do my plans really need put off?

[Dtail]

But the OP's gamble isn't cost. It's cancellation of the ACA, and with it, his ability to purchase any individual insurance. He'll have a recent cancer, a pre-existing condition that proved problematic for being insurable, before the ACA.

I agree, if the OP's post was just about dates and dollars, a financial plan b to absorb a full cost non-subsidized post-ACA plan would be good, especially since he has COBRA to buffet his first 18months.

But with cancer treatments just now wrapping up, if the ACA were really going away, he'd potentially have 2-3 years being uninsured, and that's not a risk many would want to take, not with recent treatment in the rearview mirror. Subsidy schmubsidy, he has a different concern.

I think most of us believe the ACA will survive the current challenge, and even if it evolves dramatically, pre-existing protection is now expected by most americans. But it could easily drag out through next year (it's not going to get to the SC until at least next summer, if at all).

You are talking about sucking up extra costs for unsubsidized insurance when disappearance of ACA means risk of no available insurance or far higher insurance prices.

I understand both your points. I happen to also have had cancer (Melanoma) and thus would be in the same situation pre-existing wise.

Even though my comments surrounded cost, in the end I don't truly believe there is any chance of pre existing conditions not being covered and only a small chance of high cost coverage for it even with a replacement plan (which would probably mimic the current plan in many ways but would have a different "name".

Thus if I was in the OP's specific situation, I would go for it. For me, retiring early when I realized I could do it was more important than any potential of ACA non survival.

 

[Dtail]

Plan B is pretty much always "get by with less".

Hopefully, insurance will still be available and affordable even with a pre-existing condition.

I am now cancer-free for the past 2 months. Fortunately I will be on Medicare later this year.

That is good news and wish you a lifetime of being cancer free.

 

[audreyh1]

How does one nearing retirement decide to continue working when facing a serious illness unless one flat can’t afford not to keep working?

 

[IndyGolfer]

thanks to all for all the comments


While I agree time>$$$, and stress of work is not good, the stress of the unknowm as far as insurance on the DW may outweigh everything. Happy wife, Happy life - still applies, and I plan to be around for a long time


My case is a good example of the one more syndrome. Financially I could have FIRED a few years ago, and already be on an individual insurance plan so pre existing conditions would not be an issue


Employer insurance and benefits do not allow me to do anything creative. I may try working one more year, then only risk one year of potential cancer treatments not covered, which I am thinking I will have the major costs behind me now. As a side note not dealing with hospital bills and insurance companies in the past, I can not believe the write down insurance companies get on procedures. They may not pay much initially but the write down is unreal, for me almost 70% so far.

 

[RunningBum]

How does one nearing retirement decide to continue working when facing a serious illness unless one flat can’t afford not to keep working?

Fear of bankruptcy if one loses their medical insurance and then has more major issues. I know it's unlikely that we'll return to where people can't get HI, but it could happen. And for anyone who said you could just go get a job that has HI...how many people do you think will be applying to those jobs?

It would be a tough call for me. I'd have to evaluate based on just what my medical condition is at the time. I'm not at all comfortable telling someone else, "don't worry, you'll be covered" because the stakes are too high.

 

[Rianne]

That's a really hard decision. Personally I don't see guaranteed coverage with ACA or its possible replacement going away, but if it does, you are almost certainly screwed with a pre-existing condition. With changes you could possibly have continued coverage but in a much higher risk pool with higher rates, like high-risk car insurance. I haven't heard this proposed but who knows?

If it were me I'd probably wait until the ACA battles settle back down, which might not be until after the 2020 election? Or beyond, depending on how that goes.

I would not worry about pre existing condition for HC. Almost everyone on this forum would be screwed if that were the case. IMHO. Here are statistics that made me realize eliminating pre existing condition benefit will go nowhere.
https://www.cms.gov/CCIIO/Resources/Forms-Reports-and-Other-Resources/preexisting.html
The question is how much can you afford to pay for HI? And is the stress of work making your health condition worse? If DH kept up with Megacorp stress, I'm not sure he'd be here today. Diabetes and a stroke were around the corner if he kept that up.

 

[marko]

ACA or not, I just don't see the pre-existing condition piece ever coming back.

Even in the worst case scenario, not in the time frame the OP is looking at.

All of us here know someone who put off their retirement only to die before they finally got there.

 

[MichaelB]

I think there is no basis to predict what the health care insurance environment will be like 3 years from now, and no compelling reason to assume anything specific about coverage for individuals with preexisting conditions. There are far too many variables and potential scenarios. The only certainty we have is the current law and regulation, which guarantee access.

There probably is less uncertainty with large employer coverage, because employers and insurers have built a model that works for both, so big changes are unlikely. Employers have found a way to control cost inflation (by passing it on to the employees) so it is sustainable, at least for the time being.

The small group insurance market is more more similar to the individual, so I would expect to see it evolve along the same lines.

Getting back to the OP’s question, the need for availability of comprehensive coverage can be weighed against the desire to retire and do something else. The clock is running out on all of us, so the real questions (IMHO) iare how significant are those two additional years, and how much uncertainty can you live with?

 

[Aerides]

Just another thought since the OP has only a worst-case 2 year gap:

RE at 61.5 in May as planned
Cobra 18 months as planned
Now at 63 - if the ACA is kaput, then you go back to a job. Any job that has decent medical coverage will do, salary will be meaningless, just icing.
Now at 63.5 - quit said "any job" after 6 months
Go back on Cobra for another 18 months
Ding, you're 65 go on Medicare

Still a risk there, since the economy could falter, ymmv as far as available employment based on resume, geography, etc.

 

[Carpediem]

Just another thought since the OP has only a worst-case 2 year gap:

RE at 61.5 in May as planned
Cobra 18 months as planned
Now at 63 - if the ACA is kaput, then you go back to a job. Any job that has decent medical coverage will do, salary will be meaningless, just icing.
Now at 63.5 - quit said "any job" after 6 months
Go back on Cobra for another 18 months
Ding, you're 65 go on Medicare

Still a risk there, since the economy could falter, ymmv as far as available employment based on resume, geography, etc.

Are you able to go on Cobra if you just quit a job? I thought you either had to be let go or retire.

 

[Rianne]

Are you able to go on Cobra if you just quit a job? I thought you either had to be let go or retire.

We went on Cobra a few times in our careers. Each time left said job to accept another. None of the times were we let go or RE. DH moved up ladder to new mega corps 5 times causing us to re locate.
Let me edit this: Pre existing condition created a "had to" to on COBRA. New corp HI (before ACA) required COBRA for 6 months. I'm not sure if recurrence of my pre existing was the issue. After 6 months we could go on new corp HI. Anyway, DH was not let go or ER at any point.

 

[Aerides]

You can cobra when you leave a job, period. So, early retirees that quit can count on cobra for the first 18 months. My mom retired at 63.5 before the ACA and did exactly that.

The only exception is if you are medicare eligible, or were fired for gross misconduct.

 

[RunningBum]

Now at 63 - if the ACA is kaput, then you go back to a job. Any job that has decent medical coverage will do, salary will be meaningless, just icing.

I really don't think it's going to be as easy as you think to get a job with decent medical coverage if the ACA goes away and you can be shut out with pre-existing conditions. I think it's much safer to bank that the ACA or similar coverage will exist than it is to think you can get a job over all the other people who will be in the same boat.

 

[Aerides]

I really don't think it's going to be as easy as you think to get a job with decent medical coverage if the ACA goes away and you can be shut out with pre-existing conditions. I think it's much safer to bank that the ACA or similar coverage will exist than it is to think you can get a job over all the other people who will be in the same boat.

I don't mean to imply it's easy for anyone to get a job, which is why I included "ymmv as far as available employment based on resume, geography, etc." at the bottom of my post. That's for each of us to determine - again we all have our own risk equations and I know little of the OP's specifics.

If it were me, I'd include things like working as a cashier at whole foods, or costco. I have a lot of local options for employment if I don't care what it is or what I make, but would focus on entry level work at mega-type corps, which typically include decent benefits for full time employees.

I need the ACA for 15 more years, so my risk window is long. But I also have a small business - small enough to claim I'm retired, but legit enough to grant me access into a small business group if those reappear one day too. Presumably that sort of thing would pop up again if the ACA died. So that's my current Plan B. Plan C is get any job.

 

[Dtail]

I really don't think it's going to be as easy as you think to get a job with decent medical coverage if the ACA goes away and you can be shut out with pre-existing conditions. I think it's much safer to bank that the ACA or similar coverage will exist than it is to think you can get a job over all the other people who will be in the same boat.

Generally +1 on this being the more likely concept.
There could easily be tremendous competition for the same lower level medical coverage jobs.

 

[joeea]

That is good news and wish you a lifetime of being cancer free.

Thank you! That was very nice!

 

[Dtail]

I don't mean to imply it's easy for anyone to get a job, which is why I included "ymmv as far as available employment based on resume, geography, etc." at the bottom of my post. That's for each of us to determine - again we all have our own risk equations and I know little of the OP's specifics.

If it were me, I'd include things like working as a cashier at whole foods, or costco. I have a lot of local options for employment if I don't care what it is or what I make, but would focus on entry level work at mega-type corps, which typically include decent benefits for full time employees.

I need the ACA for 15 more years, so my risk window is long. But I also have a small business - small enough to claim I'm retired, but legit enough to grant me access into a small business group if those reappear one day too. Presumably that sort of thing would pop up again if the ACA died. So that's my current Plan B. Plan C is get any job.

Bolded by me - I think it would be very difficult for a 60's corporate person to be accepted into a lower level megacorp job.
My industry (Wall St) as one example would not hire me or anyone else over 60 at this type of position.

 

[badatmath]

Worrying about insurance for the next 4 years would stress me more than working I think but YMMV as I tend to worry more than most.



Congrats on your recovery and if it makes you feel better I know someone 20 years out with no recurrence. - His PSA was rising some years out but they have determined via pet scans and such it is NOT back. . .

 

[reneeh63]

How does one nearing retirement decide to continue working when facing a serious illness unless one flat can’t afford not to keep working?

I think the decision is a bit more nuanced. Prostate cancer rarely kills but it can certainly require ongoing testing and treatments to be sure it has been controlled. That being the case, the OPs life probably won't be any shorter than before the diagnosis but it WILL certainly be more expensive for healthcare.

It may indeed be more stressful retiring now and worrying about health insurance than keeping working, especially if it's possible to "slow down" a bit and take a more relaxed approach for a few more years.

Tough decision to make OP - best wishes for a full recovery!

 

[HI Bill]

I'm almost 60 and am dancing with the dam cancer.
Just had the needle biopsies done in Sep last year - with negative results.
Looks like a potential repeat due to high PSA readings...again this year....
Again, best wishes and hoping you are cured
If possible - I would retire.......I'm planning to go at end of this year

Gamboolman, I feel for you. I had a CT scan, and they picked up a tumor. After looking in my bladder with a camera, they figured out the tumor wasn't in my bladder, but on my bladder, and pushing into the prostate. So, I also did the needle test (my PSA was never elevated). I vowed never to do the needle test again, due to the pain and discomfort, and potential for infection. The PSA test is highly unreliable, and I'd be hesitant to do the needle test again, unless imaging (CT or MRI) showed that the tumors are growing. Best wishes!

 

[RothReady2Retire]

I know in California, you can get an additional 18 months of Cobra through Cal-Cobra. Not sure if other states have this too.

Also, I personally would continue on the retirement plan for May!

 

[youbet]

Current plan is to work 2 more years to bridge the gap, but is that really the best (only) option?

Sorry to hear of your health issues..... But you may be overlooking an important consideration.

Many participants on this forum have retired very conservatively in terms of finances. That is, they're belt + suspenders + duct tape types. Is that you as well?

In the unlikely circumstances (IMHO) that ACA is eliminated when you need it during the two years between the end of Cobra and the beginning of Medicare, could your FIRE portfolio stand a, say, $200k hit for uninsured medical expenses? If so, retire!

Go to FireCalc and drop $200k off your stash amount leaving everything else the same. If you're still a go, then GO!

Time is by far your most precious possession.

Good luck!

 

[audreyh1]

Are you able to go on Cobra if you just quit a job? I thought you either had to be let go or retire.

Cobra is available no matter the reason for leaving. When I retired I simply resigned my job, there was no formal declaration of “retirement”. Cobra is available as a bridge between jobs.

Well someone mentioned being fired for gross misconduct disqualifying cobra coverage, so there are exceptions.

 

[Rambler]

Prostate Cancer survivor here. You didn’t mention if you had positive margins, extra-prostatic extension, positive vesicles, or positive lymph nodes. Also, you don’t mention post-op PSA results. If all of the above surgical biopsy results were negative, and your PSA level is <0.1 for at least 2-3 tests at 3 month intervals, then I think you are good to retire. If you have any reason to believe you may need adjuvant therapy/salvage radiation, they you may want to hang on to the j*b a little longer. But as I said, if those are not the case, retire now and enjoy life. I’m 18 months post op and doing great. The usual side effects of surgery have passed and life is good.

 

[vsri24]

Was planning to retire when ACA was introduced few years back, so continued for some years, then had kidney cancer so left one was removed. Took it easy later at work. Somehow reached 66 on jan1 and now happily covered in Medicare. No more worries. Have to be careful- something for other , means end of road ,since replacement is a long wait.