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Ouch
Old 03-15-2006, 12:48 PM   #1
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Ouch

I'm 54 and plan to RE in 2 years.* The largest financial obstacle I have to deal with is health insurance for my wife and me.* Other than my slightly high BP and high cholesterol (both under control with generics), we are in good health.* COBRA from my current employer is $715 a month for an Aetna HMO.* My company has a retiree medical program, but I just found out the monthly premium for us would be $1300. * I figure I'll stay with COBRA initially and look around for an individual policy.* I know about HIPAA and conversion policies, but getting info for budgeting purposes is tough.* In FL, where I will be living, you can get a conversion policy but it can't be more than 200% of the cost of a "regular" policy if you have preexisting conditions.* Aetna has a Point of Service individual HSA policy for $408, so I figure worst case I'll be paying $816 for a $5000 deductible policy and footing the bill for the meds and routine visits.* From a budget perspective, I'm planning on around $11-$12K a year.* I can also get group insurance from my school's alumni association but I haven't gotten prices or details yet.

BTW, moving to another country is not an option.* I'm not really looking for advice, but thought I'd share some of the harsh realities that face someone who plans to RE in the US.* However, anyone with any suggestions, will not be ignored. .* Universal health care would sure be nice.......

I'll post here as I find out more.
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Re: Ouch
Old 03-15-2006, 12:58 PM   #2
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Re: Ouch

If you take the HSA and pay for your own meds, last time I checked Costco Pharmacy had the cheapest prices for most prescriptions.
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Re: Ouch
Old 03-15-2006, 01:05 PM   #3
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Re: Ouch

Quote:
Originally Posted by Cute 'n Fuzzy Bunny
If you take the HSA and pay for your own meds, last time I checked Costco Pharmacy had the cheapest prices for most prescriptions.
Often Wal-Mart is similar. I had to get 40 generic cephalosporin caps. I called 3 pharmacies-- 1 national chain, 1 local pharmacy, and 1 regional chain. Price range was $42-$46. Then I called Wal-Mart: $14.95. The Costco is farther than I wanted to drive, so Wal-Mart won.

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Re: Ouch
Old 03-15-2006, 01:58 PM   #4
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Re: Ouch

I know what you mean. DH and I (54 & 51) pay $989 per month for our health ins. We stayed with his old workplace since it is fantastic ins. We've looked into HSAs but haven't made the leap yet.

Good luck.
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Re: Ouch
Old 03-15-2006, 02:14 PM   #5
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Re: Ouch

tomz and kz
the figures sound about right. health care is very expensive in the States, but if you don't have insurance and actually do need the care, the cost is exhorbitant.
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Re: Ouch
Old 03-15-2006, 02:18 PM   #6
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Re: Ouch

tomz, health care costs are the only thing keeping me working right now.
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Re: Ouch
Old 03-15-2006, 02:39 PM   #7
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Re: Ouch

AARP looks like they have some decent plans. Anyone out there familiar with any of the AARP medical insurance plans?
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Re: Ouch
Old 03-15-2006, 02:52 PM   #8
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Re: Ouch

We live in a pretty high COL state, CA. Our offer (outside of Cobra) upon termination of employment was a group plan, basically a group of all the past and present retiree's through Kaiser. The coverage is very good, and extremely comprehensive, with the caveat that it is only good IN CA. The only out of pocket is Dr. Visits are $15, and 100 days worth of Perscriptions is $10.

We'll be paying about $750 per month, which includes separate additional plans for Dental and Vision. Seems like a reasonable expense to us.
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Re: Ouch
Old 03-15-2006, 03:36 PM   #9
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Re: Ouch

Quote:
Originally Posted by JonnyM
The coverage is very good, and extremely comprehensive, with the caveat that it is only good IN CA. The only out of pocket is Dr. Visits are $15, and 100 days worth of Perscriptions is $10.

What do you do when you travel? Do they cover emergency care?
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Re: Ouch
Old 03-15-2006, 05:14 PM   #10
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Re: Ouch

My DW and I have been self employed for over 8 years and our biggest single expense was health insurance premiums. When we decided to ER we changed from comprehensive coverage to a major medical (hospital only, no doc visits or meds) plan and pay $385 per month for both of us. My wife takes meds that we buy through a Canadian online pharmacy.

I think that the US health care system is a disgrace and we should have a universal, single payer system.
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Re: Ouch
Old 03-15-2006, 07:12 PM   #11
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Re: Ouch

Quote:
Originally Posted by Cute 'n Fuzzy Bunny
If you take the HSA and pay for your own meds, last time I checked Costco Pharmacy had the cheapest prices for most prescriptions.
Has anyone done any research, or have any informed opinions, about how wise it is to forego prescription coverage? I've seen that some of the cancer drugs can run into the mid 5 figures.

If you had a choice between paying $11K / year for a plan with prescription coverage and $6K for a plan with very limited prescription coverage, what would you do?
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Re: Ouch
Old 03-15-2006, 07:15 PM   #12
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Re: Ouch

3 Yrs to Go:

Nobody can really answer your question - How much medical coverage is enough ?

It is only really worth it if and when you really need it. If you need the coverage then yes it's worth it. If you don't then no it's not.

Can you ever have enough medical coverage ?
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Re: Ouch
Old 03-15-2006, 11:11 PM   #13
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Re: Ouch

Yep, thats a loaded question. If something "bad" happens that requires a lot of expensive prescription meds, clearly you'll be screwed without prescription coverage.

I would suspect that the majority of people come out at the end on the plus side without the coverage. But god help you if you're one of the ones that dont.

I'd do it given that i'm in my mid 40's, that my dad hasnt taken any sustained prescription meds in 73 years, and his dad never did. Even though my wife takes some asthma drugs, they'd cost us about 1/10th to buy out of pocket and go without prescriptions on a health plan than to buy one with meds.

If I was in my 50's, taking a couple of meds regularly that dont have generics, and had a family history of needing a lot of meds in the last 20-30 years of life...maybe a different story. :/

Considering a lot of the pill pushing is marginal, and it seems like every year a couple of formerly harmless meds are found to be more problematic than the 'solution' they provided, maybe having to incorporate a financial decision into the process isnt such a bad idea...
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Re: Ouch
Old 03-15-2006, 11:32 PM   #14
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Re: Ouch

This was interesting...
http://www.kktv.com/news/features/6/519552.html

Not sure when it was written, as I didnt see a date although it was probably right in front of my face.

The "ask about the cash price" is good advice. I was prescribed a steroid cream for poison oak ("What the heck is that nasty vine wrapped around that tree? I think I'll cut it down wearing only a pair of shorts and sneakers, then cut it up, then grab big wads of it and stuff them into the trash can.") When I went to pick it up, the pharmacist asked if I wanted to put it on my insurance or pay cash for it. I asked why the heck I'd want to pay cash. "Because your co-pay is $20 and the cream is only $6....".

He got all my (limited) pharmacy business after that...
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Re: Ouch
Old 03-16-2006, 06:08 AM   #15
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Re: Ouch

I have been a nurse for many years and you need to be an informed consumer about medications.
Many health insurance plans cover meds on different tiers. As a consumer, you can ask the MD to order an older med first to see if it works before you get the expensive new stuff. Call around to pharmacies as mentioned above. Some plans also allow you to get mail order of monthly meds for a much reduced price.
Physicians are bombarded by drug companies. They often are rewarded for prescribing the latest and greatest, and many people want what they see on TV- images of a beautiful woman with long flowing hair running through a field of flowers sells a lot of drugs.
Most important is to see if you can manage you blood pressure and cholesterol and similar problems through diet and exercise. If you need diabetic or thyroid med for instance, you obviously only can't control it only by healthful living but it can't hurt.
My elderly in laws were each on a bagful of meds. When their old MD retired, they went to a new MD and they came off over half the meds and have done just fine- late 80's and still kicking.
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Re: Ouch
Old 03-16-2006, 08:20 AM   #16
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Re: Ouch

Quote:
Originally Posted by Cute 'n Fuzzy Bunny
The "ask about the cash price" is good advice. I was prescribed a steroid cream for poison oak ("What the heck is that nasty vine wrapped around that tree? I think I'll cut it down wearing only a pair of shorts and sneakers, then cut it up, then grab big wads of it and stuff them into the trash can.") When I went to pick it up, the pharmacist asked if I wanted to put it on my insurance or pay cash for it. I asked why the heck I'd want to pay cash. "Because your co-pay is $20 and the cream is only $6....".
We have great employer-provided prescription drug coverage. But lately, we have bought most of our prescriptions at the retail price at Walmart simply because it is cheaper than running it through insurance and paying the copay.

I get one medication and it is $25 for 3 months for cash. If you use insurance, you can only get 1 month at a time, and my copay is $10 per month. Obviously, the 3 month price is a better deal and more convenient.

Wife gets prescription prenatal vitamins for $2.xx per month's supply - less than her $5 generic copay.

Granted, we don't take any of the fancy expensive meds (yet!).

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Re: Ouch
Old 03-16-2006, 08:21 AM   #17
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Re: Ouch

Quote:
Originally Posted by shorttimer
Most important is to see if you can manage you blood pressure and cholesterol and similar problems through diet and exercise. If you need diabetic or thyroid med for instance, you obviously only can't control it only by healthful living but it can't hurt.
I have been on a low-sodium, low fat diet for 20 years.* I exercise daily and my weight has been more or less the same during those 20 years.* Unfortunately, for me, I have high bp and high cholesterol.* It's in the genes.* Father had it, brothers all have it.* My doctor started me on Lipitor for the cholesterol.* After 6 months, my cholesterol levels were great, but I felt like crap.* I went off it for 6 months and reduced fat in my diet even more and increased the exercise.* I felt great, but the cholesterol went up again.* Now I'm on Lovastatin - a generic.* The numbers are good and it costs half of what Lipitor used to cost.* Side effects are minimal.* BP was controlled by diet and exercise until I hit 50.* Lifestyle and diet hadn't changed, but BP went up.* I now take a generic diuretic and a generic beta blocker.* BP is no longer high.* I have insurance and the monthly cost for all of these is around $35.* Without insurance buying online, the cost would be about the same.

For some of us, lifestyle changes only go so far. * When I started researching the costs for these meds, I was surprised at the differences in costs depending on where you buy.

Quote:
Originally Posted by Cute 'n Fuzzy Bunny
The above article rang true.* *Drug prices in this country are all over the place.* Before I started thinking about RE, I just took my prescription to the local drugstore.* I have a $25 copay so I didn't care how much the stuff really cost.* Now that I am considering an insurance plan without drug coverage, I am really more aware of cost, generic vs name brand, etc.* *It's tough getting old.....

Tom
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Re: Ouch
Old 03-16-2006, 10:08 AM   #18
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Re: Ouch

As a result of drugs, I ran through a lot of fields with beautiful women...at least I think I did. Maybe they were fields of long flowing hair...

On the old MD retiring, same thing happened to my wife...her old doctor retired and it turns out the half dozen "old school" drugs she was getting for asthma and allergies were replaceable by a single newer product that worked better. Those guys are in and out of the examining room in 3.2 minutes and I'll bet most of them dont check to see what you're regimen is on a regular basis...

Mail order is a good option and reminds me of something I forgot...if you're a Blue Cross subscriber, you can get TWO months of meds for a single co-pay if you use Blue Cross's "precisionRX" mail order facility. You have to open an account with them and fax your doctor a precisionrx prescription form, they fill that out and change the prescription to a two month supply, and after that you can refill by clicking on the med on the precisionrx site. Takes about 3-5 days for the meds to arrive.

Thats a couple of hundred bucks a year for someone thats taking two meds regularly.
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Re: Ouch
Old 03-16-2006, 12:22 PM   #19
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Re: Ouch

Quote:
Originally Posted by Martha
What do you do when you travel? Do they cover emergency care?
If I was hauled into an emergency room "Out Of Area" the co-pay is $50
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