Health Insurance Question

[RCMP03]

Hello Everyone!

We are exploring all possibilities of full timing within the next 2 years. My employer provides life time health insurance through Kaiser Permanente (free to us). Problem is we must reside in Southern California in order to qualify. Since health insurance costs are expensive, we were thinking that we would keep California as our domicile to maintain the free coverage. I'm worried however that they would not recognize a domicile as a permanent "residence". Does anyone have any information regarding this?

We plan on coming back to Calif (family here) each winter and then we would be able to have our physicals, etc. then.

If not covered, my employer will contribute the cost of Kaiser coverage towards another health plan we choose. Does anyone know of cost effective coverage?

Thank you in advance everyone and I hope you are having a safe and fun summer!

Sue

[Carl n Susan]

My Kaiser plan requires we reside a minimum of six months each year within the coverage area. Full-timing is fine (IMO) if you park in So Cal. But I would be careful about being gone from the area for significant periods and Kaiser finding out.

Perhaps a more portable plan would be safer. Hopefully, someone will suggest a plan they like.

[richfaa]

All I can tell you about the Domicile/ residence issue is..your domicile is where you pay your taxes, where you vote. IE: "In law, domicile is the status or attribution of being permanently resident in a particular jurisdiction. A person can remain domiciled in a jurisdiction even after they have left it, if they have maintained sufficient links with that jurisdiction or have not displayed an intention to leave permanently"

Your residence can be anywhere. Our Domicile is here in our S&B in Ohio. We reside in Florida 6 months of the year and other parts of the country for another 2 or 3 months.

We pay Ohio taxes, we vote here, we pay proptery taxes here. This is our Domicile.

[RCMP03]

Thank you for your replies! It helps to hear from people that are living through it. We are seeing several states that are the Domicile of choice to full timers. South Dakota for one. We will need to weigh the costs between paying the extra health insurance versus high California taxes!

We are fortunate to have life time benefits (free if we reside in Southern California) and option to "shop" another health care plan such as Anthem knowing a good portion will be paid. Another option would be to pay for extended coverage in the US through my husband's insurance with the RCMP. Problem is we would have to pay out of pocket and wait to be reimbursed.

We have a lot of research ahead of us!

Thanks,
Sue

[Tom S.]

If you compare the cost of Kaiser Permanente in California with the cost for comparable coverage in other states other than the New England coastal states (especially New York) and Florida, you find the Kaiser is more expensive. Given what your employer pays for your insurance, you should be able to get comparable or even better coverage elsewhere.

[sreigle]

Sue, I hope you are able to go in a direction that means no additional out of pocket insurance costs for you. I'd like to offer a couple of suggestions in case you choose to go with another plan, such as Anthem that you mentioned.

First, if you plan to travel around the country be sure NOT to go with an HMO or PPO plan or any other plan that has a defined network of health care providers that you must go to or not be covered. Or covered at a much reduced rate.

Second, be aware that all BCBS plans, and probably most health ins companies, have "participating" health care providers, "participating" meaning they have contracts for what they'll pay the providers for your service. That's different than an HMO or PPO arrangement.

Third, Anthem is a company consisting of several Blue Cross and Blue Shield plans around the country. They probably have HMO, PPO, comp major med, and other plans available. Their HMO and PPO plans have the same restrictions I mentioned above. Their comp major med and other "traditional" plans probably are like my Second point.

In those situations, you can go to any provider and get care. If you are outside their "plan area" meaning California in your case, then you can go to a provider in another state.

IF that provider participates with his/her local BCBS plan, then your coverage should be identical to what it would be in California.

IF you go to a provider that does NOT participate with his/her local BCBS, then you will have reduced coverage, the amount of reduction depending on your particular contract. In some cases it will be additional coinsurance and/or deductible. In other contracts it may be you pay the provider and submit the claim and Anthem reimburses you according to your contract.

IF you go to a provider in another state and that provider participates with his/her BCBS, then that provider is required by contract to submit the claim to his/her BCBS who will in turn work with Anthem. It will look to you exactly as it does when you are in your home area. The KEY here is to always check first to see if the provider participates with their own area's BCBS and that they understand that they submit the claim on your behalf to their own BCBS. Most understand that, a few do not. The BCBS Association has a website where you can get a list of participating providers in the area you are located. I have used that list but usually we ask a local for a recommendation, call the provider and ask if they participate with bcbs.

Just so you have a feel for where I'm coming from, in 2002 I retired from Blue Cross and Blue Shield of Kansas. And I was project leader for the Kansas Plan's development and installation of the ITS system, the system that handles the claims mentioned above, between blue cross plans on your behalf. The development was actually between every BCBS plan in the country, so my part was small in that.

Anthem probably has some unique provisions but the basics about handling claims and coverage when you go to another area is pretty much a required standard as part of maintaining the right to be an independent licensee of the Blue Cross and Blue Shield Association.

Hopefully your Kaiser insurance can be worked out to your advantage and you won't have to worry about any of the above. Good luck. Oh, by the way, Rx works the same. We just go to any pharmacy that participates with BCBS in their area. Walmarts always do, as far as we've found. Dentists, Doctors, Hospitals, Labs, etc., same situation (except the Walmart part).

Sorry this got so long but I want to add one more thing. We are South Dakota residents, fulltiming, but carry our insurance with the Kansas BCBS. I can do that because I am part of the retiree group. What I do no know is whether you'd have to go with BCBS of South Dakota (or whatever state) if you change your residency. That is up to your local BCBS (Anthem).

[Parrothead]

Sue,
We gave up our Kaiser when we went to FT. If you compare your vehicle registration in CA to SD, you may be able to pay for your health insurance.
Happy trails............

[BirdingRVer]

quote:Originally posted by Parrothead

Sue,
If you compare your vehicle registration in CA to SD, you may be able to pay for your health insurance.
Happy trails............

Only if you aren't denied health insurance for PRE-EXISTING CONDITIONS .

[RCMP03]

Thank you everyone for your replies.

Steve: I am taking note of the information you have provided and will do some research. I spoke with my employer and they said that I can maintain Kaiser in So. Cal. but they will only pay for emergencies while on the road. This means that we will have to be in So. Cal. for our physicals and scheduled things. I don't like the idea of not having medical for non-emergencies on the road. I have not had to think about this for MANY years (have had Kaiser forever!), I am a bit ignorant on the subject. So many things to consider and I don't want to learn a lesson the hard way!

Parrothead: We are seriously looking into selecting SD as our domicile.

So many things are going through my mind as we are contemplating FTing. If I retire right now we are going to have a very limited income and I'm nervous we won't make it! We may need wait a couple more years to pay things off and increase my pension a bit. Oh boy, I want to go now!!!!!! I live through your posts and dream......

Thanks again everyone!

[NCFischers]

Sue & Harv,
I know how you feel. We also want to go now but need to pay down some debt first. I retired from Pacific Bell in California and moved to North Carolina 12 years ago. I had to take the out of area coverage since all the HMO's available to me in retirement were on the west coast. It was still better than paying the increasing costs of everything else in Ca.
Jim

[jimcol]

Sue & Harv, you stated "If I retire right now we are going to have a very limited income and I'm nervous we won't make it!" As long as your nervousness is based on realistic numbers I would not do it. Let me try and explain. I worked for a company that offered an early retirement incentive. It worked out great for us and we have enjoyed doing whatever we have wanted for the last 9 years. I had other co-workers who took the offer but didn't have their finances where they needed to be to sustain retirement. So they gave up a good salary, 11 paid holidays a year, 6 weeks paid vacation, an 80% match on their 401K contribution, and a good understanding of the internal politics of their employer. After a few months of retirement many of them found out they gave all this up to start over with a new employer, if they could find one, at greatly reduced salary and benefits. (I do believe finding employment oppurtunities for retired people was better 8 or 9 years ago then it is now). Anyway, enough of my rant. Good luck with your decision. Jim

[RCMP03]

jimcol: I agree with you whole heartedly regarding the "seasoned" candidate looking for work. DH was laid off over a year ago, we all know about the challenging job market (even harder for over 50) he has had only 4 face to face interviews through that time. We are coming to the realization that we may need to depend on my income alone. His EDD has helped keep our heads above water, but it is about the end soon. In the meantime we have been plugging along trying to pay off what ever we can with my income (has not been easy, but getting there). To top it off, our home is upside down and looking at renting it out (not desirable). Like many others, we have built our credit to good standings (hence we owe!) and although bankruptcy or foreclosure is last resort it may become reality.

My goal is to be in a position that we begin FTing within the next 2 years. I am 56 years old right now (oops, gave away my age), have contributed 32 years in the school system (last 13 years in management). We were offered a retirement incentive last year, but could not take it due to my husband out of work. ( I am optimistic that we can do this and hold out until SSS kicks in! We have CCR (free 2 week stays in CA/AZ) with memberships to RPI Preferred ($10 per night) and Enjoy America, so we are hoping to take advantage of those RV parks along the way. There is always Workaming!

Anyway, I am rambling on here. Maybe others have stories to share about how they came to making the final decision, what they spend on camping and how they keep their costs down! I very much enjoy reading your posts and learning!

Take care everyone and I hope to see you on the road someday!

Sue