Can Only the Healthy Retire Early?

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monkey_business
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Can Only the Healthy Retire Early?

Post by monkey_business » Mon Aug 22, 2011 4:51 pm

Many members of this forum have retired early, or are planning to do so. My question is: what do you do about health insurance? The majority of us do not have retiree healthcare to count on, and if you are not 100% healthy, you might not be insurable due to pre-existing conditions. Not only that, but I imagine independent health insurance for someone in their 50s might be quite costly.

Sometimes, for me, it is a bit depressing to think about it. After all, I can save all I want in hopes of enjoying retirement sooner, and have it all essentially unavailable to me because I cannot get health insurance and need to work until Medicare age (which given my young age could be pushed even further out in decades to come).

It's of course possible to self-insure, but considering the cost of healthcare in the US, you would need a very big nest egg to pull that off. You could get healthcare overseas for much less, but there are of course many potential problems associated with doing so. It would also be very tough to do if you needed many treatments and/or continuous therapy.

How do people get around this? Pretty much all I can think of is to save as much as possible, live a healthy lifestyle to help minimize chances of illnesses down the road, and hope it all somehow works out.

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Post by hicabob » Mon Aug 22, 2011 5:01 pm

@ 55 yo my individual BCBS insurance costs $400/month - big deductible but otherwise very good for "catastrophes" (it would seem although I have no wish to find out) - not excellent, but I can handle it and will be able to in early retirement - I am in decent health though - It's an additional expense that needs to be put in the spreadsheet.

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Post by hsv_climber » Mon Aug 22, 2011 5:02 pm

I am not retired, but check out:

http://www.ehealthinsurance.com

I've just typed in a hypothetical 60-year old for my zip code and I've got numbers for high deductable plans in $250 - $400 / month range.

Don't know the details about pre-existing conditions.

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Post by hicabob » Mon Aug 22, 2011 5:07 pm

hsv_climber wrote:I am not retired, but check out:

http://www.ehealthinsurance.com

I've just typed in a hypothetical 60-year old for my zip code and I've got numbers for high deductable plans in $250 - $400 / month range.

Don't know the details about pre-existing conditions.
BCBS started me off at 298 then bumped it up to $400 at the 6 month mark - apparently this is standard procedure - instead of jumping to Anthem I was informed (here in fact) that it is wise to have the same insurance for 2 years. The health insurance companies are a sleazy bunch that one is forced to deal with imo.

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Post by nisiprius » Mon Aug 22, 2011 5:13 pm

Move to Maine, Massachusetts, New Jersey, New York, or Vermont? (These being the states where state law required insurers to write community-rated guaranteed-issue health insurance. I don't know the details. One can assume this means "not cheap for anybody," of course).

We are a Federal republic, state law varies, and sometimes the differences matter a lot.
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Post by tibbitts » Mon Aug 22, 2011 5:28 pm

The question is very specific to which state you're in.

Some people may have employer-provided insurance as part of a package for voluntarily leaving; some are retired military or had other positions that provide continuing healthcare; some operate their own business in "retirement" to quality for a guaranteed-issue group policy at more reasonable rates; some buy insurance from a government high-risk pool; some are healthy enough to buy non-guaranteed-issue insurance.

Paul

freebeer
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Re: Can Only the Healthy Retire Early?

Post by freebeer » Mon Aug 22, 2011 8:09 pm

Insurance aside, the unhealthy are *more* able to retire early - for a given withdrawal rate, they have the best odds of not outliving their assets! ;-)

Sun88
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Post by Sun88 » Mon Aug 22, 2011 8:30 pm

What is considered 'healthy' by an insurer? Does taking meds to control blood pressure and cholesterol put you into the 'pre-existing condition' group? My wife and I both exercise regularly and keep our weight in check.

Our youngest daughter is going to graduate college in a couple years. My wife and I will be 58 at that point, and are strongly considering retirement. I suspect my health situation is similar to a lot of guys my age, and would be interested to hear real life experience on getting and keeping an individual policy.

Thanks.

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Re: Can Only the Healthy Retire Early?

Post by freebeer » Mon Aug 22, 2011 8:31 pm

Insurance aside, the unhealthy are *more* able to retire early - for a given withdrawal rate, they have the best odds of not outliving their assets! ;-)

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Post by texas_archer » Mon Aug 22, 2011 8:33 pm

Check with Costco or Sams Club and see if they have group insurance you can join. I know Costco offers Aetna insurance to members.

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Watty
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Post by Watty » Mon Aug 22, 2011 9:18 pm

You might want to check out this website for information on for their “Consumer Guides for Getting and Keeping Health Insurance” for your state. There may be options you don’t know about.

http://healthinsuranceinfo.net/

If you go to the bottom of your states screen you can see all the information as a PDF. Be sure to check the date, some of them have not been updated in two years or so.

In my state it turns out that there is a plan for small businesses to get health insurance of one thought in the back of my mind is that if necessary I could have some small business as a part time job to get health insurance if I needed to.

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dmcmahon
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Post by dmcmahon » Mon Aug 22, 2011 9:42 pm

Don't forget that the entire health insurance landscape may change quite a bit under the new health care law in 2014. Since you're young, you can afford to take a wait-and-see attitude.

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Post by VictoriaF » Mon Aug 22, 2011 9:49 pm

I hate to sound sanctimonious, but in general the more money and the greater health you have, the more options you have for choosing the time and the location of your retirement. The third component, of course, is living below your means (which even some people with abundant resources cannot manage).

Everything else if full of uncertainties. Whatever people do now to accommodate their health will be irrelevant by the time you need it. And new opportunities will arise.

Victoria
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Post by tibbitts » Mon Aug 22, 2011 10:01 pm

dmcmahon wrote:Don't forget that the entire health insurance landscape may change quite a bit under the new health care law in 2014. Since you're young, you can afford to take a wait-and-see attitude.
That's an important point. Regardless of the political landscape and changes that may happen before all the parts of the current law is implemented, as more people lose coverage and costs rise, the demand for alternatives is likely to grow. For a long time, the vast majority of people were almost completely isolated from the realities of healthcare cost by generous employer-provided plans, but that situation is rapidly changing.

Paul

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Post by dickenjb » Tue Aug 23, 2011 6:52 am

I have retiree health insurance. Many opt for a high deductible plan with an HSA - go over to early retirement dot org to learn more.

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Post by FinanceGeek » Tue Aug 23, 2011 8:10 am

July 1 2012 may turn out to be a key date for ER, e.g. 18 months of COBRA eligibility leading up to the "no preexisting conditions" rules beginning in Jan 1 2014.

magazinewriter
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Post by magazinewriter » Tue Aug 23, 2011 8:03 pm

As dmcmahon said, health care reform (Obama Care) will prevent health insurance companies from discriminating against people based on pre-existing conditions in 2014.

That is, of course, if health care reform is not repealed or overturned by the courts.

People who do not have employer-sponsored insurance will be able to buy policies through insurance exchanges set up by the states or, if states do not want to participate, by the federal government I believe.

In the meantime, as others have said you can check ehealthinsurance for rates but keep in mind that even if you qualify the rates listed could increase by as much as 50% (at least that is the % in my state, not sure if that is true nationwide).

I sympathize with the OP. My company discontinued health insurance for early retirees a few years ago, about a year after they offered a big buyout package for longtime staffers. No loyalty.

djw
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Post by djw » Tue Aug 23, 2011 8:49 pm

When this subject has come up in previous threads, early retirees commonly say that figuring out how and where to obtain good health insurance at an affordable price was the final box they needed to check before they pulled the trigger on their retirement.

That was certainly true for my wife and I.

One's solution to this can vary widely depending on the state of residence and personal work history. For example, my wife's job provided health insurance for both of us as long as she worked 24 hours per week, which is fairly rare these days. If you use an online site to gather price quotes, put in a variety of locations in many different states and you'll see various vendors appear and disappear and their prices move up and down by large margins. There are also international health insurance vendors which quote good prices... but cover medical expenses everywhere EXCEPT the USA.

I looked at some Central American countries which offered very reasonable insurance coverage too, but we decided not to go that route. However, many other retirees do and many say the quality of the medical care can be very good. I read about "medical tourists" who fly to India for what they perceive to be high quality and less expensive treatments.

We spent more than ten years brainstorming possible retirement locations in the USA and elsewhere. Medical coverage was a major factor as we carefully screened prospective locations (including various US states). For us, becoming snowbirds with homes in two states and Blue Cross coverage proved to be our best option, but your situation may be very different.

As laws and health care options continue to change, we'll review our situation once a year and are prepared to make a major change in our plans if conditions warrant it. The future doesn't offer any guarantees. Many folks who thought they'd been guaranteed lifetime health care have lost it with minimal notice. Good luck!
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Post by leonard » Tue Aug 23, 2011 8:57 pm

Also, keep in mind that at retirement, your stress related illness should reduce, in theory.
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monkey_business
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Post by monkey_business » Tue Aug 23, 2011 11:50 pm

VictoriaF wrote:I hate to sound sanctimonious, but in general the more money and the greater health you have, the more options you have for choosing the time and the location of your retirement. The third component, of course, is living below your means (which even some people with abundant resources cannot manage).

Everything else if full of uncertainties. Whatever people do now to accommodate their health will be irrelevant by the time you need it. And new opportunities will arise.

Victoria
Victoria,

Isn't that (underlined) true for everything in life?

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VictoriaF
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Post by VictoriaF » Wed Aug 24, 2011 8:09 am

monkey_business wrote:
VictoriaF wrote:I hate to sound sanctimonious, but in general the more money and the greater health you have, the more options you have for choosing the time and the location of your retirement. The third component, of course, is living below your means (which even some people with abundant resources cannot manage).

Everything else if full of uncertainties. Whatever people do now to accommodate their health will be irrelevant by the time you need it. And new opportunities will arise.

Victoria
Victoria,

Isn't that (underlined) true for everything in life?
monkey_business,

It's true for almost everything. There are probably some exceptions, but I cannot think of many off-hand. Perhaps, health in conjunction with young age and without money provides more options than health in conjunction with old age and with money.

The specific question was if one had to be healthy to retire early. Several answers have correctly indicated that any specific conditions and arrangements that are true today may not exist in the future. I tried to point out the factors that will remain invariable.

I apologized for the triviality of my statement ("I hate to sound sanctimonious"), but the point is that there are things we can control and things we cannot control. As individuals we have some control over our wealth and some control over preserving our health.

Victoria
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xystici
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Post by xystici » Wed Aug 24, 2011 9:19 am

To answer your question, if I were to retire earlier and had healthcare problems, I would move to Barcelona, Spain were I would be covered via the public and private healthcare systems (I do currently have private health insurance from Spain and health insurance in the US).

magazinewriter
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Post by magazinewriter » Wed Aug 24, 2011 9:30 am

monkey_business, one more idea to consider.

If you leave a company that offers group health insurance, take COBRA for the full 18 months, you can convert to a guaranteed policy even with a pre-existing condition. Insurance brokers call this a HIPAA conversion policy. It can be very pricy -- 200% of a normal policy -- but if you have enough money, I guess that would not matter. The conversion policy is with the same company that offered your former group and COBRA policies.

I am not sure if this HIPAA rule is nationwide or just in some states. The website that Watty mentioned, www.healthinsuranceinfo.net, gives excellent information for each state.

A friend who has many problems including diabetes used this conversion method. From what I recall, he pays about $1,200 per month for a policy with a $3k deductible. He is about 63.

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Post by saurabhec » Wed Aug 24, 2011 9:39 am

nisiprius wrote:Move to Maine, Massachusetts, New Jersey, New York, or Vermont? (These being the states where state law required insurers to write community-rated guaranteed-issue health insurance. I don't know the details. One can assume this means "not cheap for anybody," of course).

We are a Federal republic, state law varies, and sometimes the differences matter a lot.
I can tell you that New York's individual health insurance market is a disaster. You are looking at premiums of $1,000 per month and higher. This is because there is no mandate and no exchange. As a result of government and activist actions that betrayed a shocking amount of economic illiteracy, a market that worked for healthy individuals has now been destroyed for all. In the list that you mentioned I believe only MA is a viable individual insurance market.

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Post by saurabhec » Wed Aug 24, 2011 9:46 am

magazinewriter wrote:As dmcmahon said, health care reform (Obama Care) will prevent health insurance companies from discriminating against people based on pre-existing conditions in 2014.
I love the loaded language regarding "discrimination". If you already suffer from an expensive to treat disease, or are highly likely to do so, then how is it discrimination to deny you insurance? What you are asking for is simply cost shifting, whereby the insurance company should pick up the entirely predictable cost of your care. That is not insurance, that is simply a payment mechanism. Would you call a car insurance company that refused to insure a 90 year old blind man as being engaged in discrimination?

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Obtain Health Insurance & Then Only Retire

Post by mur44 » Wed Aug 24, 2011 10:37 am

Since health insurance is expensive and will be
more expensive in the future, you should
have good health insurance unless you are
very rich.

Even if you have Medicare, you should look
into supplemental insurance. If you have
both Medicare and Medicaid, then your
medical expenses are 'fully' covered by
Government.

Retiree health insurance is a great benefit
to have if it meets your needs.


Disclosure: I am a Certified Volunteer
Medicare Counselor from NJ

KyleAAA
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Post by KyleAAA » Wed Aug 24, 2011 10:50 am

Well if you have $20+ million in the bank I imagine you can retire regardless of how healthy you are.

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steve roy
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Post by steve roy » Wed Aug 24, 2011 11:40 am

Paul Terhorst, a well-known early retiree, has said in various interviews that early retirement is very doable, but securing health care that is anchored OUTSIDE the United States -- which he considers the least good place to get a policy -- is a better way to go.

His take, anyway.

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Post by Barefootgirl » Wed Aug 24, 2011 12:11 pm

Steve,

Does Terhorst make suggestions for doing that, what, where, when...etc.?

Tks, bfg

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Post by Wagnerjb » Wed Aug 24, 2011 1:10 pm

saurabhec wrote:
magazinewriter wrote:As dmcmahon said, health care reform (Obama Care) will prevent health insurance companies from discriminating against people based on pre-existing conditions in 2014.
I love the loaded language regarding "discrimination". If you already suffer from an expensive to treat disease, or are highly likely to do so, then how is it discrimination to deny you insurance? What you are asking for is simply cost shifting, whereby the insurance company should pick up the entirely predictable cost of your care. That is not insurance, that is simply a payment mechanism. Would you call a car insurance company that refused to insure a 90 year old blind man as being engaged in discrimination?
You hit the nail on the head. The question was "can only the healthy retire early?", and the answer is: only those who can afford to pay their expenses can retire early. If healthcare is a big expense for you and you cannot afford it, you cannot afford to retire early.

But it seems like the real question is "how can I get somebody else to subsidize my healthcare?". In my personal case, part of my compensation is that my company subsidizes retiree medical coverage. This subsidy has been reduced several times over the years, but is still a fairly attractive plan. If my company didn't include this in my compensation, I would have saved funds during my working years to take this into account.

I suspect your best bet is to save a little more aggressively than a healthy person so that you can afford the higher cost of healthcare when you are in your 50's.

Best wishes.
Andy

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Post by pkh01l » Wed Aug 24, 2011 3:06 pm

jenny345 wrote:
Barefootgirl wrote:Steve,

Does Terhorst make suggestions for doing that, what, where, when...etc.?

Tks, bfg
I think their solution is to not live in the U.S.
This is a popular option has you can have a "cadillac" plan in some Latin and South American countries for something like $150 per month. However, it seems the better approach is simply pay for the High Deductible option here in the States. If those can be had for $400-$500 per month as others have stated, this should no be that big of an expense if your debt free, no mortgage, no car payment, etc...??

My personal plan is to put the maximum into a HSA plan every year but pay for my current medical bills out of pocket (don't touch the HSA). When I retire early, this will be a nice slush fund for medical out of pocket expenses such as meeting a high deductible.

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Post by bill99 » Wed Aug 24, 2011 3:46 pm

If you're planning to early retire, without retiree health benefits like you'd have from government, union (some) or large corporate (some) employment, you absolutely need to nail down health insurance in advance -- especially if you have any pre-existing conditions.

I don't think it's practical to self-insure unless you're wealthy. It's not the expensive routine costs -- tests, doc visits, drugs. You might be able to manage those, but anything catastropic or requiring hospitalization could really hammer your assets. Remember that if you're self-insured, you pay full retail -- not the lower negotiated rates thru your insurance company.

Example: Every 2 weeks, I get an allergy shot (mold). Retail is $16 (used to be $10 a few years ago). Insurance company negotiated rate is $12.47.

Since my hideously expensive insurance plan has a $10,000.oo annual deductible (per person), my insurance company pays zero, and I pay the $12.47. [With the $10k deductibles, our insurance policies are de facto catastrophic coverage.]

When you're chatting with insurance companies, the "illustrative" rate (their standard quote) is meaningless if you have any pre-existings. If so, the only rate that counts is what they quote you AFTER medical underwriting. In our case (I'm nearly 63), the AFTER quote is always massively higher. We have group insurance in our tiny business.

We tried applying for individual insurance; my wife qualified for HIPAA but still had to go thru medical underwriting and multiple re-submissions of paperwork, and multiple requests for additional medical information. I had the impression (can't prove it, of course) that they had to offer it, but didn't really want to give it. Her HIPAA policy would have cost 4X more than a standard policy -- still a relatively 'good' deal for us compared to our existing group insurance, which we've kept, of necessity, since...

they turned ME down for individual NON-HIPAA insurance. Yikes! I have 2 pre-existings -- Lipitor for cholesterol (very moderate numbers, says my board-certified primary doc) and I get 1 allergy shot every 2 weeks.

That's it. My weight's in the ballpark, I don't have any other health issues (yet). But when I called the very nice nurse manager at the insurance company, she told me it didn't matter that my cholesterol was modest. All that mattered was I'm taking Lipitor.

That's good for 3.5 points (you're allowed up to 5 points -- their rating system to decide if you're worth insuring). Allergy shots added another 2 points for a 'score' of 5.5.

5.0 is their max. So insurance denied.

Now, according to my insurance broker (doesn't everyone have one?), only 2 insurance companies offer HIPAA in our area (all insurance is local, or, at best, state-based). Luckily for us, we're 2 miles east of the dividing line between the 2 companies' territories. If we were west of the dividing highway, we could only get the OTHER company's HIPAA, which is several times MORE expensive than OUR HIPAA, which doesn't help us, since I can't get the NON-HIPAA.

So for now, we've kept our group policy.

Will try again at renewal time. We try every year. So far, nothing works. But how can it? The insurance companies do not compete on price (IMO). They've carved up their territories, and have a nice Cartel (or at best, Oligopoly) set-up. And their price quotes all seem to be in the same ballpark, after medical underwriting. How do they manage that?

We're more fortunate than many in our situation, because my wife will qualify for Medicare next year, and I will the year after. With the supplemental policies, it will still be costly, but should be less than we're now paying, and perhaps more predictable/manageable. We'll see.

We'll also see if our docs will accept Medicare.

Sorry, long ramble, but that's our situation. Just make sure you have it figured out before you early retire.

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Post by hsv_climber » Wed Aug 24, 2011 4:06 pm

Wagnerjb wrote:
saurabhec wrote: I love the loaded language regarding "discrimination". If you already suffer from an expensive to treat disease, or are highly likely to do so, then how is it discrimination to deny you insurance? What you are asking for is simply cost shifting, whereby the insurance company should pick up the entirely predictable cost of your care. That is not insurance, that is simply a payment mechanism. Would you call a car insurance company that refused to insure a 90 year old blind man as being engaged in discrimination?
You hit the nail on the head. The question was "can only the healthy retire early?", and the answer is: only those who can afford to pay their expenses can retire early. If healthcare is a big expense for you and you cannot afford it, you cannot afford to retire early.

But it seems like the real question is "how can I get somebody else to subsidize my healthcare?".
It is not as simple as just blaming people for trying to shift the costs.

Issue with the insurance is often not only with the cost shifting like "saurabhec" claims, but with getting the reasonable cost for medical procedures.
What I mean by "reasonable" costs are costs that insurance companies actually pay to the providers vs. what providers bill to their clients. I've seen 5-10x differences on the various bills.

Going back to the previous analogy:
Would you call a car repair company that charge you 5-10x vs. 1X it would charge your car insurance company for the same repair as being engaged in discrimination?

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Post by freebeer » Wed Aug 24, 2011 4:15 pm

magazinewriter wrote:monkey_business, one more idea to consider.

If you leave a company that offers group health insurance, take COBRA for the full 18 months, you can convert to a guaranteed policy even with a pre-existing condition...
Beware, the requirements are state specific and what is offered may be insurance-company-specific. Washington State law requires offering such a conversion but my recent COBRA provider, Aetna, is not presently selling "retail" health insurance in WA. I found that their COBRA conversion policy - after going to a lot of effort to pry the offer out of them - was ridiculously uncompetitive - expensive but more importantly not covering much - clearly just a throw-away to meet State regulatory requirements.

freebeer
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Post by freebeer » Wed Aug 24, 2011 4:15 pm

magazinewriter wrote:monkey_business, one more idea to consider.

If you leave a company that offers group health insurance, take COBRA for the full 18 months, you can convert to a guaranteed policy even with a pre-existing condition...
Beware, the requirements are state specific and what is offered may be insurance-company-specific. Washington State law requires offering such a conversion but my recent COBRA provider, Aetna, is not presently selling "retail" health insurance in WA. I found that their COBRA conversion policy - after going to a lot of effort to pry the offer out of them - was ridiculously uncompetitive - expensive but more importantly not covering much - clearly just a throw-away to meet State regulatory requirements.

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Post by madbrain » Wed Aug 24, 2011 8:10 pm

Wagnerjb wrote: But it seems like the real question is "how can I get somebody else to subsidize my healthcare?".
That is the whole concept of insurance, some healthy people pay in and get less in benefits than they put in, some unhealthy people also pay in and get more in benefits than they pay in. It only works if everyone pays in.

There are many chronic illnesses that are very expensive to treat and that almost no one can be expected to pay the full cost by themselves. Cancer, AIDS, etc are only a few.

If people have paid in when they were young and healthy, I think they should be able to also collect when they become older and unhealthy. It is far too easy to lose your insurance when you get sick due to things like the insane rate hikes that have been in the news, or losing your job. I think the individual policies are a sucker's game. Even if you are healthy when you apply, the moment you become sick you will no longer be able to afford your policy. You have to be in a sufficiently large group for the insurance to make sense.

I look forward to the day the Affordable Health Care Act is fully implemented.

I still plan to retire early, despite health conditions. In fact I'm much more determined because of them - I don't want to be still working when I become too sick to enjoy retirement.

But It's very hard to say what the laws and available health insurance options will be like in 15-20 years which is my timeline.

For someone retiring today and with any serious conditions, the best option is usually to go on COBRA for 18 months, and then get a HIPAA policy afterwards.
Unlike individual policies, the HIPAA rates cannot go up based on your individual health conditions. They are only based on a state group which is by age.

I looked at the HIPAA rates for Kaiser in California and they are actually quite fine, as are the benefits. It comes to about $900/month for two at age 50. In fact, they are *much* lower than the cost of retiree health benefits that my previous employer would have offered if I remained with them until age 50 with 5 years of service, which was about $1300/month for 2 at age 50. Some benefit ! But either one is much lower than $5000/month for life in HIV drugs for 2 individuals, plus regular lab tests, doctor visits, etc.

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Post by Wagnerjb » Wed Aug 24, 2011 8:29 pm

madbrain wrote:That is the whole concept of insurance, some healthy people pay in and get less in benefits than they put in, some unhealthy people also pay in and get more in benefits than they pay in. It only works if everyone pays in.
I respectfully disagree. A 50 year old driver with a clean record doesn't pay the same auto insurance rate as the 16 year old with 5 tickets, and I don't think health insurance should be any different.

You insure for risks that don't show up regularly, not to avoid paying your fair share. I want to be in a pool with similarly healthy people. One year in ten I might need shoulder surgery or have a bad ankle break requiring surgery and therapy. That year, the others are subsidizing me. For the other 9 years I have lower than average expenses and am subsidizing the others. But we all expect to - over the longer term - have similar levels of expenses.

I am not saying that those with health conditions shouldn't be able to have health insurance. Just that they should pay more than the healthy people. That is a fair system, allowing the less healthy to avoid the huge expense of their "bad year" just like others.

Insurance should be to share common levels of risk, otherwise the price should be different.

Best wishes.
Andy

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steve roy
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Post by steve roy » Wed Aug 24, 2011 8:52 pm

Barefootgirl wrote:Steve,

Does Terhorst make suggestions for doing that, what, where, when...etc.?

Tks, bfg
From a Terhorst interview at retire early lifestyle:
How do you deal with healthcare? Are you covered by a US insurer, or one in Argentina?

We find health care to be reasonable everywhere we visit except the US. In Argentina we are part of a plan offered by the British Hospital for citizens of English speaking countries. This plan offers huge discounts for most medical care. A doctor's visit is less than $20.00

http://www.retireearlylifestyle.com/pau ... erview.htm
This was a few years ago, but it likely still applies.

madbrain
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Post by madbrain » Wed Aug 24, 2011 9:05 pm

Wagnerjb wrote: I respectfully disagree. A 50 year old driver with a clean record doesn't pay the same auto insurance rate as the 16 year old with 5 tickets, and I don't think health insurance should be any different.
I don't think you can compare the 2. Driving is a privilege and a choice that you don't have to make. Everybody gets illnesses. Many times through no fault of their own. Often the cause is simply unknown.
You insure for risks that don't show up regularly, not to avoid paying your fair share.
Then the question becomes "what is your fair share". Ant it becomes a political question.
So many illnesses have genetic causes, and so many others yet unknown.
And many of them simply cost too much for most individuals to afford. So, health insurance is needed to spread these costs and make them affordable for those unlucky enough to need expensive treatments. The others should consider themselves lucky not to need them.
I am not saying that those with health conditions shouldn't be able to have health insurance. Just that they should pay more than the healthy people. That is a fair system, allowing the less healthy to avoid the huge expense of their "bad year" just like others.
We have some of that in the way of copays and coinsurance for occasional expenses. Unfortunately, expenses for some chronic illnesses make up a huge portion of overall healthcare spending. So that really doesn't make much of a difference.
Our premiums + employer share of the premiums + all copays are still going to be less than 20% of total annual treatment costs (mainly prescription drugs) for the rest of our life. That's for the good years.

Wagnerjb
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Post by Wagnerjb » Thu Aug 25, 2011 1:00 pm

madbrain wrote:Then the question becomes "what is your fair share". Ant it becomes a political question.
Yes, this would be a political question and would be inappropriate for discussion on this forum. Suffice it to say that I respectfully disagree with you on this issue of re-distribution of my wealth.

Best wishes.
Andy

swyck
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Post by swyck » Thu Aug 25, 2011 2:17 pm

Wagnerjb wrote: I am not saying that those with health conditions shouldn't be able to have health insurance. Just that they should pay more than the healthy people. That is a fair system, allowing the less healthy to avoid the huge expense of their "bad year" just like others.
I agree with paying more when my condition dictates higher premiums. That is only right. The question is how much is too much? IMO the price for a procedure should be the same for everyone, not 10x times or more higher if you're not in an insurance plan. Sorry I don't buy the economies of scale here.

Also remember that we will ALL be on the unhealthy end of this argument if we live long enough. All of us. Everything you say about the unhealthy WILL apply to you some day.

biasion
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Post by biasion » Thu Aug 25, 2011 2:32 pm

My point of view is a little different.

Your savings should be a secondary long term care insurance, life insurance, disability insurance, getting fired, downsized, replaced by chinese/indians or a computer insurance, or a rainy day fund. Or it should be the luxury nest egg, something that helps you never need to budget, so that if your car dies and you need to drop 30k tomorrow to buy a new one, you just write the check without a second thought.

No one should ever retire unless they are too sick for some reason to keep working. This includes if you're over 80.

If you are healthy, the single most dangerous thing you can do is retire.

What's wrong with working into your 70's or 80s if you're white collar and not a laborer or doing really heavy work etc?
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fandango
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Post by fandango » Thu Aug 25, 2011 2:42 pm

Once you exhaust COBRA, you are eligible for state HIPAA coverage.
The exact process varies from state to state.

BUT:

All pre-existing conditions are covered.

Provided you file within 63 days of your COBRA insurance expiring, you can not be turned down.

Cost is in the $500 per month range.

Check with your state insurance department for more information.

madbrain
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Post by madbrain » Thu Aug 25, 2011 2:45 pm

biasion wrote: No one should ever retire unless they are too sick for some reason to keep working. This includes if you're over 80.

If you are healthy, the single most dangerous thing you can do is retire.

What's wrong with working into your 70's or 80s if you're white collar and not a laborer or doing really heavy work etc?
I can't believe you are making the argument on this forum. Unless you absolutely love your job, which I don't think most people do, there is a lot wrong with that. Even though I like my new job I would still rather play the piano or sit in my jacuzzi, or be at the beach, or cook at home, be with my partner, my cats, etc.

For one thing, if the older generations stay at work, it that will contribute to keeping a good chunk of the younger generations unemployed, as opposed to them being trained and/or entering the workforce.

I will not deny that there isn't a health and social benefit to staying at work for a long time. But an office still isn't where I want to spend my last years.

zinnia
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Post by zinnia » Thu Aug 25, 2011 3:08 pm

The country needs to have catastrophic health insurance. You pay up to a certain figure, the government picks it up above that number....

Wagnerjb
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Post by Wagnerjb » Thu Aug 25, 2011 3:16 pm

swyck wrote:
Wagnerjb wrote: I am not saying that those with health conditions shouldn't be able to have health insurance. Just that they should pay more than the healthy people. That is a fair system, allowing the less healthy to avoid the huge expense of their "bad year" just like others.
I agree with paying more when my condition dictates higher premiums. That is only right. The question is how much is too much? IMO the price for a procedure should be the same for everyone, not 10x times or more higher if you're not in an insurance plan. Sorry I don't buy the economies of scale here.
I completely agree with you here. The fact that doctors discriminate against those without insurance is unacceptable to me. Let's level the playing field as far as the true price for health care procedures.

Best wishes.
Andy

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VictoriaF
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Post by VictoriaF » Thu Aug 25, 2011 4:29 pm

madbrain wrote:
Wagnerjb wrote: I respectfully disagree. A 50 year old driver with a clean record doesn't pay the same auto insurance rate as the 16 year old with 5 tickets, and I don't think health insurance should be any different.
I don't think you can compare the 2. Driving is a privilege and a choice that you don't have to make. Everybody gets illnesses. Many times through no fault of their own. Often the cause is simply unknown.
Additionally, the losses from most driving accidents are relatively limited. The cost of health care, on the other hand, can be virtually boundless. (In the light of the recent news I am thinking of Steve Jobs.)

Victoria
Last edited by VictoriaF on Thu Aug 25, 2011 7:52 pm, edited 1 time in total.
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Post by monkey_business » Thu Aug 25, 2011 5:26 pm

biasion wrote:My point of view is a little different.

Your savings should be a secondary long term care insurance, life insurance, disability insurance, getting fired, downsized, replaced by chinese/indians or a computer insurance, or a rainy day fund. Or it should be the luxury nest egg, something that helps you never need to budget, so that if your car dies and you need to drop 30k tomorrow to buy a new one, you just write the check without a second thought.

No one should ever retire unless they are too sick for some reason to keep working. This includes if you're over 80.

If you are healthy, the single most dangerous thing you can do is retire.

What's wrong with working into your 70's or 80s if you're white collar and not a laborer or doing really heavy work etc?
Like the saying goes: "work to live, or live to work". If for you the latter makes more sense, then by all means work until you're decrepit/dead. For most, the former is true. I can bet you 90% of the people, especially those on this forum, would quit their job if they had enough to comfortably retire today. Some would maybe get a fun job instead, or a part-time job, but I doubt there would be many cubicle-dwellers and the like rushing back to work if it was truly optional.

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baw703916
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Post by baw703916 » Thu Aug 25, 2011 7:00 pm

@ Wagnerjb,

Realistically, though, there are a certain number of people whose actuarially-appropriate costs of health insurance exceed their earnings potential.
Most of my posts assume no behavioral errors.

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Post by BruDude » Thu Aug 25, 2011 8:06 pm

I should have jumped in on this thread earlier. There's a lot of both good and (somewhat) bad info here....HIPAA plans vary by state as far as coverage offered and premiums required. Some states have high risk pools, some don't. Some states limit HIPAA premiums to lower amounts (like California), others don't. Consulting with a good independent broker that represents your state's Blue Cross/Blue Shield company or companies as well as other major carriers like United Health One, Humana, and Aetna would be a wise decision.

Small business owners with a one-person or two-person husband/wife group can also terminate the group policy and become eligible for HIPAA, assuming they meet the other requirements. Since the business is the entity terminating the policy and not the owner, it qualifies as a involuntary termination. I've had to do this a couple times for husband/wife groups that were paying ridiculously high premiums.

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