Opinions/comments on health insurance/possible divorce

[madsquopper]

Will try to be brief. After 25 years, spouse and I may need to end things (amicably, best way to put it is we would have been better off being friends than marriage partners). It's possible we'd separate but stay legally married for some time (possibly longish) but eventually I expect it would be finalized.

Currently on spouses retiree health plan, I'm on the medicare advantage option (was the only thing they offered) but in our area it's a good plan so have had no complaints at all. But eventually I'd need to get my own insurance. Have been diagnoses as type 2 diabetes but well controlled with no drugs, but it's still a pre-condition.

With the current political situation I feel there's significant risk of ACA being repealed (and what it gets repealed with is totally unknown) in which case it might be much harder/expensive to get my own plan, so am considering doing it now (open season is arriving in a few weeks).

Have looked carefully into options and have found something decent and am trying to decide if I should just make the switch this year, or wait until sometime later when I have more time to consider all the options. The rational part of me says I should just switch now to be safe, but emotionally it's kind of tough.

Thanks in advance for any help, especially if you can point out things I may not have thought of.

Larry

[Z3Dreamer]

Need more info. ACA is only for those not on Medicare. So, not sure how repeal of ACA enters into your decision.

You also talk about pre-existing condition (diabetes) but don't specifically say whether you qualify for "guaranteed issue". There are situations in which you could be on Medicare Advantage but qualify for GI. Have you looked into this?

Another thing with divorce is that sometimes people want to get out of the area. If you live in a place that has great MA plans such as Vienna, VA you may want to stay on MA. If you move to my neck of the woods, MA's are terrible.

If you plan on travelling for extended periods, MA's may not work for you.

I do not know how your spouse's retiree health plan works, but explain how you get kicked off spouse's plan.

[PaunchyPirate]

Are you over age 65? It sounds like you're on a Medicare Advantage plan offered by your wife's employer.

If you're over 65, as mentioned above, you won't be buying insurance on the ACA exchange. You won't be buying an ACA plan. You need to buy another Medicare Advantage plan or change to standard Medicare plus an optional Medigap (Medicare Supplement) policy.

[ShokWaveRider]

As already mentioned. ACA is not applicable to those aged 65 and beyond.

[ivinsfan]

Sorry for your troubles, even a "friendly" divorce is horribly stressful.

Just wait on the insurance because you already were misinformed about ACA, take your time. For one thing, I'm not certain the posters talking about switching to a "regular" Medicare supplement are correct. There are a lot rules about getting back to a regular plans after being on MA for over 12 months.

If you are dropped from the spouse's company plan you will have options to get some insurance.

[madsquopper]

Yes, you all are right about ACA; forgot the age limits. I'm enrolled in Medicare A and B already, so switching to a new MA plan may not be a big deal (certainly doesn't appear to be right now). Realistically, I'd be hard pressed to ever want to leave the Wash DC general area, but it's not set totally in stone, either.

[Kroeran]

Stepping back a bit, I would dig a bit deeper into the divorce issue and the cultural ease of defaulting to that path.

I don’t raise it as a moral or religious issue, rather as an issue of wholeistic rationality.

You are in a state of pain which you think will be eased by separating from your spouse, but it’s quite likely that you will be exchanging one misery for a host of others, with half the money to work with.

I think I have seen every possible variety of marital misery. Which one is yours?

[madsquopper]

Kroeran,

I know you mean well, but your assumptions are incorrect, particularly about money, so your question is completely irrelevant to me and doesn't deserve an answer.

Larry

[Bamaman]

If you're not on meds, it's hard to tell if you're yet considered Type II diabetic legally and "on the record." There are credit bureau type info agencies that keep track of ailments that insurance companies check with new insureds.

I'm Type II diabetic on an insulin pump, and we diabetics are quite expensive to keep stable--$7K+ a year in supplies and meds alone.

You should consider getting your own Supplement in the upcoming sign up period. My wife and I both have Plan G--the Cadillac of all Medicare Supplements. We don't think highly of Advantage plans that are not universally accepted at the best hospital and at their many physicians in our medical market.

[Telly]

The "MIB", the Medical Information Bureau. Any whiff of a diagnosis of diabetes will be in there for sure. And I expect therein lies a problem for madsquopper if he decided to try to switch to Original Medicare and pick up a lettered Medigap Plan, rather than just picking another Medicare Advantage plan.

Unless his loss of his access to his wife's retirement Medicare Advantage plan is considered a special qualifying event that would allow him to join Original Medicare without being subject to health underwriting for Plan G, the default, I don't see him getting it.

A place like Chris Westfall's Senior Savings Network or Boomer Benefits, etc. could help him check that issue. Studying the Medicare website will probably also answer it. I expect MBSC knows the answer to that situation immediately!