Advice on Private Health Insurance

[Dino1]

Like most people, when I retire at 62 I will have to wait three years before I am eligible for Medicaid (my wife is two years younger than I). Therefore I need to have private insurance for myself for a three year period and five years for my wife. I am in perfect health but my wife has many health problems ("pre-existing conditions"). I can continue the coverage I have at work which is an outstanding plan at about $1600 per month for two of us or I can look outside. Does anyone have any advice on private health insurance between age 62 and medicaid? $1600 seems like a lot, Thanks in advance for sharing your expertise.

 

[REWahoo]

Dino, while $1,600 a month may sound like a lot to continue your employer's plan, it is likely good coverage with reasonable deductibles. Based on my experience you may be able to get a high-deductible ($5,000) policy for yourself at rates under $500/mo but finding coverage for your spouse will be difficult if not impossible if she has a history of health problems.

Oh, and if you do find private coverage for her they will almost certainly exclude coverage for all her pre-existing conditions.

 

[Bestwifeever]

Agree with REWahoo.

Anecdotally, yesterday I saw an ophthalmologist on staff at a major teaching hospital who is 60. He asked about what DH (62) and I (60) pay for retiree health insurance through DH's old company ($800/mo for the two of us). He said the hospital offers retiree health insurance at $3,000/mo for a couple.

 

[Silver]

$1,600 a month for both my husband and I through United Health Care is the best I've been able to find for individual HI. And that's with a $5,000 deductable. It's $2,000 a month for a $2,500 deductable.

We haven't applied yet, but I imagine there is going to be some riders on pre-existings for us. We may decide it's not worth it and self-insure...which makes me very nervous but may be worth the risk.

 

[KingB]

DW recently retired and we are continuing our HI (medical,dental and vision) through COBRA at less than 1K/month. We have an option of taking the retiree health benefit with the same coverage that is also being offered at >2K/month. Of course, we took the less expensive route. After 18 months of COBRA, I may end up going to the retiree benefit if COBRA can not be extended. DW will be on medicare then.

Check if you can get into COBRA first.

 

[RunningBum]

Find an insurance agent. Regular poster dgoldenz is in my state and he found an HSA policy that ehealthinsurance.com didn't show, and also advised me on which level he thought I'd be at given my conditions. There was no extra cost to me and it helped a lot to have the guidance.

 

[dgoldenz]

$1,600 a month for both my husband and I through United Health Care is the best I've been able to find for individual HI. And that's with a $5,000 deductable. It's $2,000 a month for a $2,500 deductable.

We haven't applied yet, but I imagine there is going to be some riders on pre-existings for us. We may decide it's not worth it and self-insure...which makes me very nervous but may be worth the risk.

Is that a HIPAA policy? That sounds really high....what state are you in?

Like most people, when I retire at 62 I will have to wait three years before I am eligible for Medicaid (my wife is two years younger than I). Therefore I need to have private insurance for myself for a three year period and five years for my wife. I am in perfect health but my wife has many health problems ("pre-existing conditions"). I can continue the coverage I have at work which is an outstanding plan at about $1600 per month for two of us or I can look outside. Does anyone have any advice on private health insurance between age 62 and medicaid? $1600 seems like a lot, Thanks in advance for sharing your expertise.

Will your employer allow you to keep your wife on the group policy without you as the primary? That is the key here....if not, you may be stuck. If so, consider keeping the group policy for your wife and buying an individual policy for yourself.

What state are you in? Even if your wife has pre-existing conditions, if your state has a good risk pool, it may be less expensive than keeping your group policy. Maryland, for example, has a great risk pool with an option to buy up to a no-waiting-period for pre-ex benefit. An independent broker that knows the companies in your state would be helpful and it won't cost you anything to talk to them. I'd suggest talking to a few since not every broker knows their stuff and a lot of the good ones are leaving the business because of commission cuts resulting from PPACA....

 

[Silver]

Is that a HIPAA policy? That sounds really high....what state are you in?


dgoldenz.....yes....it is HIPPA as guaranteed issue. I live in Florida, currently have COBRA running out soon with no conversion possible. I have worked with a local independent agent and done a lot of research myself.

There is also a product from Assurant that we might be able to get, but I have not been able to find many providers in the Orlando area that accept it. And....there would still probably be riders for the entire time of a policy.

My only fear is surgery and/or hospitalization. We can meet our routine medical needs without problem. But we haven't been able to find anything reasonable up to this point.

Thanks for the interest.

 

[dgoldenz]

dgoldenz.....yes....it is HIPPA as guaranteed issue. I live in Florida, currently have COBRA running out soon with no conversion possible. I have worked with a local independent agent and done a lot of research myself.

There is also a product from Assurant that we might be able to get, but I have not been able to find many providers in the Orlando area that accept it. And....there would still probably be riders for the entire time of a policy.

My only fear is surgery and/or hospitalization. We can meet our routine medical needs without problem. But we haven't been able to find anything reasonable up to this point.

Thanks for the interest.

A HIPAA policy would not have any exclusion riders for pre-existing conditions, which is the reason for the high rate. If both of you can only qualify with the HIPAA coverage, that sounds in the ballpark for two people in their 50's or 60's. Unfortunately there are only a couple plans available form each company in Florida. Here in VA, you can choose any plan from any company. Do both of you have pre-existing conditions that would prevent you from getting a fully underwritten policy?

I would take the UHC policy over Assurant any day...

 

[Silver]

Interestingly, I have spoken to two indepedent HI agents, and both have led me to believe that there could be exclusions riders even with guaranteed issue policies. So that piece of info is helpful. Thank you.

I have explored underwritten HI opposed to guaranteed issue. My DH has two pre-existings that are both denials for individual HI, (hypertension and DM type 2) and I have one pre-existing that would result in an exclusion rider...I had a total hip replacement 7 years ago.
We are still considering trying to get coverage for just me and just accept the rider....have not yet decided.

 

[dgoldenz]

Interestingly, I have spoken to two indepedent HI agents, and both have led me to believe that there could be exclusions riders even with guaranteed issue policies. So that piece of info is helpful. Thank you.

I have explored underwritten HI opposed to guaranteed issue. My DH has two pre-existings that are both denials for individual HI, (hypertension and DM type 2) and I have one pre-existing that would result in an exclusion rider...I had a total hip replacement 7 years ago.
We are still considering trying to get coverage for just me and just accept the rider....have not yet decided.

Did those agents have experience doing HIPAA policies before? Most companies don't even require you to complete the medical information on the application when applying for HIPAA coverage, so how would they even know what's pre-existing? United doesn't cover mental health on HIPAA, but that's not an exclusion rider since every policy works that way.

 

[pb4uski]

........ I would take the UHC policy over Assurant any day...

+10

 

[chinaco]

My biggest concern would not be the cost of coverage... but would be around the possibility of being denied coverage.

Health insurance coverage is expensive.

Can you use COBRA. I think it can be used to extend your company coverage for up to 18 months.

The Obama care state health exchanges are supposed to be available in 2013. But there are court challenges and it is being debated still in the legislature.

You might be able to use those two options until you and your DW are eligible for Medicare.

 

[Glo]

10 months until medicare for me; I've been w/o health insurance for 2 years and I'm holding my breath. I had to cancel the private insurance I had when the premium reached $1500/month with a $5000 deductible. This policy was through BCBS who I'd been with for over 20 years. I cannot get any type of insurance due to preexisting conditions. The ironic thing is that although I have preexisting conditions, I'm never sick and have never been in the hospital except to give birth.

 

[dgoldenz]

10 months until medicare for me; I've been w/o health insurance for 2 years and I'm holding my breath. I had to cancel the private insurance I had when the premium reached $1500/month with a $5000 deductible. This policy was through BCBS who I'd been with for over 20 years. I cannot get any type of insurance due to preexisting conditions. The ironic thing is that although I have preexisting conditions, I'm never sick and have never been in the hospital except to give birth.

Yikes. Age 60-64 is a tough one with individual health insurance if you aren't in good health....I have a good number of clients counting down the days until Medicare so they can get rid of their four-figure health insurance premiums. One that I just wrote an individual plan on had a family rate of $4200/month on a two-person group health policy. The other person on the policy was $1500/month for a single person, so $5700/mo for one family and one individual. Husband went on Medicare and wife went on a $400/mo $0 deductible plan. $50k/year is nuts, seems like you might as well take your chances at that point.

 

[Glo]

Sometime I think "what are we suppose to do? Lay down and die I guess".

 

[teejayevans]

Sometime I think "what are we suppose to do? Lay down and die I guess".

Insurance companies are trying to cherry pick the health individuals for maximum profit. It's why the free market "solutions" won't work.
One option is to leave US and live where you have access to cheap health care (Mexico for example).
Second option is to commit a crime, go to jail, then you'll get free health care, plus free housing
Another problem is there is no standardization, each policy is different, each company has a different list of preexisting conditions (which they don't publicize).
What a mess...
TJ

 

[eytonxav]

One of my peaves with health insurance relates to these pre-existing conditions. For example, if you were ever placed in the high risk pool due to issues such as high blood pressure and cholesterol years ago, but have subsequently been able to turn such conditions around, you can't get off the bad list. Afterall, it says nothing about ones current health, considering many people turn their lifes around by losing weight, getting fit and eating healthy, but yet they remain health insurance outcastes for life and have to continue to pay through the nose. Just seems wrong to me.

 

[dgoldenz]

One of my peaves with health insurance relates to these pre-existing conditions. For example, if you were ever placed in the high risk pool due to issues such as high blood pressure and cholesterol years ago, but have subsequently been able to turn such conditions around, you can't get off the bad list. Afterall, it says nothing about ones current health, considering many people turn their lifes around by losing weight, getting fit and eating healthy, but yet they remain health insurance outcastes for life and have to continue to pay through the nose. Just seems wrong to me.

Where'd you get that info from? Health insurance is based on your current health at the time of application and your medical history. BP/cholesterol meds a few years aren't going to get you declined if you are off them now and your numbers are good. There is a huge difference between blood pressure/cholesterol and a history of cancer/heart attack/stroke/etc. If you somehow turn things around and become healthier, get off BP/cholesterol meds, lose weight, etc, you most certainly can reapply for a lower rate.

 

[Animorph]

I'm hoping DW dosen't retire until COBRA will carry us into "Obamacare" territory. And hoping that it isn't gutted in the mean time.

It would be nice if things were structured to allow guaranteed transfers from j*b HI to individual HI without changing insurance pool characteristics. Or if individuals got the tax break on HI instead of businesses back when I started working. The current system certainly doesn't encourage RE.

 

[teejayevans]

I'm hoping DW dosen't retire until COBRA will carry us into "Obamacare" territory. And hoping that it isn't gutted in the mean time.

It would be nice if things were structured to allow guaranteed transfers from j*b HI to individual HI without changing insurance pool characteristics. Or if individuals got the tax break on HI instead of businesses back when I started working. The current system certainly doesn't encourage RE.

Nope, because you are a small minority, furthermore, you are dreaded rich, to be able to RE (ignore the fact that you sacrificed by saving money, etc).
Supreme court just decided not to fast track court cases on Obamacare, too bad, clarity would nice.
TJ

 

[eytonxav]

Where'd you get that info from? Health insurance is based on your current health at the time of application. There is a huge difference between blood pressure/cholesterol and a history of cancer/heart attack/stroke/etc. If you somehow turn things around and become healthier, get off BP/cholesterol meds, lose weight, etc, you most certainly can reapply for a lower rate.

I didn't know that, but presumed that was the case. Thats good to know and certainly should be an incentive for folks with past health issues that are reversible. Nevertheless, for me, I have retiree coverage from my former employer until medicare at 65. I am on meds for BP/Cholesterol/T2 Diabetes. The meds are very low $ (eg liscinopril, simvastatin, metformin) and coupled with eating right and exercising have kept all my readings such as BP/Cholesterol/A1C in very good shape over the past several years. However, I suspect even if I could halt the meds entirely and still have good #s, I would have a problem due to T2D diagnosis several years ago, no?

 

[dgoldenz]

I didn't know that, but presumed that was the case. Thats good to know and certainly should be an incentive for folks with past health issues that are reversible. Nevertheless, for me, I have retiree coverage from my former employer until medicare at 65. I am on meds for BP/Cholesterol/T2 Diabetes. The meds are very low $ (eg liscinopril, simvastatin, metformin) and coupled with eating right and exercising have kept all my readings such as BP/Cholesterol/A1C in very good shape over the past several years. However, I suspect even if I could halt the meds entirely and still have good #s, I would have a problem due to T2D diagnosis several years ago, no?

The BP and cholesterol are ok, but diabetes in combination with those will knock you out with every company I know of. For reference, diabetes w/ good control and oral meds only can get fully underwritten coverage here with Anthem, but if there are any co-morbid conditions (BP, cholesterol, overweight, etc) would be a decline.