Navigating Healthcare on the Road: A Guide for Full-Time RVers

Living on the open road full-time offers a sense of freedom that’s hard to beat—waking up to a new view every day, meeting fellow adventurers, and exploring the country at your own pace. But with this lifestyle comes a unique set of challenges, especially when it comes to healthcare.

For full-time RVers, managing medical needs on the move can feel daunting. Whether you’re navigating health insurance options, accessing care in remote areas, or figuring out how Medicare fits into your mobile lifestyle, staying healthy while living on wheels is a crucial part of the journey.

Understanding Healthcare Options for RVers

Health Insurance Types for RVers

Traditional Health Insurance

• For RVers not yet eligible for Medicare, traditional health insurance plans like employer-based coverage or individual plans under the ACA can be viable options.
• Consider Network Flexibility: While Preferred Provider Organizations (PPOs) generally offer more flexibility nationwide, Health Maintenance Organizations (HMOs) often restrict coverage to specific regions, which can be limiting for RVers.

The Affordable Care Act (ACA) Plans

The Impact of Your Domicile State

• Why Domicile Choice Matters:
  • For RVers, selecting a domicile state is crucial not only for tax and vehicle registration reasons but also for healthcare. The healthcare coverage you receive depends on where you legally establish residency.
  • ACA and Medicare Comparison: Just as your domicile state affects the availability of Medicare supplemental plans, it also influences ACA plan options. This includes differences in:
    • Insurers: Each state’s marketplace offers a different mix of insurance companies and plan options.
    • Networks: The geographic reach of provider networks can vary significantly, which might limit your access to in-network providers if you’re traveling outside your domicile state.
    • Premiums and Subsidies: Costs and available subsidies may be more favorable in states with larger marketplaces and more competition among insurers.

Comparing ACA Plans Between States

Explore Healthcare.gov for ACA Plans

• How It Works: Healthcare.gov is the federal website for ACA plans, and it provides an overview of the plans available in each state that uses the federal exchange. For states with their own marketplaces (like California, New York, etc.), you’ll be directed to the state’s site. You can enter basic information and compare monthly premiums, deductibles, and network types (PPO, HMO, etc.) across states.
• Best For: RVers under age 65 who need ACA coverage and want to see which states offer the most comprehensive plans and lowest premiums.

State Specific Department of Insurance Websites

• How It Works: Each state’s Department of Insurance website lists the insurers that offer ACA and supplemental plans within the state. These sites often provide downloadable guides or links to insurer websites for more information on specific plans.
• Best For: RVers seeking detailed local insurance regulations, including specific networks or state-based plans.

Consult with an Independent Medicare or Health Insurance Broker

• How It Works: Brokers can offer personal consultations to help RVers compare options in multiple states and understand the specifics of coverage for travelers. Many brokers are knowledgeable about popular domicile states and can provide insights into Medicare and ACA plan structures based on your travel needs.
• Best For: RVers who prefer one-on-one guidance to understand differences in network flexibility, costs, and additional benefits.

Use Tools Like Policygenius or eHealthInsurance

• How It Works: Online platforms like Policygenius and eHealthInsurance aggregate ACA and private plan options, allowing you to compare premiums, deductibles, and plan types across states. These sites often have brokers available for live chats or calls, which can simplify complex state-by-state comparisons.
• Best For: RVers looking for a mix of ACA and private insurance options, with the option of comparing multiple states and plan types in one place.

Telemedicine for RVers

• Access Healthcare Remotely: Telehealth services allow RVers to connect with healthcare providers regardless of location. Telemedicine has become increasingly popular among RVers, especially for routine care, mental health services, and minor medical issues.
• Consider Domicile Impacts: Even with telemedicine, your coverage and out-of-pocket costs for virtual care can still depend on your domicile state’s healthcare laws and insurance regulations.

Short-Term Health Plans and Health Sharing Ministries

• Short-Term Plans: These plans offer temporary coverage and might be useful as a stopgap, but they typically have limitations, including exclusions for pre-existing conditions.

• Health Sharing Ministries: While not traditional insurance, some RVers use these programs as a more affordable alternative. However, their availability and regulations can vary based on your domicile state.
• Medi-Share…https://www.medishare.com/
  • Overview: One of the largest health-sharing ministries, operated by Christian Care Ministry.
  • Unique Feature: Members have access to telehealth services, and there’s a large network of preferred providers.
  • Eligibility: Members must agree to certain faith-based principles and healthy lifestyle commitments.
• Samaritan Ministries…https://samaritanministries.org/
  • Overview: A Christian-based health sharing ministry focused on members directly sharing each other’s needs.
  • Unique Feature: No preferred provider network, so members can choose any healthcare provider.
  • Eligibility: Members must adhere to Christian beliefs and lifestyle requirements.
• Liberty HealthShare…https://www.libertyhealthshare.org/
  • Overview: Offers health sharing with a more flexible approach to the providers members can use.
  • Unique Feature: Allows members to share eligible medical expenses and has some coverage options for pre-existing conditions after a waiting period.
  • Eligibility: Open to anyone who agrees to live a healthy lifestyle and aligns with Liberty’s community standards.
• Christian Healthcare Ministries (CHM)…https://chministries.org/
  • Overview: The oldest health-sharing ministry in the U.S.
  • Unique Feature: Offers multiple program levels to help members choose the level of sharing that best meets their needs.
  • Eligibility: Members must adhere to Christian principles and lifestyle standards.
• OneShare Health…https://www.onesharehealth.com/en/
  • Overview: A Christian health-sharing ministry with a variety of sharing plans to accommodate different budgets.
  • Unique Feature: Includes telemedicine and some wellness services for members.
  • Eligibility: Open to people of all faiths, though members are encouraged to lead a healthy lifestyle.

Medicare Considerations for RVers

Understanding Medicare Parts for RVers

• Medicare Part A and Part B (Original Medicare):
  • Part A covers inpatient hospital care, skilled nursing facility care, hospice, and some home health services. Part A typically has no monthly premium if you or your spouse have paid Medicare taxes.
  • Part B covers outpatient services, doctor visits, preventive services, and medical supplies. Part B has a monthly premium and requires co-pays for most services.
  • National Coverage: Original Medicare (Parts A and B) offers nationwide coverage, which makes it more flexible for RVers than many private health plans. This allows RVers to access care anywhere that accepts Medicare, regardless of their domicile state or location.
• Medicare Part C (Medicare Advantage):
  • Medicare Advantage plans are private plans that combine Parts A and B and often include Part D (prescription drug coverage).
  • Limitations on Network Flexibility: Medicare Advantage plans are often region-specific, which may not be ideal for RVers who travel frequently. Many Advantage plans require members to use a specific network of doctors and hospitals, often limited to the plan’s geographic area.
  • Choosing Carefully: Some plans offer out-of-network coverage but usually at a higher cost. RVers should carefully review plan details or consider alternatives if frequent travel is part of their lifestyle.
• Medicare Part D (Prescription Drug Coverage):
  • Part D is an optional prescription drug plan offered through private insurers. Coverage, network, and costs can vary, so it’s essential for RVers to find a plan with a nationwide pharmacy network or reliable mail-order options.
  • Tips for RVers: Pharmacies like Walgreens, CVS, and Walmart, with locations across the U.S., are often included in most Part D plans. This setup helps RVers refill medications consistently no matter where they’re parked.

The Role of Domicile State in Medicare Supplemental Coverage

• Medicare Supplement (Medigap) Plans:
  • Medigap plans, designed to cover the gaps in Original Medicare, such as co-pays, deductibles, and coinsurance, are offered through private insurers.
  • Domicile State Impact: While Original Medicare covers you nationwide, the supplemental (Medigap) plans available to you are determined by your domicile state. Each state has its own selection of Medigap options, and premiums may vary significantly by location.
  • Medigap Plan Comparison: Popular Medigap options for travelers are Plans F, G, and N, which offer comprehensive coverage and are often recommended for RVers who may incur unexpected medical expenses on the road. Use tools like the Medicare Plan Finder ….https://www.medicareplanfinder.com/to compare available plans in different states.
• How to Compare Domicile States for Medicare Options:
  • Since Medigap options and premiums vary by state, it’s essential to compare the top domicile states for RVers: Florida, Texas, South Dakota, Nevada, and Wyoming.
  • Comparison Tools and Methods:
    • The Medicare.gov Plan Finder Tool ….https://www.medicareplanfinder.com/lets you see plan details and costs by state. Simply enter your preferred state, and you can review Medigap and Advantage options side-by-side.
    • Consult with an independent Medicare broker who understands the nuances of each state’s offerings for full-time RVers. Many brokers specialize in plans for mobile retirees and can provide insights on the best options for your lifestyle.

Medicare and Healthcare Accessibility on the Road

• Telehealth Services:
  • Telemedicine has become increasingly popular for routine and non-emergency care, offering RVers a convenient way to access healthcare from anywhere. Many Medicare Advantage plans now cover telehealth services, while Original Medicare also includes limited telehealth coverage.
  • Accessing Telehealth: RVers can use telemedicine for non-urgent needs like prescription refills, follow-up consultations, and mental health services, which can reduce the hassle of finding local providers while on the move.
• Locating Providers Across the U.S.:
  • Original Medicare Providers: Since Original Medicare is widely accepted, RVers can find healthcare providers who accept Medicare by using the Medicare Physician Compare tool …https://www.medicare.gov/care-compare This tool helps RVers locate doctors, specialists, hospitals, and other services that accept Medicare.
  • Urgent Care Centers and Clinics: For in-person care on the road, many urgent care centers accept Medicare. Online resources like Google Maps or RV-focused apps can help RVers find urgent care centers near their current location.

Special Considerations for RVers Nearing Medicare Eligibility

• Avoiding Penalties and Enrollment Timing:
  • Enrolling in Medicare on time is crucial to avoid late enrollment penalties. RVers nearing age 65 should ensure they sign up during their initial enrollment period to avoid added costs.
• Planning for Health and Lifestyle Needs: For RVers who plan to domicile in a state with limited healthcare options, pre-retirement planning is essential to ensure that the chosen domicile will continue to meet healthcare needs into retirement.

Combining Medicare with Other Insurance for Full-Time RVers

• Secondary Insurance: Some RVers opt for additional secondary insurance to complement Medicare, especially if they travel internationally or want extra coverage. Understanding how secondary policies work with Medicare can add flexibility and peace of mind.

Here are some companies that offer secondary or supplemental insurance plans for Medicare beneficiaries, which can be particularly beneficial for RVers who need additional coverage:

AARP/UnitedHealthcare

• Overview: AARP offers Medicare Supplement (Medigap) plans through UnitedHealthcare, providing a range of options for covering out-of-pocket expenses not covered by Original Medicare.
• Popular for: Nationwide availability, reputation, and comprehensive customer service tailored to seniors.

Mutual of Omaha

• Overview: Known for its competitive pricing and straightforward policies, Mutual of Omaha offers several Medigap plans, including Plans F, G, and N, which are popular among RVers for their broad coverage.
• Popular for: Reliability and flexibility in supplementing Original Medicare costs.

Cigna

• Overview: Cigna’s Medigap plans provide predictable out-of-pocket costs and allow members to see any doctor who accepts Medicare.
• Popular for: Transparent plan options and widespread availability in many states.

Humana

• Overview: Humana offers a range of Medigap plans as well as Medicare Advantage plans. While Medicare Advantage plans are more location-restricted, their Medigap plans provide freedom to see any Medicare-accepting provider.
• Popular for: Large network and multiple plan options, including prescription drug coverage and dental add-ons.

Anthem Blue Cross Blue Shield

• Overview: Available in select states, Anthem Blue Cross Blue Shield offers Medigap plans as well as additional options for coverage of dental, vision, and hearing care.
• Popular for: Comprehensive health coverage options and name recognition.

Aetna

• Overview: Aetna, now a CVS Health company, offers Medigap plans across the U.S., including Plans F, G, and N, with competitive rates.
• Popular for: Affordable Medigap premiums and reliable customer service.

Bankers Fidelity

• Overview: Known for specializing in senior-focused insurance products, Bankers Fidelity provides Medigap plans with a focus on predictable costs and customer support.
• Popular for: Strong reputation for working with Medicare beneficiaries and flexible plan options.

These companies provide options that can work well for RVers looking for predictable out-of-pocket costs. Plans like Medigap Plan G or Plan N are particularly popular among travelers for their broad coverage and nationwide provider access. Just remember, availability can vary by state, so it’s essential to confirm specific plan offerings based on your chosen domicile state.

Telemedicine: Healthcare from Anywhere

• Benefits of Telehealth for RVers:
  • Telemedicine has become a game-changer for RVers, offering virtual access to doctors for non-emergency consultations, prescription refills, mental health support, and more.
  • For Medicare beneficiaries, Original Medicare now covers limited telehealth services, while many Medicare Advantage and supplemental plans offer broader virtual care options.
• Popular Telehealth Platforms:
  • Many health plans include access to specific telehealth platforms, like Teladoc, Amwell, or Doctor on Demand, which provide 24/7 access to medical professionals.
  • Tip for RVers: Some platforms allow out-of-network telehealth sessions if your plan doesn’t cover virtual care, making it possible to get assistance without traveling to a specific provider location.

Finding Nationwide Provider Networks

• Choose PPOs for Flexibility: If you’re under 65 and using ACA or private health insurance, choosing a PPO (Preferred Provider Organization) over an HMO (Health Maintenance Organization) allows you more flexibility to access providers across different states.
• Nationwide Pharmacy Chains: Major pharmacy chains like Walgreens, CVS, and Walmart are located throughout the country, making it easy to refill prescriptions. Many pharmacies also offer limited healthcare services, like flu shots and vaccinations, which can be helpful on the road.
• Medicare’s Physician Compare Tool: Medicare beneficiaries can locate nearby providers who accept Medicare by using Medicare’s Physician Compare tool. This tool helps RVers find doctors, specialists, hospitals, and more.

Planning Ahead for Urgent Care and Emergency Services

• Locating Urgent Care Centers: Urgent care centers are great for non-emergency needs, and many accept Medicare or standard health insurance. RVers can use apps like Google Maps or health-specific resources, such as Zocdoc, to find nearby urgent care centers wherever they are.
• Emergency Room Care: While not ideal for routine care, emergency rooms are essential for serious or sudden health issues. All hospitals accepting Medicare must provide emergency services, regardless of location or network.
• Travel with Key Health Documents: RVers should carry a digital or physical copy of essential health information, such as allergies, current medications, and emergency contacts, which can be invaluable in urgent situations.

Mail-Order Prescription Services

• Medicare Part D and ACA Plan Options: Many Medicare Part D plans and ACA policies offer mail-order pharmacy services that can deliver medications directly to your RV park or campsite.
• Benefits of Mail-Order Prescriptions: Mail-order services often offer 90-day supplies, reducing the need to visit a pharmacy as often. They’re also a convenient way to access regular medications from anywhere in the U.S.
• Popular Mail-Order Pharmacies: Companies like Express Scripts, OptumRx, and CVS Mail Order are commonly used by health plans and provide nationwide service to help RVers stay on schedule with their medications.
• Quick Tip: We use Amazon Pharmacy for most of our prescriptions – they are much cheaper – with or without health insurance. We use Canadian Pharmacy World .. .https://www.canadianpharmacyworld.com/ for certain items – like Timolol eye drops.

Keeping Medical Records Accessible

• Electronic Health Records (EHR): Using electronic health records allows RVers to access and share their medical information securely from anywhere. Most major health systems now offer EHR access through online portals like MyChart, which can be linked to multiple providers.
• Health Apps for Record Management: Apps like Apple Health, MyChart, and Google Health allow RVers to store and access health information digitally, making it easy to have your records on hand if you need them at a new location.
• Portable Document Storage: For RVers who prefer physical copies, keeping an organized file with recent medical documents, vaccination records, and insurance information can be helpful in case of emergencies or provider visits.

Seeking Local Community Health Centers

• Federally Qualified Health Centers (FQHCs): FQHCs provide affordable healthcare to underserved communities across the U.S. They offer a range of services, including general checkups, dental care, and mental health services. These centers can be found using the Health Resources and Services Administration (HRSA) locator. …https://www.hrsa.gov/
• Nonprofit Clinics and Sliding Scale Services: Many communities have nonprofit or sliding-scale clinics that offer medical services based on income. These are ideal for RVers on a budget who might be staying in a region for an extended period.

Tools and Apps for Finding Healthcare Resources

• Medicare’s Care Compare Tool: As a Medicare beneficiary, you can use the Medicare Care Compare Tool … https://www.medicare.gov/care-compare/ to find providers, nursing homes, and more in your current location.
• Healthcare Locator Apps: Many apps, such as Zocdoc, Healthgrades, and the American Hospital Directory, help RVers find hospitals, clinics, and urgent care centers nationwide.
• RV-Focused Travel Apps: Some RV travel apps, like Roadtrippers, offer forums or resources where RVers share healthcare provider recommendations based on regions they’ve visited.

Important Considerations for RVers Nearing Retirement Age

Preparing for Medicare Enrollment

• Understanding Enrollment Periods:
  • RVers nearing age 65 should mark their calendar for Medicare’s Initial Enrollment Period (IEP), which starts three months before your 65th birthday and ends three months after. Enrolling during this time helps avoid penalties and ensures that coverage starts when needed.
  • General Enrollment Period (GEP): If you miss the IEP, you can sign up during the General Enrollment Period from January 1 to March 31, but late enrollment penalties may apply.
  • Special Enrollment Periods (SEP): If you have employer-sponsored health coverage beyond age 65, you may qualify for a Special Enrollment Period. This can be helpful for RVers who plan to work part-time on the road or have alternative health coverage.
• Planning for Initial Medicare Costs:
  • Medicare Parts A and B cover hospital and outpatient services, but they come with deductibles, co-pays, and a monthly premium for Part B. Having a financial plan for these out-of-pocket costs is crucial, especially if you anticipate needing frequent medical care.
  • Many RVers find it beneficial to add a supplemental Medigap policy (if their domicile state offers suitable options) to reduce these additional costs.

Choosing a Domicile State with Long-Term Healthcare in Mind

• Factors to Consider for RVers in Retirement:
  • Medigap and Medicare Advantage Options: Research the availability of Medigap or Medicare Advantage plans in your chosen domicile state. Some states, like Florida and Texas, offer more competitive Medigap options, while others might have limited Medicare Advantage plans suitable for travelers.
  • Tax Implications and Healthcare Benefits: States without income tax, like South Dakota and Florida, may seem attractive for financial reasons, but it’s essential to balance these benefits with the healthcare networks and options available.
• Domicile Comparison Tools and Resources:
  • RVers can use the Medicare Plan Finder or consult with an independent Medicare broker to compare plans in popular domicile states like Texas, Florida, South Dakota, Nevada, and Wyoming. Brokers familiar with the RV lifestyle can offer personalized insights based on the healthcare needs of travelers.

Maximizing Telehealth Services for Long-Term Care

• Access to Ongoing Care: For retirees, telemedicine is invaluable for maintaining continuity with primary care doctors, specialists, and mental health professionals while traveling.
• Medicare’s Telehealth Coverage: Original Medicare and many Medigap policies now include some telehealth services, making it easier for RVers to access routine care or consultations from anywhere in the country.
• Planning for Chronic Conditions: Telemedicine can be particularly useful for managing chronic conditions that require regular check-ins, such as diabetes or hypertension. For those with conditions needing consistent monitoring, a home medical kit with essentials like a blood pressure monitor or glucose meter may be helpful.

Avoiding Late Enrollment Penalties

• Part B Penalty: If you delay enrolling in Part B without having qualifying health coverage, you’ll face a 10% penalty for each year you were eligible but didn’t enroll. This penalty applies as long as you have Medicare Part B, so it’s crucial to enroll on time.
• Part D Penalty: RVers who don’t sign up for a Part D prescription plan (or have other credible drug coverage) within their Initial Enrollment Period may face a late penalty if they enroll later. Signing up for a Part D plan on time ensures you avoid these additional costs.

Balancing Travel with Access to Health Services

• Establishing a “Home Base” for Healthcare: Even while living full-time in an RV, some retirees find it beneficial to designate a home base for healthcare, such as a primary care doctor they can visit during their travels.
• Prioritizing Proximity to Medical Centers: RVers with medical needs may want to prioritize travel routes with access to healthcare facilities, especially during more remote travels. Keeping a list of nearby hospitals or urgent care centers for each location can provide peace of mind.
• Preventive Health Services: Medicare covers a variety of preventive services, such as annual wellness visits, screenings, and vaccinations. Scheduling these in advance during planned stays in larger cities or your domicile state can simplify care logistics on the road.

• Selecting Coverage for Peace of Mind: For those exploring RV travel across borders, like Mexico or Canada, supplemental international travel policies can help provide coverage for unexpected medical expenses, ensuring continuous care even while abroad.

Here’s a list of reputable insurance companies that offer travel health insurance specifically for travel to Canada and Mexico. These companies provide coverage for emergency medical services, trip interruption, and sometimes even car insurance for extended travel in these regions.

Allianz Global Assistance …https://www.allianzcare.com/

• Overview: Allianz offers comprehensive travel insurance plans that include medical coverage, emergency evacuation, trip interruption, and trip cancellation options.
• Ideal for: Short- and long-term travelers looking for a trusted provider with 24/7 global assistance.

GeoBlue (a division of Blue Cross Blue Shield) …https://about.geo-blue.com/

• Overview: GeoBlue specializes in international health insurance and offers plans tailored for North American travel. Plans cover emergency medical services, hospitalization, and some out-of-network care.
• Ideal for: Blue Cross Blue Shield members and RVers seeking comprehensive health coverage in Canada and Mexico.

IMG (International Medical Group) …https://www.imglobal.com/

• Overview: IMG offers plans specifically for North American travel, with coverage options for emergency medical needs, trip interruption, and optional add-ons for car insurance while abroad.
• Ideal for: RVers looking for flexible coverage options, including single-trip, multi-trip, and extended-stay options.

Seven Corners …https://www.sevencorners.com/

• Overview: Seven Corners’ “Liaison Travel” plans cover travelers in both Canada and Mexico, providing emergency medical, evacuation, and repatriation services. Coverage can be customized for short-term and long-term travel.
• Ideal for: Those seeking affordable, customizable coverage for medical emergencies and trip interruptions.

SafetyWing …https://safetywing.com/

• Overview: SafetyWing offers flexible travel medical insurance that includes coverage for medical treatment, emergency evacuation, and trip interruption, with a specific focus on digital nomads and frequent travelers.
• Ideal for: RVers who are digital nomads or need affordable, month-to-month travel medical insurance for North America.

MedjetAssist …https://medjetassist.com/

• Overview: MedjetAssist offers emergency medical evacuation and repatriation services to members who are traveling internationally, including Canada and Mexico. Medjet plans focus primarily on transporting travelers back to their home country in case of emergencies.
• Ideal for: RVers looking primarily for emergency transport coverage to the U.S. in case of a serious medical event.

Bupa Global …https://www.bupaglobal.com/

• Overview: Bupa Global offers high-quality international medical insurance, including options for travel in Canada and Mexico, with a focus on private healthcare and flexibility in selecting providers.
• Ideal for: Travelers seeking premium international health coverage with robust benefits and provider flexibility.

World Nomads …https://www.worldnomads.com/

• Overview: Known for flexibility and ease of use, World Nomads offers plans that cover emergency medical and dental expenses, evacuation, and certain trip cancellations.
• Ideal for: Short-term RV travelers looking for easy-to-access and customizable medical coverage in Mexico and Canada.

Additional Tips:

• Consider Optional Add-ons: Some companies, like IMG or Allianz, offer add-ons for vehicle insurance in Mexico, which may be essential for RVers.
• Look for North America-Specific Plans: Many of these companies offer plans that focus specifically on Canada and Mexico, making them more cost-effective and suitable for nearby international travel.

These companies all offer reliable options for full-time RVers planning travel to Canada and Mexico, allowing for a range of coverage levels to suit short- and long-term needs.

Final Thoughts

Embarking on a full-time RV lifestyle brings a sense of freedom and adventure like no other, but it also comes with unique challenges, especially when it comes to healthcare. By understanding your options and planning carefully, you can enjoy the open road with peace of mind, knowing your healthcare needs are covered. From choosing the right domicile state to exploring telehealth and supplemental coverage options, every step of preparation ensures that both everyday care and unexpected emergencies can be managed smoothly.

As you navigate Medicare, ACA plans, or additional insurance for international travel, remember that resources are available to make these decisions easier. Whether you’re nearing Medicare eligibility, exploring telemedicine, or planning trips abroad, proactive planning will empower you to stay healthy and safe wherever your travels take you.

Embrace the journey with confidence, and make healthcare a reliable part of your adventure. Safe travels and good health!

Safe Travels!