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Can someone point me to the best threads to read about health care options after FIRE
Old 02-06-2020, 02:18 PM   #1
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Can someone point me to the best threads to read about health care options after FIRE

I achieve FIRE last year. I have been on COBRA but that ends late in 2020. I am doing some research and looking to combine a HDHP and HSA account for me and my family (we have been very healthy to date).

I just want to learn about all my options and would appreciate it if someone could point me to some good threads to read.

Thanks.
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Old 02-06-2020, 05:08 PM   #2
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Most likely your best bet is the ACA marketplace. Start at healthcare.gov or healthsherpa.com. https://www.kff.org/interactive/subsidy-calculator/ is a quick way to determine your subsidy if you can stay at under 400% FPL.
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Old 02-06-2020, 05:15 PM   #3
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Originally Posted by RunningBum View Post
Most likely your best bet is the ACA marketplace. Start at healthcare.gov or healthsherpa.com. https://www.kff.org/interactive/subsidy-calculator/ is a quick way to determine your subsidy if you can stay at under 400% FPL.


One warning of ACA. I looked into it this month and found out the deductible for out of your immediate area (in NC) is 40k. I was shocked to hear that and have two college age boys in other parts of the state so if they were hurt there, 40k.

We were able to go back on my corporate premedicare insurance.
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Old 02-06-2020, 05:36 PM   #4
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... your immediate area (in NC) is 40k....
I missed the post above that indicated anyone was from North Carolina?!? (caught my eye because that is a possible retirement state for us -- predominately BCBS from my research)
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Old 02-06-2020, 05:57 PM   #5
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Originally Posted by retired2015b2d View Post
One warning of ACA. I looked into it this month and found out the deductible for out of your immediate area (in NC) is 40k. I was shocked to hear that and have two college age boys in other parts of the state so if they were hurt there, 40k.

We were able to go back on my corporate premedicare insurance.
Not sure how typical that is of ACA policies, so you're painting with a really wide brush.... but a fair point that the OP should consider coverage while traveling.

Our BCBS ACA policy works anywhere... we're snowbirds and use it at both homes and have had no issues at all.
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Old 02-06-2020, 06:23 PM   #6
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Not sure how typical that is of ACA policies, so you're painting with a really wide brush.... but a fair point that the OP should consider coverage while traveling.

Our BCBS ACA policy works anywhere... we're snowbirds and use it at both homes and have had no issues at all.
Thanks for pointing that (multiple states) out about BCBS. We have been buying 'Berkshire Hathaway Travel Protection' when traveling (roadtrips). Learned how expensive medical bills are if you have a car accident a few years back. You can do roadtrips and just specify $1 in this example and double the medical for like $10 extra ($50K).

BCBS site: https://www.bcbs.com/articles/covera...ss-blue-shield
Quote:
Planning to hit the road this travel season? Youíve got a lot to do! Youíll have to book your travel, lodging and activities, pack and be sure your home is looked after while youíre gone. Thatís a lot to think about, and the list goes on. With so much to do, itís easy to overlook one item that might prove crucial: ensuring that you will be covered if you need medical care while traveling.

Most Blue Cross Blue Shield members can rest easy since Blue Cross Blue Shield coverage opens doors in all 50 states and is accepted by over 90 percent of doctors and specialists. And if your extended travel plans take you abroad, you can ensure you have access to quality care through GeoBlue.
<snip>
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Old 02-06-2020, 06:28 PM   #7
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If you are healthy and your monthly income falls below certain number then you may want to consider Medicaid, provided you live in a state with expanded Medicaid. I didn't know much about it but when I was on the phone with the Marketplace advisor (I had questions) she told me that due to my income I did not qualify for an ACA plan but I did qualify for Medicaid. I filled up the application where I checked the box next to "I stopped working" and then submitted paperwork detailing my income: it's just interest and dividends totaling maybe 1k a month. I live off savings. Medicaid people don't care how much money you have, only what you're bringing in monthly. So if you sit on half a million of cash it makes no difference.

Well, I qualified and now have completely free health insurance for a year. Including dental and vision. My next recertification date is in September. Oh, it so happens that I can do ROTH conversion and capital gains harvesting and it won't affect my eligibility because if I do it in one month, it's not considered a "monthly" income - just one time event.

I know that a lot of people around these boards consider Medicaid in early retirement unethical but this was not my idea - I legitimately did not qualify for ACA. In order to qualify I would have to decide ahead of time to inflate my estimated income by selling stock or doing a ROTH conversion. I wasn't sure I wanted to do it so I ended up with tiny amount. Come September/November I will have decisions to make: do I take advantage of this free insurance for another year or do I sell stock and move on to ACA? The good thing is that I can sell as much or as little as I want and reduce my premiums to $2 a month. Yes, there would a deductible but also an access to HSA which does not need to be funded from earned income
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Old 02-07-2020, 12:03 PM   #8
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When we retired, we relocated to a warmer, lower cost of living area. Since this was an ER, we selected the only HSA-eligible ACA plan available to us (my work insurance would NOT extend beyond COBRA-mandated length). And, since we were in a new area with no knowledge of good/bad local medical providers, we chose to “front-end” our HSA plan with a concierge doc who has extensive relationships across numerous specialties. Even though he doesn’t show up as a primary-care doc in our ACA plan, our doc is listed as a specialist, and can make referrals, order tests, etc. It’s a bit more expensive, but the overall level of care we have received ranges from good to very good. The concierge plan we signed up for is through MDVIP (https://www.mdvip.com/), and has been great. Given our particular circumstances, this seemed to be the best option for us.
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