Filling the Health Insurance Gap with Mike Neighbours and Bob Nunn

The health insurance gap between an employer plan and Medicare can be quite a hot topic—especially for those who are living the RV or tiny house life. Many people living these lifestyles travel a lot, are retired, or simply do not have the traditional work, so their healthcare needs often don’t fit inside the traditional box. Bob Nunn and Mike Neighbours join the show today to clear up the misconceptions out there and offer their insight as full-time RVers and independent health insurance consultants. If you are noticing the gap left by the health insurance world when it comes to your specific lifestyle, this episode will help you see what other options and creative solutions are out there.

For full show notes and more information visit https://bit.ly/4cP2jj3

Transcript

Filling the Health Insurance Gap with Mike Neighbours
and Bob Nunn
Less House More Moola with Laura Lynch
https://thetinyhouseadviser.com
Full Episode Transcript
With Your Host
Laura Lynch
Filling the Health Insurance Gap with Mike Neighbours
and Bob Nunn
Less House More Moola with Laura Lynch
https://thetinyhouseadviser.com
It takes a brave and independent mindset to go tiny. If you are trying to
figure out your tiny pivot, this podcast is here to inspire and connect you
with the other unconventional, gritty, inspirational people within this
community.
I’m Laura Lynch, your tiny house friend and host. On this show, we are
always going to come back to money because, as a financial planner, this
is the question I hear the most: How do I make this work for me financially?
Well, that’s my jam. So jump in, let’s go. New episodes drop every
Thursday.
Laura Lynch: Well, Mike Neighbors and Bob Nunn. Thank you so much for
joining Less House, More Moola podcast. I'm super excited to have you here
today. This is a hot, hot topic that I have had so many questions about. And
that is what to do about the health insurance gap between an employer plan,
if you ever had one, and Medicare.
So many listeners that use a tiny house or an RV, they travel and they
sometimes do non-corporate types of work. Therefore, their health insurance
doesn't necessarily fit nicely inside the traditional box. So as you are both
full-time RVers and you work as independent health insurance consultants,
you know all about this. So thanks so much for joining me today. Bob, would
you introduce yourself and share your story of moving into an RV full-time?
Bob Nunn: Sure, my name is Bob Nunn. I'm from Florida, Cocoa Beach. I
had a seafood company for many years selling seafood up and down the
east coast of Florida. And after 35 years of 100-hour work weeks, my wife
and I decided to sell everything and start the RV life.
And then I fell into, met our mutual boss, Colleen Elkins, and just fell in love
with the RV lifestyle and helping people get to answer to this problem that
we're talking about today: healthcare across the nation. So I'm excited to be
here. 
Filling the Health Insurance Gap with Mike Neighbours
and Bob Nunn
Less House More Moola with Laura Lynch
https://thetinyhouseadviser.com
Laura Lynch: Awesome, Bob. And Mike, would you please introduce
yourself? You’ve been doing the full-time RV thing for a while. Share with us
why this lifestyle appeals to you.
Mike Neighbors: Awesome. Thanks, Laura. We have been, as you said, my
wife and I have been full-time RVers for 14 years. We started by accident
and thought we'd try it for a year or two, and see what it turned into. We got
caught up in the financial meltdown in 2008 and looked at what options and
alternatives might be, found the RV lifestyle, and absolutely fell in love with
it.
The big thing about it, among the big things about it, is: you can change your
scenery every day. If you like deserts, you can be there. If you like
mountains, you can be there. If you live in a sticks and bricks someplace, the
only view that changes every day is whether it's a UPS truck or a FedEx truck
that goes by your front window. My view changes, from a lake to a river to
the mountains, to whatever I want it to be, and the people that go with it.
You're meeting new people constantly, and it's just a phenomenal lifestyle.
Laura Lynch: Awesome. Yeah, I think that sense of exploration is something
that definitely resonates with me. As I mentioned to you earlier, I was once
upon a time in the Air Force, and you move around every few years in the
military, and that means you get bored easily. So I definitely understand why
that change of scenery is so valuable. So I thought that today - to talk about
this really important health insurance topic - we would walk through a couple
of case studies of sort of, maybe classic type situations where people find
themselves in need of health insurance options.
And since you are both currently nomadic and working in this space, I'm just
delighted that you bring your expertise today. So, Mike, I'm going to start with
you. Let's talk about how you guide someone who is say around 60 years
old. They have a few years left before Medicare. They recently left their
corporate employer and health plan, and they're planning to create an early
retirement lifestyle of travel around the country. What are some options for
this person? 
Filling the Health Insurance Gap with Mike Neighbours
and Bob Nunn
Less House More Moola with Laura Lynch
https://thetinyhouseadviser.com
Mike Neighbors: Great question. The first thing that people learn, when they
get exposed to life after corporate, is that it is completely different. The rules
that you played by when you were under corporate health care are
completely different when you're out on your own and shopping and
responsible for your own health care.
There are some viable options, and they're better in some cases and worse
in some cases, and I'll just kind of walk through from an overall standpoint
what's out there. To start with, if you're just being downsized from a
company, your company has a legal obligation to offer you COBRA. COBRA
in and of itself is not insurance.
It's a law that says the employer has to offer it. COBRA typically is the same
coverage you enjoyed under your corporate plan. That's the upside. The
downside is that it is probably the single most expensive way to get health
insurance that there is. But it's certainly an option and one not to be denied.
The next thing on the list would be using the exchange, referred to as
Obamacare or ACA or the exchange, depending on who's leading the
discussion. That's typically good for somebody who doesn't travel, is more
stationary in one place, and you can see the same health care providers all
the time. It is less desirable for somebody who is nomadic, because it only
provides for emergency care. And they get to define when the emergency
starts and stops and we can have a separate discussion about that.
The real upside if you're in any kind of health situation, where you're a
diabetic on insulin, you have a history of cancer stroke, heart attack, any bad
preexisting conditions an ACA plan or exchange plan may be your only
option because most other plans are going to have an underwriting criteria
that you have to qualify for.
The other things that are out there could be a short-term plan, which by
definition is a short term. You buy it for 60, 90 days, 120 days. There are
some specific places and areas where that's good. If you're within 90 days
of Medicare, it may be a good option for you. There are some limitations. If
you reach the end of the time frame that you bought it for, they don't have to
renew it again for you.
Filling the Health Insurance Gap with Mike Neighbours
and Bob Nunn
Less House More Moola with Laura Lynch
https://thetinyhouseadviser.com
You've got some risk when you do that. The next item that, they're the next
type of insurance out there you could run into are these “ministry share”
plans. Some of them are good. most of them are questionable. The risk to
them is, well, there's an upside. The upside is they're usually very reasonable
from a cost standpoint.
The downside is they are not insurance, therefore they are not regulated at
state level. If they want to don't want to pay a claim, they don't have to pay a
claim. The next option available and the most favorable one for people that
travel a lot is what's called an indemnity plan. An indemnity plan, by
definition, is strictly a financial arrangement that helps you with your health
care costs.
It doesn't try to manage your health care, doesn't tie you to a network, doesn't
tell you you have to see this doctor, doesn't tell you you have to have a
referral for a mammogram or whatever else it might be, gives you complete
freedom to see any doctor any place in the country as you travel. In practice,
that's what we found to be the best solution for most of our viewers. It's very
cost-effective, the premiums tend to be about a third less than what other
types of insurance are. The downside is you've got to be able to qualify for it
from a health standpoint. And if you have any one of the bad things that we
talked about earlier - cancer, stroke, heart attack, obesity, any of the real bad
things - you're probably not going to be able to get this.
So then we've got to look at other options. and the thing I'll end with here for
a second is that being a full-service health insurance agency, and the
experience we have dealing with the mobile community, we have a broad
range of companies available. We have a broad range of different coverages
available. We have a broad range of levels of coverage available, and we
can tailor whatever you need to what your individual needs are.
Laura Lynch: Yeah, that's excellent. Thanks for that overview. So it sounds
like one of the major things to think about for someone who is in pre-retiree
age is about location, whether you're stationary or whether you're traveling -
which in this case, we're really focused on traveling because that's the catch
for most people - and then to the health condition situation.
Filling the Health Insurance Gap with Mike Neighbours
and Bob Nunn
Less House More Moola with Laura Lynch
https://thetinyhouseadviser.com
And so would that be, I mean, we've all had something crop up, right? At
some point in our life. Like how far back are we talking for a health condition?
If it was just in the last year or so, are we talking about if you've ever had
something, kind of significant in your health history?
Mike Neighbors: With most companies and the ones that we represent and
use the most frequently, there's a different period of lookback for different
kinds of conditions. If you've got a preexisting heart condition, they're going
to go back at least ten years and see where it all started and what caused it,
et cetera, et cetera. Cancer is typically a five year look back. You could have
had breast cancer six years ago and from an insurance standpoint today,
could be like it never happened, depending on what the company standards
are.
So there are some avenues that are open to you there. and there are some
things that show up health-wise that are really interesting that you may not
think of as being disqualified. One of the big ones is rheumatoid arthritis,
because rheumatoid arthritis is an autoimmune disease.
It is considered a very serious preexisting condition, so that may preclude
you from being able to get some kind of coverages. On the other hand, a
broken arm two years ago isn't going to slow you down or stop you.
Laura Lynch: Great. So, it sounds like that ACA - to reiterate what you were
saying earlier - the Affordable Care Act, Obamacare, the exchange,
whatever you might want to call it, is really only a good option if you're sitting
still because of that geographic boundary around your care. You want to talk
a little bit more about why that is?
Mike Neighbors: Yeah, by law, any plan through the ACA has to cover you
for emergencies, no matter where you are in the country. But the irony is they
get to define what the emergency is, when it's an emergency, and when it
stops and starts. The classic example of that - and we've had some firsthand
knowledge of it in our agency - and that is: you're traveling, you're based in
New Mexico, where your place is, Laura, and you're traveling in Alabama,
and you have a heart attack. They rush you to the hospital, put you in the 
Filling the Health Insurance Gap with Mike Neighbours
and Bob Nunn
Less House More Moola with Laura Lynch
https://thetinyhouseadviser.com
emergency room and get you stabilized and you're going to live and they
transfer you to the hospital.
When they take you out of the emergency room and you could move across
the hall to a hospital room. The minute you leave the emergency room, the
emergency is over. And you could be on the hook for all expenses past that
if they don't have out-of-network coverage, which is likely impossible. You're
going to be on the hook for all the bills, if not a large part of them. So that's
kind of the downside for travelers with an ACA. You've got a skeleton of
coverage there, but it doesn't cover all the bases.
Laura Lynch: Yeah. And so that is because - and not to get too far, not for
me to take us too far into the weeds here - but that's because most states on
their plans that they offer on the exchange are health maintenance
organizations, HMOs, meaning that you have to operate within the referral
network or the network that's in, and it's a state-based plan. Is that right?
Mike Neighbors: You've actually done more homework than most people
have. Yeah, and it doesn't have to be - I don't want to expand on that for just
today - it does not have to necessarily be state-based. It's regulated at state
level, but we have seen HMOs. I've got one in Houston, for example,
downtown Houston, it's an HMO that is sponsored by a local hospital.
And the HMO service area is a three-block radius around that hospital. So
once you leave that three-block area, you're out of network, right? To start
with.
Bob Nunn: That's the same with the villages.
Mike Neighbors: Yeah, same thing. My client wanted to move to a suburb
for the lifestyle in the suburbs and had to actually change HMO plans when
he moved 35 miles away.
Laura Lynch: Wow.
Mike Neighbors: So that's kind of the downside to an HMO. 
Filling the Health Insurance Gap with Mike Neighbours
and Bob Nunn
Less House More Moola with Laura Lynch
https://thetinyhouseadviser.com
Laura Lynch: And why this comes as such a shock to us is that in our
employer plan, we always had PPOs, preferred provider networks that had
a much larger network and potentially nationwide network. Is that right?
Mike Neighbors: Absolutely true. And there are, on the individual market,
there are very few PPOs available. One of the reasons we like the indemnity
plan as much as we do for people that travel is that it is a legitimate
nationwide PPO. It has no boundaries other than the geographic boundaries
of the United States.
Laura Lynch: Yeah. And so, I know from our earlier conversation that there
is one particular state that does have a PPO on the Affordable Care Act that,
if you are able to domicile in that state, then you have a nationwide network.
Do you want to talk specifically about Florida for Florida listeners?
Mike Neighbors: I'm going to let Bob expand on that just a little bit. Florida
is unique. It's a good domicile state, but it's very hard to be a domicile there
because they do have residential residency requirements as part of that. But
the Blue Cross, Blue Shield does have one plan in Florida that travels very,
very well, and Bob will get into that when he jumps in.
The interesting irony of Florida is the particular company that offers this plan.
You have to be a Florida resident agent to be able to sell that plan and to
enroll people in it. We're fortunate to have Bob as part of our organization
because he's a Florida resident. I'm a Tennessee resident, which has its own
differentiations. And so we try to, we've got all the bases covered around on
the country because of that kind of situation.
Laura Lynch: Awesome. Bob, do you want to expand on the Florida PPO a
little bit at this point?
Bob Nunn: Yeah, it's really important when we talk to clients to ask
questions. These questions are vital. Because that plan is called a Silver
Options plan, Silver Options. You'll click if you go in to the quote engines and
you have to type in the PPO and the client. Now, those Silver Options are
good because it gives that one thing: it gives portability.
Filling the Health Insurance Gap with Mike Neighbours
and Bob Nunn
Less House More Moola with Laura Lynch
https://thetinyhouseadviser.com
The negative side of that is if you don't have a subsidy, they're very, very
expensive. So you could easily spend $2,500, $3,000 a month if you don't
have a subsidy. So, this is a small window and advised only for people who
want to travel that have serious health concerns, but it is an option because
they do affiliate with Blue Cross, Blue Shield doctors and providers all over
the country.
Florida Blue does, it's called a Blue network. So it is good, but also you really
need a health care professional when you're doing this because you have to
look at the second page about balance billing about this network. So it's
important for the people to get all the information and not just look at the
premium. The premium is just like a hook, and we don't want the fish to get
on the hook when they don't want to be.
Laura Lynch: Yeah. Awesome. So let's go back to talk about the nomadic
lifestyle and you all have in your business created a very, or cultivated a
specific solution, the indemnity plan being often a good fit.
So Mike, tell us about the nomadic part of the lifestyle and a little bit more
about how the indemnity works well for that pre-retiree person who's doing
that traveling.
Mike Neighbors: Great question. And let me just digress for just a second
here because part of the reason we got into this - and Bob was the same
way - was we found the lifestyle first and then this business found us as a
result of as a result of living that lifestyle.
The biggest concern that older people have coming into retirement a little bit
earlier before they qualify for Medicare is that Medicare solves a lot of
problems, but you have to get there. And so you've got this gap that you've
got to fill, which we do with the indemnity plan. And in essence, it gives you
a bridge to Medicare because it works very similar.
You can see any doctor, any place with Medicare. If you set it up right, you
can see any Medicare provider any place in the country. So you've got that
going in and when you get to Medicare, Medicare has to take it. No matter 
Filling the Health Insurance Gap with Mike Neighbours
and Bob Nunn
Less House More Moola with Laura Lynch
https://thetinyhouseadviser.com
what your health situation is, you get a free pass right when you age in, with
no health questions asked.
The funny example I use is: you could be laying on a gurney in the hospital,
having a heart attack, and they would have to issue a policy for you and get
you covered. But you need to get there. And what this indemnity plan is, it
gives you a couple of things. It's a monthly premium which most health
insurance is, but it's guaranteed renewable until you reach Medicare age,
and it can't be taken away from you for any health issues and your premiums
can't be raised for any health issues.
And without that premium being raised for everybody your same age and
most insurance companies aren't going to do that. So, if you're 58 and you're
forced to retire, which incidentally is what I went through in 2008 when the
big meltdown happened, you need to look at this as something to get you to
Medicare.
Because when you get to Medicare, and you set it up right - and we help you
do that because you can make some mistakes going into Medicare that will
haunt you for the rest of your life - but if you set it up right, it will make you
as bulletproof from a health insurance standpoint, as you could ever hope to
be. And that's kind of where we fill in for people that are kind of forced into
that situation.
Laura Lynch: So, the indemnity plan, when we define indemnity, it means
reimbursement, right?
Mike Neighbors: Great question, and I hadn't thought about an answer to
that. So I'm glad you brought it up. One of the things we like about this plan
is it gives you the user the flexibility to use it how you need to. You can, in
an ideal world, you're going to look at “What's my best financial outcome?”
After you look at my best health outcome, which is number one priority,
number two, what's my best financial outcome? Sometimes you're better off
telling a provider that you're self-insured. You're going to pay your own bills,
because the indemnity plan is going to pay you the same, whether you pay
it to the hospital or whether you pay it to yourself.
Filling the Health Insurance Gap with Mike Neighbours
and Bob Nunn
Less House More Moola with Laura Lynch
https://thetinyhouseadviser.com
So it puts you in control of what could be your best financial outcome. None
of the other plans out there do that. Most of them if not all of them, will say
the insurance company is going to pay first, and then you're going to pay
after the insurance company does.
What we say is this insurance company is going to pay you, either way,
whether it's first or you pay and you get it afterwards. It's up to you what is in
your best interest on how you use it, which also means that you don't have
to worry about the provider that you're seeing being in-network or out-ofnetwork. You have the complete choice of who you want to see and how you
want to be paid for that.
Laura Lynch: And what about prescription coverage?
Mike Neighbors: Ah, another great question. One of the big holes in health
care in this country is prescription coverage outside of group insurance.
Group insurance has really good prescription coverage, largely, and ACA
plans largely do. There are exceptions to that, but a lot of them do.
Once you get outside the ACA realm, there's not much out there other than
- we've seen a new generation of prescription discount plans that we
encourage and use ourselves. People like GoodRx, you might be familiar
with. There's Healthsaver, which we use. There's GoodRx. There's one
called Drexi.
And you'll find when you ask pharmacies about this, you'll find the discount
structure is phenomenal. The area that you're going to find the biggest issue
is with some of the more exotic maintenance kind of drugs, like the Osempex,
like the Xeralta's - things that control heart conditions that are very
expensive.
Their injections, they could be $1,000, $1,500 a month. The right ACA plan
is probably the only solution if you are on one of those, you can talk to the
drug companies and most of them will offer you some kind of solutions. But
from an overall standpoint, that's an area that still needs some work from an
overall standpoint.
Filling the Health Insurance Gap with Mike Neighbours
and Bob Nunn
Less House More Moola with Laura Lynch
https://thetinyhouseadviser.com
Laura Lynch: It sounds like that to be on an indemnity plan, you have to be
a little bit more in control of your health care and any of us that have come
out of corporate or any other health care arrangement, like the VA, I have
experience with, right? We're used to sort of, you've got the card, you walk
in, you're taking care of, the insurance is going to be billed.
And it sounds like that when you're in an indemnity plan, you have to be a
little bit more in charge of your health care - and on top of kind of where are
the best places and maybe shop around for more sort of schedulable things
and that sort of thing. I think my question is, do you find - well, this is a
separate question.
Do you find any challenges with access in this situation, like I know every
time I go see a new doctor, the first thing they want to know, right? Is tell us
about your health insurance, almost sounding like if you don't have it, you're
going to get some different level of service or some. We don't really want to
talk to you if we don't have an insurance company to bill. So is anybody
running into any access issues being that there is, I think, somewhat of a
shortage in care in some places?
Mike Neighbors: There's a two-part answer to that. The answer is yes and
no, because - and it's not only an indemnity plan, it's any individual
insurance. Once you get out of the group environment, you have to be a lot
more proactive and either knowing where your coverage is, or what's
covered and what isn't covered, or you can get into some hidden costs that
you didn't enter.
Like example, you're in the hospital and have an operation and they may
bring in an anesthesiologist who is out of network. You're going to get a
surprise bill for that anesthesiologist. With an indemnity plan, you're going to
ask going in, what's your daily hospital rate? Is your anesthesiologist in
network? Because it doesn't matter in the long run, because you're going to
get reimbursed either way, but it may matter to where you want that coverage
to be. If you're in California, for example, Kaiser is very dominant in
California.
Filling the Health Insurance Gap with Mike Neighbours
and Bob Nunn
Less House More Moola with Laura Lynch
https://thetinyhouseadviser.com
Well, Kaiser is a closed HMO. And if you're not a Kaiser person or Kaiser
contractee, whatever term you want to use for it, that's not a good fit for you.
Because they may take care of you in an emergency, but then they're going
to take you over, or send you to the next person down the line. So access
from that standpoint is not much more limited if any with an indemnity plan
than it is with insurance in general once you get outside the group world.
And the biggest thing that we find with people is that they really are surprised
by the difference that they see when they get out of the group environment.
We've all been used to, and I came out of the corporate environment as well,
and I had my United Healthcare card.
And I'd walk into the big building downtown and hand him my card and say,
“I'm sick, fix me”. Once you get out of the group, that doesn't work so well.
And so you've got to do a little more homework yourself to find the right fit.
And if it's not an emergency situation, you also want to find the most costeffective solution and kind of all the little pieces come together. But in reality,
the indemnity plan is no more complicated than whatever else you might be
exposed to once you're outside the group realm.
Laura Lynch: Gotcha.
Bob Nunn: Well, how I wanted to tag into that is I was just talking to a lady
from Washington State, and she wanted to say, I want a PPO. A primary
care physician.
I said, well, you have to break out of that norm. Just like the alternative
lifestyle that we've all chosen is that you cannot have Dr. Johnson see you
every three months if you're not in Washington, you're in Arizona, or you're
in New Mexico, or you're in Massachusetts. So you have to understand that
the whole concept of this lifestyle is change.
So, just like there's a different way to do it, you have to learn. We're here to
help you, but you cannot have a primary care physician see you every 3
months if you're 3,000 miles away from that person. The good thing is that
you can get a primary care physician wherever you are in America.
Filling the Health Insurance Gap with Mike Neighbours
and Bob Nunn
Less House More Moola with Laura Lynch
https://thetinyhouseadviser.com
So, it's just breaking mindsets. The other thing is that our company rewards
you for shopping, because if you get an excess benefit, that's given back to
the client, which is unheard of in regular. Have you ever gotten a check in
your corporate? No, of course - so that is so unique is that my wife got a
colonoscopy and she got $2,900 back from our company because of excess
benefit. So, it's just a different mindset.
Laura Lynch: Well, thanks for bringing that in, Bob. I appreciate that
perspective for sure. When we change lifestyles, everything else changes as
well. And so we have to kind of be prepared for that. So, we're going to go
to a new sort of case study client and Bob, these questions are for you.
I wanted to talk about someone who's a little bit younger. So someone may
be in their thirties or forties, who is taking a break maybe from their corporate
life or they're on sabbatical - or maybe they've decided that they don't want
to keep climbing the corporate ladder, or maybe they were never on the
corporate ladder and they just want to do something different with their life.
And they've converted a schoolie into, or convert a bus into a schoolie, or
maybe they're doing van life or what have you. So they too are out on the
road. And so they're really mostly concerned about catastrophic events,
right? Their health is probably pretty good.
They probably have a pretty healthy type lifestyle. But at the same time, we
all need to go for our checkups, and every once in a while you have a reason
to go to the doctor. So what are the options for this person?
Bob Nunn: Well, I would still say the indemnity plan. When you think about
those people, COVID has allowed people to realize that they can do their job
remotely.
So there are many, many people that are doing this lifestyle because they
can work remotely. A lot of those people in their 30s and 40s. The good thing
about the indemnity plan is that it's very affordable. Many times you see
premiums at the $200 or $300 a month range, which is excellent. So you can
get the indemnity plan and for a minuscule amount, you can tag on a
specified disease, which is a catastrophic plan. So, for $200 or $300 for 
Filling the Health Insurance Gap with Mike Neighbours
and Bob Nunn
Less House More Moola with Laura Lynch
https://thetinyhouseadviser.com
premium, maybe even for a full family - if they're in their 30s, they could
probably get a full family plan somewhere in the $200 range, and that is with
a catastrophic occurrence. That will escalate as they age, of course, but the
indemnity plan is very, very affordable to the 20, 30 and 40 year olds.
So that's what I would recommend, you know. Regular scheduled checkups,
the occasional hospital visit for cuts or something, like flu, but then also
you're still covered because they're young, that specified disease premium
is very affordable. So, if for some, God forbid reason that they get a heart
attack or stroke, or some kind of thing, they're still covered.
So that's really the target for us, is healthy people in their 30s and 40s is a
perfect plan. The indemnity plan is perfect for them.
Laura Lynch: And so they just like we talked about before, maybe ACA isn't
the best fit because of the being on the road element.
Bob Nunn: On that, I would not recommend the ACA plan to a healthy 30-
or 40-year-old person, because, it's not going to be covered. And second, a
$9,000 dollar deductible, which usually if, like I said, a $300 premium times
12 is what? $3,600. So, this makes no sense from a financial standpoint
when you're not getting coverage and you have a high premium. I don't even
know what the premium would be, unless their finances or they get
subsidized. But there's no way on a piece, if you do the math, that the ACA
plan works for a nomad that's healthy. It only works for somebody that's sick,
the ACA plan.
Laura Lynch: And so when you say, it doesn't work because they're not
covered. Are you talking about subsidies?
Bob Nunn: No, I'm talking about - let's use your example. You're from New
Mexico. You get a plan in New Mexico, but now you're visiting people in
Alabama.
You're not covered in Alabama. Now you're covered for an emergency, but
like Mike said in the previous segment, is that until it's not an emergency. So 
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then you're going to have to get back to New Mexico on your own dime to
recover from your heart attack or your stroke or whatever you had.
So it doesn't make any sense that you would have to circle back to your
home state to get health care. Now, if that's part of your nomadic life, then it
could maybe work. But what is the cost to get back from where you are to
your life to where your home base is? So for a lot of reasons, you really have
to think: it's just not the premium. It's everything that goes with the premium
that you have to look at.
Laura Lynch: Yeah, good. So let's talk about what happens for folks in that
age bracket when they have income changes and how that impacts the
decision-making here. So we've got folks that are taking a sabbatical. So
maybe they were making a good, maybe they had a good tech job or a good
whatever job, and then they decided to take a sabbatical.
And so their income goes from very high to nothing. And then they come
back from sabbatical back to the tech job or starting some side hustle or
whatever. So we're seeing income changes significantly along the lines. So
talk about how income changes really affect the calculus when you're trying
to determine what is the best insurance.
Bob Nunn: So at first glance, when you look at it and you're trying to
research it, you'll see the ACA plan. You go, wow, I can get a plan for my
family for $200 or $150 or nothing. Let's do that. And then you start your side
hustle and let's say you are making $10,000 a year, you don't have any
income. And then all of a sudden, at the end of the year, you made $30,000
or $40,000, you will be penalized.
They, you will have to prove that through on your tax return, and then you'll
be made to pay back those subsidy premiums. And it could be very large.
You could have a $2,000 a month ACA plan that's discounted to $125 or
$200 that you would be responsible for. So that is something to really
consider when you're thinking about that.
Laura Lynch: Yeah. And so let's talk about a little bit more detail on the
indemnity plan in practice. When you go to the doctor, one thing that - I get 
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sick every couple of years and I'm like a pretty holistic person, but there are
certain things that crop up. And I'm like, I'm going to go to a doctor.
Maybe it's an urgent care, right? Because it's something simple that happens
in my life from time to time. And I show up there - how do I deal with my
indemnity plan in that case where it's, sort of an urgent care orBob Nunn: It's funny. I liked it. Sometimes my clients, I've had someone fall,
break their wrist - and instead of calling the doctor, they called me and said,
what should I do? So I thought that was pretty good. So the first, you never
get a five-figure bill at an urgent care, but you could get a five-digit bill at the
emergency room. So, you want to identify what exactly you have to do. As
far as you getting sick, the beautiful thing that we have is telehealth.
So, that would be my first go-to for like - maybe you get a cold or some kind
of infection urinary tract infection. So, something that's not going to be lifethreatening, but it's something that happens on a recurrence - you could
telehealth and they could send you a script that you could get anywhere in
the country.
Next is that while you're having your coffee or green tea or something,
wherever you are, you just go online. You type in the zip code to the
indemnity plan. We give you a site to go there and you can find out all of the
urgent cares in your area that are going to give a discount. So, that's what I
recommend my clients to do is that if you're stationary for more than a couple
of weeks, find out where the urgent care is in case something happens, find
out the hospital that's near you.
So, you can say when they're taking you, “Take me to St. Agnes.” You want
to make sure you can because there's just a financial benefit to do that. But
if you go to the urgent care, you'll be covered. And so that is the beauty of
the indemnity plan is that you can go anywhere. We have a million providers
over the course of the country.
And so you could pretty much assured to get it. And even if not, you can go
to the cash discount program anywhere. So if you find yourself in Wyoming 
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or South Dakota or somewhere that it's sparse, you can still go to an urgent
care and pay, and get the fixed benefit.
Laura Lynch: Yeah, thanks. So that million providers are the ones that are
providing a discount based on the network inside of the indemnity plan. And
then if you go to someone who's not on the list, how does that work?
Bob Nunn: If you go to someone who is not on the list, the first thing I say,
I'm a self-payer. I want to pay cash. You should get a discount. You have to
negotiate a discount. A change of mindset, like I said before, is that before
we just handed the card. I know my deductible is $6,000, $4,000, $3,000.
now I'm saying, no, I have to negotiate my price. Because we all know, like,
if you go to a hotel, there's a reservation price, a special price, and if you
walk up and say, can I get a room?
So it's the same thing with the doctor. You have to negotiate a price when
you go in there. If you can, there's sometimes where you could be in a
situation. If you're in a coma or something, and you're coming there and you
can't do it, you just got to do what you can do and call me. You want to call
me after you're awake and so I can help you, because we have a company
that will help us negotiate price down for our provider to our clients. So it's
always just ask the questions.
Laura Lynch: Yeah, I think that's an important point because most of us
didn't go to school for negotiating our healthcare pricing, and we've never
practiced it because we've never had to. We understood that the network
provided a reduced rate, or at least we were under the assumption that our
network pricing, the pricing they give the insurance carrier, is less than they
give to the regular person. But it sounds like what you're saying that is that a
cash price may actually be the lowest price available?
Bob Nunn: I believe that. But see, when you bought your tiny home, you
didn't pay MSRP, or when you bought your car, or when you go to the store,
how much fun is it to get the piece of clothing that you want at a sale? It's
50% off, it's buy 1, get 1 free.
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That is the same thing that you have to do with your health care. You have
to negotiate price and we're here to help you. We have a price tool that you
can go in and you can find out what the average price in the county that
you're at, what's the average price of what you'd want to get done.
So, going in, if the average price is like $300 and that guy's telling you it's
$1,200, something's wrong with that.
Laura Lynch: So let's talk a little bit about, Mike mentioned earlier, that you
all will help someone transition right from pre-retirement or, pre-Medicare
over to Medicare.
How do clients that are in their more middle age protect themselves from
health changes that are either a slow progression or a sudden event? We've
talked about some catastrophic and some specified disease. It sounds like
there's some layering that takes place there because certainly none of us
think that we're going to, none of us think that we're going to get cancer,
tomorrow, but yet that does happen for folks, at younger and younger ages.
So let's talk just one more time about how we protect ourselves from health
changes.
Bob Nunn: Mike, tell us the story. I tell it occasionally about one of our
workmates that was 32 years old and got a birth defect, a heart valve. And
he was in the hospital for quite a long time and had a huge bill. So who would
ever think that? And I believe he tells the story that he didn't want to pay the
$90 premium for specified disease. He ended up getting something like, what
Mike, $27,000?
Mike Neighbors: $27,000, quarter of a million dollars worth of bills got paid
and then he got $27,000.
Bob Nunn: For $90 a month, it was called spent - we call it bundling. And
what happens is that we take the great indemnity plan that works all over the
country and it's a fixed indemnity plan and we take it with a specified disease
plan. That’s when it's - I don't want to get too far in the weeds, but it's called
a claims threshold.
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And so what that means is that you have a big bill because of the incident
and the indemnity plan is now paying the bills. When the bills get to $50,000,
$25,000, $50,000, $75,000, whatever you choose, then our plan comes in
with $250,000 or $500,000 and pays everything that's reasonable and
customary. Well, how powerful is that?
We're paying first and when our bills get to - we're paying your bills, and
when our bills get to $50,000, another $250,000 comes in to wipe all the bills
off. And so that's why we like to connect the to the indemnity plan with the
specified disease plan. So, in case of a catastrophic event, it's covered. And
on top of it, people from 25 to 50, that premium is dirt cheap.
I mean, really dirt cheap. I've seen them for like $30, for $50 for 30 year olds.
It's really just incredible. Even 40 year olds, it's maybe $100. So it's really
worth $1,200 a year or so to say, “If I have something catastrophic, I know
that I'm going to be taken care of. I'm just not going to financially ruin me.”
That's the whole part of this, is the risk management. And so you're on the
road, you're experiencing new things. This is just a different way to look at
health care. You have to change, just like our alternative lifestyle. It's an
alternative health care. And it's, I believe, the best value in America. I really
do, especially for the 30- or 40-year-old.
Laura Lynch: So if someone in this age bracket or really any age bracket,
changes their employment, right? So they are on the road for a while and
then they are lucky enough to get themselves a really nice gig that actually
provides health insurance for, while they continue to travel, or maybe they
quit traveling and settle down.
What happens with this indemnity plan and what are the hooks to start and
stop?
Bob Nunn: So what I like to do when someone tells me that I said, okay,
let's sit down and talk about it, get our little pad out and say, okay, what is
the cost for you? And so a lot of times when you go corporate, the employee
is covered nicely.
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But the spouse and dependents are not. And so I said, maybe what we can
look at, let's look at what's it going to cost for the employee and then I can
write a separate plan for the spouse and the children that might be way more
affordable than what it is for the employee and of the employer. So, that's
what we like to do.
I like to look at that. And if it doesn't work out, then they go back to the
employee and it's just a basic email to me. Or email to the agent and we can
cancel it at any time. You can start and stop this program at any time. The
only hook with that is that there's no preexisting conditions covered for a
year.
So if you start and stop it, that clock starts over again. That's really the only
negative I see. But if you're healthy, it doesn't really matter. The real thing is
that you have to analyze, “If I don't put my, my wife or my husband and
children on the program, how much is it going to cost?” Usually, employee
employer health care is very good for the employee, but not so good for the
spouse.
Laura Lynch: For the family. Yeah.
Mike Neighbors: Yes. Let me expand, take that to one more level. And that
is we have a number of clients that have regular traveling jobs. Nurses is the
first one that comes to mind. I have several clients that are travel nurses and
they typically do a 3-6-8-9 month gig, and sometimes they get insurance and
sometimes they don't.
And if the gig gives them insurance, then the next gig doesn't. They've got a
gap to fill, or the next gig gives them insurance to it through a different
company, a different kind of plan. So what they're finding is they're better
served by not taking the insurance along that comes along with their dig,
taking the cash offset, which most of the gig employees or players will offer,
and then supplying their own insurance that they don't have to get in and out
of, depending on where they are and what they're doing.
Laura Lynch: Yeah.
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Bob Nunn: That's a great question. I mean, great answer. I just had that
happen a month ago where a client canceled on me. And then three months
later, she says, “Bob, I want to renew because the insurance is so much
better than what they're doing. And they'll give me the incentive. I can
actually pay for the premium and still have a little money left over.” So that's
a real-world thing that happens all the time.
Laura Lynch: Yeah. Yeah. The traveling nurse community is really an
interesting, sort of niche focus. I love those folks, especially some are in van
life. Some of them are towing tiny houses around there. They're out there
working it.
So it sounds like that you all definitely have the solution for anybody who's
on the road, no matter what their age bracket. I think that was a great sort of
exploration of those two different kinds of case study examples. So Mike, as
we start to wrap up, are there any key tips that you have for pre-retirees that
you think are important to share today that haven't already been covered?
Mike Neighbors: Yeah, just a couple, just in passing: when you get close to
Medicare, it's really important that you utilize the services of some advisor,
be it us or somebody in another capacity, because when you age into
Medicare, some things happen automatic, some things don't, but you need
somebody to kind of walk you through the process because you could make
one or two mistakes that you will pay a penalty for the rest of your life.
I have one client right now, and I'll just use that as an example, that decided
they didn't need a drug plan. So they didn't take a drug plan when they were
65 - they are now 82 years old, and he needs some fairly expensive drugs.
The premium that has followed them for 17 years is now $62 a month, which
is more than what their drug plan is.
So there's that trap that you can fall into. And there's the same thing with the
Medicare premiums that, if you don't sign up when Medicare tells you you
need to sign up, there's a premium penalty for that that will follow you forever.
So you really need to have somebody right from the get-go, that'll steer you
the right direction.
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And I'll close that by saying that just remember that the Medicare and You
handbook is 126 pages long, and they expect you to know and understand
that. That tells you something.
Laura Lynch: Yeah. Those great government publications are so userfriendly.
Mike Neighbors: Yes.
Laura Lynch: So Bob, the insurance industry is super full of change. I myself
got a short-term plan as I mentioned to you all before, when I quit my
corporate job and started my own business, and recently I've gotten this sort
of alert that maybe short-term plans are going to get shortened even further
and deductibles are going to turn over every three months and it is ripe with
change, insurance is.
So is there anything going on that we should kind of watch out for in terms
of health insurance coverage in the future, anything that you're telling people
to keep an eye on right now?
Bob Nunn: Well, who knows about what's going to pass or not, but they're
saying something. They're going to close that gap of short-term to three
months.
If that happens, that is significant. Because I was just on the phone before I
got on this podcast about a lady that's really seriously ill that is on COBRA.
She goes off COBRA, she's in a big world of hurt. And so this has
consequences. People have to understand - and the most I think, the most
important thing when we talk to folks, we really analyze their situation and
say, like my dad used to say, there's consequences.
There's intent. There's consequences for everything. What are the
unintended consequences of my actions? And so we have to find out from
the client where they want to, what they want to do, where they want to go,
how they want to live, how they want to travel, how long they want to travel,
what kind of thing is there, what kind of house they're traveling in - and all
those decisions really make a, what's their health, like their age. 
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All of that is necessary for us to give them good advice and that's all we are.
Mike and I are not salespeople. We're advisors. We're not selling a plan.
We're trying to help you. We're advocates. And so to get the full information
from people is vital. And I think when that happens. they just need to know
and to try to navigate it by themselves is usually going to be a bad outcome.
Laura Lynch: Yeah. Just navigating insurance website options can be
overwhelming. So thank goodness that there are folks like you all that can
help sort of narrow the field. So Mike, would you please, share with us the
name of the company? Cause I don't think it's even been mentioned yet, that
you all represent and how people can get in touch with you.
Mike Neighbors: We are a full-service health insurance agency. Our name
is RV Insurance Benefits. We're very active with the RV community. We're
tied into not only podcasts like this, but to a lot of websites that we’re the
clearinghouse for RV Life, for example, for their health insurance inquiries.
The big thing is that we have available every kind of insurance that you're
going to need from a health standpoint. We have the indemnity plans. We
have the ACA plans. We have short term. One little item that people don't
even think about until after they get there is we offer international travel
insurance.
If you're going to Europe for 6 months, there are ways to cover you while
you're there because your U. S. based insurance isn't going to do that. But if
you don't know that you don't know that you need it, you don't know how to
access it. And that to me is the essence of the service that we provide, is
giving you access to all those little ins and outs, dental insurance, vision
insurance, whatever it might be. If it's health insurance related, we'll either
have an answer or be able to find one for you and steer you in the right
direction.
Laura Lynch: Awesome. We'll make sure that website is linked. And so folks
are going to try to get in touch with you, they should do it through the
website? 
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Mike Neighbors: That's probably the easiest. The website will give you our
personal contact information. It'll give you direct cell phone numbers. It'll give
you an office exchange number.
It'll give you email addresses, everything that you need. So the website again
is rvinsurancebenefits.com. And you'll see a list of all of us on that website.
We'll get to the answers that you need. There are several of us that are part
of the agency. And so we're all in this together.
Laura Lynch: Awesome. And Bob, any final thoughts from you?
Bob Nunn: Just that we love this lifestyle. We love the people that we meet.
The best thing is the community and the experiences. And so if we can help
anybody, we just love that. It's a win-win for us. We get to meet great people
and we get to help them.
Laura Lynch: Well, thank you both so much for taking this deep dive into
nomadic health insurance options. So glad that I found you and was able to
put this conversation together today. I know people will find it super valuable,
because this is the first time, like first time I've heard about something that
actually fits the bill for those that are out on the road. So thanks for being
here.
Bob Nunn: And for putting this together.
Mike Neighbors: Thanks for having me.
Hey, I’m honored that you listened to this episode of Less House More
Moolah. I hope something in it will help you continue to move toward a life
aligned with your values.
Every algorithm out there is trying to tell us what to prioritize, but we get to
choose. If you haven’t ever identified your key values, I have a free
resource on my website to help you.
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You just have to go to thetinyhouseadviser.com. It’s the tiny house A-D-V-IS-E-R dot com.
At the bottom of the page, you can grab the tiny life values worksheet.
When we design a life around “what is our core truth?”, we shortcut to deep
fulfillment.
See you next Thursday.
Please see the show notes for an important disclosure regarding The Tiny
House Adviser, LLC and this episode.