BEFORE ACA - what did retirees do?

[Amethyst]

Some people took jobs they didn't really want, just to get health insurance.

My first full-time job out of college did not offer health insurance. I didn't worry about it until I burned my hand on the kitchen stove. The first question at the ER was "Do you have insurance?" The bill for treating my burn took most of my meager savings. After that, I was determined to find a job that had HI.

 

[DenverGuy42]

depending on your state, you might be insurable with pre-existing conditions, even if the ACA goes away.

https://www.colorado.gov/pacific/do...age-pre-existing-conditions-part-colorado-law

I'll never be leaving CO (retired at 50, wife worked till I was 53 and covered me, we just ended COBRA last month, bought a plan direct from the insurer for this year) for that reason.

In addition to pre-existing, they have caps on what you can charge people as they age (like the ACA) and a guaranteed issuance (like the ACA).

Also, CO just started funding a "high risk pool" that actually saw premiums going down https://www.colorado.gov/pacific/do...nces-2020-aca-premiums-going-down-average-202

additionally - the state is trying to set up a public option for insurance https://www.colorado.gov/pacific/hcpf/proposal-affordable-health-coverage-option - one that the insurance companies are (heavily) lobbying against - but fingers crossed.

some other states have enacted the protections as well since the ACA came under fire https://www.commonwealthfund.org/blog/2019/can-states-fill-gap-preexisting-condition-protections

 

[MRG]

depending on your state, you might be insurable with pre-existing conditions, even if the ACA goes away.

https://www.colorado.gov/pacific/do...age-pre-existing-conditions-part-colorado-law

I'll never be leaving CO (retired at 50, wife worked till I was 53 and covered me, we just ended COBRA last month, bought a plan direct from the insurer for this year) for that reason.

In addition to pre-existing, they have caps on what you can charge people as they age (like the ACA) and a guaranteed issuance (like the ACA).

Also, CO just started funding a "high risk pool" that actually saw premiums going down https://www.colorado.gov/pacific/do...nces-2020-aca-premiums-going-down-average-202

additionally - the state is trying to set up a public option for insurance https://www.colorado.gov/pacific/hcpf/proposal-affordable-health-coverage-option - one that the insurance companies are (heavily) lobbying against - but fingers crossed.

some other states have enacted the protections as well since the ACA came under fire https://www.commonwealthfund.org/blog/2019/can-states-fill-gap-preexisting-condition-protections

+1

My premiums fell more than the 20%. More like a 50% reduction this year.

 

[DenverGuy42]

+1

My premiums fell more than the 20%. More like a 50% reduction this year.

yeah, we had budgeted 25% more than we are paying right now. Since our deductible and max OOP went up considerably from our COBRA plan, that is a good thing, we are just saving that money now to pay for the extra costs the plan doesn't cover.

 

[Bir48die]

Still paying out the nose.

 

[mpeirce]

Same thing we did when I was self employed - bought a policy on the open market.

We talked to a local insurance broker and found a HDHP plan that worked with our HSA.

I'm still on that plan and still shoveling money into the HSA - it's worth about $80K now (invested in the Vanguard total market fund).

 

[RobbieB]

My Dad did the usual. Worked until 65, Medicare and retiree medigap insurance, SS and pension.

Not early retirement.

 

[Alan]

I kept working until the magic “80 points”* with my megacorp so I could retire with their retiree health insurance. If ACA had been around we would almost certainly have retired earlier than we did.

*years of service+age = 80

 

[GTFan]

Yeah I was one of those that waited until ACA implementation started then I retired at end of 2014. Helped that my Mega had an ER buyout too.

It would have been a hard choice to ER without the ACA for me, and a couple of years prior to when I left the corp kicked in (I think) an extra $100k for a buyout specifically because the ACA was still uncertain. It was intended to help bridge ERs to Medicare, but given today's rates it would've been less than 10 years worth of premiums for their unsubsidized retiree insurance.

 

[calmloki]

Gal got HI for me through her employer by paying for it. Not married, so I was shown as an employee by her employer. Then she worked for a year or so with her health insurance as her only compensation while paying for my premium as a bogus employee. Then Cobra, then 1.5 years with us paying about $1600/month for HI for the two of us. Then Medicare kicked in. That was a very happy time.

 

[Mmm Rrr]

ACA was my deciding factor for early retirement.

 

[ncbill]

Five states did not allow pre-existing condition exclusions, some here had retiree health insurance through former employers, some may have been able to get individual policies, and many (most?) states had group coverage without pre-existing condition exclusions for small businesses of 1 or 2 employees. We had COBRA and then a COBRA conversion policy. The COBRA conversion and small group coverage, which was another option for us, were very expensive. With the deductibles, max out of pocket, out of network costs (one we planned on and one surprise one, the kind now banned by law in California), and some medical travel we had a $50K medical year before the ACA on a COBRA conversion policy.

We had friends who retired early give up (pre-ACA) and decided to go back to work for the health insurance. We were considering moving outside the country, at least until Medicare age. For not much more than $50K a year in annual expenses we could live in many developed countries, including medical care, instead of just spending $50K on medical care alone in California. But then the ACA came along and last year our Bronze plan premiums were $2 a month. I was also considering some kind of low stress retirement job just for the health insurance, but DH would rather have moved than go back to work.

On another forum a poster (63 or 64) who claimed no health issues was complaining about the unsubsidized ACA premium of nearly $30k he & spouse faced for the upcoming year.

IIRC he was already living in a border state, so I pointed out they could have a nice extended vacation south of the border for the above...many expats there buy into the national plan as catastrophic coverage, though traditional health insurance is still available.

 

[Offgrid Organic Farmer]

BEFORE ACA - what did retirees do?

I retired before ACA.

 

[UnrealizedPotential]

Health care could be a possible benefit of moving to another country besides the USA IF that particular country offers that for residents free of charge for basic HC. That is one of the possible benefits about moving abroad if you are so lucky to be in such a position.
But I want to make it clear that free basic HC is not my reason for wanting to relocate abroad, but it is a positive factor. I will have a legitimate reason for staying in the country. The downside is, at least in my case is that it is not easy to do.

Governments can move slow . There could be a lot of paperwork and wait time involved.

 

[harley]

I retired before ACA.

I'm glad that question has been settled.

 

[NW-Bound]

We started ER with pre-ACA insurance with a $10K deductible. I do not recall what the premium was exactly when we started in 2006, but it was perhaps around $500/month. In [-]2010[/-] 2014, the last year we had the policy, the premium was $914/month for two.

The policy did not cover existing conditions, but did not require underwriting, only that we had continuous health insurance prior to the policy.

PS. I corrected the year we last had the pre-ACA policy.

2002, long pre-ACA, I was suddenly provided with an Early-ER "opportunity", due to the crash of an industry. Late forties, missed any kind of retirement $ from megacorp by a little over a year. Turned out that didn't matter after all, as they terminated the retiree medical $ in stages shortly thereafter. My termination benefits, as I was over age 45 and had many years of credit, included 6 months totally paid HI on the family plan that I was on. And then could run COBRA for 18 months beyond that.

While on the 6 months paid, I researched private HI. Did not look good. DW would not be picked up due to BMI of 30 at that time, even though she was very healthy. I was no problem (then), as I had no conditions, no surgeries ever, no medications, no nothing, perfect! Our kids were put through underwriting with a magnifying glass. Even for the most trivial, coverage of that whatever (though no coverage was needed!) would be excepted for 6 months. Went with Golden Rule, which was bought by UHC not long after...

Golden Rule was our private HI, as described in earlier post. Starting out healthy with no problem whatsoever, I ended up costing them $200K+ in 2013-2014 with my illness. I never had any problem with them regarding the claims. Never had to talk with anybody there. On the Web, I later found out that healthcare providers liked Golden Rule because they paid promptly.

By the way, we underwent no underwriting. Not for us, not for our children. I guess that's the difference between state laws, but I never research that.

Private HI started out OK, it was a high-deductible policy on me and the kids. No premium increase in the first year. But oh boy, after that, both the $ increases and the ever-shortening time frame between increases became ridiculous. Became obvious that the situation was on the curve to untenable. Joined DW's employer plan, and the kids dropped off one by one when graduating college and getting their own employers coverage.

DW's employer plan was really cheap for worker alone, was subsidized by the plan hitting spouse and family coverage pretty hard. DW's employer has levels of plans, some are low deductible with incredible monthly premiums! She hears people there say things like "oh, I have to have a low deductible, I can't come up with like $500 just like that!!!" Yeah, and as you can imagine, they are paying incredible $ per month every month via payroll withholding for "that $500". Duh! She has tried to point that out to some people, no go, gave up, pushing the rope...

Yes, we took employer's insurance for granted. When buying our own insurance, we were initially shocked that the premium was reasonable only with the $10K deductible, and went for it after considering how little healthcare we used.

When I told my doctor, a young guy, about my high deductible, he chuckled, but I gave my reason. Next year, when I saw him he said he went for $10K deductible also.

PS. I like the Golden Rule policy I had. Very simple. Until I reached $10K/year, I paid everything. Above it, they paid everything. No copay. All or nothing.

 

[NW-Bound]

OK, I have found records of the monthly premium for my pre-ACA policy, going back only to 2010 because I did not track expenses before that.

2006 - $500(?) for family of 4
...
2010 - $856 for family of 4
2011 - $652, $703 (increase mid-year), dropped eldest child, changed deductible from $6K(?) to $10K
2012 - $703, $766 (increase mid-year)
2013 - $766, $802 (increase mid-year), dropped younger child
2014 - $802, $914 (increase mid-year)

When dropping one child and then another because they had their own employer's insurance, I was surprised to see the premium did not drop that much. Old people cost a lot of money to maintain. And we were only in our mid-50s!

 

[Mulligan]

I retired before ACA and paid about $70 for a BS/BS HSA, $5000 deductible with $7 million cap. Allowing for HSA tax deduction my insurance in the individual market was actually cheaper than free. As late as 2015 it was still only $82. But then ACA basically rooted the plan out and I had to go to ACA as they disbanded the plan. And now 4 years later this year I pay $660 for $5500 deductible, but I do get the HSA back this year after it wasnt available for two years.
Im planning on finally hopping on my GFs plan later this year, as I am tired of wasting money. I can get a $200 annual deductible with vision and dental all for about $175 a month. I will ride that out the next 9 years until medicare.

 

[NW-Bound]

I retired before ACA and paid about $70 for a BS/BS HSA, $5000 deductible with $7 million cap...

Ah, forgot that my pre-ACA policy had a $1M lifetime cap. That's very important to keep the premium from being even higher.

I remember telling my wife that if it cost more than $1M to keep me alive, I would be so sick that I would not want to linger on anyway. I did not even look for a higher cap.

 

[teejayevans]

Easy, move to a country with socialize medicine, which is pretty much every other country in the world.

 

[harllee]

I am surprised that many had preACA plans that were so inexpensive. Prior to ACA DH had a preexisting condition and had to go on North Carolina's high risk plan (it was the only insurance he could get). His monthly premiums were around $1000 per month and the plan had a $1 million lifetime cap. We were always worried about the $1 million cap--it would be very possible to go through $1million in medical expenses in a short period of time..

 

[Beststash]

I am surprised that many had preACA plans that were so inexpensive. Prior to ACA DH had a preexisting condition and had to go on North Carolina's high risk plan (it was the only insurance he could get). His monthly premiums were around $1000 per month and the plan had a $1 million lifetime cap. We were always worried about the $1 million cap--it would be very possible to go through $1million in medical expenses in a short period of time..

I am surprised myself - former employer reneged on healthcare promise for pre-65 retirees and had to go to Texas High Risk Pool with similar expense (pre-existing condition was glaucoma for both DW and I) our combined cost was about 25K for about 8 years until ACA passed. Then we were able to cut expenses until we both turned 65. After going through that it seems like Medicare was basically free! I went through cancer treatment in 2019 and expenses exceeded $1M by Oct. I had paid my OOP by end of Jan.



I actually got to see how well my MA plan worked and it worked as promised without any hitches.

 

[ShokWaveRider]

My younger wife worked for healthcare.

 

[kgtest]

I retired before ACA. We bought individual insurance in the individual insurance market. While we were healthy and would have likely passed underwriting, luckily our state prohibited medical underwriting. We had a high deductible policy, like I had at work.

For 2012 we paid $556/month (for two) and for 2013 we paid $629/month. Our first year of ACA was $682/month until we got onto a cat plan that was $472/month in 2014 and that same cat plan is $662/month in 2020.

Who knows what will happen but medical underwriting is very unpopular so I don't see it returning for people who are continually insured but I can see it coming back for people who hope to game the system by not buying health insurance until they are sick (and IMO it should).

We pay around $447/mo for HMO and DW employer kicks in a bit more. The HDHP option is about ~300. So fair to say expect ER HC costs to be about double in my situation...

 

[ncbill]

Easy, move to a country with socialize medicine, which is pretty much every other country in the world.

You may not be able to buy into their national plan...

Though there are places where expats can and it is inexpensive (e.g. Mexico @ a few hundred bucks/year)