Health Insurance on the trail

My husband and I both have our health insurance separately through our employers and will be discontinuing our coverage when we quit our jobs to through hike the AT this spring. I am currently looking at travel health insurance, and am also going to talk to my current Statefarm agent to see what she has to offer. I am looking for input from previous thru-hikers as to what they did for health insurance, input from anyone who used travel insurance on the trail or a similar extended hike, and am curious as to what other 2020 thru-hikers are planning on doing for health insurance on the trail. Any suggestions/input are welcome!

I'm not a thru hiker. Have you looked at COBRA from your previous employer?

You can keep your plan through COBRA, but you will have to pay the premium yourself.

If you had a good plan with your employer its going to be hard to beat and Cobra is the way to go. Depending on your planned income and age you may be able to get Bronze ACA plan for close to free with the subsidy planned in. Your state may have non ACA short term plans. They get you in the hospital but no preexisting conditions. The hassle is if you do need coverage on the trail you may not be able to find a hospital or doctor that is "in network" for plans. You usually can get covered for an emergency but usually get hit with a high deductible if the provider is out of network.

Note there are also Health Care Sharing plans usually tied to religion that are a back door way around having real insurance. Be real careful, they make a lot of promises and act like insurance but they aren't.

I just retired, and went with an ACA plan that was virtually identical to the plan I had with my employer but at a lower cost. I won’t get any subsidy this year, but could potentially get a 100% subsidy next year by living off my pot of gold, rather than cashing in IRAs. Crazy, that.

The thing about ACA insurance — or any real insurance — is that it will allow you to keep your house and those IRAs if you get anything serious. A new kidney is not cheap. If one’s only concerned about getting a broken leg paid for, travel insurance might be OK.

Here's the "problem". Like anything else, you get what you pay for. Picking up the full premium under COBRA isn't generally cheap if you had a good health plan at work. But, cheaper plans, especially travel and term plans, usually have much higher deductibles, out of pockets, and lower total limits of coverage, pre-existing condition clauses, etc. If you pay for good coverage and don't use it, yeah, you're out the premium money. If you pay for a cheap plan with lots of limitations, and something bad happens, you're likely out that same money - and then some. People's life situation like age, wealth, marital status, children, career, etc. all come into play. How healthy are you? How old? What are your assets? If you have a home, investments, assets, etc, you absolutely need GOOD health coverage to avoid being ruined financially if something bad happens. What is your long term plan after hiking? If you're not going back to an employer subsidized plan, you might set up the coverage that you'll use post hike.

In May 2015, I quit my my job to thru hike (flip-flop from HF north) and I decided to keep my plan through COBRA. It cost me close to $1000.00 a month. Made it to Hanover, NH. Could barely walk, so I got off the trail. An MRI revealed a stress fracture in my left Tibia. I was happy to have insurance.

I see walking as a healthy, relatively low-risk lifestyle, so I insure it accordingly.

When I left work (decades ago) I looked at the COBRA option and got sticker shock. I went to the cheapest option on the market with the highest deductible. I have never used it so I guess I'm pretty lucky. With ACA, I've stayed at the Bronze level, have still never used it, and am very happy most years to see the US pay for at least some of my premiums.

A low-end financial blogger I follow (Mr Money Mustache) had this idea--If you're not into wing suits or sky diving, try a three-month "insurance vacation." Apparently you only need nine months of insurance per year to avoid ACA penalties.

Get the highest deductible you can cover with your savings. If you're willingly leaving jobs that paid your insurance, hopefully you have a pretty good safety net saved up.

You are so right! Thank you, and everyone, for the input! I'm just trying to look at my options because Cobra is definitely not going to be an affordable option. After further research and other's input, travel insurance is definitely not the way to go as a means of primary health insurance, too many loopholes. Someone had recommended short term health insurance. Though the deductible is a little high, the cost is affordable and coverage is very decent for a 6 month period. I do not really have any assets, my car is paid off, I have no student/personal loan or other debts, no mortgage because I rent, etc. I am 37 and my husband is 39 and we are in relatively good health. I plan on looking for employment very shortly upon return from the trail, but could purchase another short term policy that could be cancelled on a month to month basis. I also plan on talking to my Statefarm agent to see what input she has.

Be aware that there are companies that knowingly prey on people whose health plan consists of "we won't get so sick that we incur major expenses."

https://www.bloomberg.com/news/featu...=pocket-newtab

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Originally Posted by peakbagger

Note there are also Health Care Sharing plans usually tied to religion that are a back door way around having real insurance. Be real careful, they make a lot of promises and act like insurance but they aren't.

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Excellent advice - be very careful. Here's an example: https://dfr.vermont.gov/reg-bul-ord/...ase-and-desist

You pay your money in for the opportunity to share, not for a guarantee of payment.

Depending on your anticipated income for 2020, the ACA might be a better option than Cobra if you qualify for subsidies. Many times, thru hikers will qualify for subsidies because they only earn income for about half of the year of their thru. You could get coverage for very little. There are two types of subsidies: Premium subsidies and cost-sharing subsidies. Premium subsidies directly lower your monthly premium. Cost-sharing subsidies exist in selected silver plans where your deductible and maximum out-of-pocket is reduced.

I make these comments as practical advice for the thru hiker, not because I necessarily agree or disagree with the ACA politically.

More detail: http://www.spartanspendthrift.com/bu...en-enrollment/

"Apparently you only need nine months of insurance per year to avoid ACA penalties."

Just FYI, there are no longer any penalties for not having coverage. This was phased out last year.

Yep, the ACA is really handy for thru hikers, kind of tailor made for a given year with a lower income.

Basically, if your combined (husband and you) income for your 2020 hike is less than about 65-70K, then you can get some subsidy, and if it's around 30K, you might get a full subsidy. Every state has a different selection of plans that qualify for the ACA subsidy, not sure how robust the PA system is, but you really should check, again, if your income is less than 65-70K for next year. There would not be much subsidy if you make the top end of the range (70K), but probably full subsidy if your near the bottom end.

My wife and I have been enrolled in an ACA "bronze" plan now for 3 years, we basically have free health insurance, and it's decent insurance, though with a hefty deductible. If you get an ACA plan with an HSA designation, you can plop money into an HSA to pay this deductible (if and when needed), and that money is tax deductible, meaning you can pull money from an IRA or 401K, which is treated as income and hence would decrease your ACA subsidy, but if you plop that into an HSA, that is now deductible, so cancels out the "income" of the IRA withdrawal, if you follow.

Contrary to what some apparently think, the ACA subsidy has NOTHING to do with your assets (you could be a billionaire, wouldn't matter), just your income.

Every year is a big mystery as to whether the ACA will exist, but it hangs in there, and will apparently still be around in 2020, as we are about to enroll again.

Coincidently I just read this cautionary article about predatory “short term” insurance plans that are sold outside the ACA exchanges and often cover almost nothing. I’d recommend giving it a read:

https://www.bloomberg.com/news/featu...-floods-market

A couple of years ago, my wife was hanging a hammock in the trees behind our house when she was bitten by a copperhead snake. 24 hours later we had spent $100K on anti-venom treatment, a life-flight helicopter ride from one hospital to another, a day in the ICU, and so many specialist doctors I lost count. She could have lost her hand, but thanks to timely medical treatment she made a full recovery. Fortunately, my mother taught me the lesson of having insurance.

Last year, I section hiked the AT south of Waynesboro for 100 miles, and came across a hiker who told me to be careful of the trail ahead which was slippery due to the rain. A hiker fell there the day before and had to be lifeflighted to a nearby hospital. I hope that hiker didn't decide to risk hiking without insurance. When my wife needed one, I found out the charge for the helicopter to take off was $25,000 plus mileage.

Insurance isn't for when you break your arm or need a prescription, it's for the things that will bankrupt your future. You don't have to have a very vivid imagination to come up with cases where you would need to be extracted off the trail.