RVer Insurance Exchange’s 2019 Guide to Health Plan Options for RVers

 If you are on Medicare, please click here to go to our Medicare Page

Quick Enrollment Links (scroll down the page for details on all of these options)

 Are you looking for assistance? If, after reading our guide, you would like further assistance then you are welcome to contact us directly at our Contact Us page: click here to contact us! Please allow 24-48 hours for a reply during Open Enrollment November 1 – December 15, 2018. Or use one of the links below to reach one of us directly:
contact Kyle Henson for details about ACA in TX,SD,FL as well as all other plan options in all states.
contact Greg Schoenberg about ACA in AZ,OR,WA.
contact Portia LaVigne for details about US HEALTH plans (option #3) only.

2019 Affordable Care Act Changes

Below are the main ACA changes being implemented in 2019 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).

  • 2019 Open Enrollment is UNCHANGED from 2018. It runs for 6 weeks November 1, 2018 – December 15, 2018.
  • For 2019, your out-of-pocket maximum can be no more than $7,900 ($6,750 for HSA plans) for an individual plan and $15,800 ($13,500 for HSA plans) for a family plan before marketplace subsidies.
  • For 2019, your Maximum deductible is the same as the Out-of-pocket Maximum, just like 2017
  • For 2019 HSA plans, the Minimum Deductible required is $1,350/$2,700 Individual/Family
  • For 2019 the maximum HSA contribution is $3,500 (+$1,000 for 55+) for individuals and $7,000 (+$1,000 for 55+) for families.
  • The Individual Shared Responsibility Provision: On January 20, 2017 President Donald Trump issued Executive Order 13765 which eliminates the Individual Mandate penalty as of January 1, 2019.
  • Short Term Medical ruling: In August 2018 the Centers for Medicare and Medicaid Services (CMS) issued a final ruling on Short Term Medical lengths of coverage in order to address affordability challenges associated with ACA plans. The two significant changes to STM plans effective October 1, 2018 are:
  1. STM plans can be initially written for up to a 364 day period.
  2. STM plans can be renewed for up to 36 months.

2019 ACA Rate Changes

You can use this tool to search for any insurance company’s requested 2019 rate increase (actual increase may be higher or lower based on state approval). Here is a summary of the rate increases requested by 3 popular insurers among RVers (as of 10/10/18):

  • South Dakota’s Avera Health: +2.58% (regional PPO plans) Rate INCREASE
  • Texas’ Blue Cross Blue Shield-6.09% (HMO plans) Rate DECREASE
  • Florida’s Florida Blue: unpublished as of 10/10/2018, according to Florida Blue not to exceed +15%

A couple of key ACA definitions to know:

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 if it were to be enforced. All ACA Marketplace plans and most major medical health insurance plans are considered MEC. Since the individual mandate tax penalty is gone as of January 1, 2019 it is unlikely that stand-alone MEC plans will have a significant roll in 2019.

Minimum Essential Coverage should not be confused with Essential Health Benefits (EHB)EHB is a set of 10 categories of services health insurance plans must cover under the Affordable Care Act in order to be offered on the Marketplace. These include doctors’ services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth, mental health services, and more. You can view more details about EHB as well as state-specific benchmarks here.

 


2019 Healthcare Plan Options

ACA PPO plans are still hard to find and even if you do find one it does not necessarily make it a good choice for nationwide coverage, given the fact that their provider networks may be regional only (Like Avera Health in SD). So, once again we are offering alternative options for those that once something outside of the ACA offerings. The two biggest changes to our offerings in 2019 are 1) Short Term Medical can be written for up to 364 days (and renewed for up to 3 years) and, 2) Premier Plans (Elite Series) are back for self-employed individuals.

Here is an overview of the healthcare plan options available to RVers in 2019:

Option #1 Affordable Care Act Coverage (‘Obamacare’)

Subsidy eligible, no medical underwriting.

Otherwise known as ‘Obamacare’ this is Major Medical health insurance like you would obtain from the Federal Marketplace or your state’s exchange. These, and only these, are subsidy-eligible plans. However, it is getting increasingly difficult to find nationwide PPO coverage options on the Marketplace exchange. But, if you can find one, and you have pre-existing health conditions and/or qualify for a subsidy then this may be the best option for you. There is NO MEDICAL UNDERWRITING with this option.

You must enroll for these plans during the annual Open Enrollment unless you have a special circumstance (like changing state of residency): November 1, 2018 to December 15, 2018 for 2019 coverage.

 An important note about Avera Health in South Dakota. Avera Health declined to renew our contract to offer their ACA plans in 2019. When we inquired as to why, we received this reply on 10/18/18: “RVers… I am sorry, but a narrow network product does not fit well for the members. We want to be able to take care of our members when they have an accident or illness. We do not have any providers or facilities outside of SD and NW Iowa, which makes us not the best fit for RVers.” Par for the course with ACA carriers in SD, unfortunately. While we agree that their plans are not a great fit for RVers, it seems it should be left to the members to decide if they are willing to risk traveling with their coverage. Nevertheless, it looks like RVers are not welcome to enroll with Avera Health for 2019.

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. 2019 Rates may not show up there before November 1, 2018.

Option #2 Nationwide PPO plans for SELF-EMPLOYED BUSINESS OWNERS.

Must be self-employed, Must be relatively healthy. 

We now have multiple plans to choose from if you are a self-employed business owner. You can not be fully retired and qualify for these plans. If, however, you or your spouse/partner work 30+ hours per week then this may be a great option for you.

We have been granted restricted access to these plans through an arrangement with the plans’ administrator and the workers’ union that offers the plans. Union membership is required and built into the premiums. All rates and details can be found once you access the enrollment sites via the links below.

Available to residents of ALL 50 STATES! Nationwide provider networks!

  • You need to be relatively healthy to qualify for these plans. Any surgery in the past 6 months or scheduled in the next 12 months will likely disqualify you. If you are taking expensive medications at the time of application you will likely not qualify. Type I diabetes, high cholesterol, hypertension are okay if there aren’t other additional pre-existing conditions. Email Kyle if you are unsure if you qualify.
  • Since these are workers’ association plans, the named primary applicant must be working 30+ hrs per week at the time of application. There are no specific income requirements.
  • You can not be fully retired and qualify for these plans.
  • Plans cover most preventive care at 100%, in addition to being a comprehensive medical plans.
  • Plans are available for individuals and families.
  • Plans are not subsidy eligible (only ACA plans are eligible for subsidy).
  • Nationwide coverage with excellent networks.
  • Enrollment is OPEN Year Round in all 50 states! You must apply by midnight of the 17th in order to get covered by the 1st of the following month.

Click on the links below to view the details, rates, provider networks and to enroll. You will need to look under the Major Medical tab in the menu. Email Kyle if you have any questions.

Choice #1 for SELF-EMPLOYED: HSA 5000, PPO X, and PPO 4 Plans click here for details and enrollment (use access code KHTX5445)

Proof of self-employment is required, plan rates are based on your age.

Choice #2 for SELF-EMPLOYED: Premier Plans click here for details and enrollment (use access code KHTX5445)

Proof of self-employment is NOT required, plan rates are not based on your age.

Option #3 US HEALTH ADVISORS (Fixed Indemnity* with optional rider) 

Must be healthy. If you are healthy and self-employed we recommend Option #2 instead.

This is a PPO health insurance plan underwritten by Freedom Life plan that does not qualify for ACA subsidies but provides nationwide coverage via the Cigna PPO network. Available with this plan is the Premier Med Short Term Rider that gives you a $3,000 deductible (dropped from $4,000 for 2019) and then covers all medical at 100% thereafter until the end of the calendar year. In essence, this one-time use rider upgrades an otherwise fixed-indemnity plan (even in the middle of a medical claim) to a $3,000 maximum out of pocket plan. However, if you exercise this rider option then you are required to leave the plan at the end of the calendar year! 

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 Portia directly at (407) 687-1550. Please note that this is the only plan Portia is licensed to assist with, so she will be unable to assist with any other options listed on this page. Her plan is not available in CA, SD, OR, WA.

** You can also schedule an appointment with Portia by clicking here ** 

  *Medical Indemnity Plans (a/k/a “fixed benefit” plans) pay a specific amount each time you see a doctor or go to a hospital

Option #4 AlieraCare Health Care Sharing Ministry (HCSM) STANDARD PLANS

Does not cover pre-existing conditions for 24 months, not health insurance. Not Available in South Dakota.

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. This was a very popular option for RVers in 2017. 

 There are other HCSM plans out there. We personally used a different popular “liberty-based” HCSM for 3 years but had a horrible time getting claims paid when we needed it in the 3rd year. Therefore, based on our own experience, we do not recommend the other ‘liberty-based’ HCSM plan. However, we understand our experience may be anecdotal and others may be happy with an alternative.

AlieraLogoThis is our preferred HCSM 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 (after a 9 month waiting period) at 100% with no out of pocket expense to the member and includes an ACA-exempt HCSM hospitalization plan. 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.

This is a Health Care Sharing Ministry + Preventive Care plan. The HCSM portion is through Trinity Healthshare. You do not need to purchase Aliera + Trinity separately. They are combined upon checkout when you enroll.

View the provider network for all AlieraCare plans here: PHCS Multiplan

You can email either Kyle with your questions about AlieraCare.

 

Option #5 Short Term Medical 

There is legislation that became effective October 1, 2018 that makes it possible to get a Short Term Medical plan for up to 364 days and to renew it for up to 3 years! However, not every insurance company nor state has adopted these rules.

Short Term Medical plans are medically underwritten so they will be most suitable for healthy individuals without pre-existing conditions or medications. Keep in mind that when you renew a STM plan you have to medically qualify each renewal term. So, if you have a medical situation occur while enrolled in a STM they can not drop your coverage but they can deny you the option to renew it at the end of your term.

** BOTH of our Short Term Medical options below provide NATIONWIDE COVERAGE! **

We now offer 2 options for Short Term Medical: National General or IHC Group

Both of these carriers offer excellent nationwide coverage, but for residents of WA state IHC Group is not available. Click on a logo below to get quotes and enroll in Short Term Medical! Email Kyle if you need assistance with choosing a Short Term Medical plan.

 


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.

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 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 primarily want MAJOR MEDICAL Health Insurance…

Then you will want to select an ACA plan or, if you are self-employed, you can consider the HSA 5000 plan and Premier Plans.

If you primarily want PREVENTIVE ROUTINE CARE benefits…

Then you will want to consider either an ACA plan, HSA 5000, Premier Plans or the AlieraCare option since these options include FULL ACA-required preventive care with ZERO out of pocket costs to members. But, we advise against purchasing a plan solely based on this offering since the largest risk of loss with healthcare is not routine preventive care but rather extended hospitalization.

If NATIONWIDE COVERAGE is the most important factor to you…

Then you may want to consider alternatives to ACA coverage like the HSA 5000, Premier Plans, US HEALTH or AlieraCare. All of these alternatives give you nationwide coverage. There are very few ACA plans that will give you this nationwide coverage for anything other than a medical emergency. There are NONE in Arizona, South Dakota, or Texas (popular RVer domicile states). Florida Blue* remains a good ACA option for Florida residents that still allows members to use the national Blue Cross Blue Shield network when traveling outside of Florida.

If AVOIDING THE TAX PENALTY is the most important factor to you (It shouldn’t be in 2019!)…

The individual mandate tax penalty has been REPEALED!

Don’t lose sight of the reason you are buying healthcare coverage: to protect yourself against a significant financial loss in the event of a major medical situation.

If you are unhealthy and have extensive PRE-EXISTING CONDITIONS…

Then the choice is clear: You need an ACA plan. 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.

 Prescriptions Tip: We suggest ALL RVers use our FREE GoodRx Discount Card program right here, regardless of what healthcare option you choose. GoodRx has a great reputation for getting the best Rx discounts in the industry.

We often get asked, “What do YOU have for coverage?”..

We encourage you to not make your choice based on what somebody else has chosen because your situation is unique to you. Case in point: There are 3 health insurance agents here at the RVer Insurance Exchange and each of us has chosen a different option above based on budget, health, lifestyle, risk aversion, and location. We strongly urge you to consider all of your options and make the choice that makes the most sense to you.

Other Recommendations…

Here are 2 additional items we suggest you give consideration to:

  1. 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 lacking nationwide coverage. Click Here for details.
  2. 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 most 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. It also includes discounts on prescriptions, dental, vision, hearing, and more.

If you currently have an ACA plan…

ACA has automatic re-enrollment in place for 2018. So if you are happy with your ACA plan, it is still available, and your income is not changing from 2018, then you can use the re-enrollment fallback if you want to. However, we suggest re-shopping your plan for 2019 since there may be better plans available to you that were not available in 2018. 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 2018 plan is not being offered in 2019.

 

Comparison Chart of Healthcare Plan Options…

Created with Compare Ninja

State Availability Chart

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Sample Only Rate Comparison Chart (Florida, nonsmokers, unsubsidized, $5000-$6000 deductible)

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