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2020 Affordable Care Act (ACA) Update

If you’re a full-time RVer under 65 (Pre-Medicare) and buy your own health insurance, then you should consider purchasing a plan from the ACA (aka “Obamacare”). ACA health insurance plans accept pre-existing conditions, are available in every state, and if you qualify, part or all of your premium cost may be covered by a subsidy. Signup for 2020 ACA plans begins November 1 and ends December 15. See

To be eligible for a premium subsidy, you must earn between $12,490 and $49,960 for a single applicant. For a family of three, the limit is between $21,330 and $85,320. See

However, not all health plans are “portable” — that is, a plan that can be used equally in every state. Non-portable plans typically require you to return to your home state for medical services or pay costly out-of-network fees. While you can use emergency services in any state, non-portable plans can require you to pick up most of the costs while out of state (or out of network).

So for a full-time RVer who travels around the country, a portable health insurance plan with a nationwide network of providers is usually a requirement. The Gold Standard of portable plans used to be a Blue Cross Blue Shield (BCBS) PPO (Preferred Provider Organization) health insurance plan. BCBS PPO plans typically came with a nationwide provider network so you could visit a doctor or hospital anywhere without paying an arm and a leg for treatment. However, though BCBS still remains a prime choice, there is no guarantee that a PPO plan has a nationwide network. Some PPOs are limited to a single state or a group of states.

States with Health Insurance Plans that have Nationwide Networks

These are the states that I believe have BCBS plans with nationwide coverage. For each state shown below, the lowest cost non-HSA plan is listed:

NOTE: I only checked 5 to 10 ZIP codes for each of the states below. Also, these prices reflect the premium cost for a 63-year-old Male who is not eligible for a subsidy. Finally, don’t take my word for it. Make sure you contact the plan provider for specific information, especially on the network. Finally, I did NOT check the health plans in every state . . . so there may be more out there.


  • Nationwide Network: BCBS of Alabama
  • Lowest Priced Plan: Blue Saver Bronze PPO
  • 2020 Monthly Premium Average: $875 (6.7% increase from 2019)

ALASKA (no state income tax)

  • Nationwide Network: Premera BCBS of Alaska
  • Lowest Priced Plan: Preferred Plus Bronze 6350 PPO
  • 2020 Monthly Premium Average: $1,137 (3.2% increase from 2019)


  • Nationwide Network: Arkansas BCBS
  • Lowest Priced Plan: Preferred Plus Bronze 6350 PPO
  • 2020 Monthly Premium Average: $739 (2.2% decrease from 2019)


  • Nationwide Network: Blue California
  • Lowest Priced Plan: Bronze 60 PPO
  • 2020 Monthly Premium Average: $1,191 (7.2% increase from 2019)

FLORIDA (no state income tax)

  • Nationwide Network: Florida Blue
  • Lowest Priced Plan: Blue Select 1452 PPO/EPO
  • 2020 Monthly Premium Average: $937 (1.4% decrease from 2019)


  • Nationwide Network: BCBS of North Dakota
  • Lowest Priced Plan: Simply Blue 60 PPO
  • 2020 Monthly Premium Average: $734 (0.9% decrease from 2019)

WYOMING (no state income tax)

  • Nationwide Network: BCBS Wyoming
  • Lowest Priced Plan: Blue Select Bronze Core PPO
  • 2020 Monthly Premium Average: $1,377 (2.3% increase from 2019)

How to Check a Health Plan’s Network Coverage

I use Health Sherpa ( ) to do this.

First, you’ll need the ZIP code of where you reside. Use it to generate a list of health plans.

In this case, because Florida is a full-timer favorite, I’ve chosen the Sumter County, FL ZIP code (33597) and selected the lowest cost plan with a nationwide network — a BCBS PPO/EPO plan:

BlueSelect Plan


Next, select Plan details and Summary of Benefits (PDF):

BlueSelect 1452 Summary


Use the information circled above to make sure your plan has nationwide coverage as networks change all the time. THIS IS EXTREMELY IMPORTANT.

For example, the following shows the difference between the 2019 and 2020 health networks of a Washington state ACA plan:

Plan changed from a National to a State Network


8 Comments Post a comment
  1. Greg Schoenberg #

    Hi there. Excellent research. Bookmarked it. FYI…..for most counties, Oregon has two insurers with nationwide coverage. PacificSource and Providence. But Oregon does have that pesky income tax but it has minimal effect for those who are eligible for ACA subsidies. Plus no sales tax….

    -Greg Schoenberg

    October 31, 2019
  2. John Karlson #

    Lot of info – thanks, but If ur 65 and older
    MediCare kicks in (if wanted). You will still need
    Supplement- but can cost zero (high deductibles) or like my plan $29 monthly. Oh yeah boys and girls, u also pay for Medicare – comes out of ur Social Security! Check em all, some better than others, and they all do NOT cover same thing!

    October 31, 2019

    For North Dakota….What do you see that is different in the Blue Direct vs Simply Blue. For me considering the copays, it looks like Blue Direct is less expensive. I am a low user and like the high deductible plans

    October 31, 2019
    • Teri, I’m really not qualified to answer your question. Have you tried the on-line Compare feature?

      October 31, 2019
  4. Mary Hughes #

    OMG Tom.. your info is precious. Medicare is a whole other story.. & I’m currently avoiding wading through it. Went to a UHC presentation and as I expected, they laid out the 3 packages that were available in our area. They brushed aside the $47/month PPO (which Kath & I have been using for the past 3 years) and focused on two other plans that were AARP/United Health Care combo. One has a $0 monthly fee, the other is $27/month. I must go over the details with a fine-tooth comb and figure out what to go for. Something to look forward to.. 😉 Mary


    November 1, 2019
    • Greg Schoenberg #

      You may want to contact my partner, Kyle Henson, regarding a Medical Savings Account Medicare plan. They are zero premium and even more pertinent for RV-ers, no network…no referrals. You can go to any providers who accepts Medicare (most do). In contrast, many UHC plans are not particularly flexible, especially HMO plans. Kyle can be reached on his webside,

      November 10, 2019

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