[Retiring before 65: How do you deal with health insurance?]

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Rajsx
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by Rajsx » Wed Mar 27, 2019 4:07 pm

Since I retired 4 yrs back, we have had BCBS in Florida, $1600/mo for both of us & copays +Meds amount to another around $400, so give or take $2000/mo. Last year it was around $26000. The Deductible is high of $7000/yr for each of us. It sort of covers the Calamities/Hospitalizations & gets us the Meds at reduced rates.

Do not qualify for ACA because of the income limits & also our doctors who we go to for years do not take ACA .
No it is not cheap by any means but we had planned for $25 -$30k in a year for medical when we retired. Eagerly waiting for Medicare in 2 years.
We do not stop laughing because we grow old, we grow old because we stop laughing !!

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munemaker
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by munemaker » Wed Mar 27, 2019 5:10 pm

Rajsx wrote:
Wed Mar 27, 2019 4:07 pm
Do not qualify for ACA because of the income limits & also our doctors who we go to for years do not take ACA .
Are you sure you are not thinking of Medicaid?

There are no income limits for ObamaCare (aka ACA).

While it is possible some doctors may not accept ObamaCare, I have never heard of one around here. The doctors in our area belong to networks. They may not accept your insurance if they are out of your insurance network, but not specifically because you are on ObamaCare.

There are income limits with Medicaid, and many doctors do not accept it.

celeste100
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by celeste100 » Wed Mar 27, 2019 5:46 pm

We will be joining the NY ACA club with no subsidy for my wife who is 60 and retiring.
I'm using Medicare.

Our thought is to choose a bronze plan and think of it as a catastrophic policy.
The cost will be 540-600 a month with a 4,000 to 7,000 deductable.
But it will protect us if there happened to be bills greater than the max out of pocket of 7,350.

We've narrowed it down to two choices:

540/mo plan with 4,000 deductable

or

590/mo HDHP plan with 7,000 deductable that allows a health care savings account.
We could put 4,500 per year in the HSA, and our AGI would be lowered by 4,500.

SQRT
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by SQRT » Wed Mar 27, 2019 6:56 pm

Spinola wrote:
Mon Mar 25, 2019 1:43 pm
Cobra, or retire to Canada, or a European country..
Your post probably wasn’t serious but. Not that easy to retire to Canada. Certainly not an expert but you certainly just can’t show up and claim “asylum”. There would be a waiting period (6 months?) to quality for healthcare I believe. As someone else has mentioned taxes are higher too. Max marg rate in Ontario for regular income is over 53% (starts at $210k) VAT is 13%.

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Re: [Retiring before 65: How do you deal with health insurance?]

Post by Horsefly » Wed Mar 27, 2019 7:20 pm

rgs wrote:
Sun Mar 24, 2019 7:37 pm
[Moved into a new thread from: Anyone disenchanted with retirement? --admin LadyGeek]

For the folks that retire before 65, how do you deal with health insurance? Do you have retiree benefits (I doubt this unless part of a union) or do you go with ACA market place or something else? If ACA, what is the rough monthly cost in premiums? Thanks
It probably doesn't help the OP's search, but the DW and I did get retiree healthcare benefits, and we were not associated with any union. I would guess it is pretty rare, but at least for senior executives our company still offered it. I'm not sure if they still offer it to new retirees, but when we retired early (age 55, 6 years ago) it was a big help, and made the decision to retire much easier.

Rajsx
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by Rajsx » Wed Mar 27, 2019 10:45 pm

"Are you sure you are not thinking of Medicaid?

There are no income limits for ObamaCare (aka ACA).

While it is possible some doctors may not accept ObamaCare, I have never heard of one around here. The doctors in our area belong to networks. They may not accept your insurance if they are out of your insurance network, but not specifically because you are on ObamaCare.

There are income limits with Medicaid, and many doctors do not accept it."
-----------------------------------
i may not have worded it right.
What I meant was we do not qualify for the ACA subsidy & we chose the networks which are accepted by the doctors we see.

Thanks
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rgs
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by rgs » Thu Mar 28, 2019 7:35 pm

Very useful and informative, thanks everybody

mark500
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by mark500 » Thu Mar 28, 2019 7:54 pm

Be aware that in many ACA (Obamacare) plans, the major USA national cancer centers are out of network. Plus, some of those plans have zero coverage for out of network providers. If they do provide out of network coverage, the deductible is very high, the co-insurance is only 50% and there is no limit on out of pocket expenses. As far as I can tell, MD Anderson accepts no Obamacare plans.
Last edited by mark500 on Thu Mar 28, 2019 8:28 pm, edited 1 time in total.

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Re: [Retiring before 65: How do you deal with health insurance?]

Post by JediMisty » Thu Mar 28, 2019 8:14 pm

In central NJ, almost no doctor's accept the insurance plans for the free health insurance, available to folks with income low enough (12k I think for singles). Only the doctors associated with hospital clinics will take it. Whereas the plans that are merely subsidized are accepted widely. For this reason, I'll try to stay employed until age 63.5, when I could use COBRA for the last 18 months before Medicare. I studied both sets of plans because my SO was unemployed in 2017, then started his own business in 2018. Whatever is available where you live, will help you decide what you want to pursue. It varies by state

ft2010
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by ft2010 » Fri Mar 29, 2019 6:56 am

Retired2013 wrote:
Mon Mar 25, 2019 1:41 pm
FelixTheCat wrote:
Mon Mar 25, 2019 12:44 pm
I see people mentioning keeping their MAGI below 65K for couples. How did you figure it out? I'm single living in CA.
In general, google the "Federal Poverty Level" (FPL) for the year. The amounts change every year.

For 2019, a family size of 2, the FPL is $16,910. You can get a subsidy if your MAGI is below 400%. $16,910 x 400% = $67,640.
In general, if your income is below 138% of FPL ($16,910 x 138% = $23,336) as a couple, then you could be on Medicaid.

So for a family size of 1, FPL is $12,490. $12,490 x 400% = $49,960. $12,490 x 138% = $17,236. The closer you get to the $17,236 MAGI, the larger your subsidy. Your best deal is usually between the 138% - 200% FPL for your family size.
I am wondering what's the consequence of mistake in managing MAGI while having no earned income (as one is retired from paid work). For example, one signs up for 2018 ACA at the end of 2017, anticipating income from investments/interests/IRA rollover for 2018 to be below 200% FPL. However, at the end of 2018 or rather at the end of 1Q2019 (while start to collect all forms to prepare filing tax returns for 2018) found out that their actual 2018 MAGI income actually exceeded anticipated amounts (lets say just over by $50). How would this "belated" finding affect (1) 2019 ACA plan they already signed up/approved (2) 2018 tax form (i.e., paying back premium cost difference and/or cost sharing benefit?

I'd like to think their 2019 ACA plan itself would not be affected as at ACA plan sign-up stage, all one has to do, is to make a honest estimate of next year's income, oversight in managing one's actual income would have consequence or punishment reflected at tax time, i.e., paying back premium cost difference, etc. Is this correct?

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Re: [Retiring before 65: How do you deal with health insurance?]

Post by SandysDad » Fri Mar 29, 2019 6:59 am

celeste100 wrote:
Wed Mar 27, 2019 5:46 pm

Our thought is to choose a bronze plan and think of it as a catastrophic policy.
The cost will be 540-600 a month with a 4,000 to 7,000 deductable.
But it will protect us if there happened to be bills greater than the max out of pocket of 7,350.

We've narrowed it down to two choices:

540/mo plan with 4,000 deductable

or

590/mo HDHP plan with 7,000 deductable that allows a health care savings account.
We could put 4,500 per year in the HSA, and our AGI would be lowered by 4,500.
Between the premiums and the tax savings for the hsa 2/3 of the higher deductible is covered anyway. Unless you KNOW you will have some significant medical expenses I would go with the higher deductible.

G3VALD1G
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by G3VALD1G » Sun Mar 31, 2019 11:39 pm

JackoC wrote:
Wed Mar 27, 2019 9:22 am
G3VALD1G wrote:
Mon Mar 25, 2019 8:26 pm
Self employed using liberty healthshare. Couldn't be happier. I know it's capped at a million, but most insurance are also capped in their own respective ways.
I couldn't say if that's the right solution for somebody else, but ACA/state compliant insurance is not capped in my state (NJ), isn't allowed to be. And that lack of a cap is an important reason we have health insurance at all. Although it's also important that having insurance means you get billed something like the real price for stuff below the OOP limit, not the 'list price' that's 2-10 times higher that also shows on your Explanation of Benefits. I guess almost nobody actually pays those bogus 'list prices' in full, but you're still starting the negotiation from a much higher level. Anyway if there was a plan with a $50k or $100k OOP annual* limit, priced accordingly lower, I'd be all over it, as long as it had no cap on lifetime benefit. The plan we have now, $1540/month for couple has an unnecessarily low $13k OOP annual family limit, but there isn't a 'catastrophic' plan that's practical for us in our state.

I realize cumulative >>$1mil lifetime health bills, while possible, are unlikely. It's just that that's what we could not afford, and basic insurance theory says to only insure yourself against costs you literally could not afford.

*which is why Out of Pocket limit and lifetime cap aren't directly comparable, a $100k annual OOP could conceivably cost you $1mil if you paid $100k/yr for a >$100k/yr cancer drug that extended your life for 10 yrs (drugs that expensive exist, though they generally don't extend life that long).
When I wrote Capped in other ways I meant, that they are not necessarily capped by any dollar amount, but still capped by what treatments you will be eligible for. Most ACA compliant policies don't let you go out of the network. I'm not sure about the current state but a couple of years ago Memorial Sloan Kettering wasn't in any ACA policy. Which means that if you have cancer in NY that option is out. There is a reason to the historic statement comparing insurance to a hospital gown, you think you're covered but you're not. With liberty healthshare I have a million coverage however I reasonably need to spend it.

In a case of cancer and 100K medications. I assume that wouldn't be a spontaneous expense of over one million. It will give time to move to a different policy that would provide the necessary coverages. There are many ways to do it and it's beyond the scope of this conversation. You could ask any health advocates or health insurance broker who are extremely knowledgeable...

basspond
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by basspond » Mon Apr 01, 2019 4:43 am

We can keep company health care until 65 (non union) and then Medicare supplement but the very low employee premium doubled.

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telemark
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by telemark » Mon Apr 01, 2019 8:19 am

ft2010 wrote:
Fri Mar 29, 2019 6:56 am
I am wondering what's the consequence of mistake in managing MAGI while having no earned income (as one is retired from paid work). For example, one signs up for 2018 ACA at the end of 2017, anticipating income from investments/interests/IRA rollover for 2018 to be below 200% FPL. However, at the end of 2018 or rather at the end of 1Q2019 (while start to collect all forms to prepare filing tax returns for 2018) found out that their actual 2018 MAGI income actually exceeded anticipated amounts (lets say just over by $50). How would this "belated" finding affect (1) 2019 ACA plan they already signed up/approved (2) 2018 tax form (i.e., paying back premium cost difference and/or cost sharing benefit?

I'd like to think their 2019 ACA plan itself would not be affected as at ACA plan sign-up stage, all one has to do, is to make a honest estimate of next year's income, oversight in managing one's actual income would have consequence or punishment reflected at tax time, i.e., paying back premium cost difference, etc. Is this correct?
The estimated MAGI is understood to be an estimate. When you file your taxes for that year, the subsidy is recalculated based on your actual MAGI, so you may end up owing more or being due a refund. For the most part, the subsidy is based on a sliding scale, so a difference of $50 is unlikely to amount to much either way. The thing to watch for is the "cliff" at the top end: if you exceed 400% FPL, even by $50, you lose the subsidy entirely and have to pay the full cost. So try to avoid that.

Estimates based on planned Roth conversions are probably more accurate than estimates based on wages, where you might get a raise, change jobs, be working for a government contractor during a shutdown, etc.

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munemaker
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by munemaker » Mon Apr 01, 2019 9:01 am

mark500 wrote:
Thu Mar 28, 2019 7:54 pm
Be aware that in many ACA (Obamacare) plans, the major USA national cancer centers are out of network. Plus, some of those plans have zero coverage for out of network providers. If they do provide out of network coverage, the deductible is very high, the co-insurance is only 50% and there is no limit on out of pocket expenses. As far as I can tell, MD Anderson accepts no Obamacare plans.
For those of us living in western PA, UPMC's ObamaCare plans cover all UPMC facilities, including the Hillman Cancer Center in Pittsburgh.

http://hillman.upmc.com/

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munemaker
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by munemaker » Mon Apr 01, 2019 9:08 am

JediMisty wrote:
Thu Mar 28, 2019 8:14 pm
In central NJ, almost no doctor's accept the insurance plans for the free health insurance, available to folks with income low enough (12k I think for singles). Only the doctors associated with hospital clinics will take it.
This is Medicaid. Right, lots of doctors do not accept it.
JediMisty wrote:
Thu Mar 28, 2019 8:14 pm

Whereas the plans that are merely subsidized are accepted widely.
This is ObamaCare (aka ACA). Yes, it is widely accepted.

ft2010
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by ft2010 » Wed Apr 10, 2019 3:46 pm

telemark wrote:
Mon Apr 01, 2019 8:19 am

The estimated MAGI is understood to be an estimate. When you file your taxes for that year, the subsidy is recalculated based on your actual MAGI, so you may end up owing more or being due a refund. For the most part, the subsidy is based on a sliding scale, so a difference of $50 is unlikely to amount to much either way. The thing to watch for is the "cliff" at the top end: if you exceed 400% FPL, even by $50, you lose the subsidy entirely and have to pay the full cost. So try to avoid that.

Estimates based on planned Roth conversions are probably more accurate than estimates based on wages, where you might get a raise, change jobs, be working for a government contractor during a shutdown, etc.
Thank you, this is very helpful.

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rgs
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by rgs » Sat Apr 20, 2019 8:39 pm

Quite honestly I didn't expect such great response when I first posted my question. Thank you, very informative.

As a follow up, post-retirement if one has (or the spouse) 1099 income, can the premiums and/or the deductibles be written off (taxes wise)?

Thanks again

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Re: [Retiring before 65: How do you deal with health insurance?]

Post by vtMaps » Sun Apr 21, 2019 5:16 am

rgs wrote:
Sat Apr 20, 2019 8:39 pm
As a follow up, post-retirement if one has (or the spouse) 1099 income, can the premiums and/or the deductibles be written off (taxes wise)?
What type of 1099 income?
If either of you has SE (self-employment) income, you can deduct both of your premiums on form 1040 line 29, the "self-employed healthcare premium deduction". Your combined SE deductions are limited to your net SE income.

--vtMaps
The optimist proclaims that we live in the best of all possible worlds; and the pessimist fears this is true. --James Branch Cabell

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rgs
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by rgs » Sun Apr 21, 2019 3:49 pm

Thank you VtMaps, yes 1099 is from independent consulting work. Are just the premiums eligible for tax deductions or the medical deductibles too?

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Re: [Retiring before 65: How do you deal with health insurance?]

Post by vtMaps » Sun Apr 21, 2019 6:01 pm

rgs wrote:
Sun Apr 21, 2019 3:49 pm
Thank you VtMaps, yes 1099 is from independent consulting work. Are just the premiums eligible for tax deductions or the medical deductibles too?
Just the premiums. It may make more sense to buy a more expensive plan (higher premiums, but deductible) than a less expensive plan (non deductible copays and deductibles). did I just write non deductible deductibles?

Dental and vision insurance is also deductible.

--vtMaps
The optimist proclaims that we live in the best of all possible worlds; and the pessimist fears this is true. --James Branch Cabell

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munemaker
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by munemaker » Wed Apr 24, 2019 2:30 pm

SteveinVanvcouverWA wrote:
Sun Mar 24, 2019 10:40 pm
I recommend a Direct Primary Care (DPC) practice. Direct Primary Care is a membership in which you get virtually unlimited access to a primary care physician for an affordable monthly fee, typically $50-100 per month.
...
Is this what is known as "concierge medicine?"

CT-Scott
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by CT-Scott » Wed Apr 24, 2019 3:48 pm

Just for fun, I went to the ACA website (which then told me to jump to a CT website), and took a look at some of the prices. I plugged in our current income, which is pretty high, and not realistic if we decided to quit our jobs tomorrow, but I was shocked by the plans/prices it was quoting me. HSA-compatible plans for me, my wife, and child were over $1100/month with deductibles of over $11K. Seriously?

If I desired to "retire" early, I think I'd be looking for whatever part-time job required the least number of hours and included health benefits.

So reading through this thread, it seems like the common wisdom is to game the system, by withdrawing from your nest egg the least amount of money you can survive off of, in order to maximize government subsidies?

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munemaker
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by munemaker » Wed Apr 24, 2019 4:04 pm

CT-Scott wrote:
Wed Apr 24, 2019 3:48 pm
If I desired to "retire" early, I think I'd be looking for whatever part-time job required the least number of hours and included health benefits.
Are there part time jobs that provide health benefits? I have never heard of any around here.
CT-Scott wrote:
Wed Apr 24, 2019 3:48 pm
So reading through this thread, it seems like the common wisdom is to game the system, by withdrawing from your nest egg the least amount of money you can survive off of, in order to maximize government subsidies?
Game the system? I guess you could say that. Is it gaming the system when you buy a house and take the tax and interest deductions? Is it gaming the system when your kids go to college and you take one of the various credits or deductions?

Withdrawing the least amount of money from your nest egg you can live off of? No way. If you plan in advance, you can arrange your assets to reduce your AGI so you can live life with your normal level of expenses. That's just good tax planning and being smart.

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LilyFleur
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by LilyFleur » Wed Apr 24, 2019 4:17 pm

CT-Scott wrote:
Wed Apr 24, 2019 3:48 pm
Just for fun, I went to the ACA website (which then told me to jump to a CT website), and took a look at some of the prices. I plugged in our current income, which is pretty high, and not realistic if we decided to quit our jobs tomorrow, but I was shocked by the plans/prices it was quoting me. HSA-compatible plans for me, my wife, and child were over $1100/month with deductibles of over $11K. Seriously?

If I desired to "retire" early, I think I'd be looking for whatever part-time job required the least number of hours and included health benefits.

So reading through this thread, it seems like the common wisdom is to game the system, by withdrawing from your nest egg the least amount of money you can survive off of, in order to maximize government subsidies?
Lots of Bogleheads do game the system, living out of a taxable account to keep their yearly income low. Those of us with pensions just above the cutoff for subsidies cannot do so, however.
I am going to be purchasing a PPO on the exchange soon with no subsidies (because of my pension), $1200 a month, no deductible, and low co-pays for doctor visits and meds. Thank God the new tax plan did not do away with the ability to deduct health-care costs above 10% of your yearly income. It is helpful for retirees with pensions (no subsidies) but without six-figure incomes.

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TheBezzle
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by TheBezzle » Wed Apr 24, 2019 5:28 pm

Rudedog wrote:
Tue Mar 26, 2019 9:52 am
[...] Illinois has "spousal coverage", so my wife who is 59 can stay on my employer's COBRA until she qualifies for Medicare. I am 62 and a half, presently on COBRA, which will run out in June, 2020. [...] See if your state requires "spousal coverage", several states do. [...]
She can stay on COBRA for six years?!

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munemaker
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by munemaker » Wed Apr 24, 2019 8:49 pm

TheBezzle wrote:
Wed Apr 24, 2019 5:28 pm
Rudedog wrote:
Tue Mar 26, 2019 9:52 am
[...] Illinois has "spousal coverage", so my wife who is 59 can stay on my employer's COBRA until she qualifies for Medicare. I am 62 and a half, presently on COBRA, which will run out in June, 2020. [...] See if your state requires "spousal coverage", several states do. [...]
She can stay on COBRA for six years?!
PA has spousal coverage too. I was under the impression that one would have to use Cobra until Medicare for this to work...i.e. one would have to start COBRA after 63 1/2 for my younger wife to be eligible for COBRA until Medicare age. But maybe I am wrong on this.

HIinvestor
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by HIinvestor » Wed Apr 24, 2019 10:11 pm

H worked 45 years for the fed govt and was able to take his family plan into retirement with him. It covers me, him and disabled dependents. H also has Medicare A&B.

We can re-evaluate when I’m eligible for Medicare A&B, but are likely to get it for me as well.

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TheBezzle
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by TheBezzle » Wed Apr 24, 2019 10:38 pm

munemaker wrote:
Wed Apr 24, 2019 4:04 pm
CT-Scott wrote:
Wed Apr 24, 2019 3:48 pm
If I desired to "retire" early, I think I'd be looking for whatever part-time job required the least number of hours and included health benefits.
Are there part time jobs that provide health benefits? I have never heard of any around here.
[...]
I managed to find one as an Educational Aide in a public school. The job is 7 hrs per day, with about 180 total work days per year, even less after the frequent snow delays and cancellations are subtracted. Maybe not part-time, but definitely part-year! The health insurance is comparable to the benefit I left behind at Megacorp:
  • The insurance carrier is the same, and the broad network is identical, as best I can tell.
  • Megacorp's plan allows for out-of-network care with higher co-insurance. Localschool has no out-of-network coverage.
  • Megacorp paid essentially 100% of my premium. Localschool pays 85% or less, on a sliding scale down to 53% for half-time.
  • The high-deductible out-of-pocket maximum is about the same, although Megacorp had co-insurance ramped at 100%, then 20%, then 0%. Localschool is 100%, then 0%.
  • Megacorp seeded my HSA according to my previous year's earnings, in three tax-like brackets (the more you earned, the smaller the seed you got). Localschool offers the same very generous seed to all, about triple what I typically got from Megacorp.
In my mid-sized city, the two major health networks form a sort of duopoly. When I checked last fall, all the ACA subsidy-eligible plans for my county on the healthcare.gov exchange were limited to one network or the other. ACA-compliant off-exchange policies are harder to check, but I fear they are likewise limited to one network or the other. Megacorp's and Localschool's insurance lets me choose from both networks. That makes the benefit invaluable to me, if I can't buy it for cash at any price.

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Re: [Retiring before 65: How do you deal with health insurance?]

Post by TravelGeek » Thu Apr 25, 2019 12:13 am

CT-Scott wrote:
Wed Apr 24, 2019 3:48 pm
Just for fun, I went to the ACA website (which then told me to jump to a CT website), and took a look at some of the prices. I plugged in our current income, which is pretty high, and not realistic if we decided to quit our jobs tomorrow, but I was shocked by the plans/prices it was quoting me. HSA-compatible plans for me, my wife, and child were over $1100/month with deductibles of over $11K. Seriously?
I currently pay around $1400 per month for my wife and myself for COBRA. For fun, check your W-2 for the cost of your employer sponsored health insurance - box 12, code DD.

https://www.irs.gov/newsroom/reporting- ... n-form-w-2

Yes, unsubsidized heath insurance is expensive and a major budget item for us.

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Re: [Retiring before 65: How do you deal with health insurance?]

Post by NotYourAverageJones » Thu Apr 25, 2019 4:27 am

Gratefully, we don't have to deal with it. DH enlisted in the USMC at age 17, retired from USMC at 39. He will retire again in a couple years at 58, but neither of us need to worry about medical coverage until age 65 when forced to downgrade to Medicare. Positive note is we still keep Tricare as our supplemental coverage. "Tricare for life." It's one of the major benefits of military service that keeps on giving, even if you go to work for another company afterwards. The lifetime benefit is invaluable. Although the extra $50k a year COLA pension is pretty nice as well! :D

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Re: [Retiring before 65: How do you deal with health insurance?]

Post by SailorManDan » Thu Apr 25, 2019 6:26 am

Wow, I guess I am in the severe minority here. I am fully retired, now age 49, and have been self-insuring my healthcare for 5 years now. Yes, I live out of the country (in the Caribbean mostly) so I don't have to pay the non-insurance fee plus healthcare is much less expensive. I am active, eat healthy and have no pre-existing conditions. Yes, it may be risky but so is paying $10,000 per year on an expense you may NOT use. Some would suggest, my parents for example, that investing 100% in the stock market is also risky but I beat them to retirement by 20 years. When I did have insurance (as an employee) I still only went to the doctor for the obligatory annual visit. Full disclose: I am single without children.

Can a big bad thing happen? Yup. But the longer I go without insurance the bigger my pot will be to pay for those expenses until, of course, I hit 65. And for all you doomsday people - I fully expect to die someday. :wink:

For those who are spending mega bucks for insurance each year (over $10,000) I'll assume you've had previous medical problems and/or family?

vtMaps
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by vtMaps » Thu Apr 25, 2019 7:10 am

SailorManDan wrote:
Thu Apr 25, 2019 6:26 am
Yes, it may be risky but so is paying $10,000 per year on an expense you may NOT use.
The usual way of dealing with the financial "risk" of not needing healthcare is to purchase a high deductible plan. Insurance is to protect you from events that would ruin you financially. You don't need to consume much healthcare to see bills well over $100k. If that won't ruin you, then yes, it may make sense to self-insure.

--vtMaps
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SunDevil
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by SunDevil » Thu Apr 25, 2019 6:04 pm

Just the premiums. It may make more sense to buy a more expensive plan (higher premiums, but deductible) than a less expensive plan (non deductible copays and deductibles). did I just write non deductible deductibles?

Dental and vision insurance is also deductible.

--vtMaps
Wow, I can't believe I never thought about this when signing up for ACA Marketplace insurance. I probably should have gone with a much higher monthly premium/lower deductible as I can take the self-employed health insurance deduction on premiums. Thank you for pointing this out!

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aspirit
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by aspirit » Thu Apr 25, 2019 6:22 pm

EMT-ALA-NIXON.....Google it,..then do some research, it might be helpful.

If I was young and healthy again i’d be using it as I was back when I was using it exclusively.
Time & tides wait for no one. A man has to know his limitations. | "Give me control of a nation's money and I care not who makes it's laws" | — Mayer Amschel Bauer Rothschild ~

TravelforFun
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by TravelforFun » Thu Apr 25, 2019 7:12 pm

I just confirmed with my HR Department that when I retire in August at age 67, my wife who will be 63.5 can buy 18 months of Cobra from the company for about $460 a month (medical, dental, and vision). She would be able to keep her doctor and dentist which is what she wants. I will go on Medicare and pay about $140 a month. I need to check to see if my doctor would accept Medicare patients.

Bottom line is our medical insurance premium would be about $600 a month, much lower than I had feared.

TravelforFun

Calhoon
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by Calhoon » Fri Apr 26, 2019 7:09 am

My understanding that in Wisconsin if you meet the poverty limits and therefore get Medicaid assistance AFTER 55 it is a loan in that any assistance received is subject to estate recovery after you die. Meaning the states gets your house/assets versus heirs. Might want to check into this and verify if I am correct if you live in Wisconsin and that's the plan.

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RickBoglehead
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by RickBoglehead » Fri Apr 26, 2019 7:32 am

TravelforFun wrote:
Thu Apr 25, 2019 7:12 pm
I just confirmed with my HR Department that when I retire in August at age 67, my wife who will be 63.5 can buy 18 months of Cobra from the company for about $460 a month (medical, dental, and vision). She would be able to keep her doctor and dentist which is what she wants. I will go on Medicare and pay about $140 a month. I need to check to see if my doctor would accept Medicare patients.

Bottom line is our medical insurance premium would be about $600 a month, much lower than I had feared.

TravelforFun
But...

What you need to also look at is any supplemental insurance you'll need WITH Medicare.
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Re: [Retiring before 65: How do you deal with health insurance?]

Post by LilyFleur » Wed Jun 26, 2019 3:59 pm

SteveinVanvcouverWA wrote:
Sun Mar 24, 2019 10:40 pm
I recommend a Direct Primary Care (DPC) practice. Direct Primary Care is a membership in which you get virtually unlimited access to a primary care physician for an affordable monthly fee, typically $50-100 per month. DPC practices typically include deeply discounted meds and labs as well as imaging studies. Find a DPC practice hear you:
https://mapper.dpcfrontier.com

I recommend you combine the DPC membership with a health sharing ministry, an alternative to health insurance in which individuals band together to pay each others' health bills. These are a safety net for the bigger ticket items such as hospitalization, cancer treatment and surgery. Here is a comparison of the options:
http://ochnahealth.com/health-cost-sharing-2019/
The health sharing ministry organizations don't seem to want to minister to people with serious pre-existing conditions. Thank God that Obamacare has compassion on this group of people.

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