Poll:Which type of health insurance do you use post RE

[bingybear]

So what type (level) of insurance do you use between RE and Medicare. Also are you qualifying for subsidy (ACA or subsidized employer retirement healthcare). If you are willing, some explanation as to why you chose what you did. For me, I'm curious about the trade-off between getting a subsidy verse doing roth conversions up to the top of the 15% marginal bracket. I'm also curious about why pick a HDHP vs. Silver, Gold or other higher cost/benefit plan.
Plans listed on the poll as with subsidy are either employer or on marketplace plans. Without subsidy can be purchased on or off marketplace -- (I'm thinking more off marketplace, but did not separate all options... too many choices already)

 

[retiredinnyc]

I retired with full medical and a shoddy dental and optical. My neighbor is navigating the whole bronze silver gold stuff he invited me over for coffe and to help him out, in my opinion you need graph paper and a Ph.D. To figure it out.

 

[bingybear]

for me, I'm presently using cobra... thus no subsidy employer plan. But this will only last so long. This is where my interest comes from. I need to figure out what to do when cobra ends mid year 2016

 

[Senator]

I do not qualify for a subsidy.

I (age 56) will be using free VA Medical care, followed by a high-deductible bronze policy. Any healthcare that I use at the VA gets billed to the bronze policy, and starts to offset any deductible.

Fortunately, I do not have to pay any of the deductible when billed as part of VA Healthcare. So my Bronze policy could be similar to a platinum policy with $0 deductible, depending on when (or if) I use it.

The DGF (age 45) will qualify for an almost free policy via Minnesotacare. It will include dental, vision, healthcare, pharmacy, etc. for $20 a month.

 

[audreyh1]

Confusing selection - there are bronze, silver, and gold. There are PPOs, HMOs. Any may be HDHP or not. None of these are mutually exclusive. For example, I'll probably do the same as other years (if I can find one) - an unsubsidized bronze PPO which is HSA compatible - meaning that it is also an HDHP.

But in addition to bronze there are silver HMOs, gold HMOs, silver PPOs, gold PPOs, etc. Some silver level may even qualify as an HDHP - I believe I saw at least one of those the first year I looked.

 

[jim584672]

You should add an "Other" category. NY has plans for <200 FPL that are not metal plans, they are BHP plans. Also no choice for Medicaid.

 

[stepford]

Retiree Medical subsidized by employer for me. Standard BCBS PPO plan with my contribution about $70/month (would have been 0 if I'd been able to last 30 years in my job, but it was worth it to leave a couple years early). No dental or vision care, though.

 

[razztazz]

TriCare. You can call it "Former employer provided insurance", or some form of Government Single Payer program. I've had both responses

 

[John Galt III]

Silver PPO with prem subsidy and cost sharing. I need to do Roth coversion of a few thousand to get me MAGI up over FPL to qualify for ACA. A few years ago I was in HDHP plan paying $230 a month, never used it (which is good, I guess) .

 

[Silver]

Confusing selection - there are bronze, silver, and gold. There are PPOs, HMOs. Any may be HDHP or not. None of these are mutually exclusive. For example, I'll probably do the same as other years (if I can find one) - an unsubsidized bronze PPO which is HSA compatible - meaning that it is also an HDHP.

But in addition to bronze there are silver HMOs, gold HMOs, silver PPOs, gold PPOs, etc. Some silver level may even qualify as an HDHP - I believe I saw at least one of those the first year I looked.

There are also EPO's which are exclusive provider organizations with no benefits if an out of network provider is used. I have a BCBS Bronze EPO with a huge provider network that works well. I like it better than a HMO because no referrals are needed to see a specialist.

 

[Trawler]

DW and I in 2014 was on a Bronze PPO Plan HSA Compatible $6K per person deductible $12K family max with subsidy income 30K was $179 month. Due to needing a sleep study for apnea in 2015 we moved to a Silver with cost share and subsidies. PPO plan $2K per person deductible $2K family max cost $379 month on 30K income.
Looking at plans 2016 it looks like we need to move to HMO or POS plan as PPO plans have skyrocketed The same bronze plan from 2014 is now $307 up from $179 and our 2015 Silver plan is discontinued for 2016 and replacement plan now $440 per month and deductibles went up.

 

[bingybear]

Confusing selection - there are bronze, silver, and gold. There are PPOs, HMOs. Any may be HDHP or not. None of these are mutually exclusive. For example, I'll probably do the same as other years (if I can find one) - an unsubsidized bronze PPO which is HSA compatible - meaning that it is also an HDHP.

But in addition to bronze there are silver HMOs, gold HMOs, silver PPOs, gold PPOs, etc. Some silver level may even qualify as an HDHP - I believe I saw at least one of those the first year I looked.

I'm not sure I've seen a sliver or above HDHP, not that they don't exist. My HDHP is a POS. So many acronyms. Sorry for the confusion. I just wasn't quite sure how to best divide up all the plans and subsidies. With all I put up... I still missed some.
The goal or hope if to learn what trades people are making among plan levels, subsidies vs roth conversion and other factors that I likely haven't considered.

 

[bingybear]

You should add an "Other" category. NY has plans for <200 FPL that are not metal plans, they are BHP plans. Also no choice for Medicaid.

not sure how to modify the poll at this point. Any ideas?

 

[rodi]

Confusing selection - there are bronze, silver, and gold. There are PPOs, HMOs. Any may be HDHP or not. None of these are mutually exclusive. For example, I'll probably do the same as other years (if I can find one) - an unsubsidized bronze PPO which is HSA compatible - meaning that it is also an HDHP.

But in addition to bronze there are silver HMOs, gold HMOs, silver PPOs, gold PPOs, etc. Some silver level may even qualify as an HDHP - I believe I saw at least one of those the first year I looked.

+1

I didn't answer the poll because it was a big hot mess. (No offense - but it didn't adequately group the categories.)

FWIW - My kids and I are on an HSA compatible HDHP HMO, bronze level purchased through the exchange. My husband is on a similar HSA compatible HDHP HMO with a different network. We are forgoing subsidies up front, even though we qualify, because I couldn't have 2 separate plans and get the subsidy in the lovely CoveredCA world. So I'll get my hefty tax credit when I file my taxes and the government gets a nice interest free loan.

 

[W2R]

I worked for two extra years past FI until I qualified for retiree medical insurance. The cost was/is identical to what those still working there are paying for the same group health insurance. That is why I chose what I did. I am happy with what I already have so when Obamacare came along I didn't switch.

So, I chose "employer plan with subsidy". Nothing to do with Obamacare subsidies, though.

 

[bingybear]

I worked for two extra years past FI until I qualified for retiree medical insurance. The cost was/is identical to what those still working there are paying for the same group health insurance.

So, I chose "employer plan with subsidy". Nothing to do with Obamacare subsidies, though.

This is what I intended that choice to mean unless you are paying the full insurance payment. Many employers pay some of the expense which is a subsidized plan by the employer.

thanks

 

[W2R]

This is what I intended that choice to mean unless you are paying the full insurance payment. Many employers pay some of the expense which is a subsidized plan by the employer.

thanks

Oh good! Yes, my employer pays much of the expense. Thanks.

By now I am 67 and on Medicare, and paying for Part B plus still paying the same for my same retiree insurance which is fine with me since my health care costs are higher now. But anyway this is what I did during the gap between ER and Medicare. I would probably do the same if I was retiring today.

 

[Sojourner]

I don't qualify for a subsidy and have a bronze-level PPO plan currently. In retrospect, a bad decision due to some some large, unexpected medical bills this year, but at the time I simply chose the plan with the least expensive monthly premium where my primary care doctor was in-network. For 2016 I am switching to an HDHP and setting up an HSA.

 

[Animorph]

HSA eligible HDHP, preferably PPO but may have to go with HMO for 2016, Bronze level. If you look at your cost at various levels of medical spending the HDHP tends to be cheaper over a wide range of possibilities. Certainly if you don't expect to have any medical expenses the HDHP plans usually have the lowest premiums. But even if you add in the max OOP they can sometimes beat the lower deductible plans, or at least come very close. Plus you get what is effectively a tax deductible Roth account that you can contribute to without earned income. Seems like a pretty easy choice as long as you don't let the high deductible frighten you.

 

[audreyh1]

HSA eligible HDHP, preferably PPO but may have to go with HMO for 2016, Bronze level. If you look at your cost at various levels of medical spending the HDHP tends to be cheaper over a wide range of possibilities. Certainly if you don't expect to have any medical expenses the HDHP plans usually have the lowest premiums. But even if you add in the max OOP they can sometimes beat the lower deductible plans, or at least come very close. Plus you get what is effectively a tax deductible Roth account that you can contribute to without earned income. Seems like a pretty easy choice as long as you don't let the high deductible frighten you.

Many of the non HSA plans have the same high deductible or close, and similar max OOPs. You might get some help with a few initial copays, but if any serious bills start coming in there won't be much difference.

 

[sengsational]

Bronze HSA eligible from the exchange with PTC. Income at about 250% FPL.

I've checked it out on i-orp and putting PTC ahead of Roth conversions makes sense for me.

If you're in PTC territory, you probably should keep on the low side because you lose PTC money at a pretty steep rate as your income goes up. See: http://www.early-retirement.org/forums/f38/the-29-bracket-in-roth-conversions-78112.html

 

[Walt34]

I just started Medicare last spring but before that it was an employer subsidized plan. My cost went up after retirement (I pay 30% of premium vs. 20% before) but we can keep it for life, it becomes secondary to Medicare at 65.

All those midnight shifts are paying off.

 

[bingybear]

Many of the non HSA plans have the same high deductible or close, and similar max OOPs. You might get some help with a few initial copays, but if any serious bills start coming in there won't be much difference.

My situation is such that every 8 to 10 years I can expect to blow through the deductible and depending on the plan, the max OOP too. If I get a plan with co-pays (not co-insurance) I may be able to keep below the max OOP. All this is just because a battery will run down in my pacemaker. I would expect this should be predictable.

 

[bingybear]

Bronze HSA eligible from the exchange with PTC. Income at about 250% FPL.

I've checked it out on i-orp and putting PTC ahead of Roth conversions makes sense for me.

If you're in PTC territory, you probably should keep on the low side because you lose PTC money at a pretty steep rate as your income goes up. See: http://www.early-retirement.org/forums/f38/the-29-bracket-in-roth-conversions-78112.html

I'll need to run your numbers again and look at the trade offs as I go to the top of the 15% bracket. I remember that plot you did. It could be tough to keep at 200%FPL over the long haul. If I remove my income for the first couple months, I did stay in that range with most income being dividend and most of that qualified. I have enough losses to negate any capital gains. Not sure I can do this for the next 10 years without restricting my investments which may be a worse penalty than the tax.
For this year and next I will be mostly on COBRA, so little to none PTC to consider.

 

[pb4uski]

I did not vote because we are none of the above. We have a catastrophic HDHI plan with no subsidies that is PPO.