While the Affordable Care Act has increased insurability coverage, full-time RVers can find themselves in the Bermuda Triangle of health insurance with few options and confusing choices.

Nearly nine million households in the United States have an RV of some sort, according to the Recreational Vehicle Industry Association. With 375,100 expected RV shipments in 2015, a 1.6% increase above 2015, there are a significant amount of new and experienced RVers who are probably wondering about health insurance in an ever changing climate.

According to a survey reported in the Journal of Health Economics, only 14% of Americans between the ages of 25 and 64 understand basic insurance concepts. And if you're a full-time RVer a whole new layer of complexity gets added.

RV insurance expert Kyle Henson from RVer Insurance saw a need for health insurance in the RV space. "I didn't plan to start a health insurance service for RVers when I hit the road as a full-time RVer with my family in 2011, but having a health insurance background I was frequently asked about the best options for RVers. I was initially under the false assumption that most RVers are on Medicare and so my initial focus was on Medicare products. It was suggested to me that I consider expanding into the non-Medicare market as there is a real need there that was not being met."

Health insurance isn't something that should prevent you from living your RV dream. Full time RVing isn't just for retirees. There's a growing group of younger full-time RVers whose job and careers are adaptable to a mobile lifestyle which requires different approaches to mail, banking, and yes, health insurance.

Where should a person start when it comes to finding health insurance?

Let's start with the fact that the Affordable Healthcare Act requires all Americans to have health insurance and, if you don't have it, you will be fined either 2.5% of your household income or the total yearly premium for the national average price of a Bronze health plan sold through the federal marketplace, whichever is higher.

To learn what your health insurance options are, you should go to Healthcare.gov, your state's health insurance exchange, or private health insurance options such as Ehealthinsurance.com. Keep in mind that income subsidies do not apply if you purchase your health insurance on anything except for a federal or state health insurance exchange.

You also need to make sure that the health insurance plan you're interested in will actually cover you as an RVer. There are some health insurance plans that have specific rules that exclude full-time RVers who don't live in a specific state the majority of the year.

Some RVers have switched domiciles in order to find better health insurance on a state's health insurance exchange, but there are negatives to that as well. Kyle Henson explains "Many people switched from South Dakota to Texas last year because of the poor options for health insurance in South Dakota only to have the largest PPO provider in Texas announce they are discontinuing their PPO options in 2016. Health insurance is changing often and changing fast. No doubt this will continue to be the case at least through the next presidential election cycle. We generally recommend riding things out and not making drastic changes unless absolutely necessary to your healthcare."

Does affordable health insurance exist?

Before you jump into a plan due to it being the cheapest price, you should do your research and make sure it is the correct plan for you and your family.

The average monthly premium per person for health insurance in the U.S. is $235.27, according to the Kaiser Family Foundation. Once you add a family into the mix, you may find yourself budgeting over $1,000 a month on health insurance.

However, there are ways to get insurance for less as well. Chris, from the popular Youtube channel "Chris And G Travels," says that "Coverage was not difficult at all. I pay $35 per month with a $6,100 deductible. If I ever get really sick or have to spend a week in the hospital I won't find myself in too bad of a spot." And while finding health insurance for $35 per month may not be possible for everyone, there are options out there."

The most expensive plans on the market are the Gold plans and the cheapest are usually the catastrophic and Bronze plans. And if your income is lower than a specific federal level, then you may qualify for health insurance that is government subsidized. The equation is pretty basic. The higher the deductible, generally the lower the policy cost. For instance, the lower cost Bronze plans can come with very high deductibles of $6,000 or more. If you're healthy and can set aside $6,000 in a Health Savings Account, that will help keep your monthly premiums down.

Alyssa Padgett is a fellow GoLife writer who thought it was going to be too difficult to attain insurance, so being young and healthy she went without health insurance for one year. Knowing that coverage was now mandatory, she contacted RVer Insurance and now is paying $265 a month for insurance which covers her anywhere in the U.S. And while it is a significant part of their monthly budget, she and her husband Heath believe it is a worthwhile expense that gives them peace of mind.

Will a health insurance plan cover me when I'm out of state?

Some health insurance plans will cover you when you are traveling out-of-state, whereas others will consider that to be out-of-network coverage (such as for emergency care when traveling), and some may not cover you at all.

Before you choose a health insurance plan, this is something you will want to be sure of as it can impact your monthly budget and healthcare needs. You may choose a plan that covers you in emergency situations out-of-state, but keep in mind that not all health insurance plans are equal.

If you have an emergency situation, usually you won't have a choice when it comes to where you are transported in an ambulance or a helicopter. This is because the paramedics will take you to whichever facility is closest and they won't be wondering about your in-network and out-of-network health insurance options.

According to the Affordable Care Act, regardless of whether an emergency room is in-network or out-of-network, you will be charged the same co-pay.

Emergency rooms are truly for emergencies. They are also the universally most expensive form of healthcare. For more affordable options, especially when traveling, look for urgent care clinics instead.

You also need to keep in mind that sometimes only the initial emergency care is considered covered when it's out-of-network, and then all of your other medical costs that may arise (such as transferring you out of the emergency room to another room in the hospital) are all on you. This could trigger thousands or hundreds of thousands of dollars in uncovered medical debt, which is something you want to avoid.

Telemedicine - the future of house calls

As an RVer, telemedicine can be a way to keep your medical costs down, while also staying healthy on the road.

Telemedicine is another product offered by RVer Insurance. Kyle Henson explains that "Telemedicine is the use of telecommunication and information technologies in order to provide clinical healthcare at a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities or while traveling. Telemedicine programs can also help bridge the gap between having a high deductible plan with a limited network and access to healthcare anytime anywhere. According to physicians, about 70% of all office visits can be handled remotely. Telemedicine helps save time and money for patients by giving them access to a healthcare provider consultation without having to leave the comfort of their home."

Jason and Nikki Wynn highly recommend telemedicine. Nikki Wynn writes, "It still blows me away. If there is one thing I would recommend every traveler to have, it is Telehealth."

With Telemedicine, you get access to a "Teladoc," as well as discounts on dental, vision, Lasik, prescriptions, and more. The monthly price ranges from $12.95 for an individual to $16.95 for a family and is even less ($129-$159) if you pay annually - a cost that's easily recovered if you make only two equivalent trips to a doctor per year.

Similar to Telemedicine, but more expensive, is concierge medicine. Concierge medicine is when a patient pays a physician's office on a monthly or annual basis in return for care that may be needed. This can then allow a patient to stay healthy while also potentially lowering their health care costs.

A non-traditional alternative.

There's still one more option for RVers when it comes to health care costs. It's a concept called a sharing ministry. Akin to mutual aid societies that sprung up in the 19th and earlier 20th centuries, sharing ministries are generally faith-based risk pools. Members pay a monthly share with an agreement to assist others in the pool with coverage of medical bills.

Two organizations, Samaritan Ministries and Liberty Health Share offer plans with coverages at different levels from $125,000 to up to $1 million.

Health sharing ministries have their positives and negatives and this is the reason why you should very carefully evaluate a health sharing ministry for your health needs and expectations and not just on price alone. Positives include lower monthly costs that can be a third to half as expensive as traditional insurance, lower deductibles, and no in-network requirements. This sharing model deeply incentivizes patients to be strong advocates of health care cost containment.

However, negatives include that many health sharing ministries will not cover you for risky behaviors, they don't want you to drink excessive amounts, pre-existing medical conditions are often not covered, there is usually a medical expense limit that they will pay, and there is no guarantee that a health sharing ministry will even pay a medical expense as they are not governed under the same laws as health insurance companies due to the fact that they are not health insurance in the first place.

Holly Johnson from the personal finance blog Club Thrifty explains why she chose Liberty Health Share:

"We were devastated when our old Anthem plan was canceled and the new PPACA plans cost more than twice as much as we were paying before. To put things in perspective, our old plan was $393 per month and had a $10,000 family deductible. Once the new health care law passed, the cheapest option available to us was around $800 per month with a $12,000 deductible.

After doing some research, we decided it made sense to try a health care sharing ministry instead of traditional coverage. I chose Liberty in particular because I liked the top tier coverage and the way premiums were collected made the most sense to me. I also liked the fact that Liberty doesn't try to force you into a narrow network of doctors and hospitals - you can truly see anyone you want. Now we're paying $449 per month for a plan with a $1,500 annual "shared amount," which is similar to a deductible. The savings are huge and I am incredibly thankful I found this alternative and went for it."

In the end, choosing health insurance is a very personal decision. There are pros and cons to the various options, but fortunately, with a little digging, you can find some reasonable solutions.


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