Early Retire in 5 months- ins is confusing

[Floralscent]

Hello- We are retiring in 5 months at the age of 56 and will be relocating to AR 2-3 weeks later. Currently we have stellar employer sponsored health ins at an amazing cost to us.

Prior to 2026, we researched ins for ER and at that time it was likely we’d qualify for a decent subsidy w/ ACA but we knew that would likely go away in 2026. Obviously the increased subsidy is gone and rates are now jaw droppingly high for not even ‘good’ coverage IMO due to high MOOP.

Our employer ins is valid for 1 month after retirement. Cobra is super spendy and with being in a new state, that’s probably not the best idea anyway as all would be out of network for us. We’ve relocated before but always had health insurance waiting for us from new employer.

Any advice on how to handle getting insurance in new state? Is it too early to get serious about finding a plan, who to best contact or is it best to diy online? We want to avoid a gap in coverage and am hoping for a smooth transition so I’m not stressed about health ins when it should be an exciting time for us at retirement.

Should mention that although I feel healthy now, I had 2 very small strokes 2 yrs ago and am lucky enough to not have permanent issues and am doing well. I take cholesterol and thyroid meds and finding coverage to cover both of those when searching ACA was impossible to find.

I sincerely appreciate any advice. Thank you

 

[RetiredHappy]

You can always check the actual health insurance cost on the exchange at AR website right now using "life changing event", without actually enrolling in a plan right now.

You can also find out the coverage and costs of the drugs that you are on when you are checking out the plans.

 

[sailor]

I recommend healthsherpa.com , my coworker kids used it when they moved from GA to FL.
Good comparisons there between the plans.
I use it myself for "what if" scenarios.

 

[COcheesehead]

I would make finding a policy priority number one. The first year I went on Cobra. Big mistake. There are less expensive options. The second year I visited a health insurance broker. They are paid by the insurance company so it was free to me. The value of the broker is he showed me all the options and how to evaluate them. That was the best take-away. I now evaluate the policies on my own and until recently, our health insurance costs dropped every year, 5 years into retirement.

 

[cmc333]

Depending on what part of AR you are planning on moving, some areas don't have a ton of doctors. If in Boone or Carroll counties, most doctors and hospital will be in Springfield MO. Either Cox or Mercy affiliates. Of course Little Rock is different and so is the Fayetteville/Springdale area. There are too few doctors for the number of people and it can take you several months to get your first appointment with a GP. Once you decide on a plan and a doctor and have an address, I would suggest you call for the first appointment because it might take quite some time to see the doctor versus the NP. You might want to make sure that Barnes Jewish Hospital in St. Louis is considered "in network" also when you're looking at plans. Good luck!!

 

[Floralscent]

I think I will first chat with a broker and see what they have to say.

Would you suggest that I find someone that just handles health ins or ACA exclusively or is it okay to work with someone who might also help us with home and auto insurance as well?

 

[PaunchyPirate]

You can sign up for ACA insurance up to 60 days prior to the "change of life" event. Unless that's one of the many things that have been changed by recent politics. I've lost track. ACA insurance plans are set up to start on the first day of the month. So you should be able to sign up for a plan in advance of your move that would start on the first day of the month you actually move in.

 

[KB]

I contacted my current insurance and asked about converting my Group plan to an Individual plan when I was about to retire. i was able to switch when I retired. This was before there was ACA though.

 

[COcheesehead]

I think I will first chat with a broker and see what they have to say.

Would you suggest that I find someone that just handles health ins or ACA exclusively or is it okay to work with someone who might also help us with home and auto insurance as well?

Health insurance broker. They’ll understand ACA and likely give you a better overall view. I wouldn’t use a general agent.

 

[MRG]

We moved states while still on ACA. Since I knew nothing about the providers in our new area I met with a broker. It was a good idea.

 

[TripleLindy]

The ACA options are relatively easy to understand, but I also spent a career in the healthcare space, so I kinda know the nuances. Personally, I didn’t find brokers all that helpful.

Your initial task should be to make sure you fully understand your income and determine if you can keep it below 400% of the federal poverty level, which is $84,600 for a couple this year. If you can keep it below that, you’ll be eligible for a subsidy, which is substantial. As an example, the cost for a Bronze plan in our area with the lowest subsidy (meaning income at the highest amount to qualify) is ~$4200/year. That same plan with no subsidy is $34k/year.

I’d be surprised that something as common as cholesterol and thyroid meds are not covered by most ACA plans. I’ve found them very comprehensive in coverage. They’re just damn expensive without a subsidy and Bronze plans carry high deductibles/out of pocket maximums.

If you do enlist the services of a broker, steer clear of indemnity plans. They can be made to look good on the surface, but the reality is that coverage is awful and they are full of exclusions and coverage caps.

 

[engineernerd]

Looks like this is AR's ACA healthplan exchange: Health Insurance Marketplace

My state's exchange has very helpful customer service, dunno about AR.

I read somewhere that brokers are paid varying amounts to sign people up to different plans, so I recommend keeping that in the back of your mind when you talk to one. Sounds like many brokers are helpful but don't confuse charm with good intentions, is the way I would put it. If you are a "pleaser" it might be better to avoid brokers, at least to start with.

I have very long experience with high-deductible individual health insurance, from even before ACA, when my state was one of only 2 or 3 states to support individual plans.

My top recommendation is to ignore the deductible and prioritize the OOPM (out-of-pocket maximum). If you end up with a serious health issue or have to use a $$-motivated hospital, your total cost has good odds of making your OOPM look quaintly small and you will feel lucky to "only" have to pay the $8-$10k or so.

Also make sure you understand how the OOPM applies to separate individual plans for you and spouse versus a family plan for both of you. Apparently the deductible in a family plan (available to us) has individual limits so that person's care is free after meeting the same deductible as would apply if they had their own plan, but the OOPM does not appear to work that way. It's unclear, so we have two separate plans just to be sure.

My second-highest-priority recommendation is to find out how the plan handles claims. I once considered switching to a different company due to their low premiums, but after reading Google review after Google review from people on their plans complaining bitterly about their preauthorization-requirement abuse, I stuck with Kaiser Permanente.

One final thought: if you are generally healthy and won't normally reach the deductible, I would not hesitate to visit doctors outside the network who either charge less per visit or who you feel will provide better care. It's a gamble, since those visits won't count towards your deductible, but you will be ahead if they charge less and your health will be ahead if they are more competent.

 

[wolf]

engineernerd offers good, actual, real life, advice. You should read his post twice. Out of pocket maximum is a "KEY" to figuring out the best plan. Been there myself.

 

[TripleLindy]

Also make sure you understand how the OOPM applies to separate individual plans for you and spouse versus a family plan for both of you. Apparently the deductible in a family plan (available to us) has individual limits so that person's care is free after meeting the same deductible as would apply if they had their own plan, but the OOPM does not appear to work that way. It's unclear, so we have two separate plans just to be sure.

As long as it’s an ACA compliant plan, the OOPM works just like the deductible and cannot exceed the individual plan OOPM for any one person enrolled in a family plan.

 

[Flyfish1]

+1 on talking to a broker. We did it when we retired, no cost and was super easy.

 

[Dtail]

I used a broker too and they were helpful, but they don't typically represent all the options out there.
For example, I went with Wellcare for Part D, which was not represented by the broker.
The broker is Boomer Benefits.

 

[Pluperfect]

I used a broker too and they were helpful, but they don't typically represent all the options out there.
For example, I went with Wellcare for Part D, which was not represented by the broker.
The broker is Boomer Benefits.

The OP is getting an ACA plan, not Medicare.

 

[EastWest Gal]

Also, research providers in the area to which you are moving, find out what plans they take, and make sure they are accepting new patients. When my dad moved from CA to PA, it was a pain finding doctors who were taking new patients. That was in 2004, and he was on Medicare. He was on Kaiser in California (since before I was born!). Kaiser Permanente might be a decent option in Arizona, depending on where you will be living. There is no Kaiser Permanente in Pennsylvania, or where you currently live per your profile. If you choose it, accepting new patients shouldn't be a problem.