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 https://www.healthcare.gov/

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 https://www.healthcare.gov/lower-costs/qualifying-for-lower-costs/

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.

ALABAMA

• 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)

ARKANSAS

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

CALIFORNIA

• 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)

NORTH DAKOTA

• 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 ( https://www.healthsherpa.com/ ) 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