I cannot imagine a more frustrating subject than that of health care for full-time travelers.   How do you make sure you are covered, if a problem crops up while you are on the road?   It is one of those questions that has no good answer.

I have spoken to dozens of people about this, and numerous full-timers, and it is clear there is no “magic bullet” solution. Most of my retired traveling friends have government- or corporate-sponsored retirement health plans, so they don’t worry about it.   Others are carrying over their health insurance from their last jobs, under the COBRA act.   Some are covered under a spouse’s plan.   But quite a few are “bare” — meaning they have no insurance at all, or inadequate insurance.

We fall in the last category: our coverage is really inadequate.   For everything except emergencies, we have to go back to Vermont.   When Eleanor had a major migraine episode two years ago, we paid cash for medical care in Tampa, then flew her to Vermont for follow-up.   Obviously that’s far from ideal.

For those who do have health insurance, when I ask what happens if they get sick while far from home, most don’t know.   They aren’t sure if their health insurance covers them out-of-state, and if so, for how long.   Emergencies only?   Follow-up visits?   Full reimbursement, or just partial?   When I ask, I usually get a blank look.

Most people aren’t sure if they are covered in while traveling in Canada or Mexico.   They don’t know if they will have to pay up-front and fight for reimbursement later.   They don’t know how to get a doctor referral in a strange town.

And even if you know all those answers … can you afford health insurance without an employer to pay most of the premium?

I hate to dry up the blog with a subject like this, but it’s a huge problem — for us, and for many others.   We are at the intersection of two negative factors:   we are full-time travelers, and I am self-employed.   That means we need coverage that goes everywhere in the USA, and we need something that is affordable.   But in the US, you can have a nationwide network of doctors, affordable prices, or good reimbursement for your expenses — pick any two.

The current presidential campaign certainly has brought up the issue of health care cost and availability, but I am not filled with hope that any of the candidates will be effective at doing something about it.   The problem is huge.   It seems likely that for the foreseeable future I’ll be responsible for paying for the health care of my family.

On the plus side, we have small advantages.   We can become residents of a state where there are more healthcare insurance options.   As my own employer, I can institute any health plan that is available to us.   A lot of people are going to partially self-insured plans, or “consumer directed coverage” such as a Health Savings Account (HSA).   That may be an option for us.

But in the current health care environment, any solution is complex, filled with little “gotchas” and highly individualized.   What works for us may not work for you.   So when people innocently ask me, “What do you do about health care on the road?” I can only sigh … because I know any answer I give will probably not be useful.

Status report:   Little things are happening, but still not much.   Jim Breitinger (“the Airstreaming Meteorite Dealer“) is in town, and he dropped by for lunch on Wednesday.   Contractor Chris has been here to work on the shower tile both Thursday and Friday, but with grout drying time and sealant, the shower won’t be available to us until next week.   Still no word from the countertop guys, and we don’t expect to hear anything for a week.

We gave the grapefruit tree a major trimming yesterday.   The poor thing has been badly neglected and allowed to grow in all sorts of crazy directions.   I’m trying to convert it from a fluffy green bush to a real tree that can produce more than a dozen grapefruit.   Now it looks like a kid with a new military haircut.   That’s the first step toward improving the backyard.   Up to now it has been just a dumping ground for the contractors.   It’s basically made up of weeds, cut-off bits of tile & slate, and junk.   Rather than try to fix it up, we’re going to leave it looking like a back alley this summer.   It’s a project for another day.But I will at least make sure the old toilet, junk plywood, scum-encrusted shower doors, and garbage cans are cleaned up before we go.

I’m thinking about stuff like that because our departure is looming in a serious way now. Time to start on the checklist of items: set up house-watching, clean up the junk, clear out the refrigerator and freezer, re-pack the Airstream, pump up the tires and lube the hitch, etc.   The list is not long and that’s a good thing, because we bought this house with the intent of having it be easy to live in, and easy to leave.