Live in MA, Need 2.5 years health insurance until Medicare

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557880yvi
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Live in MA, Need 2.5 years health insurance until Medicare

Post by 557880yvi »

Dear Bogleheads,
My husband and I both retired last year after his company was sold and a transfer to CA with the new company was not in the cards. Our COBRA runs out on Nov 30th and we have been searching for new insurance (the COBRA is a self-insured plan so not an option to continue). Both 62, in superb health, need a High Deductible Plan with HSA (to make extra tax room for converting IRAs to ROTH IRA's).

We live in MA and have the Massachusetts Health Connector (https://mahealthconnector.optum.com/individual/) but it has been extremely frustrating to use the site - seems to be geared towards low-income individuals qualified for free care. Every time I run it, it comes up with different plans, coverage, premiums (insanely high $1,800-$3,500/mo with either very restricted networks - most in or near Boston, we live nowhere near there - and all are HMO's with few choices near us). We have tried going directly to several major carriers - some don't sell direct to individuals, others seem to have different rates/plans than on the Connector but very difficult to compare. Tried an agent and he kept asking "what meds do you take" which I don't think is legal - he didn't believe us when we said none and never called back! Too nervous to go with catastrophic coverage only (or none!).

So short of going back to work,which of course, is an alternative if you can get hired at nearly 63 - we both worked in professional positions where these days, the average age of workers in our industries is under 40. Would appreciate any suggestions for where to look, insurance plans or other ideas fellow Bogleheads may have (but not "off-label" or the religious-based, self-insured plans they continually advertise).

Thank you so much!
jeroly
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by jeroly »

I don’t live in MA but when I was having problems with my ACA shopping online (in dc), there was a facilitation number I could call, and the person was fairly helpful. Worth a try! (Free!)

I’m confused about what the fear regarding a catastrophic coverage policy is... your total costs are capped. You get a lower premium. You can also combine it with an HSA account for great tax-free saving. Especially useful to someone like you that has no ongoing meds and presumably no known underlying high cost conditions. Anyway, you say you want a high deductible plan, which is basically what catastrophic coverage is!
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simplesimon
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by simplesimon »

Click on "preview plans". I did this and assumed two people born on 1/1/1957 living in Worcester (just assumed, outside of Boston) and got a number of plans starting at about $950/month.

I also am confused about the desire for a high-deductible plan but not want catastrophic coverage when they're the same thing.
Lalamimi
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by Lalamimi »

My company's insurance was self insured and we could have continued Cobra after the first year. You might need to research that, I thought it was a law. Luckily we went straight to Medicare during the time period of coverage. I would just get the cheapest coverage you can, since you are healthy. I do not believe you cannot contribute to an HSA if you are not working. Do you plan to work?
Edit - Was husband by chance in the military? there are options if he was.
Last edited by Lalamimi on Mon Sep 16, 2019 10:27 am, edited 2 times in total.
Topic Author
557880yvi
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by 557880yvi »

Thank you both - there are some "catastrophic" insurances that provide no coverage for ongoing care like doctor's visits, vaccines, routine care (and have no negotiated rates with providers). The are like reinsurance plans (you go without health insurance, then get coverage for extreme cost such as >$250k, it's not really health insurance) True "Catastrophic" health insurance under the gov't definition is only for those under the age of 30.
Topic Author
557880yvi
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by 557880yvi »

My company's insurance was self insured and we could have continued Cobra after the first year. You might need to research that, I thought it was a law. Luckily we went straight to Medicare during the time period of coverage. I would just get the cheapest coverage you can, since you are healthy. Put the money saved in the HSA and use that to pay the premium the last year(s) before you each turn 65.


(Sorry not sure how to show the response I am reply to, new to Bogleheads, so it is in italics above):

Unfortunately, companies have no obligation to offer continuation of health care benefits after the 18 mos. and this company does not. And premiums we pay that are not COBRA, LTC Insurance, Medicare or while on unemployment are NOT HSA eligible expenses! (go figure on that one - you can have an HSA eligible plan but the premiums are not eligible to be paid from the HSA) Here is the IRS rule: https://www.irs.gov/publications/p969#e ... 1000204081
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simplesimon
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by simplesimon »

557880yvi wrote: Mon Sep 16, 2019 10:25 am Thank you both - there are some "catastrophic" insurances that provide no coverage for ongoing care like doctor's visits, vaccines, routine care (and have no negotiated rates with providers). The are like reinsurance plans (you go without health insurance, then get coverage for extreme cost such as >$250k, it's not really health insurance) True "Catastrophic" health insurance under the gov't definition is only for those under the age of 30.
I didn't know this, thank you. It sounds like you're out of luck getting a plan that's HSA eligible.

The plans I saw show up were all Bronze level HMO plans. If location is limiting your choices, I'm not sure that there are other alternatives.
Murgatroyd
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by Murgatroyd »

Find yourself a local health insurance broker. They will know the landscape and help you enroll in appropriate coverage. Be somewhat wary of the “national outfits “ that have a local individual. There should be a number of individual brokers working on their own. It should be at no charge to you.

Best of luck.
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dodecahedron
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by dodecahedron »

Lalamimi wrote: Mon Sep 16, 2019 10:23 am I do not believe you cannot contribute to an HSA if you are not working.
This is NOT true. Anyone can contribute to an HSA as long as they have only qualifying high deductible coverage and they are not the dependent of another taxpayer. There is no work requirement.
IRS Pub 969 wrote:Qualifying for an HSA
To be an eligible individual and qualify for an HSA, you must meet the following requirements.

You are covered under a high deductible health plan (HDHP), described later, on the first day of the month.
You have no other health coverage except what is permitted under Other health coverage , later.
You aren’t enrolled in Medicare.
You can’t be claimed as a dependent on someone else’s 2018 tax return.
source:
https://www.irs.gov/publications/p969#e ... 1000204025
Last edited by dodecahedron on Mon Sep 16, 2019 10:50 am, edited 1 time in total.
delamer
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by delamer »

Short-term insurance might be an option, especially if you need more time yo evaluate other plans. It doesn’t cover pre-existing conditions, if that is a concern.

Here some info: https://www.ehealthinsurance.com/short- ... -guide.pdf
gtaylor
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by gtaylor »

Yes, it's an irritating muddle in MA. There are few or no PPO plans available to non-groups. Even out-of-network coverage is dwindling, especially out of state. Supposedly people were signing up as MA residents but then living elsewhere and using the out of state coverage because it is better than the in state coverage in other states.

If you end up self-employed, you do get to deduct the premiums, and participate in the group market, even with only a group of 1. For tiny groups the plans seemed to be mostly the same as the marketplace plans, with the advantage that you can enroll the company any time of year, not just in open enrollment season. I did that once as it was better than COBRA (which is not deductible as self-employed health insurance).

In any case, the actual meat of the comprehensive plans content seems to be highly regulated, the big differences are network of providers and cost reduction hoops (preapprovals, mail order drugs, drug tiers, copays, etc).

I echo the comments of another poster: talk to a MA-based broker. The insurers themselves will not deal directly with individuals or small business. There aren't actually a ton of brokers, it's a small state, and the state that Obamacare came from in the first place. My broker last time was an outfit called "HSA Insurance" (a bafflingly confusing and/or generic-sounding name choice for the space).
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LilyFleur
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by LilyFleur »

gtaylor wrote: Mon Sep 16, 2019 11:17 am Yes, it's an irritating muddle in MA. There are few or no PPO plans available to non-groups. Even out-of-network coverage is dwindling, especially out of state. Supposedly people were signing up as MA residents but then living elsewhere and using the out of state coverage because it is better than the in state coverage in other states.

If you end up self-employed, you do get to deduct the premiums, and participate in the group market, even with only a group of 1. For tiny groups the plans seemed to be mostly the same as the marketplace plans, with the advantage that you can enroll the company any time of year, not just in open enrollment season. I did that once as it was better than COBRA (which is not deductible as self-employed health insurance).

In any case, the actual meat of the comprehensive plans content seems to be highly regulated, the big differences are network of providers and cost reduction hoops (preapprovals, mail order drugs, drug tiers, copays, etc).

I echo the comments of another poster: talk to a MA-based broker. The insurers themselves will not deal directly with individuals or small business. There aren't actually a ton of brokers, it's a small state, and the state that Obamacare came from in the first place. My broker last time was an outfit called "HSA Insurance" (a bafflingly confusing and/or generic-sounding name choice for the space).
It's not fun paying for health insurance with post-tax dollars. I have taken a small job paid by 1099 so I can use most of my earnings to pay health insurance premiums as a business expense. My job won't even pay the entire premium!
NotWhoYouThink
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by NotWhoYouThink »

Tried an agent and he kept asking "what meds do you take" which I don't think is legal - he didn't believe us when we said none and never called back! Too nervous to go with catastrophic coverage only (or none!).
Some plans might be better than others at prescription drug coverage, so it makes sense that an agent would ask. You'll probably need to try another agent.
Even going through our soon-to-be-former employer, our costs will be about $3K/month for a high deductible plan after COBRA runs out, but that at least is for a PPO with a fairly broad network (not in MA). Going through the insurance market our premiums would be higher and our network narrower. Insuring old people isn't cheap, but then not insuring yourself can be pretty pricy as well.

Good luck.
Point
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by Point »

Have you considered moving to a lower cost area or state with the coverage you need? Or, buying an RV and registering it in a state with lower costs and the coverage you need. Then touring 7 months of the year while renting out your house?

Just a little out of the box thinking...
Topic Author
557880yvi
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by 557880yvi »

Oh if we could sell our home and buy an RV or move to a low cost state! Between having built a new home 10 years ago (designed to age in place) and caring for a number of elderly relatives, moving is not an option right now.

We knew the costs would be high, and can fortunately afford to pay for it (but those bucket list trips will have to wait!) Will also begin to explore returning to the workplace just for the insurance to see if that makes sense. Thanks for all the suggestions will follow up on them!!!
mnnice
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by mnnice »

Can you either make a large tax deferred distribution before the end of the year or sell taxable? Can you stockpile cash til 65 and not realize much income.

I don’t know how much income manipulation can be done my thought might not be germane if you have large taxable dividends, large pensions, rental income or two big social security checks
Topic Author
557880yvi
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by 557880yvi »

We are living on savings until 70.5, hoping to defer SS until then and using the non-income years to do ROTH IRA conversions to avoid large RMD's at 70.5. So a huge % of living expenses are eaten up by the healthcare premiums, HSA contributions and taxes to pay for the ROTH conversions.

No complaints, feel very fortunate that it is an option at this point in our lives to even consider not working (but both of us have been employed in one way or another for 50 years, it's time!) Just hoping to find the most cost-effective/appropriate health insurance for the next couple of years until we are eligible for Medicare (which as we are finding out, is not cheap either! We have friends in European countries who were able to retire at 50, full pensions, pay $0 for healthcare. They think we are crazy here! Would have moved to France 30 years had we known our healthcare system would be this expensive/complex in 2019)

Thank you!!
Katietsu
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by Katietsu »

mnnice wrote: Mon Sep 16, 2019 3:15 pm Can you either make a large tax deferred distribution before the end of the year or sell taxable? Can you stockpile cash til 65 and not realize much income.

I don’t know how much income manipulation can be done my thought might not be germane if you have large taxable dividends, large pensions, rental income or two big social security checks
The cut off for a subsidy in 2020 for a two person household looks like it will be around 66 k. With a full HSA contribution that would be over 73 k. Have you considered all the ways that people get under the limit and confirmed that it is impossible or unwise for you to do so? As mnnice stated you might need to take action in 2019 to reduce your 2020 and 2021 incomes.

I do not know the details or placement of your portfolio, but a majority of people living off savings would be able to receive ACA subsidies. Given a choice between a subsidy and a Roth conversion, it is very likely that you would be better off foregoing the Roth conversion. If you need to pull money from a traditional IRA to support your 2020 and 2021 living expenses, it could be done in 2019. If you need to sell mutual funds with embedded gains, do it now. We do not know the details of your portfolio but it might be worth working with someone who is good at moving these pieces around to result in the maximum benefit for you.
Last edited by Katietsu on Mon Sep 16, 2019 4:06 pm, edited 2 times in total.
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22twain
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by 22twain »

557880yvi wrote: Mon Sep 16, 2019 10:34 am(Sorry not sure how to show the response I am reply to [...])
Click the button with a quote mark (") in it, at the top right of the post you want to respond to. This pastes a copy of that post into your message-editing box, enclosed between "quote" and "/quote" tags (in square brackets).

You can edit the text between the quote tags, just like your own text. I strongly recommend that you remove portions of the quoted material that aren't relevant to your response, as I did above. Then your readers won't have to scroll through extraneous material that is still in the original post anyway.
Help save endangered words! When you write "princiPLE", make sure you don't really mean "princiPAL"!
retiringtype
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by retiringtype »

Never take being in "superb health" at age 62 for granted. I was smack in that category at age 61 — super fit, actually — until I was diagnosed with prostate cancer. Totally out of the blue.
retiringtype
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by retiringtype »

Never take being in "superb health" at age 62 for granted. I was smack in that category at age 61 — super fit, actually — until I was diagnosed with prostate cancer. Totally out of the blue.
HomeStretch
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by HomeStretch »

557880yvi wrote: Mon Sep 16, 2019 3:46 pm We are living on savings until 70.5, hoping to defer SS until then and using the non-income years to do ROTH IRA conversions to avoid large RMD's at 70.5. So a huge % of living expenses are eaten up by the healthcare premiums, HSA contributions and taxes to pay for the ROTH conversions.
+1 on katietsu’s comment that it may make sense to take the ACA subsidy over the Roth conversion for the two pre-Medicare years. Everybody’s numbers are different but it worked out that way for us when I did various projections trying to balance ACA subsidies with Roth conversions, IRMAA, lower tax rate sunset, and post 70-1/2 income levels with SS and RMDs.

Don’t defer SS until age 70.5 as the benefit will not grow beyond age 70.
Topic Author
557880yvi
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by 557880yvi »

Katietsu wrote: Mon Sep 16, 2019 3:50 pm
mnnice wrote: Mon Sep 16, 2019 3:15 pm Can you either make a large tax deferred distribution before the end of the year or sell taxable? Can you stockpile cash til 65 and not realize much income.

I don’t know how much income manipulation can be done my thought might not be germane if you have large taxable dividends, large pensions, rental income or two big social security checks
The cut off for a subsidy in 2020 for a two person household looks like it will be around 66 k. With a full HSA contribution that would be over 73 k. Have you considered all the ways that people get under the limit and confirmed that it is impossible or unwise for you to do so? As mnnice stated you might need to take action in 2019 to reduce your 2020 and 2021 incomes.

I do not know the details or placement of your portfolio, but a majority of people living off savings would be able to receive ACA subsidies. Given a choice between a subsidy and a Roth conversion, it is very likely that you would be better off foregoing the Roth conversion. If you need to pull money from a traditional IRA to support your 2020 and 2021 living expenses, it could be done in 2019. If you need to sell mutual funds with embedded gains, do it now. We do not know the details of your portfolio but it might be worth working with someone who is good at moving these pieces around to result in the maximum benefit for you.
Funny you should post this response right now - I just posted a portfolio/ROTH conversion advice question (quite detailed) to the Personal Investments blog! It has all that information if you want to read it - our RMD's will be brutal if we don't do ROTH conversions every year and we need to stretch the non-retirement assets very thin the next 8 years to get to 70.5. At $24-36k/yr for premiums, trying to look for any savings possible! Have run very meticulous 10-yr tax calculations and trying to optimize for lowest taxes.

Thanks for showing how to capture a reply!!
Topic Author
557880yvi
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by 557880yvi »

retiringtype wrote: Mon Sep 16, 2019 4:27 pm Never take being in "superb health" at age 62 for granted. I was smack in that category at age 61 — super fit, actually — until I was diagnosed with prostate cancer. Totally out of the blue.
Guess we have felt invincible with good health for so long, so sorry about this, hope you caught it in time. Wake up call.... thanks
Topic Author
557880yvi
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by 557880yvi »

HomeStretch wrote: Mon Sep 16, 2019 4:38 pm
557880yvi wrote: Mon Sep 16, 2019 3:46 pm

+1 on katietsu’s comment that it may make sense to take the ACA subsidy over the Roth conversion for the two pre-Medicare years. Everybody’s numbers are different but it worked out that way for us when I did various projections trying to balance ACA subsidies with Roth conversions, IRMAA, lower tax rate sunset, and post 70-1/2 income levels with SS and RMDs.

How did you do your projections? I have been running Turbo Tax and Excel projections (comparing NPV of ROTH vs NO ROTH, opportunity costs of paying the taxes, healthcare etc., keep coming up with do the ROTH. Are there income lookbacks for the ACA subsidies? We worked and had fairly high incomes and a ROTH conversion until the middle of 2018. Thank you!
HomeStretch
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by HomeStretch »

557880yvi wrote: Mon Sep 16, 2019 3:46 pm How did you do your projections? I have been running Turbo Tax and Excel projections (comparing NPV of ROTH vs NO ROTH, opportunity costs of paying the taxes, healthcare etc., keep coming up with do the ROTH. Are there income lookbacks for the ACA subsidies? We worked and had fairly high incomes and a ROTH conversion until the middle of 2018. Thank you!
I am using Excel, TurboTax and have taken a stab at confirming with i-ORP. It is complex and I say that as someone with a lot of experience with financial models. My next pass at this will be at year end as I expect to do first Roth conversions in 2020-2021 while on COBRA. After 2021, I’m leaning based on my projections towards no Roth conversions in order to claim ACA subsidies until Medicare age, then going back to Roth conversions (even with IRMAA perhaps at varying tiers) until RMDs start at age 70-1/2. I believe projections will need to be updated each year to reflect investment returns, ACA subsidy qualifications, tax rates after sunset in 2026, if RMD age gets pushed back, etc. Bottom line is that I am not sweating it as all I am doing is optimizing as portfolio should be adequate over our retirement horizon.

The ACA subsidies are based on current year’s income and trued up at tax time. There is no look back (unlike Medicare) and no assets-based means test in my state.
Last edited by HomeStretch on Mon Sep 16, 2019 5:54 pm, edited 1 time in total.
InMyDreams
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by InMyDreams »

557880yvi wrote: Mon Sep 16, 2019 10:03 am but it has been extremely frustrating to use the site
Some people find this site easier to use:
https://www.healthsherpa.com/
turnberry72
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Location: New England

Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by turnberry72 »

ObamaCare & MA Health Connector offer subsidies based on adjusted gross income, not assets .

Please do not assume you do not qualify for a subsidy -- especially, if your income is NOT driven by a pension or annuity. If you are living off your personal cash/assets if you minimize the use of 401k/IRA funds (which are treated as income) you can keep you income down considerably without effecting your lifestyle.

Suggest you read the following:

Subsidy Calculator: http://kff.org/interactive/subsidy-calculator/
http://rootofgood.com/obamacare_makes_e ... re_secure/
http://rootofgood.com/affordable-care-act-subsidy/
"When you discover you have more money than time, you should stop pursuing money and focus on getting the most out of your time."
chw
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by chw »

I also live in MA, am a few years younger than you, and my COBRA expired earlier this year. I also live outside the metro Boston area. IMO, I believe the Health Connector plans are your best options. Agree, the Health Connector website could be better, but it is ok once you figure it out. I called a live agent several times to walk me through the website until I became familiar with what I needed. I found the live agents easy to reach, and very helpful when needed. When I finally enrolled, I had an agent on the phone to walk me through the process to make sure I didn’t miss a step.

I ended up with a Bronze plan(unsubsidized) thru Tufts Health Plan, which has worked out pretty well. The docs my wife and I see were in their network, though our primary care has changed up a few specialists, which have worked out fine.

A word to the wise- if you haven’t done so, make sure you submit your paperwork to confirm eligibility to the Health Connector. I believe it takes a few weeks for the paperwork to be processed. I also enrolled in a mid level Delta Dental plan thru the Health Connector.

Feel free to PM me with any specific questions.
Topic Author
557880yvi
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by 557880yvi »

turnberry72 wrote: Mon Sep 16, 2019 5:44 pm ObamaCare & MA Health Connector offer subsidies based on adjusted gross income, not assets .

So it could come down to a NPV comparison of the savings if we could qualify for a subsidy against the tax-free growth in the ROTH for 2 years. Great recommendation, will check this out!
gd
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by gd »

I found the site amazingly confusing, but did eventually sort it a bit by (beware, from memory) finally realizing the metals & levels (e.g. hi bronze, silver low) had standard benefits, the variation was prices and provider networks. I figured out roughly what benefits I wanted (e.g. no prescriptions, few specialists, few office visits, deductible) to determine the level, then for that level looked at the providers that gave me our PCP and the occasional specialist I wanted access to. In the boonies the networks are probably critical to you. The prescription question you had was probably reasonable-- prescription coverage and formularies are a key issue for many people. With excellent health, you live in a different universe from many people. Most of the complexity is for them, not you.

Equally confusing was the actual signup procedure. The web sites are a nice idea, with a few disastrous design decisions by people considering too specific use cases making them almost impossible for me to use consistently. I had to reset everything when one of us went on Medicare, and in the billing confusion actually lost my dental because I thought they told me I'd get credit for the next month's bill and didn't need to pay it. Except for that spectacular mistake, the state phone support was surprisingly helpful.

Can't speak to the subsidies, I saw no indication I was eligible.
delamer
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by delamer »

delamer wrote: Mon Sep 16, 2019 10:48 am Short-term insurance might be an option, especially if you need more time yo evaluate other plans. It doesn’t cover pre-existing conditions, if that is a concern.

Here some info: https://www.ehealthinsurance.com/short- ... -guide.pdf
Just read an article in BloombergBusinessweek about short terms plans, and I am withdrawing my suggestion.

Title is “Health Insurance That Doesn’t Cover the Bills Has Flooded the Market Under Trump.”
Topic Author
557880yvi
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by 557880yvi »

gtaylor wrote: Mon Sep 16, 2019 11:17 am

I echo the comments of another poster: talk to a MA-based broker. The insurers themselves will not deal directly with individuals or small business. There aren't actually a ton of brokers, it's a small state, and the state that Obamacare came from in the first place. My broker last time was an outfit called "HSA Insurance" (a bafflingly confusing and/or generic-sounding name choice for the space).
I have been following up today with all the suggestions - just wanted to share that I found HSA Insurance as gtaylor suggested (and they are still called that https://www.hsainsurance.com/Home.aspx) A sales rep in the individual markets dept answered right away. In less than 5 minutes he knew what we needed (HD plan with HSA) and is sending quotes tonight. He said that the MA Health Connector is their competition and that they strive for excellent customer service as their differentiator (as the prices for the plans are the same). I would say they get an A+ for that!

Thanks for the recommendation!
bobolinx
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by bobolinx »

Health insurance can be a huge cost. I didn't have much luck with the health connector a few years ago. So I just went to every health insurer's website I could think of to find a plan that kept my doctor. Some examples of insurers are: Harvard, Fallon, Tufts, Kaiser... They are/weren't cheap. I couldn't find a plan for catastrophic medical that my sister who lives out of state has. Good Luck
gd
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Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by gd »

557880yvi wrote: Tue Sep 17, 2019 3:18 pm
gtaylor wrote: Mon Sep 16, 2019 11:17 am

I echo the comments of another poster: talk to a MA-based broker. The insurers themselves will not deal directly with individuals or small business. There aren't actually a ton of brokers, it's a small state, and the state that Obamacare came from in the first place. My broker last time was an outfit called "HSA Insurance" (a bafflingly confusing and/or generic-sounding name choice for the space).
I have been following up today with all the suggestions - just wanted to share that I found HSA Insurance as gtaylor suggested (and they are still called that https://www.hsainsurance.com/Home.aspx) A sales rep in the individual markets dept answered right away. In less than 5 minutes he knew what we needed (HD plan with HSA) and is sending quotes tonight. He said that the MA Health Connector is their competition and that they strive for excellent customer service as their differentiator (as the prices for the plans are the same). I would say they get an A+ for that!

Thanks for the recommendation!
Their "individual" page first asks if you are eligible based on the same criteria for MA Health Connector, and if not, they can't help you until the same open enrollment period as Health Connector. This sounds like a company brokering the same plans. I have no idea how they make their money doing the same thing the state does, perhaps the state gets some commission that these people pocket instead. So just as long as you understand you're dealing with an insurance salesman.
gtaylor
Posts: 339
Joined: Tue Feb 17, 2009 3:22 pm

Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by gtaylor »

gd wrote: Wed Sep 18, 2019 6:19 am Their "individual" page first asks if you are eligible based on the same criteria for MA Health Connector, and if not, they can't help you until the same open enrollment period as Health Connector. This sounds like a company brokering the same plans. I have no idea how they make their money doing the same thing the state does, perhaps the state gets some commission that these people pocket instead. So just as long as you understand you're dealing with an insurance salesman.
Oh, I'm sure there's an ongoing commission in there somewhere. The premiums go through the brokerage. When I did it there were multiple layers of companies and people, with HSA as the closest to the actual insurers. Ultimately HSA has a website internally which emits a list of plans based on my zip and age that they just emailed me screen shots from. Why the state "connector" isn't just that website I don't understand. They must have had "avoid sticker shock from exposing subsidized people to actual costs" as the top requirement, thereby making it into the user interface fiasco that it is.

One thing to look into, I seem to recall that only marketplace plans were qualified for the PTC. If it's plausible for you to qualify for that, and in your post-work / pre-65 situation it might well be, you should make sure that that will still be possible with a plan through the broker (the IRS rules say "through the marketplace", but the broker may be able to function as a marketplace assistant or whatever that category of ACA helper is called, you'll have to ask them). This costs so much it could be worth it to either target the max PTC or operate a small business so that the premiums are deductible or credited.
Topic Author
557880yvi
Posts: 124
Joined: Wed Mar 06, 2019 3:11 pm

Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by 557880yvi »

gtaylor wrote: Wed Sep 18, 2019 7:01 am

This costs so much it could be worth it to either target the max PTC or operate a small business so that the premiums are deductible or credited.
Based on the great advice everyone has provided, and that we have only a very small amount of interest/dividend income (living off savings) will try to target the maximum PTC. Trying to find out if there is an updated version of this article from 2013 (a link provided in this thread) for any changes in the ACA since, it is an excellent source for understanding how to calculate the "sweet spot" for subsidy eligibility:

https://rootofgood.com/affordable-care- ... ent-151646

Many thanks!
Topic Author
557880yvi
Posts: 124
Joined: Wed Mar 06, 2019 3:11 pm

Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by 557880yvi »

gd wrote: Wed Sep 18, 2019 6:19 am
This sounds like a company brokering the same plans. I have no idea how they make their money doing the same thing the state does, perhaps the state gets some commission that these people pocket instead.
[/quote]

I found out that yes, the plans are exactly the same. The way the system is set up (likely to not put the brokerage industry out of business when the Connector was implemented in MA, before the ACA was passed) the brokers get a commission on the first year when they place coverage for you. But they can't place coverage for anyone eligible for any subsidies.
chw
Posts: 835
Joined: Thu May 24, 2012 4:22 pm

Re: Live in MA, Need 2.5 years health insurance until Medicare

Post by chw »

557880yvi wrote: Tue Sep 17, 2019 3:18 pm
gtaylor wrote: Mon Sep 16, 2019 11:17 am

I echo the comments of another poster: talk to a MA-based broker. The insurers themselves will not deal directly with individuals or small business. There aren't actually a ton of brokers, it's a small state, and the state that Obamacare came from in the first place. My broker last time was an outfit called "HSA Insurance" (a bafflingly confusing and/or generic-sounding name choice for the space).
I have been following up today with all the suggestions - just wanted to share that I found HSA Insurance as gtaylor suggested (and they are still called that https://www.hsainsurance.com/Home.aspx) A sales rep in the individual markets dept answered right away. In less than 5 minutes he knew what we needed (HD plan with HSA) and is sending quotes tonight. He said that the MA Health Connector is their competition and that they strive for excellent customer service as their differentiator (as the prices for the plans are the same). I would say they get an A+ for that!

Thanks for the recommendation!
I found that HSA’s prices are not the same, but close to the Health Connector. Also, the deductibles/max out of pocket costs aren’t the same as the HC plans in all cases. I also almost went with HSA, but when I matched HSA's plan with the comparable HC plan, the HSA plan was about $50 a month more, and with worse deductibles/out of pocket costs. I also seem to recall the pharmacy benefit with the HC plan was more robust (I called the actual provider to confirm).
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