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Selecting a Domicile – It’s All about Counties (Part 2.6)

Updated: 8/4/2016

The following is for RVers under age 65 who purchase health care through the Affordable Care Act (ACA or “Obamacare”) exchange . . .

It’s been about three months since I published my post on how the county you live in affects your health care coverage (Selecting a Domicile – It’s All about Counties).

In a nutshell, what I said was is that for the health care plans offered on the ACA exchange, an RVer’s domicile county, not the state, determines the number, types, and cost of health care plans.

For RVers, the “Holy Grail” of health plans is a plan with a nationwide network that allows an RVer to use doctors and hospitals in every state. Typically, this means a Blue Cross Blue Shield (BCBS) PPO health plan.

After the ACA, PPO plans disappeared from Texas, South Dakota, and Florida — the “Big Three”. These are the favorite domicile states for full time RVers mainly because of no state taxes and the Escapees Mail Forwarding Service.

However, because health care costs can be a significant full timer expense (believe me, I know), the Big Three states have lost much of their allure.

Anyway, for dealing with the new ACA reality, I thought my It’s All about Counties blog provided a viable strategy — move to a county with a BCBS PPO plan. Unlike folks stuck in a house, RVers are mobile . . . we’re meant to move!

Sure, there’s more to it than just driving to a different place. However, if it could save a person hundreds or thousands of dollars in health care expenses, isn’t it worth a hard look?

Let’s just say the response to this idea reminded me of this scene from the 1986 movie “Ferris Bueller’s Day Off” . . .

What bothered me the most was the lack of response from those “in the know” — companies and individuals providing health care and other services to full time RVers.

Regardless, here is an update to my November 2015 blog.

NOTE: Not every PPO plan is supported by a national healthcare network. For example, SD Avera PPO plans only offer in-network health care in SD itself. Outside of SD you would probably have to pay out-of-network fees. Make sure to check the network coverage of a potential PPO plan, even a BCBS PPO plan.



3 Comments Post a comment
  1. Not sure if its still true, but in many of the states you list as still having BCBS PPO plans, BCBS used to require proof of 6 months physical residence within that state. I know of several fulltimers who’s BCBS policy was either rejected at application or canceled after the fact when they could not provide proof of 6 months physical residency.

    March 10, 2016
    • I called the ACA help line and they told me they had never heard of this. They also said that that doesn’t make it untrue.

      Did those several full timers you mentioned purchased plans before the ACA? Or off the ACA exchange?

      March 10, 2016
  2. Njhz #

    T, u r wonderfully efficient in the good to know dept

    March 10, 2016

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