Here's the process we use.
1. Each Fall, price individual plans. Note: We did this even BEFORE ACA, because contrary to popular belief non-group plans were available to many people in many states even before ACA, and they helped many people like independent contractors.
ehealthinsurance.com was (and still is) a very useful resource for this purpose.
2. Compare coverage & pricing with retiree coverage (if any) from former employers, tenuous as that may be. Give +1 point for group coverage (which is what retiree plan is) because that tends to give more value = coverage/premium $. Give +1 point for comprehensive coverage including very expensive things like organ transplants and centers-of-excellence care for serious conditions. Give +1 point to cheapest premiums.
3. Decide on a plan for the next year.
4. Don't worry about the year after next (yet) because things are changing. Worry about the next year in the Fall.
Worry-warts will find this whole situation challenging. Try yoga or meditation.
5. Live as healthy a lifestyle as possible. Healthy diet & exercise, wellness screenings, maintain healthy weight. The produce aisle in the grocery store is your friend.
6. Track all expenses of household, including premiums etc., and adjust expense forecast as needed in retirement plan.
7. If the premiums are in the same range as a mortgage payment
, and they may well be, and if your retirement plan cannot support that, then start job hunting to find a job that either (a) can support the premiums, or (b) provides healthcare.
Hold up sign: "Will work for group health plan only". Look at govt jobs on www.usajobs.gov
8. Itemize medical deductions and include after-tax premiums.
Yes, this is still possible. Expenses & premiums are deductible if over the 7.5% AGI threshhold, and if high enough, will exceed the standard deduction. Report mileage too.
ETA: Include dental and vision expenses too, and LTCi premiums if applicable.
ETA: Regarding step 7, which is basically a "plan B", there are additional backup plan options, such as:
- Consider moving to an area where health insurance premiums
are more affordable. This is not the same thing as affordable healthcare, which is important too. But the premiums need to be affordable first.
- Reduce your income to try & qualify for ACA subsidies. Might be difficult, especially if you were a good planner years ago and gave yourself income in retirement, income which may not be so easy to turn off. And the other problem with this is... see #4 above: Things may change.