Recommendation for High Deductible Health Care Plan - Ages 61/56

Non-investing personal finance issues including insurance, credit, real estate, taxes, employment and legal issues such as trusts and wills
Post Reply
MrOzone
Posts: 11
Joined: Wed Jan 18, 2017 8:16 pm

Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by MrOzone » Mon Jun 11, 2018 10:20 am

I am ready to go into an early retirement at my age of 61.
My wife is 56 yo. We live in Virginia.
Given our high net worth (at Vanguard!), I believe that a high deductible health care plan with a $5,000 deductible would be OK to keep monthly costs low. Clearly we want to protect against a serious illness or other health care emergency, have annual physicals, and also have some access to low cost prescriptions if necessary.
Given the vast experience on this forum, would you folks please let me know what high deductible health care plans have worked for you, or others you may know.
And is there a place or organization that can advise and assist us to find a reputable and good value Health Care plan choice.
I am happy to say that both my wife and I are non-smokers, and we are in excellent health!
Thank You for your thoughts and suggestions.

User avatar
MP123
Posts: 668
Joined: Thu Feb 16, 2017 3:32 pm

Re: Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by MP123 » Mon Jun 11, 2018 11:01 am

Your best bet is to start here: https://www.healthcare.gov/

You can see all the plans available on the exchange in your state. Be aware that there are some High Deductible plans that aren't HSA compatible so if you want an HSA (and you should) pick one that has "HSA" in the plan name.

In general you can only sign up in November but you may be able to do it now if you've lost your employer based coverage.

rob65
Posts: 334
Joined: Mon May 09, 2016 1:30 pm

Re: Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by rob65 » Mon Jun 11, 2018 6:41 pm

Don’t know if Kaiser is in your area, but we’ve been happy with them, although not in a HDHP plan. (We’re in Georgia, so a different area, but I think Kaiser is similar everywhere.)

This is a guess, but I also think they are less likely to withdraw from the healthcare exchanges.

MrOzone
Posts: 11
Joined: Wed Jan 18, 2017 8:16 pm

Re: Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by MrOzone » Mon Jun 11, 2018 11:39 pm

Thank you for your suggestions.
I am a USAA member, and USAA has a free phone service to help their members select private health insurance plans after leaving an employer.
USAA does NOT offer or underwrite health insurance.
So I called them and it seemed like the operator was just moderately knowledgeable.

Here is what I was told:

1) Try to stay on COBRA for up to 18 months after departure from work to extend your employers health care coverage as long as you can since my large company has good plans. Check cost of course.
Then after 18 months on COBRA:
2) The ACA plans from healthcare.gov are recommended since they will cover for 1 year at a time and most effectively protect your life savings, better coverage, no precondition problems, etc.
3) Private health care plans found directly from web site searches directly on the Internet only cover for a 3 months term at a time, and do not protect life savings adequately, preconditions not covered, and one must re-enroll every 3 months! Many other non-optimum features, however these are cheaper.
Does this sound right??

The ACA plans from healthcare.gov are apparently the best choice to protect life savings and provide the best coverages depending what plan is chosen.
Big risk is how high will the ACA plans cost go up to after the insurance mandate is not in force next year, and who knows what other changes each year will happen given the totally screwed up actions by congress.
I am still learning, however I never thought that the ACA plans from Healthcare.gov would be the best choice.
Does this all make sense to you folks?
Is this the basic truth for healthcare choices going into an early retirement?

NotWhoYouThink
Posts: 1951
Joined: Fri Dec 26, 2014 4:19 pm

Re: Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by NotWhoYouThink » Tue Jun 12, 2018 6:37 am

Will your employee allow you to continue COBRA-like coverage after the 18 month mark? Call them and ask. That's what we're planning on.

The plans on the marketplace are expensive and often have limited networks, but there may not be much else out there.

Spirit Rider
Posts: 8321
Joined: Fri Mar 02, 2007 2:39 pm

Re: Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by Spirit Rider » Tue Jun 12, 2018 7:55 am

They are wrong about #3. You can buy full one year plans that must meet the ACA minimal essential requirements off the marketplace.

The majority of these plans are in fact, no different than the plans available on the marketplace. In order to receive a subsidy, you must use the marketplace or state equivalent.

I you can keep your ACA MAGI below 400% of the Federal Poverty Level (FPL). You will receive a significant subsidy. You should attempt this if at all possible.

However, in some states and from some insuers there are plans that are not available on the marketplace. This is because the company and/or plan does not meet the requirements for listing. This does not mean these plans are necessarily not good plans. They may in fact meet your needs better.

Your best choice in order
  • COBRA if it is available to you and is better and/or less expensive option. This is generally true at your ages.
  • A marketplace plan, especially if you are eligible for subsidies.
  • A non-marketplace, but ACA minimal essential qualified plan. That may or may not be available. There is a small possiblity that one could offer the best value.

Rupert
Posts: 3420
Joined: Fri Aug 17, 2012 12:01 pm

Re: Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by Rupert » Tue Jun 12, 2018 8:25 am

A headline I read last week suggested that insurers are now free to ignore the ACA's prohibition against pre-existing condition exclusions. I have no idea what immediate impact, if any, this will have on ACA marketplace plans, but I believe it means that you should maintain coverage at whatever cost because a lapse in coverage may mean you no longer qualify for coverage at any price if you have a pre-existing condition. It's a truly sad state of affairs.

furwut
Posts: 1313
Joined: Tue Jun 05, 2012 8:54 pm

Re: Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by furwut » Tue Jun 12, 2018 8:31 am

Rupert wrote:
Tue Jun 12, 2018 8:25 am
A headline I read last week suggested that insurers are now free to ignore the ACA's prohibition against pre-existing condition exclusions.
Not yet. I think you are referring to a new DOJ challenge that the ACA law is unconstitutional now that the individual manadate has been removed.

J295
Posts: 1502
Joined: Sun Jan 01, 2012 11:40 pm

Re: Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by J295 » Tue Jun 12, 2018 8:37 am

We are on ACA plans due to early retirement and have been satisfied. The insurer has changed during the course of our coverage due to Blue Cross dropping out of ACA plants in our state. In our case, we keep modified adjusted gross income below the cliff, and qualify for premium tax credits that essentially pays for all of the premiums. In round numbers a $24,000 savings.

As for the poster noting a headline on pre-existing condition coverage for the future, I think he/she is referring to pending litigation in a federal court. The ACA and healthcare has been fluid over the years, but we decided we weren’t going to let the tail wag the dog and hold off on our early retirement and other life plans due to ongoing uncertainty regarding healthcare. We are adequately covered presently, and as things change we will continue to adjust as necessary.

User avatar
goingup
Posts: 3140
Joined: Tue Jan 26, 2010 1:02 pm

Re: Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by goingup » Tue Jun 12, 2018 8:42 am

I'm on an individual plan through Kaiser Permanente that's $480/mo. It's not ACA. It's a Silver plan, though next year I'll buy the Silver Flex. High deductible and I pay for all doc visits except Wellness exams. I'm 57.

User avatar
MP123
Posts: 668
Joined: Thu Feb 16, 2017 3:32 pm

Re: Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by MP123 » Tue Jun 12, 2018 11:29 am

MrOzone wrote:
Mon Jun 11, 2018 11:39 pm

1) Try to stay on COBRA for up to 18 months after departure from work to extend your employers health care coverage as long as you can since my large company has good plans. Check cost of course.
Then after 18 months on COBRA:
2) The ACA plans from healthcare.gov are recommended since they will cover for 1 year at a time and most effectively protect your life savings, better coverage, no precondition problems, etc.
3) Private health care plans found directly from web site searches directly on the Internet only cover for a 3 months term at a time, and do not protect life savings adequately, preconditions not covered, and one must re-enroll every 3 months! Many other non-optimum features, however these are cheaper.
Does this sound right??
As mentioned by Spirit Rider above your #3 are really ACA plans that are available directly from the insurer and not the marketplace. These are just like #2 except the pricing can be different in some cases and you can't get a subsidy. It's worth checking these if you won't qualify for a subsidy because in some states unlike the marketplace plans these weren't repriced higher when the funding for cost sharing reductions (CSR) was dropped.

In rough order below there are also:

4) Short term plans that don't cover pre-existing and only run for 3 months although you may be able to bundle 4 of them for a year. This is probably what the agent you spoke to was talking about for #3. These might be appropriate in some special cases (like COBRA runs out 2 months from Medicare) but probably not the best for most people for long term use.

5) Healthcare Sharing Ministries. Might be appropriate for some but be aware of the low lifetime maximums (often $150k or so), exclusions, qualifications, and the fact that it's not a binding insurance contract.

Rupert
Posts: 3420
Joined: Fri Aug 17, 2012 12:01 pm

Re: Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by Rupert » Tue Jun 12, 2018 11:38 am

MP123 wrote:
Tue Jun 12, 2018 11:29 am

5) Healthcare Sharing Ministries. Might be appropriate for some but be aware of the low lifetime maximums (often $150k or so), exclusions, qualifications, and the fact that it's not a binding insurance contract.
I'm still waiting to hear back from someone who joined one of these plans and then was treated for a hugely expensive condition, such as lung cancer or breast cancer. People tout these plans here from time to time as good alternatives to health insurance, but I've never heard anyone tell us how they've actually worked in a really expensive health crisis. Can anyone do that?

User avatar
MP123
Posts: 668
Joined: Thu Feb 16, 2017 3:32 pm

Re: Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by MP123 » Tue Jun 12, 2018 11:43 am

Rupert wrote:
Tue Jun 12, 2018 11:38 am
MP123 wrote:
Tue Jun 12, 2018 11:29 am

5) Healthcare Sharing Ministries. Might be appropriate for some but be aware of the low lifetime maximums (often $150k or so), exclusions, qualifications, and the fact that it's not a binding insurance contract.
I'm still waiting to hear back from someone who joined one of these plans and then was treated for a hugely expensive condition, such as lung cancer or breast cancer. People tout these plans here from time to time as good alternatives to health insurance, but I've never heard anyone tell us how they've actually worked in a really expensive health crisis. Can anyone do that?
To be clear I'm not recommending these but thought they should at least be mentioned if we're putting together a list.

Rupert
Posts: 3420
Joined: Fri Aug 17, 2012 12:01 pm

Re: Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by Rupert » Tue Jun 12, 2018 11:47 am

MP123 wrote:
Tue Jun 12, 2018 11:43 am
Rupert wrote:
Tue Jun 12, 2018 11:38 am
MP123 wrote:
Tue Jun 12, 2018 11:29 am

5) Healthcare Sharing Ministries. Might be appropriate for some but be aware of the low lifetime maximums (often $150k or so), exclusions, qualifications, and the fact that it's not a binding insurance contract.
I'm still waiting to hear back from someone who joined one of these plans and then was treated for a hugely expensive condition, such as lung cancer or breast cancer. People tout these plans here from time to time as good alternatives to health insurance, but I've never heard anyone tell us how they've actually worked in a really expensive health crisis. Can anyone do that?
To be clear I'm not recommending these but thought they should at least be mentioned if we're putting together a list.
Yes, sorry, didn't mean to imply you had. Someone above recommended them, and I was too lazy to scroll up and quote him/her.

book lover
Posts: 136
Joined: Thu Aug 23, 2012 4:01 pm

Re: Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by book lover » Tue Jun 12, 2018 1:08 pm

When looking at the different plans on Healthcare.Gov, be sure to look at how robust the provider network is , in my part of Ohio, there was only one plan that had a decent network with the others being Medicaid like and many providers not accepting those plans.

MrOzone
Posts: 11
Joined: Wed Jan 18, 2017 8:16 pm

Re: Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by MrOzone » Wed Jun 13, 2018 12:58 am

Someone mentioned:
"Will your employer allow you to continue COBRA-like coverage after the 18 month mark? Call them and ask. That's what we're planning on."

Is this to say the 18 month COBRA coverage period is a minimum required by law, and that an employer can offer COBRA for a much longer period? Do employers really offer COBRA for longer than 18 months? This is news to me. Has anyone actually extended COBRA from an employer for greater than 18 months??

A friend of mine has used a Healthcare Ministry called "Liberty Health Share" for his health insurance.
Seems to me that there is no real guarantee as to what will actually be covered with a ministry health share plan, and more importantly the purpose of health coverage for us is to protect our financial wealth from a major illness expense. Don't these ministry health share coverage's limit the maximum benefit payment to lower amounts that could not protect our financial wealth?

Would any of you recommend using a ministry health share type plan?

Rupert
Posts: 3420
Joined: Fri Aug 17, 2012 12:01 pm

Re: Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by Rupert » Wed Jun 13, 2018 7:12 am

MrOzone wrote:
Wed Jun 13, 2018 12:58 am
Someone mentioned:
"Will your employer allow you to continue COBRA-like coverage after the 18 month mark? Call them and ask. That's what we're planning on."

Is this to say the 18 month COBRA coverage period is a minimum required by law, and that an employer can offer COBRA for a much longer period? Do employers really offer COBRA for longer than 18 months? This is news to me. Has anyone actually extended COBRA from an employer for greater than 18 months??
Some states have extended COBRA beyond the usual 18-month period to as long as 36 months. And there are some other qualifying events that extend the period to 29 or 36 months. This link provides info: https://www.cobraplan.com/questions/ext ... verage.htm . Also COBRA doesn't technically apply to employees of small businesses with fewer than 20 employees, but some states have enacted mini-COBRA laws that extend protections to these employees. So, moral of the story, your state is responsible if you are only eligible for 18 months of COBRA coverage or if you are completely ineligible due to the size of your employer.

furwut
Posts: 1313
Joined: Tue Jun 05, 2012 8:54 pm

Re: Recommendation for High Deductible Health Care Plan - Ages 61/56

Post by furwut » Wed Jun 13, 2018 8:56 am

MrOzone wrote:
Wed Jun 13, 2018 12:58 am
Someone mentioned:
"Will your employer allow you to continue COBRA-like coverage after the 18 month mark? Call them and ask. That's what we're planning on."

Is this to say the 18 month COBRA coverage period is a minimum required by law, and that an employer can offer COBRA for a much longer period? Do employers really offer COBRA for longer than 18 months? This is news to me. Has anyone actually extended COBRA from an employer for greater than 18 months??
Some employers continue health insurance for retired employees though the employee may have to pay 100% of the premium.

Post Reply