Need Rec's for Lowering Medical Insurance Costs

[homestead]

We just went off cobra, went to a insurance broker. They get paid by the
insurance companies. They were very helpful and lowered our monthly
insurance $400.
Oregon only looks back 5 years for health issues.

 

[observer]

Thar sounds about right. Uninsured eligible retirees (ones who didn't have work credits paid in toward Medicare) could buy in at $410/month for Part A hospital coverage (2007 rate schedule), and add Part B at the usual rate.

Group Health Cooperative has a pretty good HMO reputation, and has exchange agreements with Kaiser Permanente as I recall, which can very handy.

Mexico.

Canada as well. No one there worries about health care in retirement (at any age).

 

[M Paquette]

Canada as well. No one there worries about health care in retirement (at any age).

USAians are special. Those of us who fail to deliver a steady stream of labor for large employers until we reach the approved age are deemed unproductive and therefore disposable, unless sufficiently wealthy.

 

[DeborahB]

Every agent is paid a commission...sounds like he's telling you he works in the call center and gets paid hourly, while eHealth takes the commission on the sale. Seems like reasonable advice though, so I'm guessing he won't be working at eHealth long when he figures out he can make more money on his own.

If you had cancer 15 years ago, you might still be able to get fully underwritten coverage instead of HIPAA. A HIPAA plan at age 63 is probably going to cost an arm and a leg, so you should still find an independent agent that can find out for you which companies may accept a history of cancer 15 years ago. United Health One, for instance, only asks about the last 10 years on the application.

Thanks for the input from someone in the biz - that's good to know. I know someone gets a commission - just that's what he said. I'm going to try for normal commercial insurance in the time frame indicated. I think there is something about pre-existing conditions that doesn't kick in if you were on group insurance without a break - can't remember. It might just be that the waiting period is eliminated. They can still deny me coverage.

No matter what it costs, it was worth it, to retire early. I am so glad, every day, that I am no longer working. My SO is getting tired of hearing me say that. He's self employed and not working much, intentionally, so it isn't like he resents that he leaves the house at 8 am and I get to eat bonbons all day... ... since he works from home.

 

[M Paquette]

In unrelated news, I am now exploring the possibility of establishing a personal investment corporation and software consulting firm, as a sole proprietership with both DW and I on the business license, or as a partnership with both DW and I on the Partnership Agreement. This will act as a pass-through for income from our various investments, along with all earned income. Naturally, this would require my attention at least half the time (20 hours/week), as well as DW's time (20 hours/week).

Coincidentally, if I have this up and running by February 15, I could qualify for guaranteed issue group coverage on April 1, when the Cal-COBRA coverage runs out. The rate would be between 90% and 110% of the standard rate, much better than the HIPAA rate of 170% of the standard rate. So that's a nice benefit...

Naturally the persons participating in the business must not derive a a significant portion of their income from other employment. This is also attested to on the SoleProprietor/Partner/Corporate Officer Statement Form. This rule exists to prohibit Californian's from creating a business in which they are not actively working in order to purchase guaranteed-issue small group coverage. This does not pertain to passive income, but to earnings income from employment.

 

[dgoldenz]

In unrelated news, I am now exploring the possibility of establishing a personal investment corporation and software consulting firm, as a sole proprietership with both DW and I on the business license, or as a partnership with both DW and I on the Partnership Agreement. This will act as a pass-through for income from our various investments, along with all earned income. Naturally, this would require my attention at least half the time (20 hours/week), as well as DW's time (20 hours/week).

Coincidentally, if I have this up and running by February 15, I could qualify for guaranteed issue group coverage on April 1, when the Cal-COBRA coverage runs out. The rate would be between 90% and 110% of the standard rate, much better than the HIPAA rate of 170% of the standard rate. So that's a nice benefit...

Naturally the persons participating in the business must not derive a a significant portion of their income from other employment. This is also attested to on the SoleProprietor/Partner/Corporate Officer Statement Form. This rule exists to prohibit Californian's from creating a business in which they are not actively working in order to purchase guaranteed-issue small group coverage. This does not pertain to passive income, but to earnings income from employment.

I'm not sure what the laws in CA require, but generally you both would have to be working "full time" at 30+ hours per week for a group policy. CA always does things differently though.

Have you received a "preferred" rate quote for the group coverage? Depending on the rates in CA's individual market, 170% of an individual market premium might be less than 110% of a group market premium. I just got done shopping a case for a 64 year old woman/56 year old husband where the "preferred" rates for group coverage started at $1100/month for the cheapest HSA plans and went up from there.

 

[M Paquette]

I'm not sure what the laws in CA require, but generally you both would have to be working "full time" at 30+ hours per week for a group policy. CA always does things differently though.

I'm pretty sure I'm working full time at this. Certainly I don't ever go off to another job...

I'm sure something will come along to mess this up. Getting 1/3 off just by forming a partnership and interpreting part of the revenue stream as salary and logging the hours spent in our business/lifestyle seems too easy. (It also points out how goofy medical insurance has gotten.)

Have you received a "preferred" rate quote for the group coverage? Depending on the rates in CA's individual market, 170% of an individual market premium might be less than 110% of a group market premium. I just got done shopping a case for a 64 year old woman/56 year old husband where the "preferred" rates for group coverage started at $1100/month for the cheapest HSA plans and went up from there.

Yup. The group market premium for us is just over 800/month for what we're looking at. The HIPAA rate for the nearest package is about 1300/month for 2011.

Oh, and I did finally find a broker willing to work with us without our buying whole life and an equity indexed annuity, too. Generous of him, actually, as selling KP healthcare coverage doesn't pay a whole lot.

 

[dgoldenz]

I'm pretty sure I'm working full time at this. Certainly I don't ever go off to another job...

I'm sure something will come along to mess this up. Getting 1/3 off just by forming a partnership and interpreting part of the revenue stream as salary and logging the hours spent in our business/lifestyle seems too easy. (It also points out how goofy medical insurance has gotten.)

Yup. The group market premium for us is just over 800/month for what we're looking at. The HIPAA rate for the nearest package is about 1300/month for 2011.

Oh, and I did finally find a broker willing to work with us without our buying whole life and an equity indexed annuity, too. Generous of him, actually, as selling KP healthcare coverage doesn't pay a whole lot.

I think KP doesn't even pay anything on individual and small group health in CA anymore, so he must be a generous guy! I don't work the CA market though, just vaguely remembering hearing things through the grapevine....in related CA health insurance news, Blue Shield is raising their rates for the third time in 6 months (October 1, January 1, March 1). That's some good PR waiting to happen.

 

[CoolChange]

I'm pretty sure I'm working full time at this. Certainly I don't ever go off to another job...

I'm sure something will come along to mess this up. Getting 1/3 off just by forming a partnership and interpreting part of the revenue stream as salary and logging the hours spent in our business/lifestyle seems too easy. (It also points out how goofy medical insurance has gotten.)

Please keep us posted on this approach if you follow through. I had considered trying this a couple of years ago when I thought I would be downsized; but, my position was not eliminated. (I'm still trying to figure out which kind of luck that was.)

 

[dinah mite]

Check out Walmart, they sell Healthinsurance oline and drug insurance for Medicare part D! It's worth a try.
Good luck.
Dinah

 

[frank]

I bought walmart-humana part D insurance and if you are looking for cheap drug coverage that is the cheapest. I bought that because I take no prescription drugs . but I still have to maintain the coverage or suffer a penalty if someday I need it. As far as cheap health insurance good luck with that. I would still like to hear more from people in canada, mexico, and other countries about the cost of health care.

 

[LuvSouth]

Canada as well. No one there worries about health care in retirement (at any age).

No one worries about health care at ANY AGE in Canada.

After reading all the posts, I am glad I live in Canada, frankly ! It makes ER so affordable as we practically don't have to spare $15000 or $20,000 per year for medical insurance.

In Canada, healthcare is paid by the governments from tax dollars, the quote for top-up insurance is very manageable. I once tried a website that sells medical insurance to Canadian snowbirds, I recall the cost for me (no pre ex conditions) is ranging from $280 to $350 for 6 MONTHS traveling to the US. That's what I meant by "very manageable" or "affordable".

Then I tried to increase my age, the top-up costs go up to $500-$800 for 6 MONTHS.

So, I don't have to spare $15,000 or $17,000 or even $20,000 to ER.

Good luck to those who are looking for cheaper rates, hopefully you will find some affordable rates without breaking your bank accounts.

 

[REWahoo]

After reading all the posts, I am glad I live in Canada, frankly ! It makes ER so affordable as we practically don't have to spare $15000 or $20,000 per year for medical insurance.

Many of of us living south of the border really appreciate the restraint shown by our neighbors to north who have the opportunity to gloat but refrain from doing so lest they be considered rude.

 

[kevink]

from today's L.A. Times

Blue Shield of California seeks rate hikes of as much as 59% for individuals - latimes.com

 

[Dimsumkid]

No one worries about health care at ANY AGE in Canada.

After reading all the posts, I am glad I live in Canada, frankly ! It makes ER so affordable as we practically don't have to spare $15000 or $20,000 per year for medical insurance.

In Canada, healthcare is paid by the governments from tax dollars, the quote for top-up insurance is very manageable. I once tried a website that sells medical insurance to Canadian snowbirds, I recall the cost for me (no pre ex conditions) is ranging from $280 to $350 for 6 MONTHS traveling to the US. That's what I meant by "very manageable" or "affordable".

Then I tried to increase my age, the top-up costs go up to $500-$800 for 6 MONTHS.

So, I don't have to spare $15,000 or $17,000 or even $20,000 to ER.

Good luck to those who are looking for cheaper rates, hopefully you will find some affordable rates without breaking your bank accounts.

This one made me ask an old Canadian co worker I had, so I asked him on Facebook, told me he used to pay something monthly years ago. Then they found a bunch of new oil and he's been paying nothing ever since. Said Canada is by province and he lives in Alberta. Told me to move on up there!

 

[LuvSouth]

In Canada, we have a law called The Canada Health Act which guarantees every Canadians and permanent residents EQUAL right to access universal health care, free of charge.

Health care costs are paid by each provincial governments. Doctors (MDs) bill the province for the services they provide to patients, ALL hospitals are governments run, no cost to patients (not a penny), there's no private hospital in Canada.

All procedures are regulated by the governments, income of all doctors (MDs) is capped by the provincial governments, obove which will be paid a percentage, that's the law.

Because it's regulated by the governments (income capped, no unnecessary procedures like in the US to be performed), it drives the health care costs DOWN.

This means the rich and poor are treated the same, no queue jumping. That's the beauty of Canada !

A documentary aired by CBC in December: Public Health Private Life. The cardiologist in the documentary said "MDs in Canada are paid 50% of those in the US but I stay in Canada not because of money, it's because I like the health care system in Canada"

 

[frank]

What would the procedure for recieving health care in canada if I were visiting? would I be charged nothing or is there a procedure that they use to figure the cost? as there are no private hospitals and the doctors salaries are capped, who figures what I would owe?

 

[DeborahB]

In Canada, we have a law called The Canada Health Act which guarantees every Canadians and permanent residents EQUAL right to access universal health care, free of charge.

Health care costs are paid by each provincial governments. Doctors (MDs) bill the province for the services they provide to patients, ALL hospitals are governments run, no cost to patients (not a penny), there's no private hospital in Canada.

Can you get treatment anywhere in the country or is it in any way restricted to the province in which you live? I never thought to ask before. I know Canadians pretty much love their system.

A lot of Americans see it as triage and think there are many Canadians coming to the US for procedures in lieu of waiting - I haven't seen that.

I would take the Canadian system in a heartbeat. All this angst we are going through with regard to healthcare is just so much crap. So many countries provide it as a service paid for by taxes. I'd gladly pay more taxes if that's what it provided. Considering what I pay for healthcare (currently $475/month single coverage) - I doubt if the additional tax would be more per year.

 

[Billy]

[FONT=&quot]Frank[/FONT]

I notice that some of you were moving abroad or thinking of it to recieve affordable healthcare. do you think it will be cheaper over there? do the people who moved to mexico realize better or cheaper healthcare? can anyone through out some numbers as far as costs in which countries?....
As far as cheap health insurance good luck with that. I would still like to hear more from people in canada, mexico, and other countries about the cost of health care.

[FONT=&quot]Hi Frank,[/FONT]
[FONT=&quot]
[/FONT]
[FONT=&quot]Billy and I are familiar with health care service and prices both in Thailand and in Mexico, and I can tell you the following:[/FONT]
[FONT=&quot]
[/FONT]
[FONT=&quot]1. [/FONT][FONT=&quot]** Generally there is no waiting for weeks for service. If you are ill and want to see a doctor, you can simply show up at his office. This is true for Bangkok and Chiangmai, (Thailand) or Chapala, Mexico. If there are other people in the waiting room, you might have to wait an hour or hour and a half. If you arrive when they open, you can be the first to be seen. Or you have the choice to simply go to another doctor’s office.
[/FONT]
[FONT=&quot]
[/FONT]
[FONT=&quot]2. ** [/FONT][FONT=&quot]Office fees to see a general practitioner in Chapala range from 150 Pesos to 200 Pesos, currently about $12 - $17 USD. To see a specialist in Chapala or Guadalajara, the office visit runs 300 – 600 Pesos, or $25- $50.[/FONT]
[FONT=&quot]
[/FONT]
[FONT=&quot]3. ** [/FONT][FONT=&quot]To have your teeth cleaned in Chapala it runs from $12 - $21 USD, to have a porcelain crown put on it is $100 USD, a root canal with post inserted into the tooth before a crown is placed on it is $188 USD[/FONT]
[FONT=&quot]
[/FONT]
[FONT=&quot]4. [/FONT][FONT=&quot]** An Echo Cardiogram in Guadalajara is $100USD[/FONT]
[FONT=&quot]
[/FONT]
[FONT=&quot]5. ** [/FONT][FONT=&quot]A full executive physical in Chiangmai, Thailand with stress test, all appropriate blood work, x-rays, abdominal sonogram, PSA tests or female mammogram and pap smear will run from $250 - $350 USD with your tests, results and doctor consultations all done the same day, in the same location. You can have it done in the morning, go out to lunch and then meet the doctor in the afternoon for any information about your results.[/FONT]
[FONT=&quot]
[/FONT]
[FONT=&quot]6. ** [/FONT][FONT=&quot]You can schedule a colonoscopy in a Chiangmai hospital for tomorrow and it will run you $350 USD, and the prep procedure is more humane than in the States. The day before your hospital visit you eat normally. If your appointment is at 8 in the morning, you awake at 5 a.m., and prepare 2 liters of a special solution, drink it, and by 7 a.m. you are cleaned out. Take a cab to the hospital and by 11 a.m you are finished, complete with your take home DVD to present to any doctor in the future as your baseline. The hospital takes you to your home via ambulance, included in the cost. [/FONT]

[FONT=&quot]Some time back, we wrote a piece for The Motley Fool called [/FONT][FONT=&quot]Medical Vacations: The Retiree Health-Care Solution?[/FONT][FONT=&quot] which listed cities, countries, hospitals and prices for certain procedures. If you are interested in utilizing this option, I recommend that you take a look at this piece as well as our [/FONT][FONT=&quot]Medical Tourism[/FONT][FONT=&quot] page. [/FONT]

[FONT=&quot]While this choice might seem outrageous or extraordinary for some people, it is becoming more of a common alternative, with medical tourism being a $160-billion worldwide industry and growing. Singapore and Thailand are both medical tourism leaders.[/FONT]

[FONT=&quot]LuvSouth [/FONT][FONT=&quot]
[/FONT]

This means the rich and poor are treated the same, no queue jumping. That's the beauty of Canada !

[FONT=&quot]In regards to Canada’s health care system, here is a recent article that might shed some unconventional light on the topic:

[/FONT] [FONT=&quot]Canada’s public health care at crossroads[/FONT]
[FONT=&quot]Private medicine makes inroads as nation struggles with long waits[/FONT]
[FONT=&quot]Canadian health care at the crossroads - MarketWatch[/FONT]

[FONT=&quot]or you might want to read articles written by Brian Day, the former President of the Canadian Medical Association – pros and cons of the Canadian system and the possibility of Canada opening its doors for Medical Tourism.[/FONT]
[FONT=&quot]
[/FONT]
[FONT=&quot]Why B.C. should become a destination for medical tourism[/FONT]
[FONT=&quot]By Brian Day, Special to the Sun April 19, 2010[/FONT]
[FONT=&quot]
[/FONT]
[FONT=&quot]In general, no one is pushing anyone to ‘try’ medical tourism. However it has been our experience that having more tools in our toolbox proves useful.[/FONT]

[FONT=&quot]Best,[/FONT]
[FONT=&quot]Akaisha[/FONT]
[FONT=&quot]Author, The Adventurer’s Guide to Early Retirement[/FONT]

 

[Rich_by_the_Bay]

Akaisha has summarized very well some advantages of the health care delivery systems of selected international locales. Most of the services mentioned are preventive in nature, or routine. I have no reason to believe that there is any difference in quality in N. America versus the locations described.

I would add from my long experience practicing in the US that during a more serious illness or those with numerous complications, nonroutine surgery, many expats choose to return to the US, mainly to be nearer to family and support systems. Practicing in both Fla and AZ, we saw many from Mexico, Central and South America. I don't know if that was because they felt the care here was superior, or rather for other reasons.

Be wary of those who assume that care is superior (better outcomes) in North America relative to other developed countries or in developing countries in local centers of excellence. The US no longer has a monopoly on quality or results.

 

[LuvSouth]

What would the procedure for recieving health care in canada if I were visiting? would I be charged nothing or is there a procedure that they use to figure the cost? as there are no private hospitals and the doctors salaries are capped, who figures what I would owe?

In Canada, everyone has their own health card which entitles us to access health care, free of charge.

When we visit a clinic or hospital, we show our health cards and the staff will record our card numbers and bill the government.

When American or other non Canadian visiting clinics or hospitals, obviously they have no health cards to produce, so the staff will charge them according to the services.

For a brief visit to a clinic, say a flu or stomachache, it's $27 (I think) per visit. For hospital visit, I don't know the costs but there are procedures to charge patients, item by item. Say, to be admitted to ER, it's this $, for hospital stay, it's this $ ... and so on.

But one thing I pretty sure (not 100% sure) that for the same treatment in hospital in Canada, say a broken arm caused by car accident, it's cheaper in Canada than the US. Why ? Because Canada will only perform procedures that are necessary as opposed to hospital in the US that perform UNNECESSARY procedures. We Canadians, most of us, know that ! We know as soon as the US hospitals found out we had medical insurance or top up insurance, they would treat us Candians like KINGS, performing so many UNNECESSARY procedures. Say, a minor hospital visit, they, the US MDs insisted we stayed in hosptials for ... OBSERVATIONS and hence perform numerous tests ... and bill it to the insurance companies ? US$20,000 per minor US hospital stay ... I think it is a shame that private US hospitals do that to Canadians, and probably to Americans as well ...

But I think if you really need hospital care, you might want to check out how much to buy travel insurance in Canada (I think it's definitely cheaper than US$17,000 per year, this US$17,000 is RIDICULOUS TO CANADIANS), then you can access the Canadian health care ...

 

[LuvSouth]

Can you get treatment anywhere in the country or is it in any way restricted to the province in which you live? I never thought to ask before. I know Canadians pretty much love their system.

A lot of Americans see it as triage and think there are many Canadians coming to the US for procedures in lieu of waiting - I haven't seen that.

I would take the Canadian system in a heartbeat. All this angst we are going through with regard to healthcare is just so much crap. So many countries provide it as a service paid for by taxes. I'd gladly pay more taxes if that's what it provided. Considering what I pay for healthcare (currently $475/month single coverage) - I doubt if the additional tax would be more per year.

Say, if I visit Quebec for 3 months, I don't have to change my OHIP (Ontario Health Insurance Programme), clinics and hospitals in Quebec will bill directly to the Ontario government.

I think there are only a very very very small number of Canadians going to the US to get treatment in lieu of waiting. Those are the ones who either have extra cash to burn or the treatment is not available in Canada and they don't want to wait.

In general, if treatment is not available in Canada, the province will send the patient to the US to get treatment, paid by the Ontario government based on procedures in Ontario. There is a list what is considered valid and what's considered not valid to send patients to the US to get treatment.

Say if treatment is available in Canada but the patients will have to wait for 3 months, but they have extra cash and don't want to wait, that's fine, they simply check in private hospital in the US and be treated like KINGS.

I think the additional tax you pay will definitely less than private insurance Americans are paying. To put it bluntly, we are not paying an additional US$17,000 per year specific for health care in Canada per person. So the US$17,000 per year is RIDICULOUS to Canadians.

The reasons are simple: US hospitals perform unnecessary procedures, US hospitals charge MORE per procedure compared to the same procedure in Canada, MDs in the US charge 100% (double) compared to MDs in Canada charge. That explains why Americans pay US$17,000 per year per couple (?), it's absurd and ridiculous to Canadians !

 

[travelover]

.........We know as soon as the US hospitals found out we had medical insurance or top up insurance...........

LuvSouth, what kind of "top up" insurance do you get before you travel to the US? How expensive is it?

 

[LuvSouth]

LuvSouth, what kind of "top up" insurance do you get before you travel to the US? How expensive is it?

This is "how" it works ...

We Ontarians have our own OHIP (Ontario Health ...) which covers out of province and out of country to certain limit.

Then we have our own employer's plan which tops up the OHIP.

If we didn't have employer's plan like a number of snowbirds, we simply purchase a top up plan from insurance companies specifically caters to Canadian travelers. The top up plan will kick in at mid night as soon as OHIP reaches the limit AND/OR private employer's plan expires.

The cost, I recall and depending on ages and pre ex conditions, for me is around $280 to $350 for 6 months for MY AGE, No pre ex conditions. Then I tried to make myself "older", the rate goes up to $500-800 for 6 months, again no pre ex conditions.

My advise: Travel when you are still healthy ...

 

[LuvSouth]

I tend to think patients will get the same quality of health care in both Canada and the US. They are both developed countries.