COBRA - need suggestion for other insurance

[Davidhelp]

Hello.... I currently signed up with COBRA after I retired in Nov 2021 and need suggestion for other insurance. COBRA is good for up to 18 months. Current health is fine.

I pay $806 a month for medical & dental. I live in California.



1) What to look for?
Many choices and I am not sure what I get as far as medical coverage for the money.

2) Also can I sign up for insurance at anytime?

3) Any one have a suggestion?

 

[ut2sua]

I believe you can sign up for ACA during the open enrollment period (around end of the year, but I don't know the exact date), or when you leave your job. If those dates pass, you can't change to ACA from Cobra mid year. You can when Cobra expires however. With ACA, you may get help depending on your income level. Others in this forum will provide clearer info...
Good luck

 

[Davidhelp]

So it seems I am stuck with COBRA to near the end of the year....

I should be able to buy anything at anytime but not healthcare....
That is gov't.


Did not buy loaf of bread during prescribed time period.

No bread for you!


Visit CoveredCa.com to shop for insurance. https://www.coveredca.com

I went to: coveredca.com and the silver plan Silver plan: $211 month
The gold and platinum will be more I guess, I will check out what it covers. I put in $40,000 for income. That was just to get the estimate.

If $80,000 a year then the price is $567..... for silver.
$60,000 is $425

Income is $0 so the price is: Medi-Cal
You may qualify for: no-cost or low-cost coverage


A question: How do they know what I am spending out of my savings?
I borrowed money from the stock broker against the stock for my first year expenses.

I may sell some stock in future years so there is that as income.

 

[wearefinishedworking]

We are converting from Trad IRA to Roth IRA to create income to qualify for a good ACA plan in our state. No income this first year of retirement, just living off savings. We will be converting about 60k.

 

[Aerides]

So it seems I am stuck with COBRA to near the end of the year....

I should be able to buy anything at anytime but not healthcare....
That is gov't.

You can't swap providers/plans mid-year, or decide to have nothing and just sign up when you want it. I don't think I was ever able to do that while working, pre ACA, ever. Annual enrollment, no swapping around. No "well I'll just sign up when I get sick lol". Pretty sure that's the insurance industry's requirement for decades.

As far as the ACA, the cost is based on income. Not "spending from savings" or net worth. It's part of the tax law, and your adjusted gross or MAGI is the key number for calculations of subsidies. So you consider your taxable earnings, cap gains, dividends, roth conversions, pensions, etc.

New enrollment generally starts in mid november every year.

 

[pb4uski]

So it seems I am stuck with COBRA to near the end of the year....

I should be able to buy anything at anytime but not healthcare....
That is gov't.


Did not buy loaf of bread during prescribed time period.

No bread for you! ...

There is a good reason for that. It is to discourage freeloaders... people who don't buy any insurance until they become aware that they are sick... that would end up sticking insurers with a whole bunch of costs and they would have to reflect those increased costs in their prices and then everyone's medical insurance costs would go up... a lot!

The whole idea is that we want people to get and keep health insurance to discourage freeloaders and tamper the cost and to allow someone to buy it anytime would defeat that purpose.

Most employer plans have similar restrictions... you can chose the plan when you join and change plans during an annual enrollment period, so isn't just government.... you are just totally wrong on that one.

You could have taken advantage during the recent annual enrollment period and didn't so blame yourself.

 

[pb4uski]

...A question: How do they know what I am spending out of my savings?
I borrowed money from the stock broker against the stock for my first year expenses.

I may sell some stock in future years so there is that as income.

You provide healthcare.gov with an estimate of your income for the year and your monthly ACA subsidy is based on the estimate that you provide. If your income changes during the year then you are supposed to inform them. Finally, when you do your tax return and your actual income for the prior year is know there is a tax form that is part of your tax return that computes the ACA credit that you are entitled to based on your actual income and compares it to the ACA credits that you received and your tax due is adjusted accordingly.

 

[cathy63]

So it seems I am stuck with COBRA to near the end of the year....

I should be able to buy anything at anytime but not healthcare....
That is gov't.


Did not buy loaf of bread during prescribed time period.

No bread for you!


Visit CoveredCa.com to shop for insurance. https://www.coveredca.com

I went to: coveredca.com and the silver plan Silver plan: $211 month
The gold and platinum will be more I guess, I will check out what it covers. I put in $40,000 for income. That was just to get the estimate.

If $80,000 a year then the price is $567..... for silver.
$60,000 is $425

Income is $0 so the price is: Medi-Cal
You may qualify for: no-cost or low-cost coverage


A question: How do they know what I am spending out of my savings?
I borrowed money from the stock broker against the stock for my first year expenses.

I may sell some stock in future years so there is that as income.

The Covered California open enrollment period runs through January 31, 2022, so you definitely do not have to wait until the end of the year to get off COBRA, but you do have to act within the next two weeks.

Spending out of your savings is not income, so Covered CA doesn't know or care about that money. Your health insurance premiums will be subsidized based on whatever you have that counts as income on your tax return. If you don't want to sell stock, do you have an IRA? You can generate income by converting some funds from the IRA to a Roth IRA.

 

[pb4uski]

^^^ Or if you want to generate income you can sell appreciated stock at a gain and buy it back the same day.

 

[COcheesehead]

I went from COBRA to ACA. It’s easy and saved me a bunch.

 

[Davidhelp]

Thanks everyone.

 

[RetiredAndLovingIt]

Covered California still has open enrollment till January 31st so you can still get in to start February 1st if you move quickly.
Withdrawal from savings is not income but a $20k withdrawal from your IRA for a Roth conversion would.
if you truly have 0 income then you would be able to jump on Medi-Cal at any time in the year but be aware you don't get to chose the medical group that you are sent to and Kaiser does not accept Medi-Cal patients unless they have been a previous member.

Here is an income chart that for MAGI


https://laborcenter.berkeley.edu/wp-content/uploads/2021/03/2021-03-MAGI-Summary.pdf

 

[RetiredAndLovingIt]

At 18K my premium is $127 with Kaiser, but there are cheaper options with other carriers options as low as $2 I think for the second lowest cost Silver plan. I'm happy to pay the extra to get Kaiser. I think copay is $5/$8 and very cheap prescriptions and they're literally 5 minutes from house.
You probably will be asked to provide income but they might let you sign up and give you a couple of months to provide the docs. In my first year not knowing what I was doing I gave a lower income and they automatically approved me for Medi-Cal. When I called them they advised me that only way to change their determination was to provide proof o a higher income so I immediately arranged for a Roth conversion and send them the paperwork and that was accepted. I think your income has to be above $17,609 for one person.
They were very nice when I talked to them but you've left this to the last minute, you really need to move quickly.

 

[Davidhelp]

Are the plans the same coverage but at different cost per month depending on income?

 

[RobbieB]

No, all different. Go and look.

 

[Davidhelp]

I do not yet qualify for medicare / medicaid as I am 63.
My dentist wants a PPO plan. I had that when I was working.
What is better HMO or PPO?

When I look at PPO plans at Covered California the prices are about what the COBRA plan is. I pay $806 now.

PPO Bronze plan low price is $841
HMO bronze is $628
How does one get a lot lower price?
I thought we were suppose get free healthcare.... : )


Covered California:
Choose a plan by 01/31/2022 to start your coverage on 02/01/2022.
You have 16 days left to enroll or change a plan.

 

[Aerides]

My dentist wants a PPO plan. I had that when I was working.
What is better HMO or PPO?

There was a recent discussion on the types of plans, pros and cons, here:

https://www.early-retirement.org/fo...t-for-early-retirement-hmo-vs-ppo-112486.html

Note, with most ACA plans, your dentist is irrelevant as dental is not covered by most health insurance (different states may do things but in general).

I thought we were suppose get free healthcare.... : )

I know you mean that somewhat jokingly, but no, that is not what the ACA ever promised. It meant you could have...healthcare, vs. getting refused, or a plan made like swiss cheese (but the overall benefits of the ACA have been discussed ad nauseum on this forum). And yes, lower incomes are subsidized. If your plan options are still high then you must have higher income. Or you can stay on Cobra till 65 and then go on Medicare.

 

[COcheesehead]

Are the plans the same coverage but at different cost per month depending on income?

The same plan may be priced differently for various income levels, but there are also plans that have different coverages, deductibles and out of pocket costs.

Pro tip: compare plans based on total out of pocket costs, so deductibles plus co pays plus co insurance.

You first pay a co pay, then a co insurance cost which is a percentage of a certain max amount, then your deductible kicks in.

There are no fee to you brokers who can help navigate the exchange. We used one. It was a valuable 45 minutes. They saved us a bunch and got better coverage than my COBRA.