South Dakota RVer Health Insurance Changes

south-dakota-rver-health-insurance-changesSouth Dakota has served me well as my state of residency since I became a full-timer RVer over two years ago, but in 2015 it’s going to become less ideal for us younger nomads.

The reason is health insurance. With the Affordable Care Act (more commonly known as Obamacare) swinging into full effect next year, Coventry, my health insurance provider – and the provider for most other pre-retirement South Dakota full-timers – is pulling out of the state.

As a recap, up until now I’ve been on a low-cost, high-deductible catastrophic plan. I paid for my regular health needs out of pocket, and Coventry was around in case an emergency ever befell me. Back in March I wrote about how the health insurance scene was going to be changing. Then in July I got the letter I knew was coming: Coventry would extend my current coverage until the end of this year, but after that I needed to find something else. I opted to wait until closer to the end of the year to start searching for other alternatives, because with so many changes happening in the industry I figured the playing field would look different and perhaps better by November.

Here’s what I’ve found (note: this research was for pre-retirement age RVers, I believe those that qualify for medicare have better options).

  1. If you’re not eligible for a subsidy on your monthly premium, South Dakota is still a viable residency state. Your best option is to go with Assurant.

  2. If you are eligible for a subsidy on your monthly premium, the only one of the three companies on the Marketplace that’ll take full-timers (the other two require you to be in-state 6 months of the year) is Avera.

Wait, what’s this about subsidies and the marketplace? The Marketplace (also called the Exchange) is the the official government website (www.healthcare.gov/) set up specifically for for ACA health plans. Some states chose to set up their own websites, but the three big states for full-timers (Texas, South Dakota, and Florida) all use the healthcare.gov website. This is the site you go to for information on the ACA and to enroll in ACA plans.

Subsidies are discounts on your monthly health insurance premium that you may qualify for based on yearly income. For information on this specifically, check here.

Now, as a household of one with a yearly income of less than $46,680, I qualify for a subsidy, so for me it makes sense to enroll in plans on the Marketplace, because I’ll get a lower rate.

“But wait, wouldn’t it still be cheaper to stick to a catastrophic plan than to enroll on the Marketplace?”

Probably yes, but the ACA has changed the rules of health insurance. Everybody needs to have it now, and only folks 29 and under (or those meeting certain hardship exceptions) can enroll in catastrophic plans. I turned 30 back in February, d’oh. All of the full-timers currently out there with catastrophic plans are going to see their plans getting dropped or changed if they’re over 30.

But it’s not all bad news. My taxable income for 2013 was only $16,000. Even if it jumps to $20,000 in 2015, with the subsidy I’d still be paying less per month than I am now, and getting better coverage.*

Okay, so back to Avera and South Dakota. I’d looked on the Marketplace myself this past Wednesday and knew they were my only option, but I didn’t know how good of an option they were. There were muddled reports of full-timers having their insurance canceled after they’d been approved, for not being able to furnish a utility bill as proof of South Dakota residency.

Enter Kyle.

Kyle Henson runs a ridiculously useful website called RVerHI.com (http://rverhealthinsurance.com/) and this guy knows health insurance for RVers. I dropped him an e-mail at 5 am on Thursday morning asking what he thought about Avera, and less than an hour later I had a reply.

Call it serendipity or just plain good timing, but as it turns out, some officials at Avera were just about to have a meeting that day over whether or not full-timers could enroll in their Marketplace plans, and what the coverage outside of the state would be like for those plan holders.

By the end of Thursday I had my answer through RVerHI: Avera is required by the law to offer coverage to full-timers through the Marketplace, as long as they can provide an address that is within the sate, but, starting in 2015 they’d no longer be offering access to their nationwide network.

So what it boils down to for pre-retirement age full-timers who qualify for a subsidy is this: You can get a plan through Avera and remain a South Dakota resident, but you’ll only be able to get emergency care out of state. If you wanted to make use of the shiny new benefits of the ACA (yearly checkups and other preventative care at a reduced cost, not to mention non-emergency treatment), you’ll have to go back to South Dakota to get it. Ewwy.

So what’s a rolling nomad to do?

I cannot tell you what’s best for you, but as for myself, I’m “moving” to Texas next year.

The vehicle registration costs and taxes are similar to South Dakota, and their health insurance options on the Marketplace are way more nomad friendly (and a bit cheaper). However, I won’t be moving at the start of the year. As I’m sure you’ve all figured out by now, Amazon is more than a full-time job and I just don’t have the time and mental bandwidth to pursue changing everything over to Texas before the start of the year when Coventry’s coverage ends. So, I’ll be enrolling with Avera in South Dakota for 2015, and will have the whole of that year** before it comes due again to get my mail forwarding and everything else moved to Texas through the Escapees RV Club.

I’ll be writing more about the steps to becoming a Texas resident next year like I did in 2012 when I “moved” to South Dakota. In the meantime, I hope this information on health insurance changes for South Dakota helps those of you who have, or are thinking of choosing, SD as your domicile state. Have a good week all!

*For the curious, my monthly premium with Coventry was $60 from September of 2012 to 2013. In September of 2013 it jumped to $80 with the new ACA rules creating something of a panic with healthcare providers. My Avera Bronze level (read about the various levels of coverage here) plan at an estimated yearly income of $20,000 is going to be $71 a month. Without the subsidy (if I was making $46,680 or more a year), I’d be paying over $200 a month for my health insurance. That’s a huge difference.

**Open enrollment for the Marketplace started on November 15th and goes until February 15th (December 15th if you want coverage to start by January 1st), but there are events that can qualify you for enrollment on the Marketplace outside of this time frame. I’m about 85% sure as of this posting that moving states counts as one of them, but I’ll be calling or e-mailing and getting an answer from someone to find out for sure and will report back here.

Picture courtesy of Stockmonkeys.com

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41 Responses to South Dakota RVer Health Insurance Changes

  1. Rob November 17, 2014 at 4:21 pm #

    The last I heard Texas was going to require that their yearly vehicle inspection be passed before they would issue license tabs for the year. This was going to be a new change.
    If this comes to pass your licensed vehicle will have to return to Texas to be inspected every year.

    • Becky November 18, 2014 at 4:51 pm #

      Rob,

      Escapees is working on getting exceptions made for their members, they have a bigger political presence than any other RVing club/mail forwarding company out there. Even if it doesn’t work out though, with the year I’m buying through Avera I’ve got more time to find a solution. Thanks for thinking of me.

  2. Ron November 17, 2014 at 6:08 pm #

    Welcome to Texas, our Winter Home. I think there are exceptions to vehicle inspections for full timers, check the Escapees website. Consider the Rio Grande Valley for Winter, Nearly 500 RV parks in the Valley, great beaches on South Padre island and a very low cost of living. Best fruit and produce anywhere. Quite a few free site volunteer jobs in the State Parks and Wildlife refuges. Also many seasonal jobs in the community as the population increases in Winter by about 140,000 people. Many parks are over age 55 parks but many make exceptions and not all are senior parks. Park managers, activity directors and cleaning and maint. persons are in demand. If you want or need info on the Western Valley, Mission area just ask. This is our 11th Winter here and we love it. Ron

    • Becky November 18, 2014 at 4:58 pm #

      Yes, I see advertisements for Texas job openings on Workamper News all the time, I almost volunteered at McKinney park near Austin last winter but opted for Florida so I could work the renaissance festival with Julie. It’s possible I’ll end up out that way after Amazon, I’d really like a job that offers an hourly pay on top of a site though and those are hard to find anywhere in the winter if you don’t have management/repair skills.

  3. Doug November 17, 2014 at 10:56 pm #

    I make less than $12K, and due to the dumb Coverage Gap loophole, qualify for zero subsidy. So my only practical option is Medicaid. But, like Avera, Medicaid provides only emergency coverage out of state—thus useless to most RVers. Never mind the minor detail that South Dakota, like 22 other states, elected not to expand Medicaid coverage to childless adults. So if I want affordable health care, I will likely have to move to Arizona of all places. Oh joy.

    • Becky November 19, 2014 at 3:26 pm #

      This is the same problem Julie had Doug. When she quit her job to come travel with me she was technically bringing in no income and so had to go on Medicaid even though she wanted to buy a regular plan on the Marketplace. Wisconsin is also one of those 22 states. That’s not a fun situation to be in, and I hope you can get something worked out!

      • Ramen November 19, 2014 at 9:24 pm #

        You and Julie can get married and get a family insurance plan =)

        • Becky November 20, 2014 at 5:12 pm #

          Haha, but that would be awfully hard to explain when dating. 😉

          • Ramen November 20, 2014 at 5:19 pm #

            In Utah, the more the merrier.

  4. Sarah November 18, 2014 at 3:28 am #

    You’re awesome. This post could not have come at a more perfect time. I’m 30 years old, and I’ve been preparing to leave my job and go full-time RVing in 2016, and insurance is one of the things I’ve been completely lost about. I look forward to reading the ongoing saga of your “move” to texas next year and your experience with Escapees.

    • Becky November 19, 2014 at 3:27 pm #

      Thanks Sarah and I’m glad you found it helpful. 🙂 2016 may seem really far away now but you’ll be on the road before you know it, hope to meet you out here some day!

  5. Al November 18, 2014 at 3:58 am #

    Couple of things to consider re Texas; The yearly vehicle inspections, especially if they start requiring you return by a specific date instead of the current “next time you are in Texas, within 72 hours’. other consideration if you have a high mileage vehicle. Texas sales tax is about 8% vs SD of 3%. Florida has limited vehicle inspections in a few areas which is great but very high “initial vehicle registration” fees. Our son’s 8 year old pickup initial fee was over $700.

    • Becky November 19, 2014 at 3:31 pm #

      I responded to your first concern above Al, but thanks for thinking of me. Basically it’s not an issue right now, if it does seem likely that the rule will get changed Escapees is already planning on getting an exception. And as for the sales tax, my truck is doing well for now! As you already alluded to, there is no perfect solution out there. That’s true of much of life and I’m okay with that. 🙂

  6. Jim@HiTek November 18, 2014 at 6:47 am #

    Wow. Thanks a bunch for that report! I’m in the VA health care system but it’s kind of crummy. Took me 6 weeks to get a simple yearly checkup and prescription rewrite last Aug. so I’m thinking of ACA instead. Your advice is very handy and timely for me.
    Jim@HiTek recently posted..More from Rome…My Profile

    • Becky November 19, 2014 at 3:32 pm #

      Glad the time working out Jim. 🙂 Whether you make the switch or not, better luck next year getting timely service!

  7. Dave Burdick November 18, 2014 at 8:29 am #

    Back in September I was pumping gas and a FT South Dakota guy was filling up his truck pulling a 5th Wheel. Asked him if the insurance drama was going to affect their FT status with SD and he said that he was on Medicare. “How about the Mis?” I asked. “Oh, we have insurance for her….” “Well, hate to be the bearer of bad news, but you need to look into that,” I said, and proceeded to tell him that I had just read about SD not having coverage for FT RVers anymore. She was/is only one year away from medicare….I’ll bet they chance the Avera plan. My insurance is in Arkansas due to my retirement….at least it is centrally located for yearly doctor appointments and I am covered out of state but the deductible is double and the coverage is only 60% instead of 80% for the first $4,000 instead of $2,000 after deductible is met. If something “large” happens, we will just have to travel to Arkansas until I get on medicare myself in a few years. Dave (GoingRvWay.com)
    Dave Burdick recently posted..Always A Good Day When You Beat LSUMy Profile

    • Becky November 19, 2014 at 5:04 pm #

      Dave, yeah I can see that couple using Avera if it’s only 1 year.

      Arkansas makes good sense for that kind of situation. Hopefully it works out well until you can get on Medicare. Take care!

  8. Reine in Plano November 18, 2014 at 8:42 am #

    2015 is going to be an “interesting” year for health care for lots of folks, not just full time RVers. Paul is an AT&T retiree and AT&T is no longer providing health care coverage for retirees. Fortunately they are providing a subsidy that we can use to purchase our own coverage in the marketplace but it will probably cost us more than it did in 2014.

    Follow up with Escapees about the car registration and inspection for full timers. Annual vehicle inspection requirements have been around a long time but not previously linked to vehicle registration. The next year will be “interesting” in a lot of ways.

    • Becky November 19, 2014 at 5:07 pm #

      “May you live in interesting times.” Both a blessing and a curse. 😉

      Yeah I will look that, so glad I have plenty of time this way to figure Texas out. Would have been a nightmare to try to sort it at Amazon.

  9. wheelingit November 18, 2014 at 9:17 am #

    We’re grappling with this exact problem ourselves at the moment and will likely be forced to switch domicile out of SD. A couple of things we’ve found:

    -> TX offers far less subsidies than FL. So, if subsidies are important, you may want to double-check FL as a residency option. WIth subsidies ontop FL is actually quite a bit cheaper in health insurance rates.

    -> While you are switching residency out of SD another “temp” solution is short-term insurance. We may be going that route. Kyle has a page on it in his site.

    -> Wellmark (BCBS) is not really an option in SD, even off-exchange. They have the 6-month residency rule too & rejected us as fulltime RVer when we last tried to apply. You can “sneak” in, but they have the right to check residency anytime & drop you. Really there’s only one decent insurance option left in SD -> Assurant OFF exchange…no subsidies and and they are very, very expensive.

    Nina
    wheelingit recently posted..A Cool Airstream Gal & A “Tippy” ?@#! Drive – Lone Pine, CAMy Profile

    • Becky November 19, 2014 at 5:13 pm #

      Heya Nina, hope you’re having a good time driving down 395.

      I’ll look into those points you’ve made. So sorry that Wellmark didn’t work out for you, I’ll edit my post to reflect that. When I quickly peeked at the Texas marketplace it looked cheaper than SD so I didn’t even think to compare it to FL, but don’t you have to physically be in FL longer before you can get resident status? So many factors to consider! Ah well, it’s worth it in the end.

      • Wheelingit November 21, 2014 at 5:15 pm #

        base rates in TX are cheaper, but the rebates/subsidies in FL are much bigger. I didn’t know this, but subsidies vary a lot by state…even by zip code. I’d recommend getting quotes with the subsidies included, just to compare apples to apples.

        And no, no need to be physically longer in FL. It’s a very RV friendly state and has several RV savvy mail-forwarding services (Escapees just set up there recently, there’s St.Brendans Isle, there MyRVMail)

        Good luck with everything. We’re still not sure what we’re going to do yet either,

        Nina

        • Becky November 22, 2014 at 11:28 pm #

          Thanks for letting me know. I haven’t even been able to apply for Avera yet because the healthcare.gov website is having such a hard time verifying my identity. I’ve made multiple phone calls and it sounds like the only solution now is to physically mail copies of identification to their headquarters. Good thing I got started on this early.

  10. Jodee Gravel November 18, 2014 at 12:22 pm #

    I imagine this is really going to hurt those great mailbox and domicile companies in SD! I’ve been hearing about this for months and really thought other providers would step up instead of continuing to hold customers hostage.
    Jodee Gravel recently posted..Sometimes Just Believing Isn’t EnoughMy Profile

    • Becky November 19, 2014 at 5:16 pm #

      We were all hoping that would be the case Jodee, but what can you do? Terri at My Dakota Address has treated me really well, I’ll miss the ease of it.

  11. Amber November 18, 2014 at 1:08 pm #

    Very informative article. Currently I’m still stationary in AR, but this is great information as I think about my options in the future. Thanks for sharing.
    Amber recently posted..Airstream in the air!My Profile

    • Becky November 19, 2014 at 5:16 pm #

      You’re welcome Amber, glad you’ve found it helpful!

  12. weathershak November 19, 2014 at 5:47 am #

    Hi Becky, I’m still doing the full timing thing in Delaware. I currently have a Blue Cross Blue Shield multi state plan thru the ACA. Its a bit pricey for now and of course going up for 2015. Darn, wish I was 30 again !!!!! Stay warm and be safe Gary

    • Becky November 19, 2014 at 5:18 pm #

      I’ll get up to that part of the country sometime Gary, enjoy it! BCBS is probably who’ll I’ll be using in Texas they have a good network. Take care.

  13. Ivan Lee Livingston November 19, 2014 at 10:17 am #

    My wife and I will hit the RV road in a few years.

    We had to decide on the type of 30FOOT with slides, the kitchen design and the tow vehicle …BUT…we did not have to worry about INSURANCE. You see we are Canadian and we are covered in Canada and winters in Cuba.

    The US is beautiful and I have been to Florida 8 times and on an 8,000 mile van trip to California in 1978 but we have problems. Manulife was caught covering people through CAA-AAA and independently. Then they turn down 15,000 big claims every year. ( MARKET PLACE TV SHOW IN CANADA.

    Some couples have been stuck with $160,000 to $250,000 bills due to a heart attack in the US. Manulife had lawyers and doctors make forms that are not pre authorized. These CARNAVAL FORMS are said to be impossible to fill out.

    So the US rates are too high and Cuba is a lot of warm cheap fun. I have been to Cuba 15 times and they have the most doctors in the world. Our country will pay $ 200.000 a day for hospital and $ 400.00 for ICU. is FAR UNDER OUR RATES of $2,000 a day in Canada.

    I wish I could get back to the US to show my wife all the beauty of Nevada, Arizona and the Colorado mountian’s but it is not to be. On top of that I have a genetic Neurological Disorder and the boarder considers people like me as DANGEROUS ?? I am ex-Government 23 years and my wife is ex-Government 28 years.

    • Becky November 19, 2014 at 5:23 pm #

      Ivan, your story is interesting. I follow the blog of a Canadian full timer who had a real difficult time getting insurance because they wouldn’t take a mail forwardif address and wouldn’t cover her out of the province. Eventually she bought property in Saskatchewan to be able to get coverage. She visited the US one winter and enjoyed it, this winter she’s renting an apartment in Mexico.

  14. Clint November 20, 2014 at 7:11 pm #

    Since you have so much time to make a decision, I recommend that you consider St. Brendan’s Isle mail forwarding service in Green Cove Springs, Florida for your domicile. Although I was a Texas resident all my life, I changed my residency to Florida this year for several reasons. When I toured the Escapees mail forwarding facility in Texas, it did not come close to the mail handling options that St. Brendan’s Isle provides. I receive an email from SBI when I receive mail, and I can view a scan on the SBI web site of the front of the letter, magazine, etc. that I received. I then can choose to forward, hold, shred, or scan the contents. For postcard notifications, like dentist appointment reminders, I save the scanned image and shred the card. Junk mail is shredded and recycled. If I doubt a letter is important, I hold it while waiting for additional mail. I find that I spend very little money on forwarding postage because I have this level of control over my mail. (I have not yet needed to use their option to open and scan the contents of a letter.) I obtained my Florida driver’s license in May 2014, and I love that it will not expire until my birthday in 2023. (Under current Florida law, I can renew driver’s license by mail for an additional 8 years.) In addition, I am more certain of not receiving any jury summons from Clay County (Green Cove Springs) than from Texas. If you choose Florida over Texas for your domicile, I strongly recommend that you read Technomadia’s outstanding blog post regarding their changing their domicile from South Dakota to Florida. Although I also did my own research, I used Technomadia’s detailed recommendations during each stage of transferring my domicile to Florida. http://www.technomadia.com/2013/02/setting-up-domicile-in-florida-as-a-full-time-rver/

    • Becky November 22, 2014 at 11:47 pm #

      I’ll keep this in mind Clint, thanks for the info. 🙂

  15. edward November 22, 2014 at 2:12 pm #

    Becky,
    it’s been a while since I looked, but there are or were “travel insurance” options that covered away from home travelers for periods from 3 days to a year for very little money – I have one grandfathered for $60/yr.

    edward

    • Becky November 22, 2014 at 11:49 pm #

      I have a feeling that will have all changed now with the ACA Edward, but I’ll take a peek into it. There are temporary insurance options that you can get through the Marketplace, but they don’t exempt you from the uninsured fee since it’s not considered good enough coverage now. There are exemptions depending on your situation though, just a lot of stuff to dig through.

  16. Mary November 23, 2014 at 6:00 pm #

    Just so you’re aware…there is NO annual vehicle inspection required if domiciling in Texas as some folks think.

    Starting next March, if you don’t get into Texas you don’t have to go there for an inspection. You can not go to Texas for years and are not required to have an inspection.

    You only need the inspection if you go into Texas and then you’ll have three days to get it. It’s really no big deal. It’s a simple lights, turn signals, etc. type of inspection.

    The Escapees mail service is terrific. We’ve used it for many years and it’s fully automated just like a post office. In fact, it is so large that they have their own zip code and a semi truck picks up and delivers the mail daily. We use their $85/year program. Mail is shipped Priority anytime you want it. We always receive it within 2-3 days and we’ve never had a mix-up of any kind.

    Texas has very good medical plans, too!

    • Becky November 24, 2014 at 3:51 pm #

      Thanks for clearing up the inspection confusion Mary. I was hoping someone who used Escapees would get on and say what’s what.

      And Escapees has it’s own zip code, that’s really impressive!

      • Bodhi April 2, 2015 at 7:23 am #

        Funny story…

        Escapees zip code is 77399… it is not really a zip code… it is a default code.

        While waiting for the USPS to assign them an actual zip code their printer printed everything with the default zip code.

        You are looking at THOUSANDS of people now with a default zip code… so the post office (where I work, yes, I work their Priority Mail) just said, “What can we do now? Just let them have that zip code.” All other xxx99 zip codes are postal specific.

        I think they have had it now since about 1989 – 90 and, since my building is the only building that will ever really care about it, it must be working.

        NOT so funny story…

        I envy you.

        I am ticking time away waiting for my earliest retirement date (Jan. 29, 2024) to begin my full-timing. I’ve come this far and I will have a pension and my personal IRA and a supplement from the USPS…. I just can’t leave it all on the table and walk away (although they want me to).

        LOL… sorry… I have made my post depressing… LOL

        Serious thought…

        Being as young as you are, are you building a retirement plan for yourself? (Too personal… no need to reply. I will just add this) There are some great small (not very publicized) clearing houses for buying stocks or ETFs. The best one, in my opinion, WAS http://www.buyandhold.com but they have been bought by http://www.folio.com I haven’t been with them long enough to recommend them, but from a quick scan they sound comparable. They are NOT as user friendly. Hence the slow dissemination of what they can and can’t offer.

        Thank you for your blog… I am so happy to see young people LIVING life deliberately! I am sure I will be scowling over it often… in my jealous temporary gloom. You are OFFICIALLY one of my ROAD HEROES!

        • Becky April 2, 2015 at 8:35 am #

          Hello Bodhi and welcome to IO!

          Thanks for the story about Escapees, that’s very interesting!

          Sorry to hear that you have so many years until retirement. I think a lot of people here would tell you screw it, go now-but in the end only you know what’s best for you. 🙂

          And yes, I do have a retirement plan. I think it’s a smart thing to do in case something happens and I have to get off the road.

          Safe travels and happy trails.

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