By HitchPath Team — — 9 min read
For most Americans under 65, health insurance is tied to an employer or a state-based marketplace. Full-time RVers face a specific problem: most employer plans and many ACA plans have geographically limited networks. If your network is based in Texas but you spend the summer in Montana, you may be "out of network" for most of the year — meaning routine care is either very expensive or not covered at all.
This guide covers the main options and what to actually look for, not just a list of names. Health insurance decisions are consequential — the difference between a plan that works for your lifestyle and one that doesn't can be tens of thousands of dollars in a medical emergency.
Disclaimer: This guide provides general information, not personal financial or medical advice. Consult a licensed insurance broker or financial advisor before making healthcare decisions.
If you work at a private campground full-season (typically 5–6 months) for a large employer (KOA, Sun Communities, Equity LifeStyle Properties, Encore, Delaware North), you may be eligible for employer-sponsored health coverage.
Why this is often the best option for pre-Medicare workampers:
What to confirm before accepting a position:
Large campground chains vary in their benefits packages. Ask directly — don't assume.
The Affordable Care Act marketplace offers individual health insurance plans that don't require employer affiliation. These are available during open enrollment (November–January) and during special enrollment periods triggered by life events (leaving a job, loss of prior coverage).
HMO plans: Restricted to in-network providers within a specific geographic area. If you're enrolled in a Texas HMO but you're in Oregon for the summer, you're out of network for everything except emergencies. These plans are dramatically cheaper — but inappropriate for full-time RVers who travel.
PPO plans with nationwide networks: Some insurers offer PPO plans with truly nationwide networks. These are more expensive but actually functional for people who travel. Blue Cross Blue Shield has a Federal Employee Plan (for those eligible) and some state-based plans with broad networks. Cigna and Aetna PPO plans are worth examining.
Multi-state plans: ACA-certified multi-state plans are designed to operate across state lines and may have broader networks than state-specific plans. Check Healthcare.gov for multi-state plan options in your domicile state.
If your income falls between 100% and 400% of the Federal Poverty Level (FPL), you may qualify for premium tax credits that significantly reduce your monthly premium. For 2026, a single individual at $35,000 annual income qualifies for substantial subsidies in most states.
Full-time RVers who've reduced their expenses and have modest investment income may qualify for meaningful subsidy levels. Work with a licensed insurance broker or navigator to evaluate your options — the calculator on Healthcare.gov gives a general estimate.
Health sharing plans (Liberty HealthShare, Sedera, Knew Health) are not insurance. They're membership organizations where members share each other's medical costs. They're significantly cheaper than ACA plans.
Why people consider them: Monthly costs can be 40–60% lower than comparable ACA plans.
Why they require careful evaluation:
Health sharing can work for healthy people who use minimal care and understand what they're getting. They are risky for people with chronic conditions, anyone expecting significant medical needs, or people who don't have reserves to cover large out-of-pocket costs if a claim is disputed.
If you're considering a health sharing plan: Read the member guidelines carefully, not just the marketing materials. Ask specifically: What is excluded? What's the cost-sharing limit per incident? What's the monthly personal responsibility amount? What happens if the organization runs out of funds?
If you've recently left an employer that provided health insurance, COBRA allows you to continue that coverage for up to 18 months (36 months in some circumstances). You pay the full premium — employer and employee shares combined — plus a 2% administrative fee.
COBRA is expensive. The full-premium cost is often $600–$1,200/month for an individual and $1,500–$2,500/month for a family. But if you have ongoing care relationships, in-progress treatments, or complex medical needs, the network continuity may be worth the cost during your transition to full-time RVing.
COBRA coverage must be elected within 60 days of losing employer coverage.
If you're 65 or older, Medicare removes most of the coverage complexity for full-time RVers. Original Medicare (Parts A and B) is nationwide and doesn't have geographic network restrictions.
Medicare Supplement (Medigap) Plans: These supplement Original Medicare and cover costs like deductibles, copayments, and coinsurance. Plans are standardized by letter (Plan G, Plan N are most popular). Premiums vary by state and insurer, but coverage is identical for the same letter plan.
Medicare Advantage (Part C): These are private Medicare plans that often include prescription drug coverage and additional benefits. Most Medicare Advantage plans DO have geographic network restrictions — HMO-type plans may be problematic for full-time travelers. If you choose Medicare Advantage, look for PPO options with broader networks.
Medicare Part D (Prescription Drugs): Standalone drug coverage that works with Original Medicare. Choose a plan based on your specific medications; formularies vary.
For most full-time RVing Medicare recipients, Original Medicare + a Medigap supplement plan + Part D is the most functional combination for nationwide travel.
Before enrolling in any plan, ask these questions:
Network: Is this an HMO, PPO, or EPO? What does "in-network" mean geographically? Can I see a doctor in Montana if I'm enrolled through Texas?
Emergency coverage: Is emergency care covered nationwide, regardless of network? What's the process for getting prior authorization for unexpected care?
Telehealth: Does the plan include telehealth visits? For full-time RVers, telehealth is valuable — it allows you to consult a provider without finding a local in-network office.
Prescription coverage: Are your current medications covered? What's the formulary, and what happens if you need a medication that isn't listed?
Out-of-pocket maximum: What's the cap on your annual out-of-pocket costs if something serious happens?
There's no universal best — it depends on your age, income, health status, and whether you work for an employer that offers benefits. For pre-Medicare workampers at large private campgrounds: employer coverage is often best. For those without employer coverage: a nationwide-network PPO through the ACA marketplace is most functional.
Medicaid is state-administered and typically has very narrow geographic networks — you're generally covered only in the state where you're enrolled. For full-time RVers, Medicaid is impractical except for emergency care. If your income qualifies for Medicaid in your domicile state, compare the coverage limitations carefully against ACA plans with subsidies.
Mail-order pharmacy services (CVS Caremark, Express Scripts, Amazon Pharmacy) ship 90-day supplies anywhere in the country. This is much more practical than finding a local in-network pharmacy in every new location. Confirm that your plan's formulary includes your medications before enrolling.
All ACA-compliant plans cover emergency care nationwide regardless of network status. Non-emergency care out of network is where costs escalate. Having a plan with a broad national network, or a telehealth option that can handle non-emergency consultations remotely, significantly reduces this risk.