Buying Health Insurance

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samsmith
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Buying Health Insurance

Post by samsmith »

Would like to consider retiring in next few years (age 55). Does anyone have suggestions for purchasing health insurance? I can only cobra for 18 months. The ACA plans offered in my state seem to have a limited doctor/hospital network. I am not so much looking for any subsidies, rather any suggestions for how to purchase health insurance for the gap between early retirement and Medicare age?
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susa
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Re: Buying Health Insurance

Post by susa »

How about just continuing to see the doctor(s) you like and pay cash?
All offices visited so far have offered very reasonable cash rate, in fact, surprisingly cheaply as they love the fact that no forms have to be submitted to negotiate payment. No surprise bills after leaving their offices either.

The same works for blood draw, laboratories.

That's what we do while having an ACA plan.
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dm200
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Re: Buying Health Insurance

Post by dm200 »

samsmith wrote:Would like to consider retiring in next few years (age 55). Does anyone have suggestions for purchasing health insurance? I can only cobra for 18 months. The ACA plans offered in my state seem to have a limited doctor/hospital network. I am not so much looking for any subsidies, rather any suggestions for how to purchase health insurance for the gap between early retirement and Medicare age?
I don't know how common this is today, but I recall that sometimes a previous employer plan (and/or COBRA) allows conversion (of some sort) to an individual plan.

Are there any kinds of HMO available? While, in some senses, the Physician/provider networks may be (or seem) limited, often they have excellent access to the needed type(s) of Physicin(s) and providers.

Who knows what will or will not (good or bad) happen in the next few years from the Federal Government?
Doubleeagle4me
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Re: Buying Health Insurance

Post by Doubleeagle4me »

Good luck with that. I'm in my early 60's and the best deal I cold get ( no subsidies) for a family of 4 is over $1800.00 a month with a 10m deductible. Counting the days my wife and myself are on Medicare.
turnberry72
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Re: Buying Health Insurance

Post by turnberry72 »

Before you discount subsidies -- if you can fund your early retirement with cash-in-the-bank or resources without large capital gains, you may qualify for a subsidy. Keep in mind, the ACA subsidies are not asset driven...nor are they cash flow-driven. They are INCOME driven.

Read this article for a better understanding: http://www.caniretireyet.com/retirement ... e-options/
"When you discover you have more money than time, you should stop pursuing money and focus on getting the most out of your time."
Topic Author
samsmith
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Re: Buying Health Insurance

Post by samsmith »

Paying cash for the "docs you like" works for primary care docs and if you stay healthy.
If you get sick - paying cash for out-of-network hospitals will get very expensive quickly. And the rates wont be the "discounted" ones that insurers get.
Cobra currently does not allow extension beyond the initial period (at least that is what I have been told).
I thought maybe there might be associations that offer policies or maybe people formed their own small businesses to be eligible for policies?
HIinvestor
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Re: Buying Health Insurance

Post by HIinvestor »

Some alumni associations from different Us used to offer medical insurance to the alums--you might check with the schools you and your spouse graduated from. Some professional orgs also offer medical insurance to folks belonging to their org--you can check with any you belong to. If you are a student, you can often buy a fairly inexpensive student policy (you may need to take a minimum number of credits or maybe just one course at nearby U). Some folks get part-time jobs that provide health insurance, just for the health insurance benefit. It's a good idea to have at least a high deductible plan in place, in case of catastrophic illness or injury.
DetroitRick
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Re: Buying Health Insurance

Post by DetroitRick »

Since you said "retiring in a few years", and given being pre-Medicare when you need this coverage (you mentioned age 55), just wait and see what ACA decisions materialize this year and/or next year. Keep/revise/postpone/replace - it's all a guess right now. But hopefully you can get a fairly definitive answer when this current dust settles. It's just impossible to predict network size, eligibility, and premiums beyond 2017 until this current chaos gets sorted out. It's one of the hotter issues in the US political scene right now.

As far as current ACA rules vs. COBRA, here are the current rules:
https://www.healthcare.gov/unemployed/cobra-coverage/

When I retired and COBRA ran out in Sep 2006, I was able to easily get a Blue Cross policy for individuals in our state. It wasn't cheap and it didn't cover a few basics (office visits), but was otherwise decent. They had mandatory-issue requirements for Blue Cross in Michigan prior to ACA, but I wouldn't guess what those might be in the future. Some other states had these types of deals, some had high-risk pools, but again that is all different now and highly subject to short-term change.

Paying cash for doctors is fine, but without insurance coverage hospital bills can easily lead to bankruptcy. Negotiation with hospitals and labs can be hit or miss. I'm a risk-taking guy, but wouldn't have the stomach for that much risk.

Anyway, it is quite likely you will have some options to choose from. It's just hard to pinpoint specifics for the time being.
HIinvestor
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Re: Buying Health Insurance

Post by HIinvestor »

Just a data point in case anyone on this thread is flirting with the idea of going without insurance "for awhile." This year, our insurer sent us a printout of the total in medical bills that we received for services rendered for H, me and D. The total was over $100,000 and that was for regular office visits, no hospitalizations, no urgent care! Out of pocket we paid about $5000 + premiums, but seriously medical bills can add up quickly! This is not the first year our bills got that high and we paid a small portion of them.

I agree that if you aren't retiring immediately, pay attention to how the insurance in your area ends up pricing out after things settle down on whether ACA remains or what replaces it. If you care, let your legislators know that this is a big issue for you and will affect your retirement options.
rpeebee
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Re: Buying Health Insurance

Post by rpeebee »

I am semi-retired empty-nester now in my mid-fifties. My wife works part-time and does not have health insurance from her work. Me and my wife have been using ACA based health insurance. Here in MA, we have good quality (say Tufts) affordable HMO level plans available with premium of around $600. With our taxable income being in low 50K range, we are able to get decent subsidy to the point that we pay only half of $600 per month for this coverage.

The key strategy we use is to keep our taxable income in low 50K range. We keep traditional IRA (SEPP) withdrawal relatively low by withdrawing only from one IRA account and supplement remaining expenses from Roth IRA (contributions & conversions only as penalty free) withdrawal. Roth IRA withdrawals are tax free and so are not reflected in taxable income in AGI (last line of 1040 on 1st page). We plan to use Home Equity LOC to manage unplanned cash out-flow spike (say for helping grown-up kids for down payment) so that taxable income remains in low 50K range.

I understand that ACA's future is unclear at this time. However, states like MA seem to be committed to mandate universal health care to it's resident which brings economy of scale (95+% resident have health insurance coverage either from employer and through ACA market place) advantage to this state. Perhaps that's why ACA rates are so low here. If you happen to live in one of such states, you are likely to enjoy affordable health care even after subsidy is reduced in future.
Enjoy what you have and you can live as well and as much as other person
sawhorse
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Re: Buying Health Insurance

Post by sawhorse »

susa wrote:How about just continuing to see the doctor(s) you like and pay cash?
All offices visited so far have offered very reasonable cash rate, in fact, surprisingly cheaply as they love the fact that no forms have to be submitted to negotiate payment. No surprise bills after leaving their offices either.

The same works for blood draw, laboratories.

That's what we do while having an ACA plan.
The labs in my experience can be extremely inflated for people without insurance. 10x the price or more. However, most of the time you can go to an in-network lab using orders from an out of network doctor, and insurance will cover it.
adamthesmythe
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Re: Buying Health Insurance

Post by adamthesmythe »

> Would like to consider retiring in next few years

Well it's gonna be a few years before the current repeal/replace shakes out. Don't make any plans until you see which way the wind blows.
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susa
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Re: Buying Health Insurance

Post by susa »

sawhorse wrote:The labs in my experience can be extremely inflated for people without insurance.
Just did Labcorp CBC for 2 persons. Cost was 26 per person, or total 52 and received results via email in PDF format. Covered all normal healthcare blood fractions and cholesterol. No insurance to file or submit.

Ordered Rx from LEF online sale and walked into a lab nearby.
outdoorsygal
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Re: Buying Health Insurance

Post by outdoorsygal »

This is the biggest bang for your buck. A Healthcare sharing ministry

http://www.chministries.org/programs.aspx
sawhorse
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Re: Buying Health Insurance

Post by sawhorse »

susa wrote:
sawhorse wrote:The labs in my experience can be extremely inflated for people without insurance.
Just did Labcorp CBC for 2 persons. Cost was 26 per person, or total 52 and received results via email in PDF format. Covered all normal healthcare blood fractions and cholesterol. No insurance to file or submit.

Ordered Rx from LEF online sale and walked into a lab nearby.
I'm pretty sure ordering a prescription for a lab test online isn't an option in all states.

For a healthy-ish person it's much more feasible to do lab tests this way than for a sick person in the hospital or who visits a doctor's office and then would have to travel to another location for the blood draw. Even small amounts of travel can be challenging for people who aren't in good health.
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susa
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Re: Buying Health Insurance

Post by susa »

sawhorse wrote: I'm pretty sure ordering a prescription for a lab test online isn't an option in all states.
We have ordered online lab tests in all states for three decades. The selling entity does not care where you live or where you have the lab work done. Check out directlabs and life extension online annual sales. We've used both.
Jack56
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Re: Buying Health Insurance

Post by Jack56 »

Post Obamacare there isn't a lot of choice in the market for private health insurance so I would not put a lot of time into thinking about this. Going without and trying to bargain on price is pretty risky if you are taken to a hospital with say a heart attack and are not in a position to compare prices. Then you will be billed the hospital rack rates and will be bankrupt in no time.
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