RV Health Insurance in 2024 – How to Navigate Healthcare for Full Time RVers

Does Health Insurance for RVers Exist?

One of the most common topics of conversation around the campfire is health insurance for full time RVers. We all hope that we won’t get sick on the road, but want to be prepared if something unexpected should happen. And frankly, navigating the world of full time RVers health insurance can be pretty daunting, especially if you’ve never had to find insurance on your own.

Most Americans receive health insurance as a benefit from their employer. If you still work at your corporate job from the road, you probably don’t have to worry about health insurance. In fact, our healthcare system evolved around the idea of employers providing insurance as a benefit. It’s still most easily accessible by large groups of people (or, employees of a company).

Many of us who leave the corporate world for nomadic life are freelance workers or are self-employed. We might run a small business, either by ourselves or with a partner, but probably wouldn’t be considered a “large group” by any stretch of the imagination.

If this sounds like you, don’t worry. You don’t have to live without health insurance. Even better, finding affordable healthcare isn’t as scary as it sounds. In fact, there are many options for those searching for health insurance for full time RVers that we decided to dedicate an entire article to the topic.

A note before we start: We aren’t licensed insurance professionals. If you have detailed questions, reach out to an expert. This overview is based on our observations and experiences.

Health Insurance Options for RVers and Additional Resources

RVer Insurance Exchange

The RVer Insurance Exchange, in partnership with the Escapees RV Club, is an excellent place to start researching health insurance plans available to you as a full time RVer.

If you find the whole process of searching on your own too overwhelming, you can enroll with RVer Insurance Exchange and have an agent find a plan for you. They’ll provide a free quote and can search both marketplace (ACA) and non-marketplace plans to find you the one that will best suit your individual needs.

Quick Guide to Shopping for RV Health Insurance – courtesy of RVer Insurance Exchange

In a nutshell, these factors are affordability (how much do you want to spend?) and portability (how far can you travel while maintaining coverage?).

Affordability:

• Stay healthy. The best advice for all age groups is of course to practice prevention: take care of your health to try to prevent serious issues down the road. But, we all know that even the healthiest among us can experience issues that pop up unexpectedly. Did I mention “the Joe factor”?
• Share some cost. The higher the deductible or out-of-pocket max, the lower the premium you’ll pay each month. This might also enable you to “self-insure” by setting the money you save aside for a rainy day.
• Compare plans and carriers. Details of healthcare plans are changing all the time, so it pays to shop around. You may find comparable coverage at a lower price by looking at alternate carriers.

Portability:

• Make sure the company you purchase an insurance plan from insures RVers. It may sound strange, but some policies have a rider excluding RVers from coverage. Some might require that you are physically in your domicile state at least six months per year.
• Check the plan network. Basic advice is to avoid Exclusive Provider Organizations (EPO) and Health Maintenance Organizations (HMO) plans and stick to Preferred Provider Organizations (PPO) plans. Some EPO and HMO plans have PPO-like benefits if you’re traveling outside your home state. But in general, look at PPOs that will keep you covered nationwide. On the other hand, if you don’t plan to travel for a year and are going to stick around your domicile state, you may not care much about nationwide coverage.

Recommended Plans:

Full time RV medical insurance plans offered under the ACA are: Catastrophic, Bronze, Silver, Gold and Platinum.

If you are under 30 years old, RVer Insurance Exchange recommends getting the Catastrophic plan, since it’s the cheapest and qualifies as coverage for you. Since you’re unlikely to use it at a young age (especially if you don’t participate in any extreme sports), this can be a good gamble.

If you’re over 30, the recommendation is to get a Bronze plan (or Silver, if you qualify for a subsidy to bring the cost down). Bronze plans have an out-of-pocket maximum of $6350 per person, or $12,700 per family. Deductibles range from $1250-$6350, but after the deductible is met you receive 100% coverage for covered medical and prescription drugs.

Telemedicine

Telemedicine is another option for full time RVers. And as an added bonus, it’s also a great option when in-person medical visits need to be kept at a minimum. For those times when you don’t need to physically be at a physician’s office, telemedicine can be a great and affordable alternative.

You can use telehealth for all kinds of things, from getting a prescription refilled to sourcing a second opinion on lab results. You can also use them to help determine if you need to go to urgent care or to the emergency room.

Many of these companies cater specifically to RVers, so they already understand your unique situation and needs. These services are available for a small monthly fee and are worth checking out, especially if you like the peace of mind that comes with having ready access to a qualified doctor.

They aren’t a replacement for a health insurance plan, but they’re a great supplement if you have catastrophic coverage only and would pay out-of-pocket for an office visit.

Medicare

If you’re age 65 or above, you qualify for Medicare (a federal health insurance program). You can also qualify if you receive Social Security Disability Insurance. Check the Medicare site for details on this if you think you might qualify.

Self-Employed Group Coverage

If you’re self-employed but your income is too high to qualify for an ACA subsidy, take a look at Self-Employed Group Plans.

You’ll need to do some research on whether your state considers an individual to be a “group,” if you’re the sole owner and employee of your business. You may want to just be sure that two or more people are considered a group, if you run a business with your partner.

The list of options available for group coverage are very similar to the ones offered for individuals, but you can find lower rates in some cases.

Health Sharing

Another option that some RVers choose is to go through a Health Sharing service. In many cases, these companies are faith-based, and look for sponsorship by a church to join.

It’s important to note that this is not true health insurance. In exchange for monthly dues, you are promised coverage for any unforeseen medical expenses you may have. All members of the health share pay into a shared fund that members can draw from when they need it. Typically, you would need to pay up front for any medical expenses. The idea is that the health share will reimburse you after the fact (though this is not always guaranteed).

That said, before you try a health sharing plan, read this article by Alyssa Padgett. She and her family had a terrible experience with theirs and, according the the last update, had not been paid back for all of the expenses they incurred from their pregnancy.

Supplemental Fixed Indemnity Plan

A Supplemental Fixed Indemnity Plan is also not technically insurance. This is a reimbursement coverage that works per occurrence.

For instance, you might purchase coverage that would pay out a fixed amount if you dislocated your shoulder and required surgery. This would be paid to you, the policyholder, and not the provider. As such, it’s often used as a supplement to other types of insurance, especially if you have catastrophic coverage only. However, some people use this as their sole source of insurance because the cost is low.

Our RV Health Insurance Journey

When Kait and I first hit the road in 2015, we were freshly out of our corporate jobs. We’d always had health insurance provided by our employers, and weren’t sure how to go about getting it on our own. We were also young and generally in good health, so we made the decision to go without health insurance for the last four months of 2015.

Also, this full time RV lifestyle was originally supposed to be just one year long! For the full story, check out my book, Take Risks.

When 2016 rolled around, we decided we wanted health coverage if something happened to affect our health as we traveled.

2016 – Costco Health Insurance Marketplace

You don’t have to follow us for very long to know how much we love Costco. We have bought everything from vehicle batteries to dog food to clothes there. And in 2016, we added RV health insurance to that list.

We purchased a plan through the Costco Health Insurance Marketplace which gave us nationwide health coverage at a reasonable monthly cost. One of the things we learned early on is that while in-state and in-network coverage is commonly available, nationwide coverage for full time RVers can be difficult to find. Some plans require you to spend a minimum of six months per year in your state of residence.

Unfortunately, with the changes that accompanied Obamacare (the Affordable Care Act or ACA), this plan was dropped at the end of 2016. We had to say goodbye to our Costco Marketplace coverage and start looking for plans in our domicile state.

2017-2018 – The ACA Marketplace

For the next two years, we had coverage through the ACA marketplace.

Since we were Texans, the plan was administered by Blue Cross and Blue Shield of Texas. We opted for their least expensive PPO plan, which meant we had a high deductible and were only covered for in-network providers. At the time, none of the ACA plans in Texas provided coverage outside of the state unless it was an emergency. (This will come back to rear its ugly head later.)

Our plan was to use our ACA coverage as a catastrophic plan only. If we had any serious conditions, we’d drive or fly back to Texas. So far, so good.

We both managed to remain healthy until late in 2018. We were in Florida (read: pretty far away from Texas) and I woke up one morning feeling bad enough for a trip to Urgent Care. Urgent Care promptly referred me to the Emergency Room. It turned out that some of the symptoms I had were indicative of a possible heart attack.

A few hours and every test under the sun later, I was discharged with a clean bill of health. Since I was outside of Texas when this happened, I figured our insurance would cover at least my ER bill, since that would be deemed an emergency. (That’s why they call it the “Emergency Room” and not just the “Room,” right?)

As we found out later, this wasn’t the case. Since I was not in a life-threatening condition, the ER visit did not qualify as an emergency. Here’s a good example – if you break your leg, while you absolutely need to get set and put in a cast, it’s not life threatening…yes, if you don’t have it treated you will have a lot of pain and lasting issues with your leg, but it won’t kill you. However, if you broke your leg and in doing so severed your femoral artery, then this would be considered life threatening because if you don’t get treatment immediately then you’ll bleed out and die.

I hope if I’d actually been having a heart attack, I would have been covered. But there’s only one way to find out, and I hope I never do.

The entire bill came directly out of our pockets. I was able to negotiate 50% off the bill by paying it all at once, but still. After years of having employer-provided coverage, that hurt. I’ve talked about the importance of understanding your insurance coverage before, and I’ll say it again. Know exactly what your insurance will pay for, and what it won’t. And know that before you need it.

During that same time, Kait had some health issues come up too. From her experience, we found that if we asked for the “cash” price up front, we paid less than if we showed them our insurance card and paid the negotiated rate.

Fast forward to summer 2020, I received a notice from Blue Cross and Blue Shield of Texas that my emergency room visit should have been covered. I had to find copies of all my medical bills and proof of payment to submit for review. The final verdict however is that they decided to not reimburse us for any of the costs.

2019 – Short Term Health Insurance

As 2019 approached, our ACA premiums were set to climb another 25%. Ouch.

However, the government lifted the requirement for health insurance. We found ourselves wondering if we should continue to pay for something that we couldn’t even use most of the time. Self-insuring started to look like a very attractive option for us. This would mean that we’d put aside the money we would normally spend on premiums and deductibles and save that money in a dedicated account.

This idea looked great on paper, until I reminded Kait of “the Joe factor.” By this time, I’d had five major reconstructive surgeries, and more trips to the ER to have something sewn back together than I can count. If you’re on a first-name basis with your orthopedic surgeon – or if you find yourself using the phrase “my orthopedic surgeon,” as though everyone has one of these – you know you’re in trouble.

My concern with self-insuring was that something serious could happen to one or both of us that might put us in the hospital. I wanted to have something to cover us in case of a catastrophe. The last thing we want is to rack up hospital bills, lose all of our savings, and go into debt.

This is when we found out just how many RV health insurance options exist for full-timers (covered here). We explored many of them before settling on short term health insurance.

Short term health insurance, also called temporary health insurance, is meant to bridge gaps in insurance coverage. This is often for things like loss of coverage mid-year due to a job termination. You can decide how long you want coverage (from 1-12 months, depending on your state) and you can cancel the policy with no penalty if a more permanent solution comes along.

The short term plans we were looking at were half the price of the ACA marketplace plans and covered us nationwide, in-network. Of course, there’s always a downside. In this case, that downside was a very high deductible and out-of-pocket max.

Unlike the ACA plans, you’re not guaranteed coverage. You must answer a health questionnaire to be approved. Pre-existing conditions are not covered and you can be denied coverage.

We opted for a plan through United Health One. This way, we’d have coverage nationwide in case of something catastrophic, and we’d self-insure otherwise. We applied in January 2019 and were approved the following day. Our temporary insurance cards were delivered via email, so the whole process was pretty fast. The only catch was that in Texas, we’d be covered for a maximum of 364 days in the first year, and would have to reapply each year.

2019, Continued – The Joe Factor

In the second half of 2019, I had a chance to stress-test our new RV health insurance coverage. On a ride down the Rubicon, I crashed my motorcycle and severely dislocated my shoulder. This meant another trip to the ER, followed by a sixth reconstructive surgery. (Justin, my orthopedist, asked how I liked his new offices.)

Everyone accepted our short term health insurance plan except the ER doctor. While I never had an issue with our insurance covering my procedures, I did have some billing issues. When I called United Health One to inquire, they were very nice and helpful. They even called the provider’s billing office with me on the line to work out the issue right then and there.

2024 – Sticking with Short Term Health Insurance

At the end of 2022, we settled down in Indiana and continued with the short term insurance plan. I’ve researched other plans as things seem to always change, however but I found that plans like the ACA have, still do not cover us out of state and are significantly more expensive than the short term plan we’ve been using.

From a service and usability standpoint, we’ve liked using United Health’s short term medical plans, so we’ signed up again in 2024. Since we first signed up, they’ve added more plans we can choose from to everything from the high deductible plan to “Cadillac” plans, with everything in between.

For the plan we’ve chosen each year, we each have a $12,500 deductible with an additional $10,000 out-of-pocket max. That means we could be out as much as $22,500, per person, if something major happened to both of us.

That’s a lot of money, and high deductibles like these aren’t for everyone. We’ve come to terms with the fact that we’re pretty much self-insuring and paying a monthly premium so that if the worst should happen, we won’t be out more than $22,500 each (assuming all services are in-network).

We also understand that if one of us develops an ongoing health issue, we may be denied coverage in future years – at least, under our short term plan.

While we’ve found the ACA marketplace to be expensive, it does provide peace of mind for those who may have a pre-existing condition. At least we will have a place we can find coverage if things should change.

Lessons Learned

Here is a list of a few things we’ve learned over the years about health insurance for RV living. And yes, we’ve learned many of these the hard way. By sharing these, I hope we can help you avoid our mistakes.

• You may think that the costs of medical visits and supplies are fixed, but that isn’t the case. There is often a difference between the “cash price” and the price a provider will bill to an insurance company, so make it clear to your provider that you’ll be paying out-of-pocket if that’s your situation. Since we have such a high deductible, I negotiated a cash price with the surgeon and the hospital where I would be having my shoulder surgery. This came out to be less than I would have paid if I’d gone through insurance.
• It doesn’t hurt to ask if there’s a discounted rate for paying up front rather than in installments. If you can pay all at once, you might be able save quite a bit of money. I gotten 10-50% off by calling the billing office and asking what ind of discount I could get if I paid my bill in full with them over the phone.
• When you pay a cash price, you may be required to pay prior to the service. In my case, that meant paying prior to having shoulder surgery. This feels a little odd if you’re not used to it. After all, you don’t usually even pay for a haircut or an oil change in advance! But don’t worry. You don’t need to walk into your surgeon’s office with a cashier’s check or a suitcase full of cash. Most providers accept credit cards – just make sure you have the limit to cover the cost of the surgery. I do want to caveat this with, if you’re unable to pay your credit card in full, do some calculations to see how much you can pay each month and how much you’ll be paying in interest to see if it still makes sense to pay upfront.
• Some doctors will not accept a self-pay patient because of write-offs they can take from the difference of their fee and what the insurance plan actually pays. Make some calls before you set an appointment so you know what you’ll be paying and who will accept you as a patient.
• Read your policy thoroughly and understand your coverage. This is true for any kind of insurance. Understand what’s covered by your insurance before you need it. In our case, we should have done a better job of understanding what qualified as an “emergency” and what didn’t.

So what is the best medical insurance for full time RVers?

After a bit of trial and error, the short term medical plan we have now has been the best option for us. The thing with RV health insurance is that everyone is different. We all have different needs when it comes to healthcare, and different tolerances for risk.

Explore the full time RVer health insurance options available and find what works best for you and your needs. As we’ve seen firsthand, the available healthcare plans for RVers change every year. Do your research before making a decision, and reinvestigate your options annually.

Summary

It may feel overwhelming to source RV health insurance on your own, but there are a lot of insurance options available to RVers. We know that searching through them can be a headache, so we’ve done our best to consolidate all of the information we’ve found most helpful into one single resource.

What kind of health insurance plan have you found to work best for you? Comment below and let us know!