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  1. #21
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    Quote Originally Posted by Traveler View Post
    Agreed, COBRA won't be cheap, but likely to be less expensive than purchasing individual policies (or family plan). I am not sure how the Health Exchanges work in different States in terms of missing the enrollment date. To me, quitting a job to take a 6-month hiking vacation and getting taxpayers to fund an insurance plan seems a little unethical when there are other options.
    I understand this argument, and definitely thought about it. To speak solely about my situation: My COBRA rate wasn't a good rate because my company had crappy health insurance. I would have payed a lot, but more importantly, for little coverage, which given my medical condition was too risky for me to accept. This is really getting into the weeds, but the dynamic between this and the travel plan meant that my primary insurance was in effect - and secondary inactive - anywhere within 500 miles of my hometown in PA. So if something happened to me in PA or close by, I'd have to foot the crazy hospital bill. For me, COBRA was not in a different price ballpark then individual plans on the market, which were offering better coverage. My COBRA plan was only worth it to me when my employer was contributing to the cost. And then as soon as you start shopping on the market, you are forced to enter your income, and the subsidies are automatic. Not to get too political but I think making ethical choices within an already crazy healthcare system is... complicated.
    Last edited by Nathan428; 02-22-2019 at 13:09.

  2. #22

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    Theres nothing unethical about playing by the rules, imo.

  3. #23
    Registered User rmitchell's Avatar
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    As I understand it the subsidies for health insurance payments are made directly to the insurance provider based on anticipated income tax deduction. In my case I resigned a job to provide care for a spouse with cancer. I looked carefully at all options.

    COBRA seemed expensive at first but when I considered all costs (deductible, con-insurance and maximum out of pocket) it was very close. Ultimately I did choose a market place plan, but it was a close call.


    For the OP , I would caution that even if they have no income at the moment that could likely change before the end of he year. The thru hike is probably six months. And some thru-hikes do end early. If their work status changes they should report it to avoid issues when filing federal income tax.

    Healthcare.gov is the place to check. And as others have mentioned out of state coverage (or lack thereof) is something to consider.


    Best of luck on the PCT!

  4. #24
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    Quote Originally Posted by rmitchell View Post
    As I understand it the subsidies for health insurance payments are made directly to the insurance provider based on anticipated income tax deduction. In my case I resigned a job to provide care for a spouse with cancer. I looked carefully at all options.

    COBRA seemed expensive at first but when I considered all costs (deductible, con-insurance and maximum out of pocket) it was very close. Ultimately I did choose a market place plan, but it was a close call.


    For the OP , I would caution that even if they have no income at the moment that could likely change before the end of he year. The thru hike is probably six months. And some thru-hikes do end early. If their work status changes they should report it to avoid issues when filing federal income tax.

    Healthcare.gov is the place to check. And as others have mentioned out of state coverage (or lack thereof) is something to consider.


    Best of luck on the PCT!
    Just to add to the equation, regarding filing 2019 Federal Income Tax next year, the individual mandate (and non-insured tax penalty) was eliminated by the new tax law - 2018 was the last year the penalty applied.

  5. #25
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    Default Health insurance for the trail?

    here's a thought. sign up to be an Avon lady. they probably have a group health plan for their members.

  6. #26
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    Most of an AT, all of PCT, and CDT thrus... being largely self employed or doing piece/project work of often 1 yr or less I didn't/don't qualify for employer health care. I carried my own health insurance in a group plan that covered employees and myself for about 1/2 an AT NOBO after I sold companies through a grace period. That was through Blue Cross/Blue Shield at some $120-130 monthly for myself. My approach isn't full proof but I'm not accident or health care crisis prone. I aim to do all I know how to keep myself from health or medical injury. Health care on the front end...preventively, proactively. I've had to pay out of pocket for dental and antibiotic prescriptions a few times and twice for Giardiasis stool analysis on trail but have never needed hospitalization or major medical attention on any hike. That's in more than 30K US backpacking miles. I'm overall a good risk taker meaning I do take risks but typically 'smart' risks. I hike mostly alone which has taught me out of necessity to be a better risk taker, and maintain a high fitness and health consciousness while listening to my body both on and off trail. The trail for me is becoming more and more not trail backpacking but routes. Fitness level has wavered a bit in the last 2 yrs but not absurdly ridiculous away from a strong baseline. Outside the US traveling long term or backpacking abroad I do carry health insurance but that's not your inquiry.

  7. #27
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    I have a medical travel insurance from Allianz, both for domestic and internation travels. But before getting any insurance I always careful read the policies to check what is covered and what is not;though at times it was hard for me understand those policies. It felt like was hidden in-between the lines. Still so far I haven't got any problems with pay-outs. Those feelings occur probably because I'm a fussy person
    Anyways, when I was looking for the right insurance agency, travel insurance marketplace like aardvarkcompare.com was really useful.
    And if hiking abroad, I usually go with Allianz backpackers plan/ it covers personal injuries, legal expenses, missed departure and provides emergency medical associated expenses

  8. #28
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    Recommendations? Move to Canada.

  9. #29
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    Quote Originally Posted by intune View Post
    Thanks - though we're hoping to find something cheaper than Cobra.
    You can find it, but the coverage will probably not be as good.
    Time is but the stream I go afishin' in.
    Thoreau

  10. #30
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    Hey, I'm in the same boat. Losing my job this October.
    And I don't know what to do about health insurance.
    I plan to sleep on the couch of a generous relative until next spring and then do PCT.
    I don't really want to waste precious money on health insurance premium. I'm in my 40s but healthy.

    My parents never had health insurance until Medicare, because we were poor. And they never needed it before Medicare.

  11. #31
    ME => GA 19AT3 rickb's Avatar
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    Quote Originally Posted by engineer19 View Post
    Hey, I'm in the same boat. Losing my job this October.
    And I don't know what to do about health insurance.
    I plan to sleep on the couch of a generous relative until next spring and then do PCT.
    I don't really want to waste precious money on health insurance premium. I'm in my 40s but healthy.

    My parents never had health insurance until Medicare, because we were poor. And they never needed it before Medicare.
    As I understand things, you have 60 days to from the time you lose insurance from your job to sign up for insurance through COBRA. Easy to find out how much that would be.

    I believe the COBRA insurance is retroactive, meaning that if you elect to go that route you are billed from day 1, even though you may have signed up for it at day 59.

    Alternatively, you can check out the price of insurance from your state’s “ACA Market Place”. Even if you don’t get any subsidy, the rates should be far less expensive than if you just ask an insurance company directly for a quote.

    You can figure out whether or not the Market Place ACA insurance is your best bet while you still have COBRA eligibility, I think.

    The only catch is that you can only buy market place insurance during a short time window known the open enrollment period. UNLESS, there is a qualifying event, like losing insurance from an employer. Then you have to sign up in something like 60 days— or you are screwed.

    But here is the thing. Even with an income that is 4x the poverty rate, you are likely to receive some subsidy — basically a tax credit which some people have applied in advance to their monthly insurance premium. You might even see the full amount paid for.

    But there is another catch too. If your income is too low, you won’t quality for the insurance ACA subsidy — you will be steered towards Medicaid. That represents a whole other set of challenges — perhaps even means testing, and may be something many wish to avoid.

    Please know that I have no special knowledge on those matters— and everything I have outlined above needs to be double checked given the importance of such things. Hopefully it might help you to ask the right questions of others who have more definitive info.

  12. #32
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    There are also medical cost sharing plans which is not insurance, most are christian based - and there is usually a christian based morality pledge, and they did qualify for the healthcare mandate when it was in effect.

    I had one of them years ago, though never needed it. It was much cheaper then health insurance. The basic way it works is everyone pays a monthly fee into a pool. Health expenses over a certain dollar amount (IIRC$2000) can be submitted and money from the pool can go to offset the bill. It is also incumbent on the person to try to negotiate the bill down before submitting, but they also will do that. There are other aspects to it, but generally that's how it works.

    Your other choice is hike in europe instead. Though everything will be out of pocket it is about a order of magnitude cheaper then in the US. An example 1 ER visit, then 1 Dr visit, then 1 Specialist visit, 2 Rx came to a total combined of about $225 euros or converted to dollars about $250. It's incredible how much we are being taken for and told we have the best of everything (which we do not) when questioned.

  13. #33
    Registered User colorado_rob's Avatar
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    Just to reiterate what has already been said, those of you who will have low income in 2020 REALLY should look into the healthcare.gov ACA system for 2020. Chances are you could have decent coverage for little money or even free.

    I do (have low income, basically a modest pension), and have had ACA coverage since my wife retired in 2017 (I retired in 2013, was on her health care until she retired). I'm not 100% on board philosophically with the ACA, but what can I say, I do use its benefits. My first year's premiums (2017) were $200/month for a pretty decent "silver" policy, and I've since switched to a "bronze" HSA policy, which is absolutely free, meaning my monthly subsidy (~$1700) is greater than my monthly premium (~$1600) for the two of us. Looks like I'll get the same deal in 2020.

    The subsidy is on a sliding income scale, I don't now remember the actual income limits, but it goes from about $30K/year of income at 100% subsidy to roughly $70K/year at zero subsidy. If your income in a given year is in this range or less, you might qualify for the ACA.

    Every state has a different exchange, some states with little choice of a policy, other states have good ones, varies all over the place. The healthcare.gov and in my case, "connectforhealthcolorado" websites are not the best, and sometimes difficult to navigate. Our first year on the ACA we "hired" a broker who took us through the process, with her receiving a commission from the resulting insurance company (in our case, Cigna).

    The ACA seems like it is tailor-made for thru hikers, who will have potentially low income for the year they hike.

    The down side is that if you are on the ACA, with a declared expected income for that year and the resulting subsidy, if you wind up making a lot more than you expected for that year, you will of course have to repay all or part of the subsidy.

    PLEASE, even you staunch conservatives, check out if the ACA applies to your situation. Even if you're "healthy". Ya never know.

  14. #34

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    Quote Originally Posted by rickb View Post
    But there is another catch too. If your income is too low, you won’t quality for the insurance ACA subsidy — you will be steered towards Medicaid. That represents a whole other set of challenges — perhaps even means testing, and may be something many wish to avoid.
    Medicaid will most likely not work as primary insurance while thru-hiking as these programs are state based and rarely can be used to sufficiently cover medical expenses outside the state where the patient's "home" is.

  15. #35
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    Quote Originally Posted by colorado_rob View Post
    those of you who will have low income in 2020 REALLY should look into the healthcare.gov ACA system for 2020. Chances are you could have decent coverage for little money or even free.
    Yeah, but I have a sizeable 401k account and I own a real estate. Even if my income is below Poverty, I'd be surprised if the US goverment will still give me free health care.

  16. #36
    Registered User rmitchell's Avatar
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    Quote Originally Posted by engineer19 View Post
    Yeah, but I have a sizeable 401k account and I own a real estate. Even if my income is below Poverty, I'd be surprised if the US goverment will still give me free health care.
    It may vary by state, but my understanding is that reimbursement rates are based on you anticipated annual income. Resources are not a factor. If you are making withdrawals from the 401k that is taxable or if the real estate is producing income that could come into play.

    Like colorado_rob said look at the website. It doesn't cost anything to check. All this could very well change for 2020 though.

  17. #37
    Registered User colorado_rob's Avatar
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    Quote Originally Posted by engineer19 View Post
    Yeah, but I have a sizeable 401k account and I own a real estate. Even if my income is below Poverty, I'd be surprised if the US goverment will still give me free health care.
    Yeah, the mind boggles, but you could be worth a billion bucks (asset wise) and still get a full subsidy from the ACA if you income is in the low 30K range.

    In other words, just like rmitchell just said, the current ACA is only about income, not your 401K balance (or real estate, whatever).

    I'm in the same boat, nice healthy 401K's and IRA's, but low income (retired, on modest pension). For such a situation, one does indeed have to take care not to draw money from a 401K/IRA, as that withdrawal becomes "income", and would affect the ACA subsidy. (We're living off of the small remainder of our non-401K/IRA savings (after tax money), untaill on Medicare in a couple years, at which time I'll no longer need an ACA subsidy).

    Quote Originally Posted by rmitchell View Post
    It may vary by state, but my understanding is that reimbursement rates are based on you anticipated annual income. Resources are not a factor. If you are making withdrawals from the 401k that is taxable or if the real estate is producing income that could come into play.

    Like colorado_rob said look at the website. It doesn't cost anything to check. All this could very well change for 2020 though.
    Looks like 2020 will be unchanged basically, as of now, at least. It has been a real touch-and-go situation for the ACA in recent years, for obvious reasons, but it still keeps hanging in there. I suspect 2020 will be the last year of status quo. Of course I thought that back in 2018, then 2019...

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