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Old 08-04-2013, 10:54 PM   #1
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Looking for some other opinions as I believe we are in some ways too emotionally invested to see as clearly as we might. And maybe confused, too.

I am retiring at end of this year.
We currently get health insurance thru my employer at ridiculously high cost but very good coverage. There was no way to save as the structure of my compensation was going to pay into the cost whether we took it or not.
When my employment ends, so will the coverage.
Now what to do:
My wife will still be working and we can get one of two policies thru her employer. One is a network plan that has very limited coverage for any thing out of network. In network it is pretty generous. BUT The network hospital is not well known to us, nor is it considered as any thing great...not aware that it is bad, but our current coverage allows us to go to the better places and ones we know better. I would have to change doctors and if anything goes wrong go to all new people I do not know. Furthermore this lack of any out of network coverage means a few other things. Our out of state college student will have Nothing covered while out of state. I am not even sure his college will allow him such bare bones coverage, which could mean an extra $300+ a month to buy the college plan. If any of us need a bone marrow or heart transplant (unlikely but still) that is totally not covered or in network, as it were. The cost is about $270 a month taken out of her paycheck.
The better coverage plan her work offers is so ludicrously priced it has to be there as just a prod to force everyone into the network coverage. $36,000 per year!!! Not going to happen. Period.
Wondering about not taking the work coverage at all and buying our own high deductible plan with out of network coverage. Can we do that? I think I correctly priced this at at the not unreasonable rate of about the same price as what her workplace wants for crap coverage. The private insurance would have higher deductible and co pays. But we do not currently use that much. Also the work place coverage is pre tax, so replacing that will be above what we would have to pay if we let her employer cover us. it seems to me the best idea is to reject her employer's crap coverage and get our own. Definitely if the college ends up requiring we buy him a separate policy... to me that is a no brainer if the new policy gets us out of that.
Am I seeing this correctly?
And is this how employers get out of having to pay anything at all for some employees health insurance?
Should I do any insurance purchasing thru ehealthinsurance or use an agent? (I know one thru work)

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Old 08-05-2013, 05:05 AM   #2
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You can continue with your current policy after you retire because of Cobra regs. There will be no subsidy, but if your family likes it and it covers your son at college that is an option. This is your choice and you can keep the policy for 18 months but must make the choice within 58 days of leaving your employer.

Beginning jan 1 you can buy a policy on the state exchange that will cover your entire family including away from home college son. You will have multiple PPO and HMO options, so you will probably find the policy that fits your needs. The policy options and prices should be available in the next month or so. Perfect time to retire.

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ehelathinsurace rates may be misleading....
Old 08-05-2013, 06:25 AM   #3
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ehelathinsurace rates may be misleading....


The price that you pay for insurance after Jan 1 may be different than what you see advertised on If you did not fill out the full health questionnaire, then you are likely looking at a heavily underwritten rate. That is to say that it assumes ideal health with no adverse health history.

After Jan 1, medical underwriting will no longer be allowed. That is to say that you no longer will pay extra for having health issues in your past (although rates can still be effected by age, smoking status, location and family size). All other things being equal, which of course they are not, the healthiest people's rates would need to rise to compensate for this, however older individuals may see an opposing effect in that the amount of discrimination for age will now be restricted to a maximum of 3:1 where before, in general, it was unlimited.

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Old 08-05-2013, 06:40 AM   #4
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COBRA. (continuing our current coverage) is very unappealing. As I mentioned it was "forced on us" such that even if we did not take it, I would save nothing and still have to pay for a policy somewhere else. It costs a ridiculous $18,000 a year!
My work coverage ends Nov 30, so the question becomes shall we just eat that $1500 for one month in December and the switch to one of the new policies? We are all very if not perfectly healthy.
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Old 08-05-2013, 06:44 AM   #5
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I find the whole health insurance subject incredibly frustrating. All working life had what I think was excellent insurance; when left local government could continue it indefinitely but at full freight cost; about $1,100 a month for DW and I. Pay $20 copay and $40 for specialists. Neither of us have ever had any significant health issues. That's all we've ever paid. My assumption is that since this is a group plan with over 3,000 folks, and the employer actually underwrites it and just pays United Healthcare to administer, it's probably a fairly priced plan for what you get.

That said, we likely could shop for some high deductible plan and save some money since we simply don't use it much, thankfully. However, I find it all so confusing that I prefer to just pay the price and sleep at night knowing that this plan takes good care of its employees and retirees from what I have experienced. I have this gnawing feeling that if we were able to save even hundreds of dollars a month that if something unusual happened some fine print would be brought up from a new marketplace plan that would deny us. Plus, we're now about 2-1/2 years away from Medicare so will just stick with it. I guess ours is a case of ignorance is bliss but OTOH staying with what you know and trust (at a price) has its comforts.
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