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help me sort out the health insurance market for 55 to 65 year olds


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20 replies to this topic

#1 hegemony

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Posted 16 June 2017 - 03:22 PM

early retirement is possible for me but I have no health coverage in retirement other than medicare at 65.

 

This is NOT a discussion of ACA or ACHA. I would not qualify for subsidies although the issue of preexisting conditions does matter to me as the regs regarding it will impact my costs.

 

I've played around with some major carriers "estimators" and just get confused.

 

I do not need vision or dental. I'll escrow those and self-insure.

 

What is confusing to me is even an expensive plan (NOT an ACA plan) from the largest issuer in my state is extremely limited.

 

For example, a plan with a $10,000 deductible with a $350 a month premium for 2 people has very limited "health" care:

  • Urgent care visits limited to 1 per year
  • prescription coverage limited to $750 per year.
  • four doctor office visits per year

Another plan with a $5,000 deductible and a $500 a month premium has similar limitations.

 

I'm mostly interested in a "catastrophic" plan so that our assets don't get murdered in case of a severe illness but most max deductibles I see are $5,000 to $10,000. Are there plans that would, for instance, cover everything after, say, $25,000?

 

What I am asking here is not about insurance itself, but more I am looking for advice/input how best to plan to pay for health care (insurance policy and self-insurance via high deducible & reserves).

 

What is the best way to estimate what should be set aside? Do I look at out of pocket costs over the past few years to estimate future costs?

 

I can see why I have colleagues who are only still working because they claim they need the health insurance.

 

What else do I need to look at? How best to organize my planning on this? I consider myself mostly sophisticated on financial matters but this issue has me befuddled.

 

 

 


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#2 cv91915

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Posted 16 June 2017 - 07:04 PM

I don't have anything helpful to add, however I am going to follow this thread because I have related concerns and questions. Thank you for posting this.
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#3 hegemony

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Posted 16 June 2017 - 07:44 PM

I don't have anything helpful to add, however I am going to follow this thread because I have related concerns and questions. Thank you for posting this.

 

I blocked off time next week to invest more time reading.

 

One idea I had is to CD- ladder five 5-year CDs with an amount large enough to cover high deductibles on the assumption we won't need the full amount each year.


Edited by hegemony, 16 June 2017 - 07:46 PM.

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#4 Gail

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Posted 22 July 2017 - 08:04 AM

Unfortunately this is the situation for most people in the country right now - high deductibles and high premiums. And for most policies, the deductible is a per person charge so on a $10K deductible for 2 people, would be $20K in deductibles each year.

 

If it was me, I would go with the cheapest premium policy and sock as much as possible away to cover deductibles and extra medical costs. A catastrophic plan is not an option for anyone on an ACA plan because they've been "outlawed" for anyone over the age of 30. Not sure if you can still get them on the open market.

 

What I did since I'm a generally healthy person and rely more on herbal remedies than medications was to bump up the medical payments on my car insurance to cover anything like broken bones, etc from an accident since that would be my main concern (people down here drive worse that NY and Massachusetts). Anything other than that will come out of pocket.

 

Most wouldn't agree with me on that but the cheapest premium for me is $871 a month. That works out to over $73K in premiums until medicare kicks in for something I wouldn't use anyway. That's a lot of money!!

 

Predicting health costs based on past years doesn't really work because as we age, out needs health needs change. Maybe the AARP has some info on how to figure out what your costs might be. They also offer health plans so might be worth looking at those. Membership is cheap and available at 50 years old.

 

As for the assets you have, how about protecting them with a living revocable trust? If you put them in the trust now, they'd be protected more later on when stuff is more apt to happen. Just a suggestion.

 

Hopefully, some things will get changed so that people can cross state lines to buy health insurance which will open up competition and lower premiums for better plans. Competition is always a good thing for consumers.


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#5 DollarDog

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Posted 22 July 2017 - 12:33 PM

Call your providers and pharmacies and ask how much the services and drugs you use cost with your new insurance provider.  An office visit with a doctor using Insurance Company A might be $100 and using Insurance Company B might be $500.  Only way to know is to call and ask.  Costs aren't published and fixed like shopping at Amazon.com.


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#6 Cactus Flower

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Posted 29 July 2017 - 09:06 PM

That is why so many people are working into old age.. isn't because they WANT to, LOVE it or even need the money, but they do it for group health coverage....


Edited by Cactus Flower, 29 July 2017 - 09:07 PM.

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#7 hegemony

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Posted 18 August 2017 - 10:24 AM

That is why so many people are working into old age.. isn't because they WANT to, LOVE it or even need the money, but they do it for group health coverage....

I know all too well from a couple colleagues. I'm trying to avoid having to work until medicare age. But even with group coverage our out of pocket costs have soared.

 

At this point I think we're planning to try to cashflow insurance costs in early retirement but also have an extra "emergency" fund in case costs become too much for cashflow.


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#8 IndyPoolPlayer

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Posted 18 August 2017 - 01:40 PM

My $DAYJOB has expensive insurance that only pays if you get sick while at the tavern at midnight during a full moon. But they says we gotta have it so we got it.


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#9 swimmingwithsharks

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Posted 18 August 2017 - 04:58 PM

Do any of these plans you are looking at, have out of pocket maximums?

Are you wanting only a PPO-style plan with a large network, or are you looking at HMO-style which in theory should sacrifice choice for lower costs?

Are there are any options for you through a trade organization in your field? I have to word that very broadly, but many professional societies do have some health insurance options for members.
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#10 hegemony

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Posted 18 August 2017 - 06:43 PM

Do any of these plans you are looking at, have out of pocket maximums?

Are you wanting only a PPO-style plan with a large network, or are you looking at HMO-style which in theory should sacrifice choice for lower costs?

Are there are any options for you through a trade organization in your field? I have to word that very broadly, but many professional societies do have some health insurance options for members.

ultimately it can be any type of plan; mostly looking for something that covers anything over, say, 100k.


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#11 DollarDog

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Posted 18 August 2017 - 06:46 PM

Everyone knows you're rich.

 

Unless you won the lottery, you're also smart.

 

You know exactly how the health insurance market works.


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#12 hegemony

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Posted 18 August 2017 - 06:57 PM


You know exactly how the health insurance market works.

 

no I don't. I know I'll need something before I qualify for medicare. I'm just trying to learn more so I can plan.


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#13 DollarDog

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Posted 18 August 2017 - 07:02 PM

 


You know exactly how the health insurance market works.

 

no I don't. I know I'll need something before I qualify for medicare. I'm just trying to learn more so I can plan.

 

You find, read, and post dozens of financial news posts every day.

 

And you never read anything about health insurance?


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#14 IndyPoolPlayer

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Posted 18 August 2017 - 07:03 PM

 


You know exactly how the health insurance market works.

 

no I don't. I know I'll need something before I qualify for medicare. I'm just trying to learn more so I can plan.

 

clipart-canadian-flag-2-a6bb.pngLike Hockey?


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#15 hegemony

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Posted 18 August 2017 - 07:35 PM

 

 


You know exactly how the health insurance market works.

 

no I don't. I know I'll need something before I qualify for medicare. I'm just trying to learn more so I can plan.

 

You find, read, and post dozens of financial news posts every day.

 

And you never read anything about health insurance?

 

the more I read the more confused I am. I just wanted to learn how others fill the gap between group plan via an employer and medicare.


 

 


You know exactly how the health insurance market works.

 

no I don't. I know I'll need something before I qualify for medicare. I'm just trying to learn more so I can plan.

 

clipart-canadian-flag-2-a6bb.pngLike Hockey?

 

 

Vegas Golden Knights :lol:

 

the problem with Canada is I don't think I could learn the language.


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#16 DollarDog

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Posted 18 August 2017 - 07:53 PM

My mistake.  I thought you owned a business.

 

As an employee, the HR department can answer your questions about retiree health care options.

 

Or you can purchase a health care plan here:  https://www.healthcare.gov/


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#17 IndyPoolPlayer

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Posted 18 August 2017 - 09:02 PM

 

 

You know exactly how the health insurance market works.

 
no I don't. I know I'll need something before I qualify for medicare. I'm just trying to learn more so I can plan.
 
You find, read, and post dozens of financial news posts every day.
 
And you never read anything about health insurance?
 
the more I read the more confused I am. I just wanted to learn how others fill the gap between group plan via an employer and medicare.

 

 

You know exactly how the health insurance market works.

 
no I don't. I know I'll need something before I qualify for medicare. I'm just trying to learn more so I can plan.
 
clipart-canadian-flag-2-a6bb.pngLike Hockey?
 
 
Vegas Golden Knights :lol:
 
the problem with Canada is I don't think I could learn the language.

There's "eh?" and "aboot" what else is there to know ?
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#18 hegemony

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Posted 18 August 2017 - 09:05 PM

I have no health coverage in retirement via my employer. If I had such an option, I would have not started this thread or wasted a lot of time reading about the HC marketplace.


 

 

 

 

You know exactly how the health insurance market works.

 
no I don't. I know I'll need something before I qualify for medicare. I'm just trying to learn more so I can plan.
 
You find, read, and post dozens of financial news posts every day.
 
And you never read anything about health insurance?
 
the more I read the more confused I am. I just wanted to learn how others fill the gap between group plan via an employer and medicare.

 

 

You know exactly how the health insurance market works.

 
no I don't. I know I'll need something before I qualify for medicare. I'm just trying to learn more so I can plan.
 
clipart-canadian-flag-2-a6bb.pngLike Hockey?
 
 
Vegas Golden Knights :lol:
 
the problem with Canada is I don't think I could learn the language.

There's "eh?" and "aboot" what else is there to know ?

 

 

 

poutine: the breakfast of champions.


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#19 IndyPoolPlayer

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Posted 18 August 2017 - 09:14 PM

I have no health coverage in retirement via my employer. If I had such an option, I would have not started this thread or wasted a lot of time reading about the HC marketplace.


Shame. I thought academia took care of their people better than that.
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#20 hegemony

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Posted 18 August 2017 - 09:16 PM

 

I have no health coverage in retirement via my employer. If I had such an option, I would have not started this thread or wasted a lot of time reading about the HC marketplace.


Shame. I thought academia took care of their people better than that.

 

 

in most large systems but not mine. no defined benefit, no health coverage... just like the majority of the private sector these days. oh, and as I've mentioned before no social security :lol:


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#21 swimmingwithsharks

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Posted 18 August 2017 - 09:17 PM

You know exactly how the health insurance market works.

 
no I don't. I know I'll need something before I qualify for medicare. I'm just trying to learn more so I can plan.
You find, read, and post dozens of financial news posts every day.
 
And you never read anything about health insurance?
the more I read the more confused I am. I just wanted to learn how others fill the gap between group plan via an employer and medicare.

You know exactly how the health insurance market works.

 
no I don't. I know I'll need something before I qualify for medicare. I'm just trying to learn more so I can plan.
 clipart-canadian-flag-2-a6bb.pngLike Hockey?
 
Vegas Golden Knights :lol:
 
the problem with Canada is I don't think I could learn the language.

There's "eh?" and "aboot" what else is there to know ?

The long o in pro-ject, for example.
And they call z by the name of zed.
Plus, it's cold most of the year
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