Health Insurance Question -- What Would You Do?

[sunsnow]

As DH and I approach ER (planned date for me is 3/2014), it is starting to become clear to me that DH actually likes working and isn't planning to retire. I, on the other hand, am more than ready. We are a long way from Medicare (I'm 40, he's 41), and so my plan had been to get health insurance for both of us before Oct, when the new plans will get a lot more expensive (I am guessing), due to the changes in the healthcare law that will be taking effect next year. We applied, and got back an offer to insure us both for around $300/month. That's pretty reasonable, but I am starting to have second thoughts. DH is currently self-employed, and covered on my employee policy. But it looks really likely that he will be taking a normal j*b, which will have good health benefits. If he does that, we'd be wasting a bunch of money for who knows how long on extra premiums by getting our own insurance too. On the other hand, if he doesn't like the job and quits then we'd be glad for the cheap policy -- providing that the policy still exists when we need it, and we are not somehow forced into the expensive policies, despite this planning. There's no way to know for sure, but my guess is that he will keep this job for at least 2 years. I really don't know what is the best course of action. So, please, what would you do? Thanks!

[heeyy_joe]

Stay on employers plan.

[gerrym51]

Quote:

Originally Posted by sunsnow As DH and I approach ER (planned date for me is 3/2014), it is starting to become clear to me that DH actually likes working and isn't planning to retire. I, on the other hand, am more than ready. We are a long way from Medicare (I'm 40, he's 41), and so my plan had been to get health insurance for both of us before Oct, when the new plans will get a lot more expensive (I am guessing), due to the changes in the healthcare law that will be taking effect next year. We applied, and got back an offer to insure us both for around $300/month. That's pretty reasonable, but I am starting to have second thoughts. DH is currently self-employed, and covered on my employee policy. But it looks really likely that he will be taking a normal j*b, which will have good health benefits. If he does that, we'd be wasting a bunch of money for who knows how long on extra premiums by getting our own insurance too. On the other hand, if he doesn't like the job and quits then we'd be glad for the cheap policy -- providing that the policy still exists when we need it, and we are not somehow forced into the expensive policies, despite this planning. There's no way to know for sure, but my guess is that he will keep this job for at least 2 years. I really don't know what is the best course of action. So, please, what would you do? Thanks!

you do realize that most likely after jan1 you would not be allowed to keep this plan anyways does it conform to all the ppaca requirements

[Mulligan]

Sunsnow, if I understand your health insurance situation correctly, buying insurance now in the open market will not protect you from the new coming rates. You are not grandfathered on a "grandfathered plan". The rate you would get now will only be good until next year, then you would be put automatically into the exchange.

[donheff]

+1 to the other comments explaining that the changes in the ACA will effect you whether you purchase a plan now or wait. But look on the bright side. At least you know you can get a health care plan. One of the biggest disincentives to ER until now has been the fear of being denied coverage for any number of reasons. At least you can put that fear aside and just focus on the fear that health care is expensive.

[Mulligan]

Quote:

Originally Posted by donheff +1 to the other comments explaining that the changes in the ACA will effect you whether you purchase a plan now or wait. But look on the bright side. At least you know you can get a health care plan. One of the biggest disincentives to ER until now has been the fear of being denied coverage for any number of reasons. At least you can put that fear aside and just focus on the fear that health care is expensive.

Sunshow's question brings up a thought that keeps hitting me. Although we always discuss the people who can't get insurance and their benefit from implementation of healthcare act, I think there is another group going to get hit with a nasty surprise and are currently clueless about it. Obviously Sunshow is very intelligent, but Sun was not aware of the "grandfather" clause. One of my best friends just last week who is a manager was asking me about getting a cheap policy on ehealthinsurance , unaware it becomes useless next year.
I was one of these, and I bet there are many more. This being, people who had company paid health insurance, unaware of its costs. Then retire early healthy and get on an underwritten plan with cheap rates. They have to be clueless to the possible rate jump they might increase next year
when their plan is nullified.

[sunsnow]

Thank you so much for the comments. I had no idea that all existing policies would be affected by the new requirements. From reading about the grandfathered plans, it sounded to me like if the plan had been in effect since March 2010, they could apply for that status. However, after reading your comments, I contacted the health insurance company and they verified what you all said -- those plans will all be changing big time. I am really glad I posted this question. Again, thanks so much for the very helpful advice.

Mulligan -- I think you are right, health insurance rates in 2014 are going to be a big, nasty surprise for a bunch of people. Many of us who are fully retired will qualify for the subsidies, but being partially retired is going to be tough for a lot of us.

[gerrym51]

Quote:

Originally Posted by sunsnow Thank you so much for the comments. I had no idea that all existing policies would be affected by the new requirements. From reading about the grandfathered plans, it sounded to me like if the plan had been in effect since March 2010, they could apply for that status. However, after reading your comments, I contacted the health insurance company and they verified what you all said -- those plans will all be changing big time. I am really glad I posted this question. Again, thanks so much for the very helpful advice. Mulligan -- I think you are right, health insurance rates in 2014 are going to be a big, nasty surprise for a bunch of people. Many of us who are fully retired will qualify for the subsidies, but being partially retired is going to be tough for a lot of us.

i guess the hubby will be sticking with his job

[Katsmeow]

Quote:

Originally Posted by heeyy_joe Stay on employers plan.

I don't think there is an employers' plan for her to currently stay on unless she doesn't retire. As I read it, her DH is currently self-employed and insured on her plan at her employer. But, she plans to retire so they will need coverage (she didn't say anything about COBRA options so don't know about it). She thinks that DH will probably get a job that will have health insurance which she could presumably be covered under. However, I gather that she is just supposing this could happen and that it hasn't yet happened.

Assuming all the above, I guess I would take a multi-prong attack. If you retire, then find out about Cobra and the cost and also determine your cost for an individual policy. Then do whichever one is your best choice. If your DH later gets a job with health insurance then you and he can decide whether you want to be insured under that policy or not or to keep the individual policy you bought or to keep COBRA for however long you can keep it.

[H2ODude]

Hmmm. This discussion has me thinking. When I left my local government job, I could keep it indefinitely (Cobra only forever) but I do have to pay full freight; $1,100/month for DW and me. We're 62, so it seems like a reasonable bridge til Medicare. I have never shopped around, having had good experience with this plan for 15 years. We're both thankfully very healthy, I'm sure we could do something cheaper, but it would always seem at risk. The local government self funds the liabilities, but by observation of other's experience it was always more than fair. They have somewhat of a good attitude towards their retirees; I feel like if I ran into a problem I'd have a lot better chance dealing with them than some independent carrier who would choose to interpret strictly to their benefit.

All that said, I've assumed that with the advent of ACA the full freight cost may rise, but not horribly. It rose ~10% last year. Given that I really have "employer provided" health insurance (that I pay full cost of) is it likely to experience any shocking increases over the next three years? Thanks....

[gerrym51]

Quote:

Originally Posted by H2ODude Hmmm. This discussion has me thinking. When I left my local government job, I could keep it indefinitely (Cobra only forever) but I do have to pay full freight; $1,100/month for DW and me. We're 62, so it seems like a reasonable bridge til Medicare. I have never shopped around, having had good experience with this plan for 15 years. We're both thankfully very healthy, I'm sure we could do something cheaper, but it would always seem at risk. The local government self funds the liabilities, but by observation of other's experience it was always more than fair. They have somewhat of a good attitude towards their retirees; I feel like if I ran into a problem I'd have a lot better chance dealing with them than some independent carrier who would choose to interpret strictly to their benefit. All that said, I've assumed that with the advent of ACA the full freight cost may rise, but not horribly. It rose ~10% last year. Given that I really have "employer provided" health insurance (that I pay full cost of) is it likely to experience any shocking increases over the next three years? Thanks....

PPACA subsidies can only be gotten if you purchase thru an exchange so i guess it depends on your income.

[MichaelB]

Quote:

Originally Posted by H2ODude All that said, I've assumed that with the advent of ACA the full freight cost may rise, but not horribly. It rose ~10% last year. Given that I really have "employer provided" health insurance (that I pay full cost of) is it likely to experience any shocking increases over the next three years? Thanks....

Healthcare insurance has doubled over the past decade, so it is likely to increase again next year, but this should not be driven by PPACA related regs, which should be mostly implemented already for large group policies. Any increase would probably be along the national average - large group policies have more stable and competitive pricing.

[gfdenver]

99.8% Perspective..as of today.. Colorado as Example

Jan 1, 2014 Mandatory Health Care Policies in effect

Children 26yrs and under: insured on parents health care policies still remain

All states fall into 3 categories: Decision made per state by Dec 2012

A/ State Health Benefit Exchanges
B/ Federal Exchanges
C/ State and Federal Partnerships

Oct 1, 2013--March 31,2014 Can apply for health insurance policies/
exchanges

Support legistated assistance will be available on internet/by telephone/person to person to help with enrollments and answer questions

Thereafter(2014): sign up and applications will be Oct 15----Dec 7 and go into effect starting the following Jan 1

COLORADO AS EXAMPLE::

Health Insurance Policies will be dependent on:

A/ age
B/ location
C/ family size and income (subsidies availablefor state exchanges)
D/ smoker vs nonsmoker

Health Policies will fall into 4 tiers of coverage::

BRONZE,SILVER,GOLD,PLATINUM Based on acturial value (what
insurance pays vs what you pay ) 60%--70%--80%--90%

Thier is a 5th for Catastrophic for age 30yrs and under

If you are "not" covered by an employer sponsored health care policy..If you are "not" covered under medicaid/medicare..you can apply for a private health care policy or a state health benefit exchange...State Health Benefit Exchanges have subsidies (based on income/family size)

You will research evaluate and receive information (internet-phone-person to person etc.) and fill out basic form-application...Insurance broke/state representative will review and assist--If eligible for subsidies (family size--$income) broker will adjust and new premium will be reflected on your monthly bill..passed on to consumer up front...
End of year IRS W-2 and tax forms will demonstrate documentation and settle out if any adjustments were needed to be made..

REMEMBER NO ONE CAN BE TURNED DOWN--SUBSIDIES--
NO PRE-CONDITIONS

FYI: I recently retired Feb 6 and currently on COBRA...I pay a monthly premium of $685.90...I have an HRA account through my previous employer who is paying for 15 months..I then will have to pay 3 mo COBRA in addition to 5 mo health insurance policy until I am eligible for Medicare at 65yrs (3/15)..((note:: I was turned down for a health care policy for a begning polyp 10/12 colonoscopy Kaiser..??))
I plan to apply for a Health Benefit Exchange with the state of Colorado

1st time posted...Hope this helps..Info might change but this gives preliminary workings and needed information...

PEACE nlv

[Notmuchlonger]

Pray

[gfdenver]

corrected spelling


benign polyp

[heeyy_joe]

Quote:

Originally Posted by Katsmeow I don't think there is an employers' plan for her to currently stay on unless she doesn't retire. As I read it, her DH is currently self-employed and insured on her plan at her employer. But, she plans to retire so they will need coverage (she didn't say anything about COBRA options so don't know about it). She thinks that DH will probably get a job that will have health insurance which she could presumably be covered under. However, I gather that she is just supposing this could happen and that it hasn't yet happened. Assuming all the above, I guess I would take a multi-prong attack. If you retire, then find out about Cobra and the cost and also determine your cost for an individual policy. Then do whichever one is your best choice. If your DH later gets a job with health insurance then you and he can decide whether you want to be insured under that policy or not or to keep the individual policy you bought or to keep COBRA for however long you can keep it.

OP wrote:
But it looks really likely that he will be taking a normal j*b, which will have good health benefits.

My advice again - stay on employer's plan.

[Katsmeow]

Quote:

Originally Posted by heeyy_joe OP wrote: But it looks really likely that he will be taking a normal j*b, which will have good health benefits. My advice again - stay on employer's plan.

The operative words that I was pointing out are "likely that he will be taking..." which seems to imply that he has not yet taken the job and does not have have the good health benefits. Therefore, there is not yet an employer's plan for her to stay on. Stay implies that there is a plan she is already on. The point is that, yes, getting on such a plan might end up being the best thing to do. But, if she retires before he obtains that job and gets on that plan then she will have find some other way of getting coverage in the meantime.

[H2ODude]

Access to healthcare is such a big deal. I know one good friend who wants to retire but will wait til 65 because of a heart attack years ago, he cannot find anything to cover in the meantime. We were really fortunate that when I left my long term employer they said I could re-enroll at any time. I went full time with a private firm that had good insurance at reasonable cost, so I dropped the original. When I got fed up with w*rk I was able to just sign back up. Not cheap (well, maybe it is given the coverage; no deductibles and $20 and $40 copays) but it's a plan I know and have confidence in.

I remember as a kid visiting my grandparents who were big devotees of Lawrence Welk, which got watched every Saturday night. I recall the Geritol commercials that always ended with the tag line "when you've got your health, you've got everything." Or something like that. Lot of truth in that. Whether it's "health" or "health insurance."

[obgyn65]

But your friend could retire now and get COBRA until January 1, 2014, correct?

Quote:

Originally Posted by H2ODude Access to healthcare is such a big deal. I know one good friend who wants to retire but will wait til 65 because of a heart attack years ago, he cannot find anything to cover in the meantime. We were really fortunate that when I left my long term employer they said I could re-enroll at any time. I went full time with a private firm that had good insurance at reasonable cost, so I dropped the original. When I got fed up with w*rk I was able to just sign back up. Not cheap (well, maybe it is given the coverage; no deductibles and $20 and $40 copays) but it's a plan I know and have confidence in. I remember as a kid visiting my grandparents who were big devotees of Lawrence Welk, which got watched every Saturday night. I recall the Geritol commercials that always ended with the tag line "when you've got your health, you've got everything." Or something like that. Lot of truth in that. Whether it's "health" or "health insurance."

[H2ODude]

Quote:

Originally Posted by obgyn65 But your friend could retire now and get COBRA until January 1, 2014, correct?

I think he will do that but I incorrectly said waiting until 65, I think he will do the cobra when he's 24 month's from that.