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Breast Cancer Survivor and ER
Old 01-13-2019, 11:04 AM   #1
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Breast Cancer Survivor and ER

Hi,

My wife wants to retire at 62 she is 60 now. We have what seems to be enough together in 401k savings to do it. I am 56, and out on the shutdown, contractor with no so great benefits.

Currently we are under her heath insurance, and it is possible I could get a better job that has good heath insurance or just switch to mine.

Question is because of her breast cancer 4 years ago, saving money is not an option, getting the most coverage is. Sounds correct right?

Cobra sounds better to be then ACA before medicare? I think she can only stay on cobra for 18 months. My getting a job with good heath benefits is a good solution, and hopefully works.

Question two is independent heath insurance possible with a breast cancer survivor, my thought was cobra would be cheaper then the former.

30 year count down is almost here.

thanks in advance.
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Old 01-13-2019, 11:16 AM   #2
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I would definitely do the cobra.
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Old 01-13-2019, 11:18 AM   #3
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Your wife's prior medical history will have no impact on either ACA or Cobra pricing (as of the current law). Pre-existing conditions are protected, both from coverage denials and from pricing scales.

COBRA, ymmv, but if her employer has cadillac insurance now, then continuing that with no changes to plans or docs can be an added benefit even if it's pricier that most anything else. Yes, cobra only lasts for 18 months (except CA has a longer version).

No one can guess what prices will be in 2 years, as they vary by market/state/county, etc. But health sherpa might be a good place to look for general planning.
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Old 01-13-2019, 12:13 PM   #4
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My wife had cancer 11 years ago, and she would be essentially uninsurable on private non ACA insurance. As a type II diabetic, I too would be uninsurable on private insurance. I am very thankful to have the ability to purchase healthcare thru my employer from age 58 ER until age 65 and going on Medicare with a supplement.

There are many workers that continue to work for insurance. The deductibles and co-pays on the ACA are simply debilitating to one's pocketbook.

Does your DW have the ability to purchase insurance through her company as part of retirement benefits?
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Old 01-13-2019, 12:22 PM   #5
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The ACA rates vary quite a bit depending what state AND county you live in.
Have you checked out Healthcare.gov and Healthsherpa.com for potential rates?
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Old 01-13-2019, 03:23 PM   #6
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Bamaman

No my DW can't keep Her insurance when she retires, and we don't think that will change. I think i always planned to work a little longer to cover the heath insurance.


Dtail
The ACA I have checked out but we are not going to get any gov subsidies. I am planning on about 15k for health insurance for every year we cover it ourselves.
The idea is to get the best coverage just incase. ACA seems to be the last resort.

Aerides
Still unsure ACA, may have excluded preconditions for private insurance but does not mean the rates could be out of sight. I thought it was more complicated than that.
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Old 01-13-2019, 03:54 PM   #7
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It really does depend on where you live and what her current insurance is like whether COBRA is best. I live in Massachusetts. The costs were similar Cobra cost more but ACA had higher deductibles and copays so it balanced out. The ACA plan was better because it had a less restricted network.

Research and list the doctors and hospitals you and she would want to see if her cancer recurs or if something new crops up. Find the ACA plan ( if it exists) that allows you to do this. Check her current plan.

Of course plans do change but you will figure out which ones are less restrictive. Be sure to read the fine print!
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Old 01-13-2019, 05:36 PM   #8
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COBRA is just continuing your insurance, for 18 months. It basically means you stay on your exact employer plan, just you pay 102% of the full cost.

ACA - there is no health check for enrollment. You are not asked if you have cancer or any current or former issues. You are priced based on your market and age, period. Someone next door to you in perfect health, at the same age, gets the same price for each plan. Yes, rates could still be high, but no worse because of her history.
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Old 01-13-2019, 09:10 PM   #9
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My wife is also undergoing current cancer treatment since 2015. I retired and kept her on Cobra for 18 months and then switched to ACA. Cobra costs were about 24000.00 per year for me and my wife. With ACA subsides due to controlling taxable income, we currently pay 0 for our health coverage with comparable ded and OOP max to the cobra coverage. This takes some planning and ability to control sources of income. I am now 10 months from medicare and she is 18 months out. Good luck and I hope you find what works best for you and your wife.

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Old 01-14-2019, 07:40 AM   #10
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So much depends on your wife's prognosis. Where is she in recovery? I was DX(diagnosed) in 2011, had MX, no chemo, no radiation. I see my oncologist once a year. It's a broad statement to say cancer DX. There are many types of cancer, slow growing, aggressive and in between. Was it in her lymph nodes? Did it metastasize? Treatment could be minor or major. What is the chance of it returning depending on the stage. We have ACA bronze, lowest on the totem pole and I am completely comfortable with it. $6K/$6K deductible and max out of pocket.
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Old 01-14-2019, 01:49 PM   #11
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Originally Posted by Rianne View Post
So much depends on your wife's prognosis. Where is she in recovery? I was DX(diagnosed) in 2011, had MX, no chemo, no radiation. I see my oncologist once a year. It's a broad statement to say cancer DX. There are many types of cancer, slow growing, aggressive and in between. Was it in her lymph nodes? Did it metastasize? Treatment could be minor or major. What is the chance of it returning depending on the stage. We have ACA bronze, lowest on the totem pole and I am completely comfortable with it. $6K/$6K deductible and max out of pocket.
She finished chemo, and seems to be ok. I just think ACA would not make sense for her/us.
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Old 01-14-2019, 03:48 PM   #12
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Originally Posted by 30yeardraw View Post
She finished chemo, and seems to be ok. I just think ACA would not make sense for her/us.
Then she has no choice but to stay working, on employer insurance, until she is at least 63.5, and then fund cobra for the 18 months until she is eligible for medicare.

The only other options for private insurance, off the ACA, are plans where the provider can limit coverage, and come (currently) without many of the protections.

Since you have plenty of time, she should be doing the research to see what options are best for her situation, understanding of course that much can change year to year in the available providers for your state/county.
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Old 01-14-2019, 05:39 PM   #13
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It sounds like you may have the misconception that one would only signup for an ACA plan if you were to receive a premium subsidy. This is incorrect. If your MAGI is greater than 400% of FPL, it is true that you won’t get a subsidy, however you will still benefit from no pre existing condition discrimination and the other 100% covered wellness services such as annual physicals, flu shots, women’s health including mammography. You might not get these services with a private plan.

I suggest you search to see what ACA plans are available for you current physicians, hospitals & specialists. Then compare those plans to the private & cobra. Assume no subsidy and be sure to compare co-pays and out of pocket max amounts as well. You may be surprised

One other benefit of an ACA plan even with no subsidy, if your income should decrease during the year ( unplanned) and you end up below 400% FPL, you’ll get a refund of at least some of your premiums paid on your 1040. If you’re on a private plan and have the same income drop there is no rebate of premium (but they might send you a calendar).

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Old 01-14-2019, 06:12 PM   #14
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Here is a prior thread on comparing the costs of health care plans. See post #85 for a excel spreadsheet, created by Animorph, that you can download to help compare plans. I use it every year during open enrollment to make sure I'm getting the best priced plan for my family and our current health care needs.

Bronze, Silver and Coinsurance/Copay
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Old 01-14-2019, 09:26 PM   #15
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Having good, comprehensive insurance, that is accepted by major cancer hospitals, especially the one of your choice, is key.


My last job had horrific insurance. Not only did it have a high deductible, it was not universally accepted. One of my co-workers came down with cancer, and one of the most well known NYC cancer hospitals did not take the insurance.
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