BEFORE ACA - what did retirees do?

[NW-Bound]

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)

Does one get the same expensive treatments and surgeries as in the US for those few hundred dollars per year?

 

[razztazz]

Does one get the same expensive treatments and surgeries as in the US for those few hundred dollars per year?

Does one get the same expensive treatments and surgeries available in the US in the US if one cannot afford them?

 

[MichaelB]

Does one get the same expensive treatments and surgeries as in the US for those few hundred dollars per year?

Of course not, they are less expensive most everywhere else.

 

[MRG]

Of course not, they are less expensive most everywhere else.

And they tell you what it costs upfront.

I actually tried to get a price for a surgery my insurance wouldn't cover. They stopped short of saying: Only the computer knows.

 

[travelover]

I am surprised that many had preACA plans that were so inexpensive............ .

Some plans had low caps, many plans only took healthy people. Some excluded pre-existing conditions, so you were only partly covered. There were exclusions for mental health.

 

[NW-Bound]

Does one get the same expensive treatments and surgeries as in the US for those few hundred dollars per year?

Of course not, they are less expensive most everywhere else.

Perhaps the less expensive treatments can cure 99% of the cases, and they just let the tough 1% of the cases "go"?

Does one get the same expensive treatments and surgeries available in the US in the US if one cannot afford them?

ACA now has unlimited lifetime coverage. Can it be a factor to make the premium more expensive?

 

[ncbill]

Does one get the same expensive treatments and surgeries as in the US for those few hundred dollars per year?

Most treat it as catastrophic insurance...heart attack, hit by bus, etc., paying for routine care out of pocket.

For younger expats without chronic health conditions it's an absolute bargain.

Moving back to the U.S., if needed, is a qualifying event for ACA signup.

Older expats often choose to pay Medicare Part B & supplement...one I read returned to the U.S. for a liver transplant.

 

[Offgrid Organic Farmer]

My employer [US Navy] allows me to live anywhere I want to live.

If I choose to live near a US military base [within a 50-mile radius] than my family and I must go on-base for medical treatment.

When I first retired, we lived near a base, so we went on-base for medical treatment. Since I am no longer Active Duty, I can not get 'walk-in treatment. I can go into any military hospital and sit/wait. If they have an opening, then they may fit me in. Or if there are no openings, then I can return the next day and sit/wait again.

We moved away from all bases, and now we are covered by their insurance. I pay $500/year as an enrollment fee and we have co-pays for office visits, surgeries and prescriptions.

The best part of staying away from military bases is that now I can see 'doctor' MDs. Adults who have gone to college treat me now. On base, as during my Active Duty career, my family and I were only treated by HM Corpsmen/medics.

In my personal opinion being treated by 'doctor' MDs is much better quality than HM corpsmen/medics can provide.

Some bases have a written policy that they refuse to treat retirees, they only treat Active Duty personnel.

For a couple of years, we lived near the US Coast Guard academy. Some percentage of USCG cadets are the children of Congressmen/Senators. So their medical clinic is staffed with real 'doctor' MDs. And they allow retirees to be treated there. That was nice.

I have been treated in British hospitals and in Italian Ospitales, and I prefer American quality much better.

 

[Nords]

Farmer, I don't know where you're getting your military healthcare information, and you're describing the system in terms which might lead civilians to think that military healthcare is worse than the requirements on the Tricare website.

Let's update your post with some links.

If I choose to live near a US military base [within a 50-mile radius] than my family and I must go on-base for medical treatment.

Here's the requirement for Tricare Prime:
https://tricare.mil/primeaccess
"Scenario 2: You live more than 30 minutes from a military hospital or clinic.
The military hospital or clinic will decide if they can accept your enrollment request.
You’ll need to waive your drive time standards (see below).
If you’re not able to enroll at the military hospital or clinic, you can select a network PCM.
Scenario 3: You live more than 30 minutes from a military hospital or clinic, but within 100 miles of a network PCM.
You can select a network PCM.
You’ll need to waive your drive time standards (see below)."

You're also eligible to switch to Tricare Select and see any doctor anywhere who participates in Tricare Select.
https://tricare.mil/Plans/Enroll/Select

That's one of several Tricare options other than Prime which allow seeing civilian doctors.

I live on Oahu within a 50-mile radius of every military clinic on the island, yet our regional manager waives the requirement to use a military treatment facility. As a military retiree I've been seen by the same clinic for over 17 years, both before ACA and after.

When I first retired, we lived near a base, so we went on-base for medical treatment. Since I am no longer Active Duty, I can not get 'walk-in treatment. I can go into any military hospital and sit/wait. If they have an opening, then they may fit me in. Or if there are no openings, then I can return the next day and sit/wait again.

Are you complaining about having to sit and wait for an opening when you don't have an appointment, especially in an emergency room? I'm pretty sure this what the rest of Americans have to do with their health insurance, both before and after the ACA.
https://tricare.mil/CoveredServices/Mental/GettingMHCare/Prime_Appts

We moved away from all bases, and now we are covered by their insurance. I pay $500/year as an enrollment fee and we have co-pays for office visits, surgeries and prescriptions.

You give the impression of complaining about paying $500/year for military healthcare among posters who are paying more than that per month.

I'm currently (2020) paying $50/month for Tricare Prime. Since we only visit doctors every 2-3 years, we could pay less if we went on to Tricare Select.
https://tricare.mil/Costs/Compare

The best part of staying away from military bases is that now I can see 'doctor' MDs. Adults who have gone to college treat me now. On base, as during my Active Duty career, my family and I were only treated by HM Corpsmen/medics.
In my personal opinion being treated by 'doctor' MDs is much better quality than HM corpsmen/medics can provide.

My corpsmen friends would object to this characterization. (Especially the ones who were saving lives in situations where doctors never set foot, and the ones who have gone on to get their MD.) But they'd still treat both of us.

I've been treated by good & bad doctors, good & bad corpsmen, and all sorts of healthcare professionals in between. I'm not sure that "adult" or "college" are any guarantee of quality.

Some bases have a written policy that they refuse to treat retirees, they only treat Active Duty personnel.

Yes, that's correct. Again, there are other Tricare plans (linked above) for military retirees and survivors of military retirees-- and the VA for other military veterans.

For a couple of years, we lived near the US Coast Guard academy. Some percentage of USCG cadets are the children of Congressmen/Senators. So their medical clinic is staffed with real 'doctor' MDs. And they allow retirees to be treated there. That was nice.

While all college campuses have some percentage of students who are the children of members of Congress, I don't understand how that affects the assignment of doctors to those institutions... let alone to service academies. Perhaps you could back up your statement with a link.

 

[Offgrid Organic Farmer]

Farmer, I don't know where you're getting your military healthcare information, and you're describing the system in terms which might lead civilians to think that military healthcare is worse than the requirements on the Tricare website.

Let's update your post with some links.


Here's the requirement for Tricare Prime:
https://tricare.mil/primeaccess
"Scenario 2: You live more than 30 minutes from a military hospital or clinic.

That last time that I looked into it, the requirement hinged on 50-miles, that was in 2005. So now it is 30-minutes. Big deal.

Hamburger / cheeseburger.

... The military hospital or clinic will decide if they can accept your enrollment request.

So it is still up to the local military base hospital to decide.

... Are you complaining about having to sit and wait for an opening when you don't have an appointment

Two different military hospitals have told me that as a Retiree, I can not get an appointment. The only way to be treated is to walk-in and wait.

 

[Independent]

I retired at age 60 before ACA. My employer provided post retirement HI on the same terms as regular employees. They had announced a gradual reduction in subsidy, but I figured we'd have a decent deal until Medicare kicked in.

After a few years, 2009 hit, the company lost a lot of money, and that was a good excuse to get out of retiree HI. We got the letter when my wife was in the middle of her chemo treatments.

The company arranged a non-subsidized high risk pool for us. IIRC, the premiums were $18,000 per year with a high deductible.

We eventually switched my wife to an expensive plan not connected to my former employer, and I was able to move to underwritten blue cross.

It was not a good situation. ACA is way better.

 

[saydiver]

In 2007 after going into remission from leukemia, DH decided to retire, but getting health insurance was an issue, since he was now uninsurable. We wanted to move to Florida, but their health insurance high risk pool was closed to new members. Texas also had a high risk pool and it was open to new members, so we moved to TX. Rather than just moving our domicile to TX and moving directly into a RV, we moved to an apartment for seven months, so California couldn’t question the move.

 

[ziggy29]

I'm thinking "pray" would be about right, assuming you were of some kind of faith.

 

[marko]

Very possible I may retire next year - .....at least I can buy insurance without having an employer.

My question.... if ACA goes away - what do early retirees do for insurance?

You always could buy insurance without having an employer; you just have to pay on your own.

That's what we've done for 15 years to the tune of ~$30K (before I was Medicare eligible) and DW still pays about $15K per year for the next 3 years.

 

[Teacher Terry]

Without a plan from our employer we wouldn’t have been able to retire. Thankfully we worked for the state.

 

[harllee]

You always could buy insurance without having an employer; you just have to pay on your own.

That's what we've done for 15 years to the tune of ~$30K (before I was Medicare eligible) and DW still pays about $15K per year for the next 3 years.

Not true--not everyone could buy insurance before the ACA. Pre ACA my DH had a preexisting condition and no private health insurance company in our state would issue a health insurance plan to him at any cost. He was without health insurance for a while and was thinking of going back to work just to get the insurance. Finally our state started a high risk pool and he was able to get on it but the premium was about $1000 per month and the coverage was very limited (no drug coverage) and the policy had a lifetime cap of $1,000,000. Pre ACA health insurance was practically nonexistent for early retirees with preexisting conditions in many states.

 

[daylatedollarshort]

Not true--not everyone could buy insurance before the ACA. Pre ACA my DH had a preexisting condition and no private health insurance company in our state would issue a health insurance plan to him at any cost. He was without health insurance for a while and was thinking of going back to work just to get the insurance. Finally our state started a high risk pool and he was able to get on it but the premium was about $1000 per month and the coverage was very limited (no drug coverage) and the policy had a lifetime cap of $1,000,000. Pre ACA health insurance was practically nonexistent for early retirees with preexisting conditions in many states.

It depended on the state. It might have been true for where Marko lives, but pre-existing conditions were issues in all but around 5 states, pre-ACA. If the ACA is repealed, we could be going back to that situation

 

[marko]

Not true--not everyone could buy insurance before the ACA.

Well, of course. My reply was to the way I read the OP; it implied that pre-ACA, the only way one could get insurance was through an employer as I had bolded in his quote.

 

[EastWest Gal]

Some people died due to lack of health insurance before the ACA. Some still do.

My mom’s brother died from complications from alcoholism when he was in his early fifties. My aunt remarried not long after. Her husband was older and soon retired. She went uninsured. Then she got colon cancer. Now she was uninsurable. . They paid through nose. Then he died. She had metastatic disease. She was a housewife, and was now too sick to work. Faced with losing a place to live and a poor prognosis, she chose to stop treatment. She died soon after.

Before the ACA, thousands of people in the U.S. died from lack of affordable access to health care. A few studies before the ACA estimated 45,000 people died each year from lack of health insurance.

 

[daylatedollarshort]

Well, of course. My reply was to the way I read the OP; it implied that pre-ACA, the only way one could get insurance was through an employer as I had bolded in his quote.

Early retirees couldn't buy individual insurance pre-ACA in many states at any price if they had disqualifying pre-existing conditions.

 

[marko]

Well, of course. My reply was to the way I read the OP; it implied that pre-ACA, the only way one could get insurance was through an employer as I had bolded in his quote.

Early retirees couldn't buy individual insurance pre-ACA in many states at any price if they had disqualifying pre-existing conditions.

Yes, I know that. Most people know that. I, myself, had a friend in that situation.

My point was that the OP said: "...I find myself rather thankful that no matter how costly or imperfect ACA plans are at least I can buy insurance without having an employer...." which is incorrect, assuming he has no pre-existing.

A pre-existing condition wasn't in question; it was the false idea that only an employer could buy HI. Yes, if you had a pre-existing, you had to be employed to get HI but that wasn't what I think the OP meant.

 

[grasshopper]

I only have numbers from 2012 to our both being on Medicare now. Grandfathered BCBS PPO $2500 deductable retired in 2006 ages 53/51.

2012 both $705
2013 both $768
2014 both $861
2015 both $937
2015 both $1026 big age change
2016 Ms.G $472
2017 Ms.G $554
2018 Ms G $616

Now you no why Quicken is our friend.

 

[socca]

Early retirees couldn't buy individual insurance pre-ACA in many states at any price if they had disqualifying pre-existing conditions.

BCBS of FL issued me a pre-[A]CA health insurance policy with an addendum that specifically excluded coverage for my pre-existing condition: an unrepaired inguinal hernia. This was either (1) an insurance company being evil; or (2) an insurance company trying to run a business. Check your favorite social media outlet for the spin on this topic that suits your fancy.

P.S. I've told the story before about the BCBS of FL "nurse" who grilled me about my weight during a pre-[A]CA underwriting session. She was worried that my BMI of 19 meant that I had some kind of horrible wasting disease. I assured her that I had been at that weight by choice for years with excellent results. The insurance policy was issued without further ado. I'm still asked for my height and weight during medical underwriting today.

 

[LimaPop]

I've been using sharing since the mid 1990's, it has worked well for me and my family.

 

[MichaelB]

When we were planning on moving from NY to Fl I contacted BCBS Fl and they assured me they would give me a policy with a rider to exclude my pre-existing condition. When I applied, a month before the move, they repeated their assurance and said I first had to establish Fl residency. We moved, we applied, and both were immediately rejected, me for the condition I had discussed with them. I later learned my rheumatoid arthris always led to denial of coverage, there was never any intent to cover or add rider. DW was denied coverage for an unrelated health concern even when her physician wrote a letter indicating their concern was totally unfounded.

Denial of health insurance coverage was real and quite systematic. No spin, nothing to do with social media.