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Advice on private health insurance b4 age 65
Old 01-04-2012, 06:52 AM   #1
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Advice on private health insurance b4 age 65

I would like to retire at 62 and pretty much the only thing stopping me is health care for my wife and I. I know Medicare does not kick in before age 65 and I can't afford to continue the excellent health care plan offered by my company after I retire. My friend has Florida Blue Cross/Blue Shield but they do not cover pre-existing conditions which my wife has a few (I have none). Can anyone advise me on this? Do I have to work three more years just for health care coverage? Can anyone recommend an insurance company that I should get estimates from? Anyone have ballpark estimate of costs? I plan on living in St. Pete, FL. Thank you in advance for your time and expertise.
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Old 01-04-2012, 07:08 AM   #2
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Hi Dino1. Not much to update since this thread Advice on Private Health Insurance. The best way to get a realistic estimate of costs and coverage is by calling an agent. COBRA is the most reliable way to get a policy when preexisting conditions are a factor, and large group policy rates tend to be lower than other options, so if your rates are already too high your options may be limited.
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Old 01-04-2012, 09:07 AM   #3
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I would add that Fl BCBS is pretty expensive and not the best insurance. Shop around.
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Old 01-09-2012, 11:46 PM   #4
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Maybe you are only stuck for 18 months and then you can use COBRA for the next 18 months prior to Medicare at 65.

The COBRA may be quite expensive but at least it is guaranteed coverage. Maybe you can purchase a high deductible individual policy for yourself and leave your wife on COBRA.

I am 53 and DH is 62 and we have no pre-existing conditions. Our policy is a HDHP through Humana (Humana One) with an $11,900 family deductible and then 100% coverage. Our premium is $339 per month.

This is what I copied off the Humana website for the name of the plan:
HUMANAONE FL OPEN ACCESS HDHP PHP-R - Medical IAP

I highly recommend talking to a broker. I would give you the name and number of the one I used but his phone number is in the phone I dropped into Boca Ciega Bay. Using a broker costs you nothing.
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Old 01-10-2012, 07:37 AM   #5
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Originally Posted by 67walkon View Post
I would add that Fl BCBS is pretty expensive and not the best insurance. Shop around.
Here is a site that lets you compare ratings, BCBS does pretty well, for my county (clay) they are the highest rated PPO insurance company.

Compare Health Plans

TJ
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Old 01-18-2012, 11:58 PM   #6
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Originally Posted by Buckeye View Post
Maybe you are only stuck for 18 months and then you can use COBRA for the next 18 months prior to Medicare at 65.

The COBRA may be quite expensive but at least it is guaranteed coverage. Maybe you can purchase a high deductible individual policy for yourself and leave your wife on COBRA.

I am 53 and DH is 62 and we have no pre-existing conditions. Our policy is a HDHP through Humana (Humana One) with an $11,900 family deductible and then 100% coverage. Our premium is $339 per month.

This is what I copied off the Humana website for the name of the plan:
HUMANAONE FL OPEN ACCESS HDHP PHP-R - Medical IAP

I highly recommend talking to a broker. I would give you the name and number of the one I used but his phone number is in the phone I dropped into Boca Ciega Bay. Using a broker costs you nothing.
H1 has weird rules about their network in Florida...something about going outside their Florida network makes it an out of network claim....I don't recall exactly but I shied a few clients away moving there away from it and into another company. I'd look at United Health One.
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Old 01-21-2012, 04:56 PM   #7
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We have bcbs il, after being part of a megacorp plan, it was an eye opener as to how much it would cost.
We started out using COBRA for 1 year until I found out it was a high cost alternative, but less then the megacorp firee plan (a premium plan). We then found through a broker a plan that suited us UNICARE. My DW had an existing condition which was not covered for the 1st year. Then Unicare got out of the il market and we, were switched over to BCBS for about the same premium with annual physicals included (btw, large deductible). Each year we have had an increase in premium (10% or so). Last year they gave us the option of raising the deductible for a lower (same as previous year) premium for the next year. We did not take it. This year they offered the same thing and we took it. In retrospect, we should have taken it last year. We are in relatively good health so a large deductible makes sense for us.

Check out BCBS in your state for a quote. We are as satisfied as one can be under the circumstances. Buying insurance still is a pain.

Hope this helps.
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Old 01-21-2012, 09:10 PM   #8
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H1 has weird rules about their network in Florida...something about going outside their Florida network makes it an out of network claim....I don't recall exactly but I shied a few clients away moving there away from it and into another company. I'd look at United Health One.
Isn't that normal? Use an out-of-network provider, and your claim is treated as out-of-network. You must mean something else.

I don't receive a monthly statement from Humana, paper or email. Is that normal?

My January premium was a few dollars less than normal so I contacted them to see what was going on. They said they had neglected to charge me the $3+ "administrative fee." Are such charges normal? I have my premium automatically debited from my checking account each month.
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Old 01-22-2012, 08:25 AM   #9
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There are so many people I know in this situation. I can't help but think how much we could reduce unemployment if we could get health insurance severed from employment status. Or think about how much innovation and entrepreneurship could be unleashed if people felt like they could leave their Megacorp health insurance behind. It's sad.

If the recent health care reforms hold up, retirement in July 2012 should be pretty safe as you could take 18 months of COBRA and then the new laws will kick in which could help people with concerns about preexisting conditions and underwriting.
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Old 01-22-2012, 09:28 AM   #10
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There are so many people I know in this situation. I can't help but think how much we could reduce unemployment if we could get health insurance severed from employment status. Or think about how much innovation and entrepreneurship could be unleashed if people felt like they could leave their Megacorp health insurance behind. It's sad.
I know several people in the situation described above and we would be too if we were not in good health. I thank my lucky stars we have no pre-existing conditions. Of course, it's not all luck and one needs to make good choices but there is always genetics and maybe working in a job that is hard on one's health causing long term issues.

For those who are still slogging away and are in good health, I always make sure they are aware of the high deductible policies. Some people have never done the cost/benefit analysis of the premiums versus the high deductible. They are conditioned to wanting low co-pays and low out-of-pocket and not the total cost of the insurance.
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Old 01-25-2012, 05:22 AM   #11
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Hello Buckeye - please could you elaborate a bit on this point, maybe by providing a couple of examples ? I am not sure I understand what you mean. Thank you.
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For those who are still slogging away and are in good health, I always make sure they are aware of the high deductible policies. Some people have never done the cost/benefit analysis of the premiums versus the high deductible. They are conditioned to wanting low co-pays and low out-of-pocket and not the total cost of the insurance.
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Old 01-25-2012, 10:10 AM   #12
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Hello Buckeye - please could you elaborate a bit on this point, maybe by providing a couple of examples ? I am not sure I understand what you mean. Thank you.
My recommendation to check out a HDHP comes after a little probing about health status because the person must be able to purchase individual health insurance.

To answer your question (if I understood it correctly) - Based on comments I've prevously heard at work during open enrollment, employees focus heavily on the annual deductible of the health insurance options presented versus the total cost of their health insurance. That made sense when employees paid 0% of the policy premium but that's changing, even at megacorps.

At my previous job (final job?) at megacorp, for 2011 employees were responsible for 25% of the annual cost of the company's cost of their health insurance policy. I didn't find anyone who had analyzed the total cost of the HDHP (25% of lowest premium of the policy options, significant company contribution to HSA, higher deductible, equal copay after deductible) versus the "regular" insurance (25% of higher premium, no company contribution to HSA, lower deductible, equal copay after deductible). People immediately threw out the HDHP/HSA option because of the $1,500/$3,000 deductible or ignored it because they didn't understand how it worked.

People are also not doing these calculations to determine if they can afford individual insurance if they decide to quit working. HDHP's and their possible cost effectiveness are not even on folk's radar. If I hadn't done the HDHP analysis and had stuck to "regular" insurance options, I would still need to work.

For example, our current policy has an annual deductible of $11,900, 0% coinsurance and our monthly premiums are $339. If instead I purchased a plan with a $1000 annual deductible and 0% coinsurance our premium would be $1565 from United Healthcare (ran a scenario on ehealthinsurance). By self-insuring for the $11,900 deductible, our premiums are $1226 less per month ($14,712 annually). Because we are low consumers of healthcare and we have adequate financial reserves, this trade-off makes sense for us.

We chose such a high deductible because we currently have access to the VA which reduces our risk of having to pay the entire deductible. We also carry $100k medpay on our auto insurance since so many serious injuries come from car accidents. Maintaining a healthy lifestyle is another aspect of risk reduction and my husband is only a few years away from Medicare.

There can be a lot of moving parts to analyze at but it seems many people don't get beyond.........."Your deductible is HOW much?"

Did I answer your question?
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Old 01-25-2012, 10:49 AM   #13
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To answer your question (if I understood it correctly) - Based on comments I've prevously heard at work during open enrollment, employees focus heavily on the annual deductible of the health insurance options presented versus the total cost of their health insurance. That made sense when employees paid 0% of the policy premium but that's changing, even at megacorps.
My Megacorp actually did a pretty good job of explaining "total cost of health care" in their benefits seminars during open enrollment. They pointed out that you should consider all the costs -- premiums, deductibles, out of pocket limits and presence or absence of employer matches and incentives.

Our HSA-eligible plan costs us $170 a month for employee + spouse coverage. It has a $3000 deductible. The standard PPO has a $800 deductible and costs $320. Plus, our HSAs are given "seed money" in the form of a $1000 employer contribution (not a match, an outright contribution) if we choose that option.

So if we look at the premium costs plus what we pay until exhausting the deductible, with the standard PPO we'd pay $3840 in premium plus $800 to meet the deductible, for a total potential cost of $4640 before benefits kick in. With the HDHP/HSA, we pay $2040 a year in premiums plus $3000 in the deductible for $5040 total before benefits begin. But when you subtract out the $1000 employer contribution to the HSA, it's effectively $4640 (PPO) versus $4040 (HDHP/HSA). And if you have very few medical issues in a year, the HSA comes out even farther ahead.
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"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

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Old 01-25-2012, 12:13 PM   #14
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My Megacorp actually did a pretty good job of explaining "total cost of health care" in their benefits seminars during open enrollment. They pointed out that you should consider all the costs -- premiums, deductibles, out of pocket limits and presence or absence of employer matches and incentives.

Plus, our HSAs are given "seed money" in the form of a $1000 employer contribution (not a match, an outright contribution) if we choose that option.
It was unfortunate my local HR people were pretty clueless about HDHP's and HSA's. There was info in the big annual benefits booklet (now online) but I've never met another person who has read it.

My megacorp kicked $1500 into my HSA for an employee+spouse policy. Families with children received $2,000+ (can't remember exactly).
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