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Old 02-06-2008, 08:24 AM   #15
rec
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thanks for all the info

Thanks for everyone's input -- I'll definitely check into the escapees forum too. However, the suggestions about "hanging on until medicare kicks in" aren't feasible for us -- my husband and I are 35 years old

Whatever insurance we have would be for the "self-employed" -- we currently have major medical with HSA's through Golden Rule. But I'm not sure if we can hang onto these when we change states -- I was told somewhere along the way that Golden Rule isn't available in South Dakota (where we've almost certainly decided to domicile).

I had been told by my chiropractor that blue cross / blue sheild was a good option because signing up didn't depend on what state you lived in -- that I could get it living anywhere in the US. But when I asked my insurance guy about this, he said of course the state mattered, because that's how they determine your costs -- and he said BC/BS didn't offer policies in SD. If someone who has BC/BS and lives in SD can speak to this, I would love to hear about it. Or if someone in SD has a particular HSA they like, let me know. Otherwise, I'm heading off to the escapees forum. THanks!
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Old 02-06-2008, 01:41 PM   #16
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Quote:
Originally Posted by rec
...I had been told by my chiropractor that blue cross / blue sheild was a good option because signing up didn't depend on what state you lived in...


-- that I could get it living anywhere in the US....

and he said BC/BS didn't offer policies in SD.
well bc/bs is a good option...

and while it IS available 'living' anywhere in the usa, you can't just transfer coverage from one state/region or provider to another...

a NEW POLICY must be applied 4 and the individual/family accepted by the new (bc/bs) provider...

and yes the products are available in sd...

bc/bs individual plans s.d....

which gets back to the original issue of establishing a credible residency in that state...

it's important to understand that bc/bs isn't ONE insurance provider...

each state (or region, or major metro area) may have it's OWN independent bc/bs franchise-licensee...

selling plans and providing coverage in a defined region and risk pool...

bc/bs basics wiki style...

at 35 and self employed the hsa approach noted already is a sound approach...

but now u indicate a unitedhealthcare, hsa plan is already in place.

regardless of asking the question here on on the e' forum...

you'll need to provide a LOT more information about WHO and WHAT u are trying to get covered, at what price, at what provider level and so on...

the issue REALLY is trying to set up a shell residency, skirting regional regulations, avoiding taxes and so on...

each game has it's own tricks, rules and 'gotcha-z!'

the residency game is really beyond any one simple set of guides...

and just because someone else is 'doing it' doesn't mean it's legal or correct or that folks won't get snagged at some point...

keep in mind tax evasion is retroactive and retro-collectable...

self employed folks providing their 'goods and services' in a particular state/s,

are subject to income tax, business licensing and regulatory codes IN that state...

regardless of the shell state claimed for residence...

retirees, 4 the most part aren't tracked or audited in this regard, but younger folks WITH A legitimate BUSINESS are a different issue.

cheers
2air'
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Old 02-09-2008, 07:20 AM   #17
rec
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thanks again

I may not understand what you mean about skirting the law by trying to set up "shell" residency -- we're going to declare domicile in SD, which I understood to be a legitimate legal option for full-timers. So I assume that I will be able to get health insurance based on domicile, rather than residency (we'll be traveling full-time, so I don't intend to meet the residency requirements for any one state). Everything else about declaring domicile seems pretty straightforward, but damn, this health insurance thing is confusing!
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Old 02-09-2008, 01:18 PM   #18
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I am currently living in Idaho and Oregon. My declared residency is Montana. I have a PO Box, I pay taxes and I own land there(not required). I have a physical address. This is want you need to have residency and get insurance. A BC/BS policy will vary depending on the state. The laws change so the coverage changes.
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Old 02-09-2008, 02:23 PM   #19
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Quote:
Originally Posted by rec
...We are leaning toward SD as our state in which to declare domicile, because I've read over and over again how generous they are with full-timers...
most (not all) of the folks trying this approach are retired full timers,

attempting to save a little cash on taxes, vehicle fees (tags/insurance) and other things that impact their fixed income status.

they have medicare or kept their major medical coverage through their past provider (like bc/bs or uhc or the va or as a union benefit)

so when you suggest s.d. is 'generous' on this issue understand the population in question.

i know a few working folks who use s.d. on this forum, perhaps they'll see your thread and pm u about it.

you've got LOTS of other issues to consider like voting, divorce, business licenses, unemployment benefits, filing state tax returns, and so on.

simply having a bank account, drivers license and mail drop isn't gonna cut if 4 ALL the issues facing a younger couple, with children.

the advice the LOCAL s.d. insurance agent provided is pretty clear.

to be eligible for bc/bc OF s.d. you need a physical address and presence IN the state.

more importantly (depending or your work/business) there may be better state options for you

or other states that are easier to buy coverage in and that benefit might offset a few 100$ saved on vehicle reg...

do you have a business license anywhere or a company/business registered in another state?

Quote:
Originally Posted by rec
...we're going to declare domicile in SD, which I understood to be a legitimate legal option for full-timers. So I assume that I will be able to get health insurance based on domicile, rather than residency...
since you currently reside in maryland you can apply for bc/bs major medical there, IF you wanna drop the united health care plan.

the uhc policy you have in maryland should provide coverage while traveling, depending on the policy.

bc/bs issued by the maryland company WILL be honored while on the road anywhere in the usa, depending on the policy YOU select.

so why the push for s.d. based health insurance? is it because the rates are better in s.d.?

-if this is why it's because the risk pool is different,
-the provider charges are different and
-the services most frequently used BY 'dakotans are different.

wellmark is the provider in that state, YOU have to meet their eligibility requirements to buy coverage from them.

take a look at the other 'retiree states' like texas, az, wa, fl, and so on...

companies writing health insurance in ALL of these regions r aware of this issue and r changing WHO they will accept.

the escapee forums on these issues is fine, but the more unique situations aren't all addressed.

and many young full timers are back in a physical address within 1-2 years...

so that's a big consideration, because you'd be reapplying for another NEW insurance policy at that time...

best of luck and don't lose your current coverage.

i'm still trying to convince the POST OFFICE i don't want ANY address

cheers
2air'
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Old 02-12-2008, 12:38 PM   #20
rec
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again, more great info to think about

again, thanks for the input -- let me see if I can clarify all the reasons NOT to keep our coverage in MD (even if we pick someplace other than SD):

- I do have a business, but I'm a GA corporation doing business in MD (it was easier to do this when we moved from GA where I started my business than changing my corporate status to MD) -- however, we will be selling this business and planning to start fresh with a simple "DBA" business for our "on the road" activities -- I figure I can do that in any state and do not have to be tied to MD for this -- I was going to set it up in the state we domicile in

- we pay ridiculously high EVERYTHING in MD compared to other states -- health insurance, car insurance, state income taxes, etc. -- so I don't want to continue any of this in MD

- we don't have kids, don't plan to have kids, and that isn't a concern

- we're reasonably sure that we will full-time for a very extended period of time (many years at least), and even if we do decide to park it at some point, it won't be in MD -- so I don't need or desire to have any ties to this state

So what you're saying is that if you don't have health insurance in the first place and don't have a residence, you simply can't get insurance??? That seems nuts! We don't plan to buy property or spend significant amount of time in any one place -- in fact, we may be out of the country for months at a time -- and so I'm just left hanging? I love this country -- maybe we should just expatriate to Canada
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Old 02-12-2008, 04:27 PM   #21
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well it looks like the pro/con northern border posts were deleted?

at least that keeps us more on point with this issue...

of how a young couple maintains or acquires health insurance while full timing on the road.


Quote:
Originally Posted by rec
...So what you're saying is that if you don't have health insurance in the first place and don't have a residence, you simply can't get insurance??? ...
well that's an understandable response, but isn't at all what i've suggested.

IF you already have insurance, you cannot be denied a policy from other vendors when u apply...

BUT the premium isn't guaranteed at the same rate.

IF you do not have coverage anywhere u can still apply and get accepted,

but again the premium might be high and some conditions might be excluded for a few years or permanently.

i'm not suggesting this is right or wrong, just how the current maze works...

the issues that determine 'residency or domicile' are often very different for tags, licenses, voting, n other quasi governmental issues...

than the residency issues are for qualifying for INSURANCE coverage.

so the local s.d. agent was just relaying the requirements for s.d. health insurance.

the other 'tax haven states' have insurance vendors with different residency requirements.

in addition to understanding the specific requirements to qualify by region/provider...

it's important to understand WHAT the insurance policy actually provides in terms of coverage, benefits and so on...

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for example..."how much does procedure X or surgery Y or treatment Z cost you the person who has it?"

costs/charges vary based on region, the 'approved network' and YOUR PROVIDER/INSURANCE COVERAGE.

for example a colonoscopy (seems like a good example 4 this thread ) might have 'charges' around 5,000$, all total...

but your insurance company has a negotiated fee of 2,000$ total from your doctor/clinic/provider...

so even before you've been billed for the copay on this item, the billable price has already been discounted SIGNIFICANTLY...

many small insurance companies (like the self employed policy vendors)

DON'T have ANY discounted fee schedule for their policy holders...
_________________________________________

the above example could be retold for 1000s of medical billing issues and is exactly why...

having NO COVERAGE at all or trying to 'self insure' without a big provider policy negotiating discounts...

is the most expensive approach to medical coverage.

cheers
2air

Quote:
Originally Posted by rec
...in fact, we may be out of the country for months at a time -- and so I'm just left hanging?...
world travel can be expensive IF you expect to have ALL of the comforts and coverage of domestic life...

most major medical policies include some coverage while traveling world wide.

sometimes injuries that result from military events, or terrorist acts or ailments acquired while committing a crime...

aren't covered.

there companies that SPECIALIZE in health insurance during international travel, and you need to explore those options.

and that would be a whole new thread!
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