Rv'ers medical insurance experience

[JEFF1963]

Must be my age and bored on Saturday night - BUT... Inasmuch as many owning/using RV's (not to exclude younger folks mind you) are approaching or exceeding Medicare age, it might be instructive to advise, recommend, or relate any experience anyone may have regarding the necessity of having medical insurance while traveling/camping in any non-permanent situation, e.g. RVing. Many of us have invaluable expertise to pass along about our mechanics, living conditions, et al - but never have I seen any serious suggestions or experiences referencing medical emergencies. Hate to bring up such an unpleasant subject, but perhaps many of us would benefit of such information.

[Bassdogs]

Unfortunately just experienced such an emergency while vacationing on the beach south of Houston. While eating dinner a week ago DW got a chunk of something caught in her esphogas and despite numerous attempts to "throw" it up, we made a 11pm trip to a hospital in Lake Jackson TX about 15 miles away. The situation made it impossible to swallow even a sip of water but did not affect her breathing. After 4 hours in emergency she was admitted to the hospital and was scheduled for a throat scope the next morning. Long story but the scope was postponed [Doc didn't think it was enough of an emergency to come in on Sunday] so she ended up spending a 2nd nite in the hospital. Scope was finally done late the 2nd day and with threats on my part to get the discharge papers finished or we were walking out without them; she was finally discharged at 6:30pm and free from captivity with instructions for her to only eat pureed food for 2 weeks and take meds to prepare for a follow up in 2 weeks. Since we won't be anywhere near SE texas in 2 weeks we have made arrangements to follow up on all this when we get home.

As to the insurance ??, we both have an Anthem medicare advantage plan. There was no issue at all getting accepted at the hospital and we walked out with $0 copay at time of discharge. Hoping for no surprises when all of this is submitted by the hospital for insurance reimbursement. We'll see!! One thing I do no is that conventional Medicare or a private medicare advantage plan like we have DO NOT COVER INTERNTIONAL TRAVEL. You might get covered for treatment on a cruise boat but not in a country outside of the US. This would be an issue on an RV drive to Alaska.

[havnfun]

Jeff-Compare all your options before you buy a Medicare Advantage Plan (MA)or a Medicare Supplemental Plan. We used a local Medicare health insurance "expert" to guide us thru the quagmire of options. Found out that an MA plan may show no copay but the premiums are probably much higher than a Supplemental plan. When you add it up over a year, the MA may cost you more.
For us, we pay a $168 annual copay and our annual premiums plus copay total quite a bit less than he best MA plan we could find. I think it may depend on the area you live in but in NM a Supplemental works best for us. We went with Transamerica for that plan. We know of many other families in our town who have experienced the same situation. We also make this comparative study each fall before enrollment period so we can make a Medicare allowed change if necessary.
So.......my advise is to check it out and compare total annual costs, not just the zero copay. Just my $.02

Good luck and Happy RVing,
Jeff

[Bassdogs]

Certainly can't argue against doing your research before you enroll in medicare related insurance. Advantage plans are not for everyone, but among other benefits, to me one of the most important is you never have to deal with the government. In addition it all goes thru one claim process not first to medicare, and then to a supplemental. Advantage plans [at least the one we have] have a monthly premium but copays for a doc visit are like $15 and our recent hospital visit s/b $200 per day out the door. Everything will be filed by the hospital, GI specialist, path report etc and all we will be liable for is the $200 per day. We have been on this plan for 4 and 5 years [I'm a year older] and have zero complaints.

With our incident, I entered hospital in the GPS and it took us to the closest major hospital. Showed them the card and we were good to go.

[tmielke]

Guys, MA plans are managed care and use networks. You could find yourself in a situation where you are out of network. Out of pocket can go up quickly. Bassdogs, I would be very surprised if your DW had a two night hospital stay and you don't get a bill. Hope you don't get a bill for outpatient observation, they can do that for 72 hours.

The gold card for a person that travels significantly is a Medigap plan F or G. Doesn't really matter what insurance company. You will be able to go to any doctor or facility nationwide that accepts medicare with out paying more for being out of network. No networks for Medigap. In Michigan MA plans are much less expensive than Medigap. I sell a bunch of both.

[DanNJanice]

My sister got a rude awakening the other day. She had signed up, through her employer, for a policy that allowed you to go out of network, for a higher deductable. A lot of people do this so if they need to, they can get coverage elsewhere. What she did not realize is that the out of network coverage did not apply to the annual out of pocket limit. Basically, these policies have not out of pocket maximum when you are out of network, even though you may still be covered 50%-70%. However, if you run up a large bill you could easily be on the hook for tens of thousands in addition costs.
Just something to check on.

[Bassdogs]

Originally Posted by tmielke

Guys, MA plans are managed care and use networks. You could find yourself in a situation where you are out of network. Out of pocket can go up quickly. Bassdogs, I would be very surprised if your DW had a two night hospital stay and you don't get a bill. Hope you don't get a bill for outpatient observation, they can do that for 72 hours.

The gold card for a person that travels significantly is a Medigap plan F or G. Doesn't really matter what insurance company. You will be able to go to any doctor or facility nationwide that accepts medicare with out paying more for being out of network. No networks for Medigap. In Michigan MA plans are much less expensive than Medigap. I sell a bunch of both.

I guess the truth will be told in 4-6 weeks when I get the benefits summary from Anthem. I fully expect to get a bill and fully anticipate it will be for $200 which is my hospital per diem. My confidence is strengthened by the fact that in Oct 2015 I was rushed by ambulance from a regional hospital a few miles from our rural home in south central Kentucky. After a 2 1/2 hour ride to a major hospital in Nashville Tn I was admitted and spent 5 days being treated for a severe infection. While Anthem was billed for a total north of $25,000, my liability for this out of network hospital was $1100 [$200/day and a few misc charges I don't remember].

I wish we didn't need "experts" to cut thru our healthcare options. I also wish the so called "experts" really knew as much as they think they know and certainly more than they learned in a short training seminar. Some need it but if you have 3/4 a brain and can read and are willing to do your own research it is quite reasonable to expect that you can figure it out without stopping at that Kioxk at Walmart.

[Bassdogs]

UPDATE: May 1 [2 1/2 months later] and so far I have been billed ZERO $$$. The hospital and attending doctor have submitted roughly $14,000 for the 2+ days my wife was there. The insurance processed these claims and paid something like $3000. !00% of the claims submitted were approved and per Anthem benefits summary my responsibility is $216. The rest was discounted back to the hospital and doctor. Frankly I have been surprised as I was expecting a bill for between $500-600. No additional claims have been submitted by the providers since the initial claims.

It is important to note that my Advantage plan thru Anthem has a provision that is a much bigger deal than I had understood before this experience. ALL EMERGENCY ROOM visits are treated as "in network" regardless of the status of the facility. My copay for a trip to the emergency room is $75. In addition if you are admitted as an impatient directly from the emergency room, all subsequent treatments are also covered at "in network" rates. I suggest everyone on the forum review their advantage plan. If I had seen a doctor and then sent to the hospital the charges would have been significant as both the doctor and hospital are out of network providers and I would have been responsible for 20% of the approved claim after paying a $500 deductible.

As an Rv'er traveling outside their network coverage, GO TO THE EMERGENCY ROOM if you need medical attention. Seeing a doctor first could result in a big bill down the road.

[tmielke]

Bassdogs, I don't know of a MA plan that doesn't treat emergency as in network, at least in Michigan. Be careful with your recommendation to go to the ER for medical attention when traveling. If your diagnosis isn't an emergency, you may not have coverage.

Look closely at your plan and see if urgent care is covered in-network regardless of where you are. It could make a BIG$$ difference.

I still stand by Medigap plans as being the best for those that spend a lot time, one month or more, traveling out of state.

[Bassdogs]

Originally Posted by tmielke

Bassdogs, I don't know of a MA plan that doesn't treat emergency as in network, at least in Michigan. Be careful with your recommendation to go to the ER for medical attention when traveling. If your diagnosis isn't an emergency, you may not have coverage.

Look closely at your plan and see if urgent care is covered in-network regardless of where you are. It could make a BIG$$ difference.

I still stand by Medigap plans as being the best for those that spend a lot time, one month or more, traveling out of state.

I would never seek medical care when traveling unless it is an emergency so all I'm saying is don't see a doctor and then get sent to the hospital. Something as simple as a serious cut would dictate a trip to emergency. I don't live in Michigan so what goes around up there is of no concern but I will check out the urgent care coverage in my Anthem plan. I am also not speaking as an expert but rather suggesting people look at their plan to understand all of this. Advantage plans do operate in a network environment so this thread is on what to do if traveling outside the network. My suggestion based on my own experience is to go to the emergency room if you need medical care away from home. This is even more important if you are then admitted to the hospital since in my case that locks you in to "in network" coverage.

I didn't go back to the previous posts, but if I remember you where the one who cautioned forum members to shy away from Advantage plans because they could get caught up in "out of network" charges. My comments are focused toward showing how you can protect yourself from these higher charges. Anything from a cut to a broken arm easily qualify for a trip to the emergency room. If someone is running to the doctor for every thing from a hang nail to a bad hair day, and they are a traveler, then you are right, they should stay with regular medicare and a supplemental.

I have a love / hate relationship with Anthem but I'd rather deal with them than the Government any day any where and for any reason.

[tmielke]

Originally Posted by Bassdogs

I have a love / hate relationship with Anthem but I'd rather deal with them than the Government any day any where and for any reason.

It probably is easier to fight with an insurance company than with the government!

[chabunga]

I'm old enough for Medicare, but my wife is not. What are our options for her? Travel Insurance? We've gotten that in the past. But they are generally base on how much the trip cost. That's going to be hard to do with an RV.

[2edgesword]

Thank you for starting this thread. My wife and I will be retiring next year (her fully and me doing some part-time consulting) and spending more time on the road. We've got to do some research and this thread will be a good starting place hearing about real world experiences.

[Grumpy]

Originally Posted by 2edgesword

Thank you for starting this thread. My wife and I will be retiring next year (her fully and me doing some part-time consulting) and spending more time on the road. We've got to do some research and this thread will be a good starting place hearing about real world experiences.

Even though tmieke's post is two years old I completely agree with him if you travel frequently a MEDIGAP F or G plan is what you should look at very closely. The reason being is, any DR or HOSPITAL accepting Medicare patients are "IN NETWORK". There are varying levels of MEDIGAP and they have different co-pays, naturally the lower the premium the higher the co-pay. Also most MEDIGAP plans require a separate prescription plan.

Even though we're FL residents I had my back surgery in Illinois where my daughter lives and where we spend our summers, so we had someone to help if needed, and I paid absolutely nothing. Even when we use Urgent Care for routine things there are no co-pays.

Definitely do your research.

[Chet & Marie]

We have a United Health Care (AARP) supplement in addition to Medicare and have been very happy with it. At 70+ we have used them here at home as well as our travels and winters in the south. Bumper to bumper insurance at a reasonable cost. Any doctor or hospital that accepts Medcare takes it and no copays.

[t18skyguy]

There's an excellent book called "Get What's Yours for Medicare" by Philip Moeller. It's a very informative read. There are other books as well, but it's such a critical topic a book is very helpful.