Health Insurance in ER?

[observer]

With individual private health insurance getting more and more expensive, I'm curious how members here are planning their medical coverage before Medicare elegibility? Some of us here are even talking about ER in our 40's let alone early 50's.

I know some companies offer retiree health coverge, but those companies are getting rarer and rarer. And those that do offer it, the premiums are now (for the most part) quite high.

So how are you guys doing this? High deductible policies or just paying huge individual premiums?

 

[Dimsumkid]

Private insurance for us. We just got approved this morning for a high deductible polcy using Costco/Aetna. I'm 48, DW is 47 and son is turning 11 tomorrow. It's a 70%/30% co pay, $5000 deductible, max family out of pocket of $16k, includes dental and Costco generics Rx for $15. Cost is $455/mo, sure beats $1200/mo for Cobra!

Costco only offers this in 4 states right now, Il,Pa,Tx and Ga.

 

[observer]

Private insurance for us. We just got approved this morning for a high deductible polcy using Costco/Aetna. I'm 48, DW is 47 and son is turning 11 tomorrow. It's a 70%/30% co pay, $5000 deductible, max family out of pocket of $16k, includes dental and Costco generics Rx for $15. Cost is $455/mo, sure beats $1200/mo for Cobra!

Costco only offers this in 4 states right now, Il,Pa,Tx and Ga.

That's a great package at the price. Congrats on being so savvy in finding that.

 

[frayne]

Retired when I was 55 and have retiree health insurance, cost about $6K per year for DW and I.

 

[REWahoo]

So how are you guys doing this? High deductible policies or just paying huge individual premiums?

Yes...and yes.

I retired at 58, DW was 56. After 18 months on COBRA, I purchased a $5000 deductible BC/BS policy and DW went into the state pool for similar coverage. We later increased her deductible to $7,500 to reduce costs.

Now we are 64/62 and our annual premiums in 2011 will run around $11K.

 

[Dimsumkid]

That's a great package at the price. Congrats on being so savvy in finding that.

We live in the Chicago area too, so you can look into it since you're in the same area. They have higher/lower deductible options to consider based on your own financial risk tolerance vs. coverage. They want 3 years of medical history, I have early arthritis, very mild, but they made me get more details before I got approved. No other health issues in the family and pregnancy/maternity isn't covered. I'm sure they assumed I needed a hip replacement. I had to get my Dr. to amend her notes stating the situation was very mild. I don't even take aspirin for it!

 

[rescueme]

Retired from mega-corp at age 59 and have contributory medical for pre/post Medicare through them (e.g. their plan becomes our medi-gap policy).

I currently pay just over $6k/year for both of us. Actually, this is just a bit over what I had to pay while wor*ing there (around $400/mo for both of us) so the increase was not bad, since we planned at 100% of expenses for pre to post-retirement.

The rate will drastically drop in another two years, when we both are on Medicare and their insurance will just be used to pick up the 20% of Medicare that is not paid...

 

[CoolChange]

Probably HSA eligible plan for first year then Mexico for a few years.

 

[zinger1457]

Retired at 52, have a high deductible ($5000) HSA plan with Aetna. No pre-existing conditions so the cost for myself is $166/month. I have been fortunate in that my health has been good and I work at keeping it that way. The only need I have had to see a doctor since retiring is for an annual physical and flu shots which are covered as preventive care and are paid for before the deductible.

 

[dgoldenz]

Private insurance for us. We just got approved this morning for a high deductible polcy using Costco/Aetna. I'm 48, DW is 47 and son is turning 11 tomorrow. It's a 70%/30% co pay, $5000 deductible, max family out of pocket of $16k, includes dental and Costco generics Rx for $15. Cost is $455/mo, sure beats $1200/mo for Cobra!

Costco only offers this in 4 states right now, Il,Pa,Tx and Ga.

Buying health insurance without brand name Rx coverage is like buying health insurance without hospital coverage. There are a lot of prescriptions with no generic alternative that can cost hundreds or thousands of dollars per month that wouldn't be covered under your plan.

I'd talk to an agent instead of Costco and look into an HSA policy with full brand name Rx coverage....that is, if I were in your position. You could probably reduce your max OOP for the whole family to $5-6k for about the same price with much better Rx coverage.

 

[dex]

I'm single 55, retired 4.5 years and am paying aprox. the same rate for all those years - now $2684/year. That amount may go down by $300 because I'm questioning the rate increase for pins in my collar bone that have been there for 5 years and the previous policies didn't go up because of them. I use BCBS of Georgia for all that time. It has a deductible of $5K with a max out of pocket of $8K or $7,500.

I use a 15% growth rate for health ins. I'm estimating I'll be paying $8,616/year in 2020 when I turn 65 - 23% of my estimated budget.

You can keep the costs down by looking at alternative plans annually and switching. If you don't have a pre-existing condition it shouldn't be a problem. There are many plans with BCBS that are very similar. The difference between my old and new plan is how the emergency room plan - a small difference.

 

[Dimsumkid]

Buying health insurance without brand name Rx coverage is like buying health insurance without hospital coverage. There are a lot of prescriptions with no generic alternative that can cost hundreds or thousands of dollars per month that wouldn't be covered under your plan.

I'd talk to an agent instead of Costco and look into an HSA policy with full brand name Rx coverage....that is, if I were in your position. You could probably reduce your max OOP for the whole family to $5-6k for about the same price with much better Rx coverage.

I'm willing to look into cheaper and better coverage. I know that coverage rates are state specific, even zip code specific. If you know something that I should consider for Chicago, let me know. The Rx doesn't bother me at all, we don't have any Rx's and rarely ever have. If you have something specific in mind, let me know. We talked to Aetna throughout this process, they're the provider for the Costco health insurance.

 

[dgoldenz]

I'm willing to look into cheaper and better coverage. I know that coverage rates are state specific, even zip code specific. If you know something that I should consider for Chicago, let me know. The Rx doesn't bother me at all, we don't have any Rx's and rarely ever have. If you have something specific in mind, let me know. We talked to Aetna throughout this process, they're the provider for the Costco health insurance.

Most people say that....until they need a $5k/month prescription and it's too late to get other coverage because you're now uninsurable. You're also not currently in the hospital and probably rarely have been, but you have the insurance in case you are in the future.

Even Aetna should have HSA plans with full Rx coverage if you want to stay with them.

 

[bbbamI]

Retiree medical benefit with a $2400 deductible costs $240 a month for DH (56) and yours truly (53). I hope we continue to receive this benefit...even if the premium doubles. Finding insurance with pre-existing conditions would be very difficult and costly.

 

[observer]

Retiree medical benefit with a $2400 deductible costs $240 a month for DH (56) and yours truly (53). I hope we continue to receive this benefit...even if the premium doubles. Finding insurance with pre-existing conditions would be very difficult and costly.

Great policy... try to keep it at all costs (so to speak). Generous company to its retirees.

 

[observer]

Retired when I was 55 and have retiree health insurance, cost about $6K per year for DW and I.

Also reasonable. I see $10-17k per year is typical range for retiree family annual premium.

 

[DeborahB]

Most people say that....until they need a $5k/month prescription and it's too late to get other coverage because you're now uninsurable. You're also not currently in the hospital and probably rarely have been, but you have the insurance in case you are in the future.

Even Aetna should have HSA plans with full Rx coverage if you want to stay with them.

Does the Costco plan ONLY cover the generics or does it perhaps have a higher co-pay for non-generics?

I've known people who suddenly were on terribly expensive drugs, as dgoldenz said. You need some protection. Unfortunately, it only takes one severe hospitalization/surgery/illness etc. to change your whole medical situation.

I think I used to be healthy.... but that all changed in a day.

 

[dgoldenz]

Does the Costco plan ONLY cover the generics or does it perhaps have a higher co-pay for non-generics?

I've known people who suddenly were on terribly expensive drugs, as dgoldenz said. You need some protection. Unfortunately, it only takes one severe hospitalization/surgery/illness etc. to change your whole medical situation.

I think I used to be healthy.... but that all changed in a day.

I'm pretty sure all of Aetna's $5k deductible plans only cover generic Rx, no brand name coverage.

 

[DeborahB]

I'm pretty sure all of Aetna's $5k deductible plans only cover generic Rx, no brand name coverage.

NOT GOOD, then!

 

[Dimsumkid]

The Pharmacy deductible per Individual on the Costco plan is $500 (does not apply to generics). Generics are $15/20 (ind/family) deductible waived, preferred brand $30/$35 after deductible and non preferred brands are $45/50 after deductible.

 

[dgoldenz]

The Pharmacy deductible per Individual on the Costco plan is $500 (does not apply to generics). Generics are $15/20 (ind/family) deductible waived, preferred brand $30/$35 after deductible and non preferred brands are $45/50 after deductible.

Sounds good then. Their plans work differently here in VA. I have seen too many people opt for plans without full Rx benefits just because they were a little cheaper. I won't even sell a policy without full Rx benefits because of the "you never told me that" amnesia people seem to get when they have a problem. Too easy to blame the insurance agent...

 

[Dimsumkid]

I'm curious, aetna told me only transplant patients incur rx's in the 1k and up per month level. I'm sure cancer patients may also. Were all healthy and have to weigh generics only for $455/mo or add in preferred rx's, but that option pushes premiums to $590/mo

 

[dgoldenz]

I'm curious, aetna told me only transplant patients incur rx's in the 1k and up per month level. I'm sure cancer patients may also. Were all healthy and have to weight generics only for $455/mo or add in preferred rx's, but that option pushes premiums to $590/mo

That's laughable and whoever told you that should be fired. Try pricing up any of the following:

Oxycontin 80mg
Betaseron
Avonex
Rebif
Enbril
Baraclude
Orthoclone
Zenepax
Avastin
Remicade
Humira

The list goes on...I could probably name 100 more.

 

[Mulligan]

I am stunned by some of the premiums my fellow early retiree's are forced to pay. I flat out couldnt afford to be retired if I had to pay what I am reading here. I just called BC/BS today because my monthly bill hasn't came. They said it was delayed shortly because of adjustments to new health reg's. I asked what mine was and she said it will be $61 a month. I had been paying $72 monthly. It went down! I have a HSA with $5000 deductible (I am 46). By funding my HSA each year, I essentially get my health insurance for free. I guess I should be very thankful.

 

[DeborahB]

I am stunned by some of the premiums my fellow early retiree's are forced to pay. I flat out couldnt afford to be retired if I had to pay what I am reading here. I just called BC/BS today because my monthly bill hasn't came. They said it was delayed shortly because of adjustments to new health reg's. I asked what mine was and she said it will be $61 a month. I had been paying $72 monthly. It went down! I have a HSA with $5000 deductible (I am 46). By funding my HSA each year, I essentially get my health insurance for free. I guess I should be very thankful.

This is individual insurance - not through a group? Then it may be your age. I'm envious.