Health Insurance Marketplace Problem

[gblair52]

Our mail is out of South Dakota but haven't been there for 8 years. Insurance marketplace (Obama) stated there's only one provider in SD. (Avera). After applying and paying first premium, discovered ALL in-network service can only be done in SD. Otherwise, coverage is just 20% of bill expenses. We are in AZ, CA, NM, FL......all over the country. This insurance is of no use to me and very expensive for what I would receive.

So without insurance I'm being penalized through the IRS. Thank you Mr. Obama! 

Anyone else in this predicament and if so, what are you doing?? 

Thank you for any assistance. 

 

[tbutler]

After we retired, we went full time in the motor home.  We had insurance coverage through our employers and had to return to that state for our routine medical treatments.  Those were the days when insurance companies could refuse coverage if you had pre-existing conditions so we had to keep our coverage in effect of face losing all coverage if we had a serious health problem. In our case, we had family located there as well but it did present a challenge at times.  You should be able to get emergency treatments elsewhere but may sacrifice some of your coverage benefits. 

We were registered out of South Dakota for ten years and we enjoyed being residents during that time.  If South Dakota isn't working out for you as a home state, maybe you should move to a new state.  Do a little investigating to determine which state might offer better health options and/or be more convenient to visit on a regular basis.  We were fortunate to be in good health and could work with a spring and fall visit but if you require more visits than that, a new more convenient state might be your best choice.

One of the problems with the Affordable Care Act is that it was a compromise from the original plan.  States with small populations, South Dakota being one, are struggling to maintain coverage.  A provision was made to assist those states but a lawsuit resulted in that provision being nullified.  Florida has a much larger population and should have many more coverage options as well as being a location you cite as being more convenient.  Florida has many of the same tax advantages as South Dakota so it might be an alternative.  Out of the states that you mention, I believe that Florida may be your best option though I don't know any specifics regarding their health insurance options.

You don't indicate your age or health condition.  We are now on Medicare and rather than selecting a Medicare Advantage plan which can be state specific, we have opted for the regular Medicare with a supplement plan.  Medicare is not state specific, we can get care wherever we are though we like most people always prefer a physician and hospitals that we are familiar with.  So when you get to 65, things should get better!  In fact there has been some discussion of lowering the age for Medicare eligibility to 55 which would help many older people.  Only time will tell how the various plans will develop.

[lmsooter]

3 hours ago, gblair52 said:

Our mail is out of South Dakota but haven't been there for 8 years. Insurance marketplace (Obama) stated there's only one provider in SD. (Avera). After applying and paying first premium, discovered ALL in-network service can only be done in SD. Otherwise, coverage is just 20% of bill expenses. We are in AZ, CA, NM, FL......all over the country. This insurance is of no use to me and very expensive for what I would receive.

So without insurance I'm being penalized through the IRS. Thank you Mr. Obama! 

Anyone else in this predicament and if so, what are you doing?? 

Thank you for any assistance. 

 

You don't say what your age is but I am assuming you are not eligible for Medicare.  If that assumption is wrong, the following may be useful.  Our home is in Texas and we have a Medicare Advantage plan which is not state specific.  My wife had knee replacement surgery in 2014 in Arizona and we were pleasantly surprised at our cost.  We traveled almost all states east of the Mississippi last year and were never more than 20 miles from a network hospital or physician.