Healthcare insurance and retirement - again!

[Youngster]

All I want is a low cost catastrophic plan until I qualify for Medicare. By low cost, I am thinking about $200.00 per month.

 

[ivinsfan]

One interesting note. For the Cook County, IL area, there are no insurance carriers who offer individual plans, either in the exchange or off it, that have a network that includes any of the university medical centers or any of the what we might call the upper tier of hospitals. So, for my wife who is two years from medicare, she cannot purchase a plan, at any price, that offers the standard of care that is actually available in our area. In her case, we are working to get one of our friends to put her on the "payroll" at zero wages and zero work, but allow her corporate medical care. If that does not work, then we have to consider moving or at least changing official residence.

So we have a regular C corp group plan the BCBS and our agent ( who we are related to), just mentioned a training seminar where BC said they will be pursuing any "bogus" or non qualified group members. Best be certain you won't be landing your friend and their plan into hot water.

 

[Golden sunsets]

One interesting note. For the Cook County, IL area, there are no insurance carriers who offer individual plans, either in the exchange or off it, that have a network that includes any of the university medical centers or any of the what we might call the upper tier of hospitals. So, for my wife who is two years from medicare, she cannot purchase a plan, at any price, that offers the standard of care that is actually available in our area. In her case, we are working to get one of our friends to put her on the "payroll" at zero wages and zero work, but allow her corporate medical care. If that does not work, then we have to consider moving or at least changing official residence.

Would not what you are attempting to do be classified as illegal, both for your wife and the company that is a party to this? I have to think that insurers regularly require their employers for proof of employment of their insured employees in some form or another and that the penalty for the type of activity that you suggest is quite serious. Please be careful. I would think that a lousy plan for two years is a lot better than the risks of filing fraudulent claims to an insurer.

 

[euro]

I agree. However the only action that can be taken is to take whatever steps you can to remain healthy. Now if that doesn't work we're back to the original discussion. How will I afford coverage in the future and what steps can I take now to get there.
I am speculating a bit here but I believe most of those posting here with a cavalier attitude have what they feel is a secure position through one gov't program or another. Like my DM who constantly complains about ACA care yet has had steady supply of services and replacements with very little oop costs.
I feel full disclosure is important, and while I have a corporate retiree medical plan (so far) I genuinely feel for those facing an obvious and significant change going forward.
The ideas of this thread are a very good starting point. And please no more red ink "reminders". It takes me back to third grade.

+1 on all of those point! Great post!

 

[NW-Bound]

We've been dealing with this in Texas. As far as I know, as of 1/1/2016 in many parts of Texas, there were no plans available through the Marketplace which included Houston's M.D. Anderson Cancer Center and a few other top tier regional medical centers. It's been a big concern for a lot of people.

Could it be because the premium would be prohibitively high and there would be so few subscribers, so the insurers say "Why bother" ? When hamburger costs $10/lb, who can afford filet mignon?

For a while, I wonder if I will have any plan offered at all, on or off the exchange. And this is in a county with 4 million residents. I still have not signed up for anything for 2017, though I did look at what is offered.

And I have not spent much time researching what the coverage will be. What difference does it make when you have no choice? Actually, I still have two choices: insurance or no insurance.

 

[daylatedollarshort]

Would not what you are attempting to do be classified as illegal, both for your wife and the company that is a party to this? I have to think that insurers regularly require their employers for proof of employment of their insured employees in some form or another and that the penalty for the type of activity that you suggest is quite serious. Please be careful. I would think that a lousy plan for two years is a lot better than the risks of filing fraudulent claims to an insurer.

A few years ago we looked into a similar option for our small business of two which still counted for group rates, at least it did pre-ACA. In order to qualify we had to have K1 partnership papers or similar type documentation of multiple owners or a payroll stub as proof we were partners or employee & employer to document the "group". I would think a payroll stub with zero pay on it would draw some questions. I think even an hour a month or work and a payroll stub counted though as a group. I asked about that and no one I asked at the time could give me any minimum hours of work needed by any members of "the group".

 

[Fermion]

One only has to look to the non subsidized costs of insurance in a place like Alaska to get a hint at what insurance companies might charge to a small group of people if they are forced to cover them. Rates for a couple in their early 50s with a $6000 deductible are over $25,000 a year.

So if they keep the pre-existing condition how is it useful for the average person if they are going to have $30,000 to $40,000 a year in basic medical expenses?

I think we need to start considering other strategies, like how to shelter assets from medical bankruptcy. To my knowledge 401K and IRA are still very good for this. I would definitely consider going with insurance if faced with $30,000 a year premiums. The risk/reward would just be too good if one managed to stay healthy for 10 years (that would be about $400,000 after compounding). Medical bankruptcy if you get unlucky. Protect a million of your assets in your 401k.

I mean...the alternative is to work until you are 65?

 

[Senator]

As i must point out again-a personal mandate that is not obeyed is no mandate.

ACA has a mandate. Healthy people either did not obey it or took the penalty.

re-doing a mandate in a revised Trumpcare will not work.

I am unsure how you know what will work, and what will not work, in a plan that has not even been proposed in detail.

The only way for this to be a mandate is to have it be a payroll tax. Then, it is mandated and actually paid. Raise the medicare portion of the payroll tax another 2% or so, on both sides.

 

[daylatedollarshort]

Could it be because the premium would be prohibitively high and there would be so few subscribers, so the insurers say "Why bother" ? When hamburger costs $10/lb, who can afford filet mignon?

For a while, I wonder if I will have any plan offered at all, on or off the exchange. And this is in a county with 4 million residents. I still have not signed up for anything for 2017, though I did look at what is offered.

And I have not spent much time researching what the coverage will be. What difference does it make when you have no choice? Actually, I still have two choices: insurance or no insurance.

Mexico? Of course you're gonna have to find a way over the wall that will be going up soon.

"Patients say the quality of care is simply better and one of the biggest factors in driving them to Mexico.....The number of Americans coming to Mexico for medical care is only expected to grow. With some not being able to afford Obamacare and others that may be left uninsured after an overhaul Mexican hospitals are doing sophisticated marketing, forming clusters and partnering with hotels."

Mexican Hospitals Prepare for Influx of American Medical Tourists

 

[NW-Bound]

If one has a portfolio in the 7-figure, an option would be to self-insure. Of course this is feasible only if hospitals do not charge you rack rates.

Cancer treatments are expensive, but they only run to the high 6-figures if you are Stage 4 or near terminal. I often say that when it costs $100K to keep me alive for a month in the terminal phase, life quality would be so low that I would not have the will to live, even if I were a billionaire. I would be headed to Colorado, where assisted dying was recently made legal.

And if it costs most of my stash to really cure me, then just being alive and well is good enough, even if it makes me broke. I can go live in a class C parked on New Mexico state land, under the open sky.

 

[shotgunner]

I too have been wondering what will happen with regard to the tax credit aka subsidy. A lot of people made some important life decisions when the ACA passed Constitutional muster in 2012. I remember reading posts by people in this group who chose to leave jobs with HI benefits as a result. For many there is no backing the truck up, they can't return to those jobs. So will they be thrown to the curb by the new Administration. It's 10 million of more people.

There is a relatively easy fix I see as part of a replacement/change to the ACA. That would be to allow everyone currently receiving a subsidy to move to Medicare regardless of age for the going rate. Is that far fatched?

 

[pb4uski]

Not a paywall for me either. You may be able to get around the paywall by googling the title.

+1

 

[nun]

Cost is really the bottomline here. If you can't afford reasonable coverage then what's the point in having access to that coverage. The ACA was on the way to that situation and I can't see the new administration solving that problem. The basic fact is that US healthcare costs at least twice as much as healthcare in other developed countries and that must be solved.

I have a friend who's wife was diagnosed with Leukemia a couple of years ago. He's self employed and the family gets health insurance from his wife's job. She had to leave her job a year ago as she's on continuing chemo and bone marrow transplants and has been on COBRA which will run out soon. They have two kids and a silver plan through ACA would have cost them between $20k and $30k a year with premiums and out of pocket costs. With Trump as President they are unsure and worried about what will happen.They live in MA so will have access to coverage, but how much will it cost??

 

[nun]

There is a relatively easy fix I see as part of a replacement/change to the ACA. That would be to allow everyone currently receiving a subsidy to move to Medicare regardless of age for the going rate. Is that far fatched?

getting some younger and presumably healthier people onto Medicare while paying their premiums might be a good thing, but there would also be an increase in the number of years someone would have access to medicare with the associated costs. Maybe an increased early Part B premium would help. However, I don't see a Republican administration expanding Medicare

 

[razztazz]

There is a relatively easy fix I see as part of a replacement/change to the ACA. That would be to allow everyone currently receiving a subsidy to move to Medicare regardless of age for the going rate. Is that far fatched?

Sounds like what was being called The Public Option when the ACA was being put together. It was not liked by some of the principals so it was left out.

In fact even before the ACA I remember hearing some groups proposing that a fix to medical insurance access was simply to open medicare to everyone and let them buy into it. It was never brought up again

 

[niven]

The only way for this to be a mandate is to have it be a payroll tax. Then, it is mandated and actually paid. Raise the medicare portion of the payroll tax another 2% or so, on both sides.

Right, but it might have to be some tax on all income, not just earned income. And as NW-Bound kept saying, we need ways to control and hopefully reduce the cost of healthcare as well.

 

[shotgunner]

Sounds like what was being called The Public Option when the ACA was being put together. It was not liked by some of the principals so it was left out.

In fact even before the ACA I remember hearing some groups proposing that a fix to medical insurance access was simply to open medicare to everyone and let them buy into it. It was never brought up again

I was not suggesting Medicare be opened up to everyone under 65 aka the Public Option. I suggested it as a potential alternative to kicking 10 million people to the curb who would be negatively financially impacted if the subsidies were pulled away.

 

[razztazz]

buying into medicare is not the same and getting subsidized medicare..

Obviously with a subsidy.

Medicare qualifiers-65-use far more and far more expensive services than young people

Gee, I had no idea

 

[pb4uski]

All I want is a low cost catastrophic plan until I qualify for Medicare. By low cost, I am thinking about $200.00 per month.

Yeah, good luck with that. How big a deductible do you have in mind for a $200/month premium?

 

[Walt34]

In her case, we are working to get one of our friends to put her on the "payroll" at zero wages and zero work, but allow her corporate medical care. If that does not work, then we have to consider moving or at least changing official residence.

I strongly suggest talking to a lawyer about this plan.

You could find yourself without any insurance at all if the insurance company finds out she was a "fictitious employee" for the purpose of obtaining the insurance and then, quite justifiably, returns the premiums, cancels the policy, and says "have a nice day".

You and your friends could even find yourselves facing criminal charges for uttering the false statements in the insurance application. Tread carefully.

 

[MichaelB]

I strongly suggest talking to a lawyer about this plan.

You could find yourself without any insurance at all if the insurance company finds out she was a "fictitious employee" for the purpose of obtaining the insurance and then, quite justifiably, returns the premiums, cancels the policy, and says "have a nice day".

You and your friends could even find yourselves facing criminal charges for uttering the false statements in the insurance application. Tread carefully.

Yes, and the regulations prohibiting insurance recission do not apply, so the insurer will refuse to pay at the precise moment it it most needed.

 

[NW-Bound]

It just occurs to me that most posters here are or used to be workers at megacorps or the public sector. When talking about ER, they talk about leaving a secure health policy with their employers.

We tend to forget that not every worker in the US has this benefit from work. Many work for small mom-and-pop businesses, or for themselves. They never have what you and I take for granted.

Now, I understand what the average person has to deal with. I will look for that statistics again, but recall seeing the number of workers outside of megacorps and the government. The number of the self-employed and employees of small businesses is huge. It's something like 50% of all workers.

 

[ziggy29]

It just occurs to me that most posters here are or used to be workers at megacorps or the public sector. When talking about ER, they talk about leaving a secure health policy with their employers.

I have a little over 1.5 years in as a career USPS clerk and I need to get to 10 in order to qualify for retiree health insurance there. I'm a lot less optimistic about my odds of having that waiting for me in 2025 now than I was only a week ago. And I'll leave it at that.

 

[audreyh1]

Sounds like what was being called The Public Option when the ACA was being put together. It was not liked by some of the principals so it was left out.

In fact even before the ACA I remember hearing some groups proposing that a fix to medical insurance access was simply to open medicare to everyone and let them buy into it. It was never brought up again

It seeemed like we were going to end up with the public option as companies started pulling out of the individual insurance market. Seems like insurance somapnies really only want to be in the group insurance business, so they were bailing left and right.

 

[samclem]

With Trump as President they are unsure and worried about what will happen.

So will they be thrown to the curb by the new Administration.

Some folks are determined to get this thread closed down. A shame, really.

There are three branches of government. Nothing that is law right now will/can change unless at least two of those branches (hundreds of people) agree, and maybe the SCOTUS, too. This won't be one person's job to fix (just as it took a lot of politicians to design this thing we have now).

I know feelings are raw right now. Well, we've all been on the receiving end of similar disappointments.