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Medicare Insurance for RVers Summary
For many RVers, health insurance is a significant factor when considering the RV lifestyle. Some might say it’s the #1 obstacle to overcome before hitting the road full-time. Maybe it is, but for a lot of folks it’s a legitimately daunting hurdle that can’t be ignored. We don’t see any reason why it has to be a prohibiting factor so long as your expectations are reasonable and your risks are properly managed.
If you are eligible for Medicare then you are in luck because the Medicare program and all of the supplement plans and the Lasso Medicare Advantage plan we offer all provide you with nationwide coverage!
The two main health insurance issues that have to be addressed for RVers are affordability and portability. Let’s talk about these briefly…
Of course, “affordability” is relative, isn’t it? What we consider affordable, you might not, and vice-versa. So, let’s see what we can do to make health insurance affordable for you. The best thing you can do is to manage your risks and expectations.
Health insurance is risk management. When you purchase insurance you are transferring risk from you to the insurance company. The more risk you transfer to the insurance company, then the more expensive that transfer will be. So, in order to make that transfer more affordable it’s important to not look at insurance as replacing all medical expenses. Instead of looking at health insurance as a “healthcare payment plan”, try looking at it as “asset protection”. Don’t buy insurance to help pay for every little healthcare need in your life. Can you imagine how much car insurance would cost if it covered every routine oil change, tire change, tune up, etc.?
Buy insurance to protect your family from serious financial disruption should a significant healthcare need arise (i.e. major surgery, lengthy hospital stays, disability, etc.). Here are some important ways to make health insurance more affordable:
- Assume some risk: Having even a small deductible, coinsurance, and/or copayment can go a long way in helping to reduce your premiums. Thankfully for Medicare enrollees there is not a whole lot of risk involved.
- Comparison shop: Since Medicare supplement plans are standardized and easily identifiable by the letters A-N it is easy to comparison shop. Just a little “leg work” can yield significant savings with Medicare plans.
The good news for people on Medicare is that Medicare is about the most portable health insurance available to anyone! The vast majority of healthcare providers (over 95%) in the USA still accept Medicare. You do not have to be too concerned about providers turning you away with Medicare. There are no “In-network” and “Out-of-network” benefits to speak of with Medicare, so you are generally covered for care at the same level regardless of where your travels take you.
The best thing you can do to maintain the portability aspect of your Medicare is to . . . Keep Original Medicare**!
If you enroll in a Medicare Advantage plan (Medicare Part C) you are giving up the use of Original Medicare. This could mean you are placing restrictions on your access to care. Medicare Advantage (MA) plans are network-based and contract-based plans. This means that each MA plan has it’s own network of providers and has a contract with Medicare that has to be renegotiated each year. You will have to be aware of your MA plan’s out-of-network benefits. Also, MA plans are not guaranteed renewable because of the renegotiating that has to take place each year between Medicare, the MA plan, and it’s network of providers.
**I do have one exception to this general rule of always keeping Original Medicare and adding a Medicare Supplement plan. As of November 2018 we are now offering a new Medical Savings Account plan for Medicare enrollees. This is a rare Medicare Advantage plan with nationwide coverage and $0 premium.
Our Recommendations for RVers on Medicare
For a lot of “want-to-be” full-time RVers, getting that Medicare card in the mail is the last piece of the puzzle before hitting the road. If you are on Medicare then you arguably have the most affordable and portable health insurance available to anyone in the country.
The good news is that the vast majority of healthcare providers in the country still accept Original Medicare. Our general recommendation is to keep your very portable Original Medicare and purchase a Medicare supplement plan to fill in the gaps. Medicare Supplement plans, just like Original Medicare, will go with you wherever you go.
So, which Medicare Supplement plan is best? Remember, Medicare Supplement plans are standardized by the federal government. This makes it a little easier to shop for the right plan because all plans of the same letter have to cover the exact same things. So, a Plan F offered by “Insurance Company A” has to be identical in benefits to the Plan F offered by “Insurance Company B”.
If you want a $0 cost plan…
This is a Medicare Advantage plan that can be used at any Medicare doctor in the country. It consists of a Medicare-funded MSA account + a high deductible health insurance plan. The MSA funds give you some first-dollar coverage before the deductible is met.
If you want the most coverage regardless of premium we recommend…
- Plan F: No out-of-pocket costs, premiums about $140-200+/mo.
If you want the “best” coverage, get Plan F. It covers the most with virtually no out of pocket expenses. There are no deductibles or co-payments for anything. But you will pay a higher premium, of course.
Note: The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) passed by Congress and signed into law on April 16, 2015 will abolish Plan F (and C) in 2020.
If you’re willing to share some minimal costs for a lower premium…
- Plan G: You only risk paying the $185 annual deductible, premiums about $125-$160/mo.
A good option would be to get Plan G. It covers everything Plan F does, except you pay your annual Medicare Part B deductible ($185 in 2019). With plan G you can often save $20-40 per month in premium over Plan F, making it worth the risk of having to pay a small annual deductible that usually amounts to less then your annualized savings.
- Plan N: You risk paying $185 annual deductible and some small co-pays, premiums about $90-$140/mo.
We like Medigap Plan N as well. It covers just about all of your Medicare co-insurance and deductibles except 3 small items:
- Your Medicare Part B annual deductible ($185 in 2019)
- A $20 co-pay for office visits
- A $50 co-pay for Emergency Room visits (waived if you are admitted to the hospital)
If you are willing to assume the risk for these few items, then we suggest giving Plan N a serious look. The premium savings over a Plan F or G can be substantial. We’ve seen Plan N rates as much as $75-$100 per month cheaper than a Plan F.
If you are willing to share more costs for a much lower premium we recommend…
- High Deductible Plan F: You risk paying $2,300 (2019) annual deductible, premiums about $35-$75/mo.
Possibly the most overlooked Medigap plan is the High Deductible Plan F (HDF) option. This plan will cover 100% of your Medicare gaps after you meet your annual deductible of $2,300 (2019). If you’re in reasonably good health and only go to the doctor for your check-ups and other preventive visits then this might be the most economical option. Premiums for HDF are often half of what you would pay for F, G, or even N.
Since Medicare is now covering a lot of the preventive care, it’s possible you could have HDF and rarely have to meet your deductible while still getting the routine care you need. But, if something more serious occurs then your maximum exposure is the $2,200 (plus your premiums). In fact, we really wouldn’t consider Plan F a “catastrophic” plan since the deductible is relatively small and your coverage is very comprehensive once the deductible is met.
Why not Plan K, L, or M? These three plans have not been popular since their inception in 2010. Since they are not popular, they are not priced competitively. Generally their premiums are comparable to a Plan G or Plan N, which both offer richer benefits. Plan K can be 25% lower, but with a $4940 out-of-pocket limit you would be better off with the High Deductible Plan F…it’s cheaper and better.
***Plan N has a $20 office visit copay + $50 ER copay
How to choose an insurance company
Which company you purchase your plan of choice from is really not that important from a portability standpoint. They all are accepted at the same places. Your Medicare supplement coverage follows you wherever you go in the USA.
However, some companies will certainly have lower rates than others for the exact same plans. In fact, the best thing to do is **compare the rates for all of the plans you might be interested in before deciding which one to go with. I also recommend going with a carrier that has been in the market for a while because oftentimes the “newest and cheapest” company rarely stays the cheapest.
You also might want to review the insurance company’s A.M. Best rating. This rating is a reflection of the company’s financial strength only. It has nothing to do with a company’s customer service or claims paying history. I don’t consider it crucial to go with an A+ rated company since federal law protects you if your insurance company goes out of business. However, all things being equal it’s better to choose the higher-rated company.
Finally, remember these key points about Medicare supplement plans:
- They are guaranteed renewable each year
- Your coverage travels with you in all 50 states
- They are accepted everywhere Medicare is accepted
- They provide freedom to choose own doctors
- No referrals required
Medicare Part D (Prescriptions)
UPDATE October 2019: Medicare.gov has redesigned their Medicare Plan Finder. If you plan to visit Medicare.gov please understand that it is NOT a useful resource to shop for a Medicare Supplement (Medigap) plan because their data is not accurate and not complete. It is, however, very useful for shopping for a Medicare Part D plan. They have a lengthy (37 min) How-To video for shopping for a Part D drug plan here on YouTube.