8 Replies Latest reply on Oct 6, 2011 12:34 AM by Geno

    Heath Insurance before age 65

    john_em

      I looked over the message board and did not find a discussion directly related to this, so I'll start one here.

      I am looking to retire this July.  I have adequate savings, plus a small pension, and a financial planner who has worked out how long my money will last given reasonable economic ups and downs.  Also, I bought a long term care policy, so I am covered for that.  My health is excellent.

      So, what's the problem?  Medical Insurance. I will be exactly 61 years old when I retire.

      Seems I miscalculated a little when I was planning before.  I investigated some of Kaiser's rates (my current provider), and found some monthly premiums as low as $231 for an individual, which is my case.  Great, I thought, I can pay that.  But then I realized that a plan like that has a $5000 deductible, and costs for visits could be $50, and prescription drugs are not covered.  It would not be anything at all like my current plan under covered employment, in which many services either have a $20 copay or are free. 

      Then there is also the cost of a dental plan, which I would also have to provide.

      So, how can one best understand and approach such a situation?  Are there experts who specialize in this kind of stuff?  My financial planner is great for funds and annuities, but I believe this would be out of his league.  I'd be interested to hear from others who have dealt with this situation, keeping in mind that everyone is a slightly different case. 

      Thank you for your suggestions.

       

        • Re: Heath Insurance before age 65
          john_em

          BTW, I did do some research - for example, a company like Kaiser may charge a copay of $50 for a service AFTER DEDUCTIBLE.  That doesn't tell you what the service costs before deductible.  I was able to google their real fees and got a PDF with about 7 pages and costs for procedures.  But still, an office visit could cost anything from $50 to $205, depending on the severity level.  Other fees are more precise; for example, colonoscopy is $654 if it includes tissue removal, and so on.  So it is possible to guess what a person will pay, sort of, per year, based on past experience. 

          I guess I could go around to all the other insurers and repeat the info gathering process.

          However, I still feel that I am not an expert in this area, and the knowledge that I could miss something important bothers me.  Where are the real experts? 

            • Re: Heath Insurance before age 65
              JerryD
              Before Medicare for me, we did a Blue Cross, $2500  deductible. We paid out of pocket for years on this. The spouse still uses it for a bit longer. Never saw need for dental after looking at premiums and payback. Same goes for glasses. Didn't have the Kaiser option that you have.

              A recent colonoscopy was closer to $4000+ for me so that figure seems outrageously low or fabulous if true. One thing to remember is that even if you have to pay due to deductible the costs are negotiated already and likely to be much cheaper than you could get.

              Compare a couple of plans from reputable providers. Get a reasonable deductible. Sign up and stay healthy for a couple more years.
                • Re: Heath Insurance before age 65
                  john_em

                  Thanks Jerry.  I did a comparison of different plans within Kaiser, who I am with now, but the individual plans.  Looks like when you factor in the deductible, and have a few of the standard visits every year, nothing out of the ordinary, the lowest I could get it would be about $4250 per year, including premiums (this is in southern California).  That's about $350 per month.  Right now I am paying zero for premiums, because it's paid through my employer, and the copays probably don't even amount to $150 per year, if that much.  So, big difference between covered employment and going on an individual plan. 

                  If I had a serious condition come up, though, it could be much worse.  Some things like hospital stay and surgery in one of these individual plans could be very costly, because they are percentages of the fee, not set copays.  That's scary.

                  The other scary thing is that the first group of consumers to get hit with premium increases will be the individuals.  They have no bargaining power, and their fees are likely to increase the most.  In the long run, being healthy is the best strategy, I guess.

                   

                    • Re: Heath Insurance before age 65
                      JerryD
                      John, looks like you did some research. I would look into Blue Cross also. We had their plans in IL and AR for an individual annual cost in the area you mentioned. As I recall though, I don't think that there is any percentage cost to you after we made the deductible.

                      Just one caution, we used some of those short-term policies that cover you for 6 months or so without going through underwriting. We didn't realize how worthless those can be if you have any serious problem. After the term expires you then have a preexisting condition and you are stuck for getting any affordable insurance. But one hint on preexisting conditions if they ever become an issue. The insurance company may try to make the condition excluded forever and may even try to exclude a whole set of conditions like both eyes if you only had a problem with one eye. Our experience is that these exclusions are negotiable. We got one eye covered and negotiated the exclusion on the other down to 3 years. Insurance companies can intimidate, just negotiate. We also found that it pays to go right up to the state department that regulates them. They have the last word.
                  • Re: Heath Insurance before age 65
                    Olive5018
                    John- I live in NY & am not old enough for Medicare, either. I was able to get a group rate through an art organization I belong to. You should check around for a group that you might be interested in joining in your area. Dues are sometimes very reasonable; my annual membership is $50. Many Chambers of Commerce have group Health plans available. That is not to say my insurance is cheap, but cheaper than whet I could get independently.
                    Good luck in your search.
                  • Re: Heath Insurance before age 65
                    Geno
                    Good Luck John , hope that works out for you.
                     
                    I have a another question, I'm eligible for Tricare Health (Military service) coverage and was wondering if it's worth taking over my current benefits through my employer. I guess my question does anyone have any cons for the Tricare system? My only Pro is that its one third the cost of my employer's.
                    thanks in advance.
                      • Re: Heath Insurance before age 65
                        JerryD
                        Geno said...
                        Good Luck John , hope that works out for you.
                         
                        I have a another question, I'm eligible for Tricare Health (Military service) coverage and was wondering if it's worth taking over my current benefits through my employer. I guess my question does anyone have any cons for the Tricare system? My only Pro is that its one third the cost of my employer's.
                        thanks in advance.
                        Geno, IMO you are on the right path. Look at the benefits, deductibles and premium cost. I find spreadsheets valuable.
                         
                        From your profile, you not appear eligible for Medicare. When you are I again recommend that you compare any employer and military options against Medicare with a good supplementary insurance (Medigap). For instance, I currently have a BCBS Medigap with no deductibles which covers all Medicare deductibles and some preventive care. It costs me about $230/month. No dental or glasses which I view as worthless for my health status. Of course drug coverage (Part D) is extra, but in good health the Humana/Wal-Mart plan is only about $200/year. That's hard to beat if you have any co-premium for the some pretty good coverage. One caution, our friends in Congress are trying very hard to eliminate options without some annual deductible, even with Medigap coverage. Let's say that they get that passed and it's about $500/year, just throw that cost into your spreadsheet analysis and make an informed decision. One good thing, I believe that once you are in a good Medigap plan, they can't eliminate it - it is grandfathered. Check this assumption when/if this passes.
                          • Re: Heath Insurance before age 65
                            Geno
                            Thanks Jerry, for the advice, Yes congress is getting it's way and raising the Tricare prime family rate to 520 premium for the year, but this is still a lot more pocket book friendly then the health care plans offered here at the university.  Also it looks like they may raise and give us military retires a COLA (cost of living)once again, so that will help too. No I'm not eligible for Medicare yet another nine years or so.. I' can wait...LOL
                            Thanks again, Geno