Health Insurance for retirees

[Titanfan22]

I’m sorry if this thread is off cruise topic, but I have been searching for a group of 55 plus to maybe find great options for those retirees that have taken the plunge.  My wife and I are considering retirement the end of next year so we can spend more time together and with family.  I will be 60 and she will be 59.  Our big hang up is health insurance for several years until we hit 65.  We have had a terrible time dialing in the cost so we can budget and feel comfortable taking the leap. Any input as to good recommendations and what may work well for you would be appreciated.  An idea of cost would help also.  Thanks so much for pulling away from cruise mode to help.

[Mary229]

It just isn’t cheap unless you qualify for a subsidy under ACA.  Lots of people use questionable tactics to take advantage of those subsidies.  You can review costs on that website.  Your other options are HSAs, concierge policies and catastrophic coverage.  I went self insured for 30 years and save thousands if not hundreds of thousands of dollars in premiums.  You need to be in good health and have the resources to manage your own healthcare, emergencies included. 

[Titanfan22]

Thank you for your response. I will review the options you have mentioned .  I am sure there are many different ways people have dealt with this so hopefully others will contribute to this question. Tks again.

[Mary loves to travel]

I agree with considering catastrophic coverage only; then you are basically self-insured until you hit the large (huge) deductible.    Saves quite a bit on monthly premium, but still covers you from financial ruin in the event of a very large medical bill.

Just be sure to carefully read which doctors/hospitals are included in the plan you choose.

 

It's a big expense, either way, but part of the cost of retiring before you are eligible for Medicare.

 

As someone else mentioned, using the ACA website to get idea of costs & options available to you.

 

Best,

Mary

[Wayfairers]

EHealth webpage has several different insurance options.  We retired at 40 and had good reasonably priced insurance options until Obamacare.  Then it became so expensive we changed to catastrophic insurance. That is when we started using eHealth.  Very helpful when you call…I usually call to renew. 

[Titanfan22]

Tks for the additional info.  I will review Ehealth..

[aml3679]

We have Obama Care for around $200 a month and it is great

[Mary229]

23 hours ago, aml3679 said:

We have Obama Care for around $200 a month and it is great

You must have Obamacare with a subsidy.  My quote for Obama care was $1500 per person per month with a $7500 deductible.   I don’t consider that insurance 

[Mary loves to travel]

31 minutes ago, Mary229 said:

You must have Obamacare with a subsidy.  My quote for Obama care was $1500 per person per month with a $7500 deductible.   I don’t consider that insurance 

I had about a year and a half between when my COBRA ran out & I became eligible for Medicare.   That's when I came to understand just how very expensive health insurance is for older people.   

Thinking over my health status & options, I realized that what I really wanted to insure against was a large financial loss.... I could handle the payment for a small number of office visits and the random Rx.  But, I wanted coverage in case something catastrophic or near catastrophic happened. 

 

I went with a plan with a similar large deductible, and a very restricted choice of doctors and hospitals.    That was almost $800 per month, just for me.    It was the lowest plan, is that Bronze?

Thankfully, I never had to use it.

Turning 65, and becoming eligible for Medicare, was a happy day 🙂

 

Mary

 

[Mary229]

4 hours ago, Mary loves to travel said:

I had about a year and a half between when my COBRA ran out & I became eligible for Medicare.   That's when I came to understand just how very expensive health insurance is for older people.   

Thinking over my health status & options, I realized that what I really wanted to insure against was a large financial loss.... I could handle the payment for a small number of office visits and the random Rx.  But, I wanted coverage in case something catastrophic or near catastrophic happened. 

 

I went with a plan with a similar large deductible, and a very restricted choice of doctors and hospitals.    That was almost $800 per month, just for me.    It was the lowest plan, is that Bronze?

Thankfully, I never had to use it.

Turning 65, and becoming eligible for Medicare, was a happy day 🙂

 

Mary

 

I went self insured for 30  years and am really bothered by all of the hoops of insurance now that I am on Medicare.  Wisely or not I just pick the advantage plan with the largest part b buyback and don’t worry about it.   

[Mary loves to travel]

44 minutes ago, Mary229 said:

I went self insured for 30  years and am really bothered by all of the hoops of insurance now that I am on Medicare.  Wisely or not I just pick the advantage plan with the largest part b buyback and don’t worry about it.   

Advantage Plans have become very popular, and I can understand their appeal.

Your approach makes sense to me 🙂

 

Personally, I just don't care for HMOs, so went the Medigap route.    Funny thing, I mainly stay within one very large medical group, but do like the freedom to go outside that group if I ever needed to.

 

Best,

Mary

 

 

[Mary229]

4 minutes ago, Mary loves to travel said:

Advantage Plans have become very popular, and I can understand their appeal.

Your approach makes sense to me 🙂

 

Personally, I just don't care for HMOs, so went the Medigap route.    Funny thing, I mainly stay within one very large medical group, but do like the freedom to go outside that group if I ever needed to.

 

Best,

Mary

 

 

Not all advantage are HMOs, actually most here are PPOs.  I think for those of us who live in a well medically provisioned area of a large urban center advantage is a great plan.  It is definitely not a one size fits all decision .  The HMOs require a lot of attention to detail and if the part B buy back were not so large this year I would never go HMO.  So far I have stayed in the PPO and that is very easy to maneuver. 

[Mary loves to travel]

20 minutes ago, Mary229 said:

Not all advantage are HMOs, actually most here are PPOs.  I think for those of us who live in a well medically provisioned area of a large urban center advantage is a great plan.  It is definitely not a one size fits all decision .  The HMOs require a lot of attention to detail and if the part B buy back were not so large this year I would never go HMO.  So far I have stayed in the PPO and that is very easy to maneuver. 

You make a good point about living in a medical well provisioned urban area.  
I do like PPO plans.   
I know that any Medigap plan doesn’t have to take you back after a pretty short time in any Advantage plan (1-2 years).   
I wonder if it’s the same with Advantage Plans - if you go HMO, can you in the future easily switch back to the PPO Advantage plan?
 

And why are there so many crazy rules & “gotchas”? (Rhetorical)

[Mary229]

35 minutes ago, Mary loves to travel said:

You make a good point about living in a medical well provisioned urban area.  
I do like PPO plans.   
I know that any Medigap plan doesn’t have to take you back after a pretty short time in any Advantage plan (1-2 years).   
I wonder if it’s the same with Advantage Plans - if you go HMO, can you in the future easily switch back to the PPO Advantage plan?
 

And why are there so many crazy rules & “gotchas”? (Rhetorical)

You can switch every enrollment period October and December and if you don’t like the plan you can switch again between January and March 31.  It has gotten very lenient.  They cannot turn you down for any reason. Medigap is underwritten but not with advantage - they must take all comers.   So with an HMO you must stay in network except for emergencies where you can go to the nearest provider.  Once out of network you pay 100%.  For a PPO if you stay in network you are covered except for some small deductibles, if you stray from the network  they still pick up  costs but the deductible is larger.  Most doctors will ask you which network you are in so that when they send out lab tests or refer you they will be sure to pick an in network doctor, pharmacy or lab.   In my area all pharmacies, hospitals and most labs are covered by the major PPOs.  It is best to review the network directory online before choosing.     The advantage plans usually also offer a wide array of other benefits that Medigap doesn’t. These other benefits are very appealing to us and include dental, vision, gym memberships, OTC allowance and of course the part B buyback.  With a part B buyback not only do you not pay an additional premium over what the government takes but the insurance company pays part of the government premium.(This is not Medicaid or an aid scheme).  

Edited November 15, 2022 by Mary229

[Mary loves to travel]

11 minutes ago, Mary229 said:

You can switch every enrollment period October and December and if you don’t like the plan you can switch again between January and March 31.  It has gotten very lenient.  They cannot turn you down for any reason. Medigap is underwritten but not with advantage - they must take all comers.   So with an HMO you must stay in network except for emergencies where you can go to the nearest provider.  Once out of network you pay 100%.  For a PPO if you stay in network you are covered except for some small deductibles, if you stray from the network  they still pick up  costs but the deductible is larger.  Most doctors will ask you which network you are in so that when they send out lab tests or refer you they will be sure to pick an in network doctor, pharmacy or lab.   In my area all pharmacies, hospitals and most labs are covered by the major PPOs.  It is best to review the network directory online before choosing.     The advantage plans usually also offer a wide array of other benefits that Medigap doesn’t. These other benefits are very appealing to us and include dental, vision, gym memberships, OTC allowance and of course the part B buyback.  With a part B buyback not only do you not pay an additional premium over what the government takes but the insurance company pays part of the government premium.(This is not Medicaid or an aid scheme).  

Good to know!

 

Thank you.

[aml3679]

On 5/14/2021 at 7:07 PM, Seamus6 said:

I have always thought sliders were overrated as appetizer.  Never really found one that was all that special 

 

21 hours ago, Mary loves to travel said:

I had about a year and a half between when my COBRA ran out & I became eligible for Medicare.   That's when I came to understand just how very expensive health insurance is for older people.   

Thinking over my health status & options, I realized that what I really wanted to insure against was a large financial loss.... I could handle the payment for a small number of office visits and the random Rx.  But, I wanted coverage in case something catastrophic or near catastrophic happened. 

 

I went with a plan with a similar large deductible, and a very restricted choice of doctors and hospitals.    That was almost $800 per month, just for me.    It was the lowest plan, is that Bronze?

Thankfully, I never had to use it.

Turning 65, and becoming eligible for Medicare, was a happy day 🙂

 

Mary

 

 

[aml3679]

I have Obama care without a subsidy and now that I am not working my husband said it will be free.

[Mary229]

11 hours ago, aml3679 said:

I have Obama care without a subsidy and now that I am not working my husband said it will be free.

After reviewing they now call the subsidy a premium tax credit.   

[Roz]

Health insurance (or lack thereof) is one of the main things that keeps people working until they qualify for Medicare.  

 

I turn 70 at the end of the month and retire the day after.  I've been on my employer's medical insurance but had signed up for Medicare Part A in 2018.  I could write a book about all the hoops I've had to jump thru and obstacles I've faced trying to add Part B and a Part D drug plan.  I'm using the Medicare supplement my employer has for retirees.  They pay part of the premium based on years of service.

 

[Roz]

On 11/15/2022 at 9:43 AM, Mary229 said:

You must have Obamacare with a subsidy.  My quote for Obama care was $1500 per person per month with a $7500 deductible.   I don’t consider that insurance 

 

My sister in NC was paying $1,400 per month for Obamacare with a high deductible.  She couldn't afford it anymore and basically self-insured until she qualified for Medicare.

[sandiego1]

$2300/month for a Blue Cross plan with $7k deductible pp! Just turned 61 and DH about to turn 60. It’s our largest monthly expense in retirement 

[Mum2Mercury]

On 10/25/2022 at 3:48 AM, Titanfan22 said:

... Our big hang up is health insurance for several years until we hit 65 ...

Totally understand where you're coming from. 

- I just retired in June, and I'm sitting pretty:  I was a teacher for 30 years, so I have good insurance at no cost until I turn 65 ... then the state will pay for my Medicare D (drug coverage, not very expensive) for life.  

- BUT I cover my husband, and it costs 20% of my pension check every month.  It'll be six years 'til he turns 65 and I can drop him.  Okay, that sounded bad -- I don't want to "drop" my husband, but I am looking forward to that sweet raise when he turns 65 and goes on Medicare!  

- Last year I had a conversation with the school nurse.  She's not a school employee like me -- she works for the Health Department -- so she doesn't have health coverage for retirement.  She and her husband are considering going without insurance until they hit 65.  I think she's a little older than I am, so it'd probably be 3-4 years for her.  I'm just afraid to do it -- one of my dear friends went through Breast Cancer last year, and she said over and over, "I'm so glad I have teacher insurance AND my husband's insurance."  

On 10/26/2022 at 6:27 PM, Mary229 said:

... I went self insured for 30 years and save thousands if not hundreds of thousands of dollars in premiums ...

We had low-premium /catastrophic-only insurance for about a decade, and we saved big.  But now we're older and are afraid to do it. 

- I spent one night in the hospital two years ago -- went into the ER with shooting pains up my left arm, fearing a heart attack.  Nope, pulled muscle.  Turns out my heart is in better shape than the average 56 year old woman.  Cost about 10K.  

- My husband had a (thankfully small) stroke and spent one night in the hospital.  Very little care, but -- again -- about 10K.  His physical therapy wasn't cheap, but it was worthwhile.  

- So we've had two hospital stays in two years.  That makes me afraid to self-insure.

On 11/15/2022 at 4:13 PM, Mary loves to travel said:

Advantage Plans have become very popular, and I can understand their appeal.

As I said, it'll be a while 'til Medicare becomes part of our lives, but I'm already convinced that the Advantage plans (sometimes called Medicare Complete) are the best deal.  

It matters where you live too.  My mom, who has a Medicare Advantage plan, moved from one county to another (moved into a rural, poor county) and her premiums went from low to ZERO.  

On 11/17/2022 at 6:17 AM, Roz said:

Health insurance (or lack thereof) is one of the main things that keeps people working until they qualify for Medicare.  

Yes, I have several friends who are working JUST for the insurance ... or who retired from their "real jobs" and are working at the grocery store (or similar) just to have insurance.  

[crystalspin]

I am 11 years younger than my husband and when he retired we lost the ability to insure me through his medical corporation.

 

We went with National General with Get-Me-Care to cover the $5000 (!) deductible for catastrophic illness or injury. Things like vaccinations (COVID, flu shot) and routine screenings are not covered. It was and is considered a short-term policy but was renewed at the end of the first year, and I will age-into Medicare before the second year expires. Allstate bought National General but it was seamless as far as my plan; just got new cards to carry.

[Mum2Mercury]

1 minute ago, crystalspin said:

I am 11 years younger than my husband and when he retired we lost the ability to insure me through his medical corporation.

 

We went with National General with Get-Me-Care to cover the $5000 (!) deductible for catastrophic illness or injury. Things like vaccinations (COVID, flu shot) and routine screenings are not covered. It was and is considered a short-term policy but was renewed at the end of the first year, and I will age-into Medicare before the second year expires. Allstate bought National General but it was seamless as far as my plan; just got new cards to carry.

Would you mind telling us your monthly premium?  If that's too intrusive a question, please don't feel obligated to answer!  

[crystalspin]

18 minutes ago, Mum2Mercury said:

Would you mind telling us your monthly premium?  If that's too intrusive a question, please don't feel obligated to answer!  

$375 for the Allstate and $161 for the gap policy. But then my husband pays $228 for Medicare Supplemental plus something for parts B&D. So it won't be a big change when I hit 65.