine so expensive.
Research this option carefully before signing on and make sure you align philosophically and/or spiritually with the HCSM you choose.
This is a new plan from Aliera Healthcare that combines the 63 Minimum Essential Coverage preventive care benefits plan with a HCSM for hospitalization. It is an ACA exempt plan because it covers preventive care at 100% with no out of pocket expense to the member and includes an ACA-exempt HCSM hospitalization plan (view the letter of approval from CMS). It is not two separate bundled plans but is one plan through Aliera. Rates look good, benefits are nationwide, and the application is simple. The Statement of Beliefs is non-evangelical personal rights/liberty oriented, making it appealing to a broader audience than some of the other HCSMs.
Although this plan is not offered in SD AlieraCare is NOW AVAILABLE IN South Dakota!
Please go here to learn more about details of the AlieraCare Plan.
This is a Health Care Sharing Ministry + Preventive Care plan. The HCSM portion is through Unity Healthshare (an affiliate of Anabaptist Healthshare). Click here to view the full guidelines of the Unity Healthshare membership. You do not need to purchase Aliera + Unity separately. They are combined upon checkout when you enroll here.
Please NOTE: We DO NOT recommend the Value Plans due to the limited benefits…It is recommended that you choose either the Plus or Premium plans only.
View the provider network here: First Health Network
Short Term Medical–UPDATE 10/12/2017!
President Trump signed an Executive Order on 10/12/17 allowing individuals to enroll in Short Term Medical plans for up to a year! This eliminates the earlier law that went into effect in April 2017 that stated you could only have it for 90 days and could not renew it. Under this new rule you can also renew your STM plan at the end of the year. This makes STM plans a GREAT option for RVers since most of these STM plans have fantastic nationwide networks. Short Term Medical plans are medically underwritten so they will be most suitable for healthy individuals without pre-existing conditions or medications.
** Please go here to get a quote and enroll in a Short Term Medical plan. Warning: avoid the Connect Lite plan, stick with Connect Net or Connect STM **
We understand it can be overwhelming when looking at these options and the comparison chart (below) to try and decide what is the BEST option for YOU. But, please understand there is no one-size-fits-all here. You will have to weigh your options carefully before deciding for yourself which option makes the most sense for you and your family. As stated previously, we do not necessarily endorse any of these options over another…you must make the best choice for you and your family.
The first question to ask yourself is, “what’s most important to me?”.
Is it monthly cost? Out of pocket costs (i.e deductibles)? Nationwide coverage? Using a subsidy? Avoiding the penalty? Covering your pre-existing conditions? You will have to consider the importance of each of these categories before deciding which healthcare plan strategy to have in place for 2017.
So let’s look briefly at each of these separately…
If MONTHLY COST is the most important factor to you…
Then you will need to determine if you qualify for a subsidy first. You can do that right here or by running quotes at our ACA enrollment page right here. If you qualify for a subsidy and MONTHLY COST is the most important factor to you then a ACA plan is probably your best option since none of the other options can be used with a subsidy. If you do not qualify for a subsidy, however, you will probably find any of the other options offer a 30-70% lower cost option than an ACA plan.
If you want PREVENTIVE CARE benefits…
Then you will want to consider either an ACA plan (option #1 or option #2) or the AlieraCare option since these are the only two primary coverage options that include FULL ACA-required preventive care with ZERO out of pocket costs to members.
If NATIONWIDE COVERAGE is the most important factor to you…
Then you may want to consider our off-exchange Option #2 (available in all 50 states) or one of our alternatives to ACA coverage like US HEALTH, or AlieraCare. All of these alternatives give you nationwide coverage. There are very few ACA on-exchange plans that will give you this nationwide coverage. There are NONE in Arizona, South Dakota, or Texas (popular RVer domicile states). Florida Blue* remains a good ACA on-exchange option for Florida residents that still allows members to use the national Blue Cross Blue Shield network when traveling outside of Florida (we confirmed this on 11/1/2016).
If AVOIDING THE TAX PENALTY is the most important factor to you…
Then you will want to choose either an ACA plan (Option #1 or Option #2) or one of the alternatives we offer that allow an exemption from the ACA penalty like AlieraCare or another HCSM. US HEALTH plans DO NOT provide you with an exemption by themselves.
Keep in mind that there are many other exemptions you may qualify for even if you do not have an exempt or compliant plan. You can check those out right here.
NOTE: One exemption we expect a lot of people will qualify for in 2017 is the Affordability Hardship exemption. This exemption applies if you can not find a ACA plan in your area that costs less than 8.16% of your household (MAGI) income. ACA rates have increased so much this year that many will likely qualify for this exemption. Also keep in mind that it’s based on income only, not savings. Secure the advise of a qualified tax professional before assuming you qualify for any exemption.
If you are unhealthy and have extensive PRE-EXISTING CONDITIONS…
Then the choice is clear: You need an ACA plan Option #1. ACA plans are the only option that will cover all pre-existing conditions on day 1 without waiting periods. Same with prescriptions. If you have lots of prescriptions you need coverage for then an ACA plan is your best option. Most alternative healthcare options will give you discounts on prescriptions but will not give you a “copay” structure like ACA plans—although many ACA plans do subject you to your plan deductible first. Some ACA alternatives will cover pre-existing conditions after a 12-24 month waiting period.
Here are 2 additional items we suggest you give consideration to:
- Consider adding an Accident/Critical Illness (ACI) policy to whichever option you choose if you have a high deductible or no nationwide coverage. An ACI plan can help cover first-dollar expenses if you have an accident or specified illness. This is a particularly good idea for ACA plans with high deductibles and/or not nationwide coverage. Click Here for details.
- As always we suggest every RVer enroll in our Telemedicine plan so that you can get telephone consultations anywhere in the country. Some of the options in the chart above include a Telemedicine plan but others do not. You can join our very popular Telemedicine program by clicking here. It’s low-cost, convenient, and can save you a lot of time and money if you need to consult with a doctor.
If you currently have an ACA plan…
ACA has automatic re-enrollment in place for 2017. So if you are happy with your ACA plan, it is still available, and your income is not changing from 2016, then you can use the re-enrollment fallback if you want to. However, we suggest re-shopping your plan for 2017 since there may be better plans available to you that were not available in 2016. Additionally, it is very important to report income changes to the Marketplace if you are receiving a subsidy.
Your insurance company will send you a letter if your 2016 plan is not being offered in 2017.
If you enrolled in your 2016 plan through RVer Insurance Exchange the same automatic re-enrollment rules apply.
Comparison Chart of Options
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Plan Availability Chart
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