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Individual health insurance in ER question
Old 08-29-2012, 12:58 PM   #1
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Individual health insurance in ER question

Do you buy private health insurance in ER? If so, has the cost of your insurance coverage gone up every year? By what percentage? And does the increase in insurance cost correlate with your health statistics? i.e., if your blood pressure, or cholesterol is high, your premium seems to go up significantly the following year?

I need to buy health insurance on the open market and this is the only uncertainty left between me and ER. Please share your knowledge on this topic. Thank you so much!

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Old 08-29-2012, 01:26 PM   #2
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This topic has likely been covered in other threads. But you've hooked me so I'll reply with information that was helpful to me and DW when we made our decision to FIRE about a year ago.

For us the easiest way to see if we could find coverage that would work for us was to check www.ehealthinsurance.com you don't have to enter any personal information except your age(s) and zip code to see what type of coverage may be available in your area. By the way, we found there are lots of options for our state - various types of plans... HMO, PPO, HSA, etc and a variety of price points. But we were surprised to find that is not true for all locations.

After a visit to ehealthinsurance we contacted a local insurance agent that sells a variety of plans. He offered the same options and plans that we found online and the price was exactly the same so we "applied" under two different providers. We had a feeling who we would like better but we applied to two in order to understand the process and see if there were different approaches to what they would cover and what they might add a "rider" to. In the end, we went with the provider that we originally liked and they also had the least number of invasive questions and did not stick us with any riders.

To supplement the selection process we subscribed to the online Consumer Reports (Health) data. We signed-up for the year but then cancelled after a few months to receive a pro-rated refund. Subscribing allowed us to see the CR comments about procedures, plans, providers so we could make an educated decision.

In the end, our high deductible HSA plan is relatively affordable for us. It's much lower in monthly premium than the plan offered to retirees through my former employer. However, the deductible is $10k (vs. $5k from the employer).

We received a 10% increase in premium recently simply due to our ages increasing. We expected this. We planned/budgeted for 12% annual incrases so we're good for now.
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Old 08-29-2012, 01:30 PM   #3
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You may want to start on this link:

(FAQ archive) Buying Private Health Insurance

Much of this is currently subject to change in 2014.
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Old 08-29-2012, 02:02 PM   #4
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Thank you Nvestysly and Ziggy for this information.
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Old 08-29-2012, 05:16 PM   #5
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My experience was similar to Nvestysly. I looked at premiums from numerous providers for high deductible and the deductible was about twice when I was employed. We bought health insurance for two main reasons: 1) to avoid financial ruin if one of us were to have a major illness and 2) to gain access to negotiated rates for medical services.

I found small group premiums through the local Chamber of Commerce to be about 25% less than individual plans with similar benefits, so I formed a LLC for any consulting that I might do, joined the Chamber (cost $100/yr) and then signed up for their small group plan (one employee - me with spouse coverage).

So far so good.
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Old 08-29-2012, 06:29 PM   #6
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I retired in 2006 and got a family plan with Aetna (5000 ded.). The cost was $336. per month. Now the same plan is just under $1100. per month. So, yes expect the rate to up....
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Old 08-29-2012, 06:52 PM   #7
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Just received BCBS increase of 9% today, in 2008 $416 a month to now $768. PPO $2500 deductible 2 adults, underwritten policy no exclusions.
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Old 08-29-2012, 07:48 PM   #8
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Bought by private insurance when I retired, June 2010. No riders, got best quoted rate from ehealthinsurance. It is BC/BS Anthem Lumenous plan with $5500 deductible. Premium started out at $73 a month. In 2011, it dropped into the low 60's for some odd reason that they never mentioned. It went to $71 in Jan. 2012, and when second anniversary occurred June 2012, it went to $76 a month. Not too bad for 2 plus years. Now they added some deal that if I stay below my deductible 3 years in a row, they will pay the first $3000 of my first claim that meets my deductible. I certainly cant complain about mine.
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Old 08-29-2012, 07:54 PM   #9
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Btw, Retire 2014. If you do go the high deductible route, make sure you set up an HSA with it and get the tax deduction benefit. I have 2 thick headed Neanderthal brained friends who have high deductible plans and wont set up an HSA, because they cant pay attention long enough to understand why they need to.
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Old 08-29-2012, 08:20 PM   #10
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High-deductible ($11,900) with Humana in Tampa Bay area of FL. $339 in 2011. $375 in 2012. Ages 53/63. No pre-existing.
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Old 08-29-2012, 09:08 PM   #11
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Quote:
Originally Posted by Retire2014 View Post
Do you buy private health insurance in ER? If so, has the cost of your insurance coverage gone up every year? By what percentage? And does the increase in insurance cost correlate with your health statistics? i.e., if your blood pressure, or cholesterol is high, your premium seems to go up significantly the following year?

I need to buy health insurance on the open market and this is the only uncertainty left between me and ER. Please share your knowledge on this topic. Thank you so much!

Retire2014
Hi Retire2014,

Yes, I have private health insurance in ER. For me, the cost of insurance goes up about $10 a month each year. Approx 5% or so thus far. The rate isn't based on my individual health but get raised when the insurance company raised it for everyone in my policy group (I think I said that right). Also, when I became 50 years old, it got raised too.

When looking for health insurance, also keep in mind that's it's best to use an insurance broker from NAHU - Consumer Information - Find an Agent as using them doesn't cost more than if you apply for insurance directly from the insurance companies. Plus, they have closer contact with the insurance companies which helps as they may know ahead your chances of being accepted before approved. Ehealthinsurance.com is also a great place to get an idea of coverages and estimated costs available.

Additionally, if you company offers a HSA and a HSA which High Deduction Insurance makes sense to you, the next open enrollment, you might want to make sure to go the HSA route as when you leave, the HSA belongs to you. (That is what I did. The previous open enrollment when I contemplated ER'ing, I purposely signed up for the HSA knowing that I may very well say goodbye in the near future ).

Also, as you know I'm sure, 2014 and Health Insurance is a big wildcare with the Affordable Care Act.
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Old 08-30-2012, 08:32 AM   #12
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New York is a terrible state for individual HI. When I ERed in 2008, I had a policy for $461 a month from GHI which began in 2009. By 2011 it had risen 50% to around $700 a month, a far bigger increase than I had built into my ER budget. I found this through ehalthinsurance.com and it remains the cheapest policy even after the 50% increase!

I switched to a BCBS hospital-only plan which costs a lot less but does not offer as much coverage. I look forward to the PPACA's exchanges becoming a reality so I can return to an affordable HI policy which is broader than what I have now.
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Old 08-30-2012, 09:33 AM   #13
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Originally Posted by scrabbler1
New York is a terrible state for individual HI. When I ERed in 2008, I had a policy for $461 a month from GHI which began in 2009. By 2011 it had risen 50% to around $700 a month, a far bigger increase than I had built into my ER budget. I found this through ehalthinsurance.com and it remains the cheapest policy even after the 50% increase!

I switched to a BCBS hospital-only plan which costs a lot less but does not offer as much coverage. I look forward to the PPACA's exchanges becoming a reality so I can return to an affordable HI policy which is broader than what I have now.
The premiums some of you have to endure is just outrageous. That $700 is higher than my house payment. If I had premium payments like that I would not enjoy life as I would spend every day, all day complaining about it. After my HSA deduction is figured in, my insurance is essentially free. Where I live for me anyways, it really hasn't been a concern. If I lived in a state like NY, I wonder if I ever would have ever retired, because it would kill me to essentially write a monthly donation to a company without the charitable tax write off benefit.
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Old 08-30-2012, 09:39 AM   #14
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These premiums and rates of increase are pretty typical, and we have seen them in a number of threads over the past two years.
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Old 08-30-2012, 10:45 AM   #15
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I should add that the $1100 premium is for a family of 4 with no pre existing. I turned 55 and my wife turned 50 (we have B-days one day apart). Those ages triggered a large increase in monthly premium.
I may switch to a 10,000 deductible in the future.
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Old 08-30-2012, 11:08 AM   #16
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Would love to hear what people who do have pre-existing conditions are paying.
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Old 08-30-2012, 12:03 PM   #17
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Would love to hear what people who do have pre-existing conditions are paying.
I have pre-existing conditions and just got an individual policy for $685 per month (just for me). That's marked up from $474 for those with no P.E. conditions.

It's a 70/30 PPO with $1,900 deductible and $2,500 max out of pocket.

I've budgeted for 10% increases each year. I hope that's realistic.

Edited to add: I just turned 55, but the policy started a month earlier.
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Old 08-30-2012, 12:12 PM   #18
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It may be flogging a dead horse, but the single greatest question/concern for the ER crowd is affordable health care. I am not yet retired and may be looking at an 11-12 year gap to Medicare (if it still exists). When I play with budgeting on a spreadsheet, I allow 24k/yr for family health insurance and I assume this will be a high deductible/HSA plan. So, I never tire of getting input for this issue. I've learned a great deal from others.
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Old 08-30-2012, 02:54 PM   #19
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$1101/mo premium
$1500 per person deductible/out of pocket max
$3000 per couple deductible/out of pocket max
Pre-existing condition for DH
Budgeted for high insurance premiums when DH retired 7 years ago. Didn't quite expect it to be this high though.
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Old 08-30-2012, 03:06 PM   #20
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Btw, Retire 2014. If you do go the high deductible route, make sure you set up an HSA with it and get the tax deduction benefit. I have 2 thick headed Neanderthal brained friends who have high deductible plans and wont set up an HSA, because they cant pay attention long enough to understand why they need to.

Mulligan, thank you, I will be sure to look into HSA since I will go the high deductible route.
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