If you are retired & 54 - 59 yrs old, how much are you paying for health insurance?

[PaddyMac]

We're both 57 and in 2018 our Bronze Plan with HSA in New Mexico jumped to $1087 a month. Self-employed, semi-retired (royalties still coming in).

We did not qualify for ACA subsidy in 2017 due to high income, but I'm going to try to fit our lower income in 2018 into the space as an estimate I ran said we could get $10K back in subsidies. So it might be worth it to stuff our 401k.

I expect it to jump a lot in 2019, but our (income from royalties) continues to drift down.

 

[Walt34]

I retired at 52, DW at 46. We are fortunate to have heavily subsidized HI (BCBS) from my former employer who pays 70% of the premium and we pay 30%, which comes to a hair over $700/month for the two of us. Since I'm now on Medicare it is secondary to Medicare and will be for DW when she hits 65. No deductibles, office visit copays are $10 for her, none for me and emergency room visits are zero if admitted and $50 if not admitted for her. Prescriptions are normally $5, occasionally $10.

Last year I had two surgeries for two different melanoma sites (both caught very early so no follow-up needed) and my OOP was $0.

All those midnight shifts are paying off big time.

 

[ikubak]

I'm definitely retiring around 56-58. I have no company insurance, no military insurance .. so my only hope is ACA or whatever system will replace it. It's just DW and myself. She's currently covered under my insurance and we pay around $560/month (and it is subsidized by my work). We don't have kids.



I know with ACA, an income of $18,000-$44,000? will receive subsidy.



And if it is lower than $18,000, meaning if I don't withdraw that much from my retirement account, I fall within Medicaid ? Not sure. Is Medcaid dependent on income or assets? I know ACA depends on yearly income.



I was just wondering how much you guys in this particular age bracket are paying for health insurance (husband and wife, without kids). Thanks!

56 and pay $0 for a bronze plan. Fortunately, DW and I are pretty healthy at this stage of life. DW has had two Dr visits this year, a periodic dermatology visit and eye dr checkup from a cataract surgery a year or two ago. We also get regular dental cleanings once a year. No drugs other self medicating with caffeine and alcohol and the occasional OTC drugs.

 

[ikubak]

I will also add that we keep our MAGI in the range that keeps a bronze plan fully subsidized. We have funds in taxed deferred accounts, Roth accounts and funds outside of retirement accounts. Our SS and pensions don’t start for about 5 years. So we mange our use of funds from the right accounts to keep our MAGI in the “free bronze plan” range.

 

[Dtail]

This is so confusing! I don't understand how premiums can be so all over the place, Point Breeze and Dash Man for example.

There can huge differences depending which state/county you are from plus the MAGI reported.
My brother and I pay a total of $300 monthly for a full silver plan with no deductible based on 24K MAGI in FLA.

 

[GTFan]

Yes, exactly. It all depends on where you live, the metal level you choose and how much income you report.

We pay $68/mo. for an Ambetter 250 ded/750 max OOP per person Silver plan. Only reason it's that cheap is because we have kept income below 150% FPL.

I'm glad Blue Cross is coming back to metro ATL next year because their network is much better but we have had no issues with Ambetter this year.

 

[hotwired]

Health Insurance

We are semi retired, 52, and pay for our own. The premium is 18K per year with 13K deductible per person. BUT, we got lucky this year ... O'Bama care pays all but $3 per month. It's still "virtually nonexistent insurance" but it covers wellness and we do have an HSA which we use as a retirement account. If our AGI goes a cent over 80K we have to pay the entire 18K subsidy back.

I can't believe some of the rates I'm hearing on this thread. We've NEVER paid less than $400 per month (family of 3. Myself, wife, both 52 and daughter 17,. 13K deductibles, no copays or limits otherwise. We basically pay 100% of our health care except our annual physical). We will be "expatriating" to at LEAST Florida ASAP for this reason and many others.

 

[MBSC]

We are semi retired, 52, and pay for our own. The premium is 18K per year with 13K deductible per person. BUT, we got lucky this year ... O'Bama care pays all but $3 per month.

You may want to review your policy again. An ACA-compliant family plan with a high MOOP must have an embedded individual MOOP that does not exceed $7,350 in 2018.

Effective Jan 1, 2016, non-grandfathered health plans cannot allow any individual, including those with family coverage, to spend more than the individual out-of-pocket (OOP) maximum established under Patient Protection and Affordable Care Act (PPACA). Commonly referred to as an embedded individual OOP maximum, this rule could impact a family’s total health care expenses, especially if only one family member incurs high medical expenses. The 2018 PPACA OOP maximum amount is $7,350 for an individual.

How it works

* Once an individual with family coverage meets the individual OOP maximum, the plan must pay 100% of all covered expenses for that person, even if the family maximum has not been met.

* Once the family OOP maximum is reached the plan must pay 100% of all covered expenses for every covered individual — regardless of whether each family member has reached the individual maximum.

Source: https://www.cigna.com/health-care-reform/embedded-oop-customer-impacts

For 2018, the individual OOPM is $7,350, and the family OOPM is $14,700. Under the rules that took effect in 2016, no single member of a family can be required to pay more than $7,350 in out-of-pocket charges in 2018, regardless of whether the rest of the family has incurred any claims. This includes people enrolled in family HDHPs, and HHS has clarified that this does not conflict with HSA and HDHP requirements.

Source: https://www.healthinsurance.org/faq...hat-full-deductible-even-for-just-one-person/

 

[Dtail]

We are semi retired, 52, and pay for our own. The premium is 18K per year with 13K deductible per person. BUT, we got lucky this year ... O'Bama care pays all but $3 per month. It's still "virtually nonexistent insurance" but it covers wellness and we do have an HSA which we use as a retirement account. If our AGI goes a cent over 80K we have to pay the entire 18K subsidy back.

I can't believe some of the rates I'm hearing on this thread. We've NEVER paid less than $400 per month (family of 3. Myself, wife, both 52 and daughter 17,. 13K deductibles, no copays or limits otherwise. We basically pay 100% of our health care except our annual physical). We will be "expatriating" to at LEAST Florida ASAP for this reason and many others.

That's the deal. Get yourself to FLA.

 

[hotwired]

Correction

A couple of you caught my error. The deductible I was referencing was our old plan from 3 years ago. Our deductible is 6500 per person with a $13,000 family deductible. I usually have a better handle on my numbers than that, sorry! All the other numbers are accurate.

 

[tb001]

This is a great thread; thank you all again.

I continue to fret about health care costs for those FIRE'd, not on a company plan, and not yet 65. And also with a significant disease. Stuff does indeed happen, and indeed, I think health stuff happens fairly commonly, certainly as one moves into their 50's and heads towards their 60's. I know exceedingly fit people who have died of heart attacks or cancer in their 50's.

Another wrinkle. None of the plans available to me on the exchange covered the top hospitals, and similarly, some of the top hospitals, so I've come to learn, tend not to accept ACA plans.

You also are gambling that you don't get a fairly common disease such as cancer that could benefit from treatment at a top hospital.

Selectively quoting, but I think the assumption you are making is that people on a company plan are going to have access to those top hospitals. They don't.

I agree it's a big issue, and personally I want access to top care, but at some point you have to weigh the impact of work on your health vs the extra $ you're putting in the bank for healthcare by working.

 

[jim584672]

0-150 FPL, $0 premium, $200 MOOP

150-200 FPL, $20 a month, $2,000 MOOP

Unsubsidized Silver SLCSP 2017 $456 single, $913 couple, no age rating


NY rates

 

[Dtail]

0-150 FPL, $0 premium, $200 MOOP

150-200 FPL, $20 a month, $2,000 MOOP

Unsubsidized Silver SLCSP 2017 $456 single, $913 couple, no age rating


NY rates

Wow much better rates even than FLA for a SLCSP.

 

[Rianne]

Tru dat.

Health insurance is a misnomer in terms of what a policy is inherently designed to do for the insured. "Health insurance" and the companies that sell these policies provide little in the way of insuring an individual's health. Viewed through that lens, health insurance is a flawed product. It's really asset insurance for the purpose of providing some level of protection from exorbitant health care costs for the insured and ultimately turning a profit for the insurance company.

An earlier poster mentioned diligence when it comes to taking care of one's health in retirement. The best insurance is that ounce of prevention from a lifetime of good habits - along with the caveat that in spite of one's best efforts, sh*t can happen!

Well said. I do find it odd that car insurance is required and health insurance is not. I guess there are penalties not having HI, but if you're without car insurance it is illegal in 50 states. I'm guessing CI protects all the injuries the accident, but a chronic illness affects many others too. I think the responsibility for an illness is contained in the family? Or spouse? A car accident could affect many outside the family.

 

[scrabbler1]

Well said. I do find it odd that car insurance is required and health insurance is not. I guess there are penalties not having HI, but if you're without car insurance it is illegal in 50 states. I'm guessing CI protects all the injuries the accident, but a chronic illness affects many others too. I think the responsibility for an illness is contained in the family? Or spouse? A car accident could affect many outside the family.

With car insurance, some but not all coverages are mandatory (and even that can vary from state to state). Third party liability coverages such as Bodily Injury (BI) and Property Damage (PD) are the main ones which fall within mandatory insurance laws. No-Fault (or PIP, Personal Injury Protection) is usually required in the minority of states which allow it, while Medical Payments, PIP's frequent substitute for PIP, is usually not required even though most people buy it. PIP and Med Pay tend to be first-party coverages but include some benefits for others.

Other liability coverages such as Uninsured Motorists Bodily Injury (UMBI) are sometimes mandatory but usually are optional although, like Med Pay, most people buy them. Uninsured Motorists Property Damage (UMPD) varies more from state to state and is less often mandatory.

The Physical Damage coverages such as Comprehensive and Collision are never required the way liability coverages are, unless you have a bank loan on the car; the bank will often if not always require you to buy those coverages to protect their interest. Even then, most people buy those coverages until the value of the car becomes way too low (usually through age).

I think HI should be required and have no problem with PIP being required.

 

[bobandsherry]

$0 per month for HMO ACA plan for the two of us.

Retired 4 years ago at 55.

Similar here, we are paying $0 annually for Bronze plan, $6,400 deductible. This is $1,391 subsidy. Silver would have cost $341 w/$0 deductible (after subsidy), we are ahead of the game by going with Bronze this year.

 

[Reach]

Similar here, we are paying $0 annually for Bronze plan, $6,400 deductible. This is $1,391 subsidy. Silver would have cost $341 w/$0 deductible (after subsidy), we are ahead of the game by going with Bronze this year.

Interestingly, we (myself & spouse) have been able to stay with the same Florida BlueOptions plan before and after ACA. We use it for its national and global coverage options in-network.

In 2014-2016, ACA Silver plans gave us more favorable out of pocket options (lower deductibles, copays) at the same premium as we'd been paying for the high deductible plan on our own.

In 2017-2018, we switched to a Bronze plan, as the Silver premiums went through the roof (100% increase). The Bronze plan reduced the premium back to where we started at the price of a higher deductible, again.

I figure that we are back where we started at ER 10 years ago... with the exact same plan! Our ages went from 39/45 to 49/55 during this time.

Can't imagine paying the outrageous premium without the subsidy now though... our 2008 monthly payments were $157 ($10k deductible) and that same plan in 2018 ($6500 deductible) now has a monthly base premium of $1365.

 

[cyber888]

Similar here, we are paying $0 annually for Bronze plan, $6,400 deductible. This is $1,391 subsidy. Silver would have cost $341 w/$0 deductible (after subsidy), we are ahead of the game by going with Bronze this year.

Wow, nice .. so I guess if you use up all the deductible .. that will amount to around $530+ a month at $6,400.

 

[bobandsherry]

Wow, nice .. so I guess if you use up all the deductible .. that will amount to around $530+ a month at $6,400.

More than that as it's $6,400 is per person. And max OOP for two of us is $13,800 or $1,150 if we each encountered significant medical expenses in the year. By comparison Silver plan would have cost us about $4,000 for the year before any benefits paid. Our out of pocket expenses paid this year (so far) are less than that. So ahead of the game just on premiums alone.

However, the value I see in having insurance is negotiated rates, keeps those costs down. As example Dr visit would be $250, I pay $30. Also had cataract surgery, facility charge w/o insurance was $8,209, but negotiated rate was $967.

 

[45th Birthday]

57 and 60. FloridaBlue Bronze HSA plan. Broad network. $12K family deductible. 2019 premium $24K. So, if we get really sick, we pay $36K.

Oh, that and the extra Obamacare tax of $42K that we had to pay last year.

Love those stories about people with substantial means getting free health care. Who do you think is paying for it?

 

[sengsational]

I will also add that we keep our MAGI in the range that keeps a bronze plan fully subsidized. .... So we mange our use of funds from the right accounts to keep our MAGI in the “free bronze plan” range.

Nicely put. I was about to say "we pay $0" for our NC plan, but like the wording you came up with because it better describes the process.

 

[bobandsherry]

57 and 60. FloridaBlue Bronze HSA plan. Broad network. $12K family deductible. 2019 premium $24K. So, if we get really sick, we pay $36K.

Oh, that and the extra Obamacare tax of $42K that we had to pay last year.

Love those stories about people with substantial means getting free health care. Who do you think is paying for it?

Based on some of you earlier postings, I don't think anyone is going to need to set up a "go fund me" for you. Nothing wrong with people who work within the IRS rules and such. The funds they are using today have been taxed earlier, and probably at a pretty significant level.

And I'll bet that if you think back you've probably found ways to make the IRS rules beneficial to you (people who own their own company always have a lot a latitude with what and how things are reported). No harm, no foul.

 

[Dtail]

Based on some of you earlier postings, I don't think anyone is going to need to set up a "go fund me" for you. Nothing wrong with people who work within the IRS rules and such. The funds they are using today have been taxed earlier, and probably at a pretty significant level.

And I'll bet that if you think back you've probably found ways to make the IRS rules beneficial to you (people who own their own company always have a lot a latitude with what and how things are reported). No harm, no foul.

This subject has been addressed many times and the bottom line is mostly no one who is able to manage MAGI for the ACA credits has an issue with it. Only the ones who can't do it.
Should the mortgage interest deduction folks give a subsidy back to the renter folks?

 

[bobandsherry]

This subject has been addressed many times and the bottom line is mostly no one who is able to manage MAGI for the ACA credits has an issue with it. Only the ones who can't do it.
Should the mortgage interest deduction folks give a subsidy back to the renter folks?

Agree.... And the ones who can't are those that have tucked away income for years and paid no taxes on that money. They had no problem earning money and not paying their "fair share" then, after all someone has to pay for the cost to operate the government.

And the ones that can manage MAGI are those who already have paid taxes on those earnings and now spending that money. As the tax man says, pay me now or pay me later.

 

[Dtail]

Agree.... And the ones who can't are those that have tucked away income for years and paid no taxes on that money. They had no problem earning money and not paying their "fair share" then, after all someone has to pay for the cost to operate the government.

And the ones that can manage MAGI are those who already have paid taxes on those earnings and now spending that money. As the tax man says, pay me now or pay me later.

Nice angle.