ACA gap to Medicare help

[JohnDoe]

I am not that lucky to have that much in after tax accounts which is why I started to make the shift a few years ago.

I am about 25% after tax and 75% tax deferred.

Hard to build up a Roth when you were late to the game and limited to a measly 5 or 6k a year.

 

[jdiaz]

What I found is that if you are a low utilizer of health care services, or a high utilizer of health care services, the cheapest premium is what's most economical. If you rarely use services, getting lower deductible doesn't help, because you won't hit even the low deductible. And so what if you've got a low copay for your one or two visits because it's nothing compared to the monthly premium difference.

This.

When we've chosen our plan each year, the max out of pocket is listed for each deductible and premium tier, so it makes that decision fairly easy. And a Bronze plan always wins out for us.

 

[KarenF]

I will tell you our experience, in case it is helpful. We retired when we were 60 (our birthdays are 4 months apart) and did COBRA on my insurance for 18 months. It was about $1400/month. When it expired I waded through options - I set up a special burner email account and Google Voice account and looked for insurance agents. Don't let anybody contact you on your regular email or regular phone numbers, it has been months and I am still getting lots of messages. I went through the numerous sketchy messages until I found a couple that sounded reasonable. I talked the them and was impressed by one guy who explained how to tell if he was a legit insurance broker (I googled to verify) and who sent me his insurance agent registration info for my state. He is in Florida, I am in Georgia. My husband and I talked to him and it turned out my husband qualifies for private insurance that does not meet ACA standards (mainly it does not cover you if you are pregnant, which is fine for a man over 60). His private insurance is about $650/month and the rate is guaranteed for 2 or 3 years. I did not pass underwriting for private insurance (I have an autoimmune disease). I called all my doctors and asked what insurance they took. Then I got on the ACA website and waded through all 17 pages of available plans. I am pretty healthy in general and my autoimmune disease (Hashimotos) is well controlled so I settled on a Bronze high deductible ($9000 deductible and $9000 out of pocket max) plan. I called the insurance agent and went over the options and he agreed I had picked the best plan. We do not qualify for subsidies, so my ACA plan is a little over $900/month. Our total is around $1600/month now, not terribly more than COBRA. The main downside is that there were no PPO ACA plans available so I have an HMO. Luckily my doctor is great and refers me to anybody I need with a quick message. For what it is worth, unless our health changes a lot, I plan to sign up for a high deductible Medicare supplement from Boomer Benefits as well in 3 years.
ADDING: My COBRA had Vision and Dental. We don't have that now, but we get some Eyemed coverage through our LTC policy, and our dentist has a membership plan that costs less than our dental insurance did, and covers more.

 

[Go Bolts]

ADDING: My COBRA had Vision and Dental. We don't have that now, but we get some Eyemed coverage through our LTC policy, and our dentist has a membership plan that costs less than our dental insurance did, and covers more.[/QUOTE]



Your ACA plan will cover examinations by an ophthalmologist as they are checking eye health, screening for glaucoma, cataracts, etc.

As with many insurance plans, ACA won’t cover refractions, glasses, etc.

Maybe between ACA and EyeMed, you’ll be good to go.

 

[jim584672]

Medicaid covers eye exams, glasses, basic dental.

 

[MBSC]

Your ACA plan will cover examinations by an ophthalmologist as they are checking eye health, screening for glaucoma, cataracts, etc.

As with many insurance plans, ACA won’t cover refractions, glasses, etc.

An eye exam may be covered by the ACA plan when the patient has an eye disease or is at high risk. Otherwise...

The Affordable Care Act requires coverage for pediatric vision care as one of the essential health benefits. The ACA does not require insurers to provide routine vision care coverage for adults.

Reference: https://www.healthinsurance.org/faqs/how-is-vision-care-covered-under-the-affordable-care-act/

All plans in the Health Insurance Marketplace® include vision coverage for children. Only some plans include vision coverage for adults.

If your plan doesn’t include adult vision coverage, you can buy a “stand-alone” vision plan to reduce your vision care expenses.

Reference: https://www.healthcare.gov/glossary/vision-or-vision-coverage/