This comes up way less often than you’d think in the bus life community, and that’s kind of a problem. Everybody talks about solar panels and floor plans, but nobody wants to talk about what happens when you get sick 400 miles from your doctor.
The short answer is that most full-time bus lifers handle healthcare through ACA marketplace plans, health sharing ministries, telehealth services, or employer-sponsored insurance from remote jobs. Some people go without insurance entirely and pay out of pocket, which I wouldn’t recommend but it happens more than anyone wants to admit. The key is picking a plan that works nationally, not one tied to a specific state network, and using telehealth for the routine stuff while keeping an emergency fund for the unexpected. It’s absolutely doable — it just takes more planning than most people put into it before hitting the road.
“Nice bus! One thing I don’t see mentioned on any of these type of videos for expenses is healthcare. Is everyone going without?”
This question honestly stopped me in my tracks when I first saw it, because I’d been guilty of the same thing. When I was putting together my budget for bus life, I had line items for diesel, insurance, campground fees, food, phone bills — and healthcare was just sort of… absent. Like it didn’t exist.
And no, not everyone is going without. But some people are. I talked to one guy at a meetup in Arizona who told me straight up he hadn’t had health insurance in three years. He was 34, healthy, and said he’d rather pay cash at an urgent care if something came up. That’s his choice, and I get why someone would make it when premiums are $400-$600 a month for a decent plan. But I also know that one bad accident or one surprise diagnosis can wipe out everything you’ve saved. (See our guide on 11 Ways to Make Money While Living in a Bus for more on this.)
Here’s what I found most people actually do. The most common route is ACA marketplace insurance — that’s healthcare.gov. You pick a plan during open enrollment, and depending on your income, you can qualify for pretty significant subsidies. A lot of bus lifers have lower reported incomes because they’ve structured their life to need less money, which means the subsidies can bring your monthly premium down to $50-$150 range. Sometimes even $0 for a bronze plan.
The trick is which state you enroll through. You use whatever state your domicile address is in. So if your legal residence is South Dakota (which a lot of nomads use because of the mail forwarding services there), you’re shopping on South Dakota’s marketplace. Some states have way better options than others, so this is worth thinking about before you pick your domicile state. I wish someone had told me that earlier. (See our guide on How Do You Get a Mailing Address Living in a Bus? for more on this.)
The other thing nobody mentions is that ACA plans have out-of-network coverage issues. If you’re traveling full-time and your plan has a narrow network, you might be “covered” but unable to actually find a doctor who accepts it wherever you happen to be parked. PPO plans are better for this, but they cost more. It’s a tradeoff.
“What will you do when you have chronic health issues?”
This is the question that actually worried me the most. Healthy people can wing it. But what about someone who needs regular prescriptions, ongoing specialist visits, or treatments that have to happen on a schedule?
I spent a lot of time reading forums and talking to people about this one. What I found surprised me. There are bus lifers managing diabetes, autoimmune conditions, and even people doing bus life while going through cancer treatment. They make it work, but it takes serious planning.
Prescriptions are actually the easier part. Most chain pharmacies — CVS, Walgreens, Walmart — can transfer prescriptions between locations. So if you’re parked in Tennessee this month and New Mexico next month, you call ahead and have your prescription transferred. Some people use mail-order pharmacy services through their insurance, which ship a 90-day supply wherever you tell them. You just need to know where you’ll be when the package shows up, or use your mail forwarding service.
Telehealth changed everything for people with chronic conditions. I’m not exaggerating. Services like Teladoc, MDLive, and even your own doctor’s telehealth portal mean you can do routine check-ins from the bus. One woman I read about has rheumatoid arthritis and does her monthly check-in over video from wherever she’s parked. Her rheumatologist is in Ohio, she’s wherever, and they manage her medications remotely. She only goes back in person twice a year for blood work and imaging.
Now, that twice-a-year thing is important. Most people with chronic conditions build their travel schedule around medical appointments. They’ll loop back to wherever their specialist is, or they’ll establish care with a new provider in a region they spend a lot of time in. It’s not that different from someone who travels for work — you just plan around it.
The people who struggle most are the ones who don’t plan. If you have a chronic condition and you think you’ll just “figure it out” on the road, you’re setting yourself up for a rough time. Get your medications sorted, get a telehealth setup with your doctor, and know what your insurance covers out of state. Do that before you leave, not after.
“Great Mobile home! Just curious on how to sustain this type of living. What type of work do you two do to pay for all the diesel fuel, vehicle maintenance, health insurance, vehicle insurance?”
I love this question because it gets at the real thing people want to know, which isn’t just “how do you afford healthcare” but “how do you afford any of this.” So let me break out the healthcare piece specifically.
Here’s a rough monthly budget for healthcare on the road, based on what I’ve gathered from dozens of bus lifers:
ACA marketplace plan with subsidies runs most people $0-$300 per month depending on income and the plan tier they choose. Telehealth visits are usually $0-$75 per visit, and most plans cover them fully. Prescriptions vary wildly, but GoodRx or Cost Plus Drugs can cut costs significantly if you’re paying out of pocket for generics. Dental is separate, and a lot of bus lifers skip dental insurance entirely and just pay cash for cleanings twice a year, which runs about $75-$200 per cleaning depending on where you are. Vision is similar — most people just pay out of pocket for annual exams.
So realistically, you’re looking at $100-$500 per month for healthcare costs depending on your situation. That’s not nothing, but compare it to what most Americans pay. The average employer-sponsored plan still costs the employee $100-$300 per month in premiums alone, plus copays and deductibles. Bus lifers aren’t necessarily paying more — they’re just more aware of it because the money comes straight out of their pocket instead of getting deducted from a paycheck.
As for how people pay for it, remote work is the big one. If you’ve got a remote job with benefits, your healthcare situation is basically the same as any other American with employer insurance. You just happen to live in a bus. Web developers, writers, virtual assistants, customer service reps, graphic designers — these are all jobs I’ve seen bus lifers doing. Some people work seasonal jobs that offer benefits, like Amazon CamperForce (though that program has changed over the years) or park host positions with the National Park Service. (See our guide on Can You Legally Live in a Converted School Bus? for more on this.)
Health sharing ministries are another option I keep seeing come up. These aren’t technically insurance — they’re organizations where members share each other’s medical costs. Medishare, Samaritan Ministries, and Christian Healthcare Ministries are the big ones. Monthly costs are usually $150-$500 depending on the plan and your household size. They work well for some people, but there are limitations. They often don’t cover pre-existing conditions, mental health, or anything related to alcohol and tobacco use. They can also deny claims that traditional insurance would cover. I looked into these pretty carefully and my takeaway is they work great for healthy people who want catastrophic coverage at a lower price, but they’re not a replacement for comprehensive insurance if you have ongoing health needs.
One more thing I want to mention. A lot of bus lifers stack multiple approaches. They might have an ACA bronze plan for catastrophic coverage, use telehealth for routine stuff, pay cash for dental, and use GoodRx for prescriptions. It’s not as tidy as having one employer plan that covers everything, but it works. You just have to be more hands-on with managing it.
The people who sustain this lifestyle long-term are the ones who actually budget for healthcare instead of pretending the expense doesn’t exist. I’ve seen too many build videos where someone lists their monthly costs and healthcare isn’t even on there. That’s not sustainable. It’s just a bill you haven’t gotten yet.
There’s one more piece to this that’s worth talking about, and that’s the emergency fund. When you’re living on the road, things can go sideways fast. A broken tooth, a sprained ankle on a hike, an ER visit for food poisoning — this stuff happens. Most financial planners say keep 3-6 months of expenses in savings, but for bus life I’d say healthcare specifically needs its own cushion. Even $1,000-$2,000 set aside for medical emergencies can be the difference between a bad day and a financial disaster. Especially if you’ve got a high-deductible plan, which a lot of bus lifers choose because the premiums are lower. (See our guide on How Do You Get Internet and WiFi Living in a Bus? for more on this.)
So here’s where I landed after digging into all of this. Healthcare while living in a bus isn’t the crisis people think it is, but it’s also not something you can just ignore. The tools are there — ACA plans, telehealth, mail-order pharmacies, cash-pay options, GoodRx, health sharing ministries. You have more options than people realize. The real problem isn’t access, it’s that people don’t plan for it. Build healthcare into your budget the same way you budget for diesel and maintenance, figure out your domicile state before you pick a plan, and get comfortable with telehealth. If you do those three things, you’re in better shape than a lot of people who live in houses and still don’t have a plan. For more on the financial side of making bus life work, check out our complete breakdown on how to budget and finance your bus conversion, and if you’re curious about the work side of things, we’ve got a full list of ways to make money while living in a bus. (See our guide on 15 Things Nobody Tells You About Living in a School Bus for more on this.)
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