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Yahoo - Bleak Outlook
Old 09-22-2008, 12:18 PM   #1
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Yahoo - Bleak Outlook

I hope to retire in about ten years, but I got discouraged from this link in Yahoo which painted a rather bleak picture of getting health insurance. It basically said that with any health issues, the health insurers would exclude you en toto or add an exclusion to your policy. They then offered some more practical solutions which I've listed below. My question is this: are these the only options available at this time? Are there better solutions?

http://finance.yahoo.com/focus-retir...-post-spending

"
Start the search. Launch your hunt for an individual policy a few months before you leave your job or before COBRA expires (once offered a policy, you usually have to start it within a month). You may want to begin your search at a site like EHealthInsurance.com, but keep in mind that those rates apply to the healthiest applicants. That's why an agent can be helpful in finding the best insurer and deal for your circumstances.
To keep your premiums affordable, your best bet may be a high-deductible insurance plan coupled with a health savings account (HSA), if you qualify. While you'll be on the hook for, say, the first $5,000 in expenses annually, you're protected from big-ticket disasters.
An Aetna plan from AARP (aarphealthcare.com) recently quoted $246 a month for a healthy 56-year-old male in Weber's zip code. You then pay for out-of-pocket costs with money from your HSA, which doubles as a tax-deferred savings plan. HSA contributions are tax deductible - the 2009 limit is $3,000 for an individual, $5,950 for a couple; plus another $1,000 if you're 55 or over. Funds grow tax-free; any nonmedical withdrawals after 65 are taxed as ordinary income.
Look for a last resort. If you can't get individual coverage, you have options, though they're not ideal. By law, states must make last-resort insurance available if you're HIPAA-eligible. But these plans can be limited and costly.
Another tack: Some states mandate guaranteed group plans for businesses with even one employee, which may make sense if you'll do any consulting work. For a national overview of your options, go to statehealthfacts.org and click on Managed Care & Health Insurance. Get in-depth information about your particular state at healthinsuranceinfo.net.
Finally, if you're up for adventure and can bear cold winters, you could move to one of the five states - Maine, Massachusetts, New Jersey, New York and Vermont - that forbid insurers from rejecting applicants for medical reasons. You'll pay for the privilege, however: Monthly individual HMO premiums in Albany, N.Y., for example, run from $666 to $1,333.
Weber, meanwhile, is intrigued by the high-deductible plan linked to an HSA. "It sounds like an attractive option," he says. Gently reminded by McClanahan that he may need to take better care of himself to qualify, Weber says that he'll get his cholesterol tested at an upcoming company health screening and see his doctor soon. He's willing to put in the effort to make his retirement a masterpiece."
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Old 09-22-2008, 01:48 PM   #2
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Hmmm - whatever happened to an American Passport and a sincerely bad attitude toward US medical pricing?

No - I'm NOT recommending going 12 yrs without medical and then the last few yrs with 10k deductible like I did - but there has to be a 'screw you' I'm healthy and I will do something else rather than pay you suckers -contingent out there!

heh heh heh - and yeah the Saint's lost to Denver. .
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Old 09-22-2008, 01:50 PM   #3
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This FAQ talks about your options: http://www.early-retirement.org/foru...nce-30756.html
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Old 09-22-2008, 04:11 PM   #4
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Wow! Thx for the great compilation of links. You know it sounds like many people would possibly want to choose the state they retire in strictly based on health insurance?!? Unless you're swimming in cash, health insurance is probably going to be your biggest post-retirement expense and the one you need to manage the most carefully, right?
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Old 09-22-2008, 04:13 PM   #5
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Btw, I don't know if anyone will know this, but I'm curious: how often do states chagne their policiies? What I'm wondering is if you go to all the trouble to move to a "insurance-friendly" state, what are the odds that that state will get uglier over the next ten to twenty years??
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Old 09-22-2008, 04:16 PM   #6
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Hmmm - whatever happened to an American Passport and a sincerely bad attitude toward US medical pricing?
Sorry for my ignorance in advance:

I've read a number of articles/links about good and inexpensive care in various Latin American and Asian countries where the doctors are trained here, etc. But you have to pay for everything yourself in that case, right? Can you get insurance in one of these countries out of curiosity? And, if so, I take it it would be non-American insurance obviously??

And I realize my q's may have been answered in the links that Martha provided and, if so, just tell me to be patient and read those first...
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Old 09-22-2008, 06:04 PM   #7
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Sorry for my ignorance in advance:

I've read a number of articles/links about good and inexpensive care in various Latin American and Asian countries where the doctors are trained here, etc. But you have to pay for everything yourself in that case, right? Can you get insurance in one of these countries out of curiosity? And, if so, I take it it would be non-American insurance obviously??

And I realize my q's may have been answered in the links that Martha provided and, if so, just tell me to be patient and read those first...
I shouldn't have posted that as I don't have the skill set to put up some of Billy and Akaisha's past articles in this area. Perhaps a forum member can bail me out.

Note - not a perfect fit as they have an ex pat lifestyle more so than many here.

heh heh heh - .
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Old 09-22-2008, 08:49 PM   #8
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Wow! Thx for the great compilation of links. You know it sounds like many people would possibly want to choose the state they retire in strictly based on health insurance?!? Unless you're swimming in cash, health insurance is probably going to be your biggest post-retirement expense and the one you need to manage the most carefully, right?
Health insurance was a significant factor in where we retired.

You inquired about how often states change their rules. Rules have been slow to change; the biggest changes came when HIPAA (a federal law) was enacted.

I believe that there will be significant changes in the future because the cost increases are not sustainable.
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Old 09-24-2008, 04:44 PM   #9
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Healthcare is #1 in this USA Today article yesterday.

Quote:
When Steve White began preparing to leave his medical practice in a small Georgia town 12 years ago, he and his wife, Charlotte, began searching for a reasonably priced retiree health care policy that would last until they qualified for Medicare.
They never quite found it. Today, the Whites, who are in good health, pay $12,000 for an annual policy with a $20,000 deductible. Steve White, who turns 65 next week, says he knows people in affluent Hilton Head, S.C., where the Whites live, who can't afford to retire until Medicare kicks in at age 65, because private health care is prohibitively expensive.

READERS: What are you doing to plan for retirement?
"Health care premiums," White laments, "hold more people hostage from retirement than any other issue."
Everyone knows that wannabe retirees are in a bind today as they consider whether they have the financial security to make the leap. Shrinking nest eggs, nagging inflation, stagnant wages, vanishing pensions, dubious advice and runaway health care costs are among the obstacles that can block a retiree's escape route.
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Old 09-28-2008, 07:58 AM   #10
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One of the root problems is that there is no way for an individual to get on a group policy. For example, the premium that my company pays is much lower than I would have to pay for individual insurance. I'm sure there's a great Keynesian or Friedmanesque reason for that, but the bottom line is that it's inequitable and kills the little guy.

Does anyone see any end in site for that?
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Old 09-28-2008, 07:59 AM   #11
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Health insurance was a significant factor in where we retired.

You inquired about how often states change their rules. Rules have been slow to change; the biggest changes came when HIPAA (a federal law) was enacted.

I believe that there will be significant changes in the future because the cost increases are not sustainable.
Excuse my ignorance, but why does HIPAA effect you so much? Can you explain a little more?
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Old 09-28-2008, 08:38 AM   #12
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Originally Posted by Whisper9999 View Post
One of the root problems is that there is no way for an individual to get on a group policy. For example, the premium that my company pays is much lower than I would have to pay for individual insurance. I'm sure there's a great Keynesian or Friedmanesque reason for that, but the bottom line is that it's inequitable and kills the little guy.

Does anyone see any end in site for that?
There are a couple of reasons I can thing about for the disparity.
- the company can use it's large pool of those to be insured to shop around and negotiate a better rate.
- lower commission costs on selling the policy to a co. than a person
- Risk analysis - the ins. co. can look at a company's industry and past claims to help to determine the ins. co. costs and therefore the premium.
- stability - company pays on time and less likely to switch plans a lot.

So the ins. co. has lower costs associated with a company than an individual.
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Old 09-28-2008, 10:35 AM   #13
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Originally Posted by Whisper9999 View Post
I hope to retire in about ten years, but I got discouraged from this link in Yahoo which painted a rather bleak picture of getting health insurance. It basically said that with any health issues, the health insurers would exclude you en toto or add an exclusion to your policy. They then offered some more practical solutions which I've listed below. My question is this: are these the only options available at this time? Are there better solutions?
Whisperer, I can think of a better solution for some people though I don't yet know enough about you to know if it would work for you.

If you are presently 47 or older, you can take a job with the federal government and retire in 10 years with full lifetime medical coverage for yourself and your family, at the same group health rates that active employees pay (though after tax instead of before tax). This type of retirement eligibility is called "MRA+10", and applies after 10 years' federal employment once you reach the minimum retirement age, which is around 56-57 depending on your year of birth. You will also get a (tiny) partially COLA'd pension and will be eligible for SS.

Of course working for the feds will very likely entail lower pay, less prestige, and few choices of location where your family can live and work. These are some of the reasons why people aren't beating down the doors of agencies to seek federal jobs. It's not as much of a free ride as the "grass is always greener" group would have you believe. However I think we are given a fair and reasonable pay+benefits package, and it can be a good option especially for those with pre-existing conditions.
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Old 09-28-2008, 05:06 PM   #14
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Whisperer, I can think of a better solution for some people though I don't Of course working for the feds will very likely entail lower pay, less prestige, and few choices of location where your family can live and work. These are some of the reasons why people aren't beating down the doors of agencies to seek federal jobs. It's not as much of a free ride as the "grass is always greener" group would have you believe. However I think we are given a fair and reasonable pay+benefits package, and it can be a good option especially for those with pre-existing conditions.
Where does a 59 yr old woman with a editorial/English teacher background get a job with the federal government? I'd even consider relocating from my beloved Colorado. My point being that some Plan B's don't always work out. This one because of likely age discrimination.

But on the OP's topic. I discovered that the best health insurance option that I could get was a HSA high deductible ($2700) plan with several major exclusions. I was lucky to get it, according to my insurance agent. And I am, by all accounts, in perfect health.
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Old 09-28-2008, 05:22 PM   #15
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Where does a 59 yr old woman with a editorial/English teacher background get a job with the federal government? I'd even consider relocating from my beloved Colorado.
Oh, too bad! We just hired somebody like that a couple of months ago as an editor. Fooey. Wouldn't that have been cool? I think it would have been neat to work with you. www.usajobs.opm.gov and keep looking. Every few days the jobs available changes, so I always looked once a week before I got this job. Did it every Friday as part of my routine. You have a marketable skill so you can probably find a federal job a lot faster than I did, though I was "only" 50 when I was hired.

Like you are considering, I moved here for the job, not because I wanted to live in New Orleans. That part came later after I had lived here a while.
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Old 09-28-2008, 11:36 PM   #16
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Whisperer, I can think of a better solution for some people though I don't yet know enough about you to know if it would work for you.

If you are presently 47 or older, you can take a job with the federal government and retire in 10 years with full lifetime medical coverage for yourself and your family, at the same group health rates that active employees pay (though after tax instead of before tax). This type of retirement eligibility is called "MRA+10", and applies after 10 years' federal employment once you reach the minimum retirement age, which is around 56-57 depending on your year of birth. You will also get a (tiny) partially COLA'd pension and will be eligible for SS.

Of course working for the feds will very likely entail lower pay, less prestige, and few choices of location where your family can live and work. These are some of the reasons why people aren't beating down the doors of agencies to seek federal jobs. It's not as much of a free ride as the "grass is always greener" group would have you believe. However I think we are given a fair and reasonable pay+benefits package, and it can be a good option especially for those with pre-existing conditions.
I had actually thought of that a few days ago, so it's interesting that you brought it up. The pay is just SO much less though. But my wife's salary is very likely to significantly increase so maybe it would be worth it. Well, I don't know - it's hard to imagine as I would probably have to take 30% pay reduction to get a federal job.

But it's an intersting idea.
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Old 09-28-2008, 11:39 PM   #17
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Where does a 59 yr old woman with a editorial/English teacher background get a job with the federal government? I'd even consider relocating from my beloved Colorado. My point being that some Plan B's don't always work out. This one because of likely age discrimination.

But on the OP's topic. I discovered that the best health insurance option that I could get was a HSA high deductible ($2700) plan with several major exclusions. I was lucky to get it, according to my insurance agent. And I am, by all accounts, in perfect health.
When you say "exclusions", you mean like body parts? Do they say, "We'll insure you but not your lungs?" or things like that (if you don't mind me asking)? That could get tricky if you have, for example, high blood pressure as that can lead to stroke, etc. So could they exclude a host of downstream illnesses? Or is it more by body part or organ?
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Old 09-29-2008, 09:00 AM   #18
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Excuse my ignorance, but why does HIPAA effect you so much? Can you explain a little more?
HIPAA guaranteed my ability to go from a group insurance plan of my employer to an individual plan, with no waiting period, no pre-existing conditions exclusions, and no underwriting.

The downside is that HIPAA plans can be prohibitively expensive and the coverage is often not as good as the group plan that you left. So you have to decide where you want to live and what insurance offerings are available to you in that area. For example, California has a risk pool as a HIPAA option, but it is expensive and only provides $75,000 of coverage per year.

Minnesota (our home state) was our best bet for insurance for two people who are otherwise uninsurable. Their HIPAA option is a risk pool but it is probably the best risk pool in the nation.
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Old 09-29-2008, 09:28 AM   #19
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There are a couple of reasons I can thing about for the disparity.
- the company can use it's large pool of those to be insured to shop around and negotiate a better rate.
- lower commission costs on selling the policy to a co. than a person
- Risk analysis - the ins. co. can look at a company's industry and past claims to help to determine the ins. co. costs and therefore the premium.
- stability - company pays on time and less likely to switch plans a lot.
Add "lack of adverse selection" to this list. Employer group plans tend to have almost universal participation, meaning that their plans have enough younger and healthier participants to subsidize the greater risks. And indeed, this is why many "universal health care" advocates believe insurance needs to be compulsory in order to make it halfway affordable for the older and less healthy individuals.
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Old 09-29-2008, 09:50 AM   #20
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When you say "exclusions", you mean like body parts? Do they say, "We'll insure you but not your lungs?" or things like that (if you don't mind me asking)? That could get tricky if you have, for example, high blood pressure as that can lead to stroke, etc. So could they exclude a host of downstream illnesses? Or is it more by body part or organ?
Different states have different rules regarding exclusions. Some states do not allow plans to exclude certain conditions. Other states even allow "basic" medical plans where something is covered only if it is included.

Exclusions may be based on conditions, often pre-existing conditions noted in underwriting. By way of example, exclusions might be for treatment related to high blood pressure, asthma, non-melanoma skin cancer. My understanding is that if there are more than a couple of these types of exclusions most insurers at that point turn you down.There also might be exclusions for certain medications. Plans may also have exclusions that are not based on your particular health. For example, pregnancy exclusions and smoking cessation treatment exclusions.

I would not get a policy with an exclusions like high blood pressure because a heart attack or stroke may not be covered. I would look at alternatives, like a HIPAA plan or risk pool in that case.
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