ER and health insurance

[nun]

I'm looking at my ER budget and one big ticket item is health insurance.
Living in MA there are some good options for me and I can get plans ranging from $300 to $600 per month. Obviously this in in the news today so I wondered what people do for that when they leave work before Medicare kicks in. Especially if you have a family to insure too.

 

[bbbamI]

We have medical, dental and vision through retirement benefits from Mega Corp. The cost for two is $230 a month.

 

[nun]

We have medical, dental and vision through retirement benefits from Mega Corp. The cost for two is $230 a month.

That's good, but increasingly not an option for many. Isn't this an enormous consideration/issue for people thinking about ER?

I have 3 options. Get one of the private plans in MA ($300 to $600 a month) delay ER for 8 years and get insurance from the state when I'm 55 (I work for the state) at $100/month, or return to the UK (I'm a dual citizen) and get health care at no cost.

 

[W2R]

I will have federal employees' medical benefits, so I am one of the few for which this will hopefully be a non-problem. My present plan will cost about $155-$160/month in after tax dollars.

Frank assumed he would get medical benefits upon retiring, but because he was transferred to the "new retirement plan" at his work, it now looks like he won't. He will be looking at individual policies and may have to do some contract work from time to time in order to pay for health insurance until he is old enough for Medicare. He has high blood pressure, though, and we don't know if that will be a problem in finding insurance. Missouri has a high risk pool so he may need to look into that.

 

[ERD50]

What about a high deductible policy? I don't know what they run for a family, but a $5K deductible for my son after he graduated was ~ $60/month.

-ERD50

 

[TromboneAl]

Nun, how has the recent Massachusetts healthcare reform affected your choices and costs?

Are you considering moving back to the UK? You'd have $3,600 to $7,200 more to spend each year, just based on savings on premiums, plus the savings in healthcare costs. That would be quite an incentive.

 

[bbbamI]

Frank assumed he would get medical benefits upon retiring, but because he was transferred to the "new retirement plan" at his work, it now looks like he won't.

Bummer....

We didn't feel like DH's retirement was complete until the benefits kicked in. It took a couple of months to get the pension and medical benefits started. I felt like everything would be ok, but...stuff can happen.

 

[W2R]

Bummer....

We didn't feel like DH's retirement was complete until the benefits kicked in. It took a couple of months to get the pension and medical benefits started. I felt like everything would be ok, but...stuff can happen.

That's so true. His retirement has been pretty unusual because he worked there when he was young, worked elsewhere for 15 years, and then came back on the month that the new pension plan was to start for new employees. So, they are counting his early years in determining his pension, vacation, and so on, but he has been getting conflicting information from personnel on some things. He is determined, though, and that counts for a lot.

 

[nun]

Nun, how has the recent Massachusetts healthcare reform affected your choices and costs?

Are you considering moving back to the UK? You'd have $3,600 to $7,200 more to spend each year, just based on savings on premiums, plus the savings in healthcare costs. That would be quite an incentive.

I currently work for the state and as a single person my MA state monthly premium is $400 of which I pay $100.

In MA now you have no choice about whether to have health insurance, it's mandated. So now 98% of MA residents have health insurance. If you earn less than $32k/year as a single person there's a sliding premium scale going from 0$ up to about $150/month. there are no deductibles on these plans. For singles earning over $32k there's a range of plans. Ones with deductibles of $4k are about $300/month and no deductible plans range from $500 to $800. These plans are all offered by insurance companies, but they must follow rules set by the state. The big push now is to come up with ways of keeping costs down.

I am seriously considering returning to the UK when I retire as my experiences with the UK health system have always been good as have my experiences with US health care. But, I'm worried that the US will not be able to control the cost/effectiveness equation as well as they can in Europe. Like any bubble health care costs cannot keep increasing at 10% a year and there are so many vested interests in the US medical system that it looks like it will continue the same way until it collapses.

 

[tuixiu]

That's interesting. Do you know how do they enforce the health insurance mandate?

Also = are there insurers who don't play? As in they don't find the conditions as profitable so don't offer insurance in MA?

 

[M Paquette]

I put together a whole decision tree for health insurance before I retired, and switched to an employer plan that would produce the best results, that is, supported as much of both the entire tree of possibilities, and my 'worst case scenario.'

I started retirement by switching to COBRA coverage, and then applied for a high deductible HSA plan, my desired path. I got DD on this, but not DW and I. So, we stick with COBRA for the full 36 months, then continue onto an HIPAA plan that doesn't require medical review.

Expensive? Oh, yah, sure, you betcha! At least we have coverage.

 

[nun]

That's interesting. Do you know how do they enforce the health insurance mandate?

Also = are there insurers who don't play? As in they don't find the conditions as profitable so don't offer insurance in MA?

You get a form from your insurance company each year and have to include it's details on your state taxes. If you don't you get a fine.

The insurers/HMOs are look to be same as in the state's plan so Blue Cross, Fallon community, Tufts and Harvard pilgrim

 

[Kabekew]

There's private plans through brokers like ehealthinsurance.com (have to qualify for it, although I went through them and it was painless), expensive but HIPAA guaranteed also through brokers, then there's wait-and-see what congress comes up with on a national plan. Aren't they aiming to get it done this month?

 

[Stevewc]

The health care thinky congress is working on looks more and more like pie in tha sky. At first I was thinking it might actually be something that would cut our cost and help retiree's. I guess I was expecting to much. Now, it looks like it will be so watered down that we will be lucky if we aren't paying more for less. Maybe they will, at the very least, stop some of the pre-existing condition stuff so we can buy policies for our families without being turned down or charged more.
While I'm at it, let me ask a question. Do you think the AHIP (high risk) pools would be forced to lower prices if congress does stop the pre-existing conditions that apply today?
Steve

 

[Bikerdude]

Part of my "total compensation" package at MegaCorp included retiree health benefits. It is no longer offered to new employee's. My single policy costs $6,750 of which I pay $2,400 a yr. with a $500 deductible and 20% co-pay until a $5,000 out of pocket is met. No limit on coverage.

 

[DangerMouse]

Nun, remember if you are returning to the UK to take advantage of the healthcare you will have to be sure you live in the right area due to the postcode lottery that is the UK system. However, you don't have to limit yourself to the UK, think of other countries that you can access the medical system due to the EEU.

As an Australian I know Australia has a reciprocal agreement with Greece and Italy so we could live in either of those countries (DH has a UK passport) and have the free medical.

 

[Martha]

Minnesota risk pool, I pay $396 a month, $2000 deductible, 80/20 coverage, $3000 maximum out of pocket.Though I use the full deductible each year it is still cheaper than the low deductible plans which have much higher premiums. Spouse is in the next up age group, he pays $375 a month but with a $5000 deductible/maximum out of pocket. By far, health care costs are our largest expense.

 

[Zoocat]

Minnesota risk pool, I pay $396 a month, $2000 deductible, 80/20 coverage, $3000 maximum out of pocket.Though I use the full deductible each year it is still cheaper than the low deductible plans which have much higher premiums. Spouse is in the next up age group, he pays $375 a month but with a $5000 deductible/maximum out of pocket. By far, health care costs are our largest expense.

That's about what I'm paying with my private coverage. I thought the public risk coverage was cheaper. But there's no exclusions, right? What's your lifetime maximum benefit, Martha?

 

[IndependentlyPoor]

The MegaCorp I worked for pays 100% of the health coverage for the lucky dudes who retired a few years ago. They don't pay any of mine, but they did allow me to remain a member of the group after retiring.
I wonder how widespread this is, as it seems to be a good idea. It doesn't cost the company anything and is a great benefit to us retired folk. Without it, my only option would be the expensive Texas assigned risk pool. (The plan probably does cost them more due to more sicker old folks in the pool.)
Just having insurance is most of the game anyhow. My recent last lab tests would have cost an uninsured person $420. The negotiated rate saved $342.

 

[audreyh1]

For us as a couple 49&54 - high deductibles ($5K and $8K respectively), no dental, no vision, $690 a month.

 

[cardude]

Our family plan for me (44), DW (43) and kids (9 and 12) runs $491 through Blue Cross Blue Shield. High deductable (5K each) and 20% copay so it's not very good, but will work for emergencies I guess.

Found the plan though ehealthinsurance.com

 

[Martha]

That's about what I'm paying with my private coverage. I thought the public risk coverage was cheaper. But there's no exclusions, right? What's your lifetime maximum benefit, Martha?

No exclusions. Minnesota is the least expensive risk pool for what you get. Three million lifetime max.

 

[Stevewc]

Martha,
Do you think the State type risk pools will change for the better if the pre-existing condition thing is eliminated due to congressional changes? Seems to me it would no longer be considered a high risk pool and everyone would be treated the same? That is giving me some hope for better pricing in my State which has a very expensive AHIP plan.
Steve

 

[REWahoo]

I suspect state pools may go away entirely if the pre-existing condition exclusion is removed via new health care regulations. Things are still way too fuzzy to be sure at this point.

 

[ksr]

I have a high-deductible ($2500 ded) HSA-eligible plan and pay about $150/mo. I'm 49. I think the premium is going to jump to closer to $200 next year when I turn 50. I bought it through ehealthinsurance.

I also pay for a dental plan that gives me negotiated rates at my dentist. That plan costs about $100/yr but saves me more than $100 with just a typical year's worth of dental visits (I did the math before I signed up, and also verified that my dentist participated in the plan).