Updated June 2020
Five years ago, I became a full-time traveler in my 17' Casita camper with a 6' x 13' living space. I travel with my cat all over the country. I have no house or apartment and own no property. I am a 69 year old woman who went from apparent perfect health to a hospital with embolisms in my lungs and spleen and in extreme danger of a heart attack or major stroke. That led to me to Mayo Clinic in Arizona for treatment of a rare blood cancer and AFIB. With my lifestyle I must have a health plan that will allow me to have insurance-covered medical care anywhere in the United States.
Because I have no home and the IRS wants people to have an address. I have my "domicile" in South Dakota. Everything I own is in my car, my camper and a 5' x 10' storage unit in KY. I chose SD because they have no state tax and registering and licensing my camper and car is less than most other states.
So this blog is coming from my experience and my knowledge which may be different for other people.
First and foremost.....most likely there will come a time in your future when you will need expensive health care. You may need heart surgery, joint replacement, cancer treatment and on and on.
When I first joined Medicare I chose an Advantage PPO Plan. Everything I read made me believe I would be covered anywhere I traveled. I was a happy camper! But, I was WRONG! I found out that there were areas in the United States that may not cover me at all if they are outside of the PPO area!! What a shock!!! When I left KY I had to change plans.
I contacted Kyle at RVInsurance and he filled me in on the weaknesses of Advantage Plans for my life style. So, I started looking at Medicare + Medigap + Prescription plans. I said to myself, "I'm healthy. I can change plans every year. Why not get a high deductible plan and save money now?". Seemed like a good idea. Then someone else said that this was NOT the time to penny-pinch. It will cost you dearly. Wow...was she right. For me, healthy one day to life-long high medical expenses.
Why high-deductible is not a good choice
1. I couldn't be seen at Mayo without huge out of pocket money. They may not have accepted me at all with my lack of insurance coverage they accepted.
2. The lower premiums would never have made up for what I have spent annually on higher deductibles and overages. I will have very high annual medical expenses so this loss of savings would have been ongoing every year.
3. Some Medigap plans, including my Plan G, may not have been available to me at a premium I could afford if I had not chosen it within the first year of Medicare coverage. I could have been turned down for the best plans and left with secondary level of plans.
If I had continued on my PPO plan: :
1. If I was on ANY Advantage Plan I would not have been accepted as a patient at Mayo Clinic. I want to be able to chose where I go and not have the insurance companies make that decision for me.
2. Insurance companies can and do drop their Advantage Plans. Physicians and hospitals can change whether they accept a current Advantage Plan.
3. During my travels I could have found myself in areas that would have not accepted my insurance.
Medicare and Medigap plans:
The chart found at the link for RVer Insurance is for those who stay on Original Medicare and purchase a Medigap Plan.
Within 6 months of signing up for Medicare you can change plans. After 6 months, if you can change, it may be at a much higher premium due to late sign-up and pre-existing conditions. For many, the plan you'd like to have may be financially out of reach after that first 6 months.
With my many bills Plan G has paid for everything except the small deductible. I have Mutual of Omaha aka Omaha Insurance and have been very satisfied. Check Medicare.gov for reviews and compare premiums. I would suggest though going with a solid, well-known, financially stable insurance company. I believe the carrier can be changed each year but you don't want to change your plan.
I am not an expert in this field. I tried to do my homework and found it all very confusing. I can say, that for my needs, I believe I have the one and only plan that could have worked for my situation. I believe this could be true for many others.
MY PLAN
Plan G Premiums for me in South Dakota was $94/month in 2017. On November 1 it is going up to $99. They can do price increases twice a year.
Prescription Plan - $17/month for Humana/Walmart Prescription Plan. That will go to $20.40 in 2018. As with most prescription plans there are tiers and deductibles that I don't understand. Most of my drugs are generic and I pay $1 - $4. I have one non-generic drug that I had to pay over $400 the first time to reach a new tier and now pay about $77. Prescription costs, if non-generic, can be very high. You can go to Medicare.gov and then to prescription plans and enter your medications and it will tell you your annual cost for every single Medicare Prescription Plan offered. A wonderful tool! I use it every year during the sign-up period and do change plans to save the most money.
Once you are on a Medigap plan, including Plan G, you are on it forever and cannot be charged more for medical conditions.
HOWEVER and this is a biggie......
1. If you have already signed up for Medicare you can change your plan within 6 months to any other plan and only be charged the same as if you had signed up for it originally. You should not pay a higher premium due to existing conditions or the change. I ran into an issue when I moved within the 6 months. The insurance company originally said I couldn't get Plan G because I moved. I held firm that I was changing due to the 6 month choice NOT because of my move. Get the facts so you can stand up for yourself. Find an agent who will fight for you.
2. If you change after that six months there may be additional premium increases for the late change AND/OR for pre-existing conditions. I understand those difference in premiums can be substantial amounts. I believe after that first 6 months your choice of Medigap plans does not include all plans.
Links I have found helpful. I have not checked these links in a couple of years.
When I switched from PPO to Medicare these guys really were a huge help and easy to work with. They helped me with the issue of the 6 month change vs I was moving. Plan G was only available when they argued for the 6 months change rather than the move.
Good article and company even if you are not an RVer.
For those who are not 65 but are travelers. Kyle at RVerInsurance really knows his stuff. This is the site and person who helped me figure it all out.
NOTE THAT PLAN G IS THE ONLY PLAN THAT COVERS EXCESS CHARGES or OVERAGES! EXCESS CHARGES CAN BE HUGE AMOUNTS!!!! Do some research to find out what they can include. Mayo does not agree to the monetary limitations set by Medicare. Those extra charges are covered. Some physicians have a bit of a scam going. They will have an extra surgeon join them during surgery. You may not even know that person was there and was never asked if it was okay. If his bill is not covered by medicare then you pay it! Of course, there are times when an extra surgeon is needed and that bill is above board but still an excess charge.
It's important to take the time and figure this out when you go on Medicare!