Full Time RVer

“When I get older, losing my hair, many years from now,” sang the Beatles. For those of us who laughed and sang those words, ‘many years ago,’ we may not have lost all our hair, but most of us are either Medicare eligible, or looking it in the face. Our fulltiming lifestyle may keep us feeling younger, but it doesn’t necessarily stop our bodies from needing medical attention. Medicare insurance for most Americans is a reality. But for fulltimers, just “what’s the best kind of insurance” when in the Medicare system? We can’t give you an exhaustive answer to the question, but we can give some advice.

First, a bit of a Medicare primar: Medicare is the federal government sponsored health plan for folks 65 or over, or others who are eligible for the plan because of a disability. Medicare has several important “flavors” if you will.  Part A covers hospital stays and “skilled nursing facility” care. Part B is for the day-to-day doctor visits, lab tests, x-rays, and a host of other medical services. Durable medical equipment like canes and walkers fall under Part B. Part D is the most recent Medicare add-on, which helps pay for prescription drugs.

No, we didn’t forget Part C. This is an optional plan, where you can voluntarily sign up for a “Medicare Advantage Plan,” which in many cases actually saves you money. Part C offers a variety of individual health insurance “plans” which often limit who you can see to a given list of medical providers in their “network.” Go out of the network, you may have to pay more. The question fulltimers often raise is simple: Why on earth would you enroll in such a plan if you spend time traveling outside of the network area? With “standard” Medicare Parts A and B, you can go to any doctor, anywhere in the country who accepts Medicare and get help.

It often comes down to money. On standard Medicare, Part B visits (say to the doctor or get X-rays) you’ll pay 20% of the total bill–after you’ve satisfied a yearly deductible amount (presently $135). Need to go to the hospital? Hold on to your wallet! You’ll pay over $1,000 before Medicare starts picking up the bill. However, one RVer we know who carries a Medicare Advantage plan coughs up a co-pay of just $100 a day for being in the hospital. When he visits the doctor he hands over a $20 co-pay (or $30 for a “specialist). How much does he have to pay for the plan? The same amount is deducted from his Social Security check that all other Medicare recipients are docked, and for his plan, he pays nothing else. Prescription drugs? Under his plan, $8.00 a month each for his “generics.”

What about the network restrictions? “On my plan,” he tells us, “I can see any doctor, anywhere in the US who will accept Medicare assignment and whose willing to bill my insurance company. I had surgery in Tucson, seen specialists in Washington State, and if I need to see somebody in Vermont, I won’t have any problems.” But here’s the fine print: The plan isn’t available to everyone on Medicare. What plans are available are based on your residency address. Our RVing friend shows his residence address in a fairly large city in Washington, and his plan is just one choice among many. Another friend of ours who shows residency in Quartzsite, Arizona has few plans to choose from.

For fulltimers, here’s just one more thing to throw into the mix of where to call “home” for tax and insurance purposes. By logging into the Medicare web site, you can investigate what plans are available by logging into medicare.gov. We’ll spell out a specific way to go about this later. You can also compare “medigap” plans on the web site, which are insurance plans that allow you to keep standard Medicare but help pay the difference between what Medicare pays the doctor and what the total bill is.

Doing the research is admittedly a pain in the neck. It can be a frustrating bunch of mumbo-jumbo, but if you stick with it, you’ll find what Medicare option best fits your needs–and your finances.

What to look for: First, you’ll need to evaluate your own priorities. If money is an issue, find out how much the plan costs, both in terms of an up-front monthly payment to the insurance company, and how much individual co-pays are for each type of service. When you check out plans on the Medicare website, you’ll be asked the general state of your health, and the site will provide estimates of your annual cost for each plan. It’s a pretty broad estimate, but at least you can compare plan for plan to see which would likely cost less.

You’ll also need to know what happens if you go out of the network–if the plan has one. Some plans are very tight and only allow you to obtain non-emergency services in the network. Others will allow you to go out of the network for a higher cost. Still others may allow you to see any doctor, anywhere, who’ll accept Medicare assignment.

Be sure to check out how much it will cost you for prescription drugs. Each plan has its own “formulary” of what drugs it allows, and how much you’ll pay for them. If you’re on a lot of drugs, or some expensive ones, it will pay to shop around.

The one RVer cited above who has the “go anywhere” plan, there is another hitch to look for: He can’t be out of his “home” state for more than six months. As a result, in his travels he always plans on being “home” twice a year to meet the plan requirement.

Learning more about Medicare plans: Log on to www.medicare.gov.  Lookfor the option on the left side of the screen labeled, “Plan Choices” (this will also help you sort out Medigap plans) and click on it. Chose the “Medicare Advantage Plans” option. Now look for the choice, “Medicare Options Compare,” and next find “Find and Compare Health Plans.” (Whew! Told you this could be frustrating!). If you click on “General Plan Search” you can enter a zip code for any town in the country you might call “home,” and you’ll find what plans are available and the details.