Health insurance for full-time RVers and van lifers can be really hard to figure out. Especially those of us who are under 65 and don’t qualify for Medicare.
Fulltime RVers and van lifers travel around so much that it doesn’t make sense to only have health insurance that works in our domicile state. Who wants to drive across the country just to see a doctor?
Hillary Bird of @GreenVanGo expressed her frustration: “Figuring out health insurance has been a nightmare” she said. “I just have Medicaid in New Hampshire, where I built the van. So unless I’m in that state, it’s almost useless.”
So what’s an RVer to do? Have short-term insurance? A fixed indemnity plan? What about a healthshare non-profit organization?
In this post, I hope to clear the air when it comes to health insurance options for fulltime RVers and van lifers. You’ll be able to go into your decision informed and ready to pick what’s best for you.
The Types of Health Insurance for Full Time RVers and Van Lifers
Next, we’ll look into the types of health insurance options for fulltime RVers. What you end up choosing is entirely dependent on your personal situation. There’s no one-size-fits-all approach for RVer health insurance.
You should know that the individual mandate to purchase health insurance was eliminated in 2020, so you won’t be fined if you don’t have traditional health insurance.
The Affordable Care Act Health Insurance Plans (Obamacare)
The Affordable Care Act, otherwise known as Obamacare, is one health insurance option for full-time RVers. The main problem with the ACA is that it usually only works in your domicile state, with the exception of Florida.
Florida is the only state left in the country that offers nationwide ACA plans, which makes it a popular domicile state for nomads.
“Florida has the Florida Blue Plans, which are an EPO-hybrid and have opened up their doctor networks a lot broader than in most states,” said Andrew Monk with Monk Health Insurance Advising, who puts together individualized health insurance plans for RVers. “Florida is a good state if you want an ACA plan.”
The Affordable Care Act makes sense for certain people with pre-existing conditions or who need to see a doctor regularly. ACA plans aren’t allowed to turn people down for pre-existing conditions, or if people get a debilitating disease.
ACA plans are especially good for RVers who have a low enough income to qualify for subsidies. If you’re a remote worker with a high income, the ACA could become extremely expensive.
If you’re changing domiciles when you start RVing or living in a van, make sure that state has health insurance options you can actually use.
I was just informed that in South Dakota, they won’t give insurance to anyone without a physical address. Both insurance companies know if you’re using a personal mailbox like America’s Mailbox or ChooseSD.
TIP: If you do want to stick with the Affordable Care Act, we recommend starting a Health Savings Account (HSA) so you can pay for medical expenses tax-free. Funds in a Health Savings Account can also be invested, so you’ll make money off your deposits as well. You can use your HSA to pay for deductibles, copayments, coinsurance, prescriptions, eyeglasses, etc. Contribution limits per year are around $3,500 and can also be invested.
To look through Affordable Care Acts, this is the best website to sift through plans: HealthSherpa.com
Positives of Affordable Care Act Plans:
Negatives of ACA plans:
Fixed Indemnity Plans
Fixed Indemnity plans are growing in popularity as a health care option for full-time RVers. These plans work all over the country, and offer a fixed benefit for various treatments and illnesses.
Fixed Indemnity plans are good for people who are basically healthy and don’t mind taking a bit more risk with health insurance.
Fixed Indemnity plans came to be as a way to supplement income loss for patients affected by illness and industry. The Brookings Institute argues they were never meant to be used as a sole form of health insurance.
Here’s an example of how a Fixed Indemnity Plan might work: $250,000 maximum per year per insured person, $2,000 per day for a hospital stay and $75 per doctor visit. Fixed Indemnity plans offer payments per service or per day spent in a hospital or in treatment.
However, this sort of plan isn’t for everyone. “If you get cancer, at that point you’re looking at $1-2 million per care for treatment in the first two years, and a fixed indemnity plan isn’t going to fit the bill,” said Monk.
And another example from the Brookings Institute: “In some fixed indemnity products, the plan will leave consumers exposed to significant additional costs in almost all cases: plans that pay $500 per day of hospitalization or $700 per surgery will leave most patients exposed to very large costs.”
That’s why Fixed Indemnity Plans are cheaper than plans offered by the Affordable Care Act. The insurance company knows exactly how much risk it will take on (and how much money it will be out), so can charge less for coverage.
If you’re worried you might exceed your specified amount in a year, you can “level up” to add on additional coverage for accidental injury or illness.
RVer Geoff Matthews puts together Fixed Indemnity health insurance plans for full-time RVers. One plan he told me about had several different “layers” you can add to your insurance. Here’s an example of what you can add:
- 24-Hour Accident: If you have an accident, you’ll get $4,000 payment for medical expenses and up to $10,000 for an ambulance ride
- Critical Illness: This is a cash payment you’ll get if you’re struck with an unforeseen illness. The company would give you a check for $30,000, which you can use in any way you want
- Catastrophic Accident and Disease: In this case, the insurance company would make another $500,000 available to cover your accident or illness after it first pays out $50,000.
As you can see, you can layer on more options for additional coverage. What’s cool about Fixed Indemnity health insurance plans for full-time RVers is that they’re really flexible and can suit your needs.
But please read the fine print and make sure you’re okay with the risk associated with Fixed Indemnity Plans.
If you want to contact an insurance agent about getting a Fixed Indemnity Plan, we recommend:
- RVer Geoff Matthews: [email protected]
- Monk Health Insurance Advising and Andrew Monk: [email protected]
Positives of Fixed Indemnity Plans:
Negatives of Fixed Indemnity Plans:
Short Term Health Insurance for RVers and Van Lifers
Another option is short-term health insurance for full-time RVers. Short-term health insurance was created for people who are between jobs or health insurance plans. It wasn’t created to serve as the only health insurance policy you use.
Health insurance expert Andrew Monk seriously cautions against getting short-term health insurance. “I had a client on a short-term plan who was diagnosed with Stage 3 cancer on the 1st month of the cycle of his plan. He had excellent coverage for two months, then the company dropped him.”
Unfortunately, insurance companies have gotten pretty tricky with short-term insurance plans and aren’t required to disclose they’re offering a short-term plan.
Look for terms on the plan that say things like “12, 24 and 36 months.” That’s how you know it’s a short term plan. Some states, like South Dakota, are trying to push through a bill to require companies to disclose they’re short term.
Despite the downsides of short-term health insurance plans, they’re just right for some full-time RVers, including for Laura and Mike Peters of MikeandLauraTravel.com.
Both of them are 30-years-old, and were paying $600 per month for health insurance through both IMG Global and Liberty Healthshare. Neither company would pay for expenses when the need arose.
“We realized that we were paying out of pocket for our basic appointments anyway, so why continue to pay $600+ per month for health insurance that wouldn’t cover us anyway?” said Laura.
So the two switched to a short term catastrophic plan through Pivot Health, where they pay just $80 per month. “Anything over $10,000 is covered, but anything less than that we pay out of pocket. It has actually saved us thousands of dollars each year.”
If you’re interested in checking out short term insurance, here are two popular companies:
Positives of Short Term Insurance:
Negatives of Short Term Insurance
Medical Cost Sharing Non Profit Organizations for RVers and Van Lifers
Health cost sharing non-profit organizations have exploded in popularity over the recent years. They’re typically cheaper than Affordable Care Act plans but they aren’t legally required to pay their customers’ claims.
The way it works is like this: you put money into a pool every month, and that pool is used to pay members’ medical expenses.
Not everything is covered, though, and usually what is covered is within the realm of Christian values. For example, some medical sharing ministries will refuse to pay for birth control or even for maternal care if it’s out of wedlock. Some ministries have annual or lifetime limits or restrictions on what they will cover.
However, all health sharing non-profits are different in what they do and don’t cover. We recommend reading the fine print before signing up for one of these health care plans.
[To understand the differences between health sharing and traditional insurance, download this document written by health insurance expert Andrew Monk]
One company we advise avoiding is Liberty Healthshare. We’ve heard from way too many RVers who were refused coverage. You can read about one RVer’s experience here. We’d recommend you avoid that organization.
However, other RVers and van lifers sing the praises of other health sharing non-profits. Here are a couple you might like to look into:
Zion Health gets great reviews online and is a health sharing organization I’m particularly interested in. They don’t decline anyone due to prior medical conditions or religious beliefs. There are no lifetime caps on sharing and they even share costs incurred outside the U.S.
You choose between three plans. With the first option, you’ll be responsible for $1,000 for the three first times you need medical care. After that, Zion pays for everything. With the second option, your responsibility is $2,500, and with the third, $5,000. The higher the amount you pay initially, the lower your monthly premium.
What I like about Zion is they cover 100% of preventative care. Plus, all Teledoc visits are completely free, and you can get prescriptions through this type of appointment.
Amber Baldwin of the YouTube channel StoryChasing lives in a Dodge Hymer campervan and loves Zion Health so far. She used to pay $600 per month for traditional health insurance. “I’m a healthy adult and it didn’t make sense for me to be paying that much when I basically just used it for preventative care.”
I asked her about whether she was worried if Zion would refuse to pay out and she said this: “I heard about one guy who had prostate cancer and Zion paid for everything.”
Zion does have a pre-existing condition phase-in period. For example, you have a one-year waiting period where Zion pays for nothing, then up to $25,000 the second year, $50,000 the third year, and so on.
Samaritan Ministries Health Sharing for RVers
Samaritan Ministries offers two different levels of plans: Classic and Basic. With Samaritan Classic, you only have to pay $400 before Samaritan pays 100% of your bills. Samaritan Basic offers a lower monthly premium but your out-of-pocket amount is $1,500 before Samaritan steps in and pays 90%.
The maximum this healthshare pays out is $230,000-$250,000 per year per member. If your expenses exceed those amounts you’ll have to apply for additional help.
RVer Kristi Corder of Way Beyond the Norm is really happy with her Samaritan Ministries membership. She pays $500 per month for a family of five.
Here’s her experience:
“Our daughter had a medical emergency 8 years ago that left us with almost $15,000 in out-of-pocket expenses despite being on traditional health insurance. It was at that point that we realized that had we just said we were uninsured, our total emergency room and surgery bill would have been discounted to less than the $15,000 we owed WITH insurance coverage. So we dropped the insurance and switched to Samaritan Ministries.
“We submitted our daughter’s $15,000 worth of medical bills to Samaritan as a “special prayer need” (because we were not members when the incident happened) asking fellow believers to 1) pray that we would financially be able to pay those bills, and 2) to give any small amount if they were able and felt led to give.
“Within a month, we were gifted 90% of what was needed to cover those bills. We asked ourselves, ‘if this can work so well for a special prayer need, how much better can it work for actual publishable needs?’ We’ve been pleased with our membership ever since.”
Christian Healthshare Ministries is also a recommended health share to check out.
Positives of Medical Cost Sharing:
Negatives of Medical Cost Sharing:
No Insurance at All/Accident Insurance
Some RVers are so fed up with trying to figure out the whole health insurance debacle that they drop out of being insured altogether.
Ross R. from AskTheRVEngineer.com decided to get out of the health insurance business.
“Instead, I opted for accident injury coverage through Spot, which is less than $28 a month! Unlike lots of other injury coverage programs, this one covers most extreme sports like rock climbing or wilderness kayaking,” said Ross.
He said it didn’t make sense for him to continue paying the high premiums associated with health insurance as he hadn’t stepped in a doctor’s office for 15 years.
“I’m hard to break and pretty healthy, so I didn’t need traditional health insurance,” said Ross. “Prices for catastrophic insurance were still exorbitant; Spot was just right! The $20,000/incident coverage will pay for 90% of any injuries I may suffer in the outdoors.”
Of course, this is the riskiest type of insurance as you aren’t covered for sudden illness like cancer, heart attack or stroke.
What about Safety Wing?
We’ve seen Safety Wing mentioned in some blog posts about the best health insurance for full time RVers, so we decided to look into this program a bit more.
Safety Wing is a travel insurance company that started offering health insurance for digital nomads, called Remote Health. At first glance, it looks pretty cool, with full cancer coverage, surgeries, COVID, etc, with only a $250 deductible.
Here’s what their website says about Remote Health, which makes it seem like a really appealing option:
“A fully-equipped health insurance made for remote workers and nomads who spend as much time abroad as they please. Full coverage in your home country, and no exclusions for pandemics.”
However, you are not allowed to live in the United States to use this coverage. You need a physical address outside the U.S. and be able to prove your physical address with a rental/lease agreement, bank statement, VISA card or proof of P.O. rental.
You can then put on a “U.S.” add-on, which gives you coverage if you travel to the U.S. for up to six months. But your physical address can’t be in the U.S.
I got a quick quote for myself and as a 40-year-old woman, my coverage per month with the U.S. add-on is over $400. This doesn’t cover any outpatient care like physicals, preventative care, urgent care, etc., only in-patient care where I’d be admitted to a hospital.
So for me, this program didn’t make much sense and I can’t imagine it would be useful for full-time RVers or van lifers.
The only way this would work is if you’re an RVer who spends part of the year outside the country renting an apartment. You could use that address as your primary address and then head back to the U.S. for up to six months for RVing.
What if you’re an RVer who also does world travel part of the year?
One thing that I face while pondering health insurance as a van lifer is the fact that I live on a sailboat in Mexico for 6 months of every year. Therefore, I really only need U.S. healthcare for 6 months out of every year in case I get ill or injured.
There are a few companies that offer a hybrid of health insurance that works around the entire world including in the United States. This isn’t travel insurance, but real health insurance.
I won’t write about these options in-depth as I think this applies to a smaller group of RVers and van lifers, but wanted you to check out the links if you’re curious:
If you’re just taking short international trips you can use travel insurance.
Things to Keep in Mind when Choosing Health Insurance as a Full Time RVer or Van Lifer
We have a few tips and suggestions to consider before you choose the best health insurance plan for life on the road.
Choose your Domicile State Accordingly
Many RVers and van lifers choose to change domicile states when they go full-time. The top three states for nomads are South Dakota, Texas and Florida, mostly due to lack of state income tax, registration and insurance costs and less restrictive vehicle inspections.
When considering your domicile state, you should also think really hard about health insurance. If it’s important to you to be part of the Affordable Care Act and have nationwide health insurance, you should consider switching your domicile to Florida. That’s the only state left in the U.S. that offers a type of nationwide care.
If the ACA isn’t important to you, your domicile state won’t matter as much because you can join a Fixed Indemnity Plan or a Health Sharing plan.
When I just inquired about being on ACA plans in South Dakota, they informed me both major medical plans won’t accept a personal mailbox, and are aware of every company offering PMBs to RVers.
Look for Telehealth
Telehealth is a really good health insurance option for full time RVers and van lifers. Many plans offer telehealth as part of the plan, and you can use telehealth and unlimited number of times. Telehealth is great for asking a doctor questions and even getting a prescription sent to a pharmacy near you.
Many ACA plans, Fixed Indemnity Plans and Health Share Plans offer telehealth.
You can also purchase Telehealth through a company like Teledoc.
Figure Out Your Risk Tolerance
A lot about picking the best health insurance for full time RVing is assessing your risk tolerance. How much are you willing to be on the hook if you get an awful illness like cancer? Do you want to trust that a medical sharing non-profit will actually pay your costs? What will you do if they don’t pay your costs?
The price of health insurance is directly correlated with risk.
“When you get an insurance policy – whether its car, homeowners, RV, or health insurance – what you are doing is you’re asking a company to cover a risk,” said Andrew Monk. “With health insurance it’s the risk of you getting sick or injured. Risk is correlated to cost. The higher cost plans are probably higher cost because the insurance company is assuming more risk.”
For example – most ACA plans cost more than Fixed Indemnity because that company is going to pay ALL YOUR BILLS after you meet your deductible, even if you need millions of dollars in cancer treatments.
Save up an emergency fund
You never know when you’re going to get hit with an illness or injury, so it’s important to keep some savings around. Some RV blogs suggest opening a Health Savings Account (HSA) so you can put money in there pre-tax to pay for medical care.
Keep in mind that HSA accounts only work with Affordable Care Act plans.
You can’t use them alongside Fixed Indemnity, Short Term or Medical Sharing organizations.
It’s a good idea to keep a decent amount of savings for medical emergencies – at least enough to meet your deductible.
So, what health insurance am I getting?
At the time of publishing this article in May of 2021, I’m still trying to figure out which health insurance option is best for a van lifer and sailor who is part-time in the U.S. and part-time in Mexico.
Right now I’m leaning toward joining Zion Health as they cover preventative care and expenses that occur outside the U.S. I’ll probably buttress this with a plan that covers search and rescue and potential Coast Guard evacuation for accidents and injuries at sea.
I am hoping a combination plan like this will suit my needs as a healthy person who only sees the doctor for preventative care.
I’ll be sure to update this post with my experiences finding the best health insurance options for life on the road and on the water.
- RVerInsuranceExchange.com is a great place to interact with insurance agents and explore a wide range of plans.
- Andrew Monk is a health insurance professional that helps RVers find plans that suit their individual needs.
- Geoff Matthews is a full-time RVer focused on helping RVers get fixed indemnity plans
Other articles to check out: