Health insurance handcuffed

[Rianne]

That's an incomplete sentence. "to get a subsidy" needs to be in there. You can still get an ACA insurance policy with no underwriting at any income level, but beyond a certain amount of MAGI (used to be 400% of the Federal Poverty Level but now the subsidy phases out above that) you get no subsidy.

Yes, that sentence should be corrected. But explained our experience. I thought it obvious we got a subsidy to get a good healthcare policy for $8-12/month for both DH and me.

 

[sengsational]

I made a prediction that when the ACA went into effect, there would be a flood of handcuffed workers that bailed.

I was one that bailed on the first year of the ACA, but later looked at the data, and didn't see a bump. My BS bucket was full and HI was a handcuff...when the ACA was in effect, I was free. At the time, I was healthy and didn't care too much about which plan... just picked one that wouldn't bankrupt me if something "really bad" happened (and that's all of the plans). The idea of comparing copays and deductibles with my work plan never entered into it. The question was "can I get health insurance for a reasonable price", and with the PTC, it was cheaper than reasonable... unreasonably cheap, actually.

 

[Dtail]

I definitely didn't want an HMO. But the EPO we did choose had all of the providers we've ever had in-network, as well as the better hospitals here. Worked for us.

Cheers.

Same here.

 

[ShokWaveRider]

The ACA was good for us pre-Medicare. But we trip over doctors and specialists here in NW Fla. There is a reason we are one of the healthiest counties in Florida. The only thing is that they did not cover the Mayo Clinic. Other than that, all peachy. Now on Medicare and we love it, Mayo included and with an AARP supplements our only OOP is ~$5k a year for both of us including the Medicare deductible, a bargain for some of the best HC the USA has to offer. Absolutely no complaints for top notch service, about the same cost to us as our overage when we were W@#king, although that is a distant memory.

This is definitely not the same for the poor states, we have friends/acquaintances in a few of those and they have very different stories. They are regretting moving there just because they thought it was cheaper. It pays to live in a more prosperous state. Remember this is the USA, you only get what you pay for.

It is the same in Florida, research the counties and their healthcare ratings. The poorer counties can really lack decent healthcare and access. We are fortunate we live in #1. There are other advantages to retiring in Florida other than the weather.

https://www.usnews.com/news/healthiest-communities/slideshows/healthiest-communities-in-florida

 

[aaronc879]

Everyone's situation is different with regards to ACA. Don't go by what other people tell you as things will be different for everyone. ACA is great for me and Medicare will be a big Increase in costs when I am forced to go that route. You need to look into what ACA would look like for your specific situation. Can you get your income below 400% of the FPL? If not then the cost will probably be high but the coverage should be good in most places.

 

[jim584672]

The 400% FPL cliff was removed through 2025. Whether it comes back depends on who controls the government. If nothing is done it comes back in 2026.

 

[Jerry1]

Anyone here handcuffed by HI, otherwise would have been FIREed?

Does MEGAcorp offer retiree health insurance?

No, they don’t, unfortunately.

If you don’t have retiree health insurance, then I don’t see you as being handcuffed. I see you as having not met your retirement number. I was “handcuffed” until 55 because my company did offer retiree HI at 55 which includes a generous subsidy even through my Medicare years. That was a huge benefit. Since you have nothing like that to lose, it’s just a matter of how much are you willing to spend to be able to retire in the manner that you envision.

As others have noted, check out your options and see if you can cover yourself until Medicare. Once you hit Medicare, you’re in no different position than you would have been in had you worked to 65.

In your research, don’t forget to look at all options consistent with your health status. For example, if you’re relatively health, maybe a high deductible, lower cost plan would suit you well. There’s some risk there but manageable given the limits on any plan you might buy.

 

[Aerides]

If you don’t have retiree health insurance, then I don’t see you as being handcuffed. I see you as having not met your retirement number. I was “handcuffed” until 55 because my company did offer retiree HI at 55 which includes a generous subsidy even through my Medicare years. That was a huge benefit. Since you have nothing like that to lose, it’s just a matter of how much are you willing to spend to be able to retire in the manner that you envision.

As others have noted, check out your options and see if you can cover yourself until Medicare. Once you hit Medicare, you’re in no different position than you would have been in had you worked to 65.

In your research, don’t forget to look at all options consistent with your health status. For example, if you’re relatively health, maybe a high deductible, lower cost plan would suit you well. There’s some risk there but manageable given the limits on any plan you might buy.

Similarly, my MC HI would not kick in until 55, and we retired way before that.

As far as the ACA we have a high deductible plan. I don't view that as a risk, but a budget item. Once so far in 7 years on the plan, one of us met the cap. If someone gets on a plan with HD and finds they are spending that deductible each year...then change plans! It's only a risk if you don't budget for it and don't adapt if you don't find it works for you.

Just like each year at Megacorp open enrollment - plans and providers could and did change.

 

[Trailwalker]

ACA planning is helpful before pulling the trigger. Under the current system, there is no cliff, but there is a strong incentive to keep taxable income just above Medicaid income levels. We put a chunk of post-tax money into Treasuries to cover expenses during the pre-Medicare years. We have less than two years to Medicare, and our plan seems to have worked out. Whether the current system is good policy is another question, but these are the rules we play by.

 

[Tetto]

This is a great thread; you guys are giving me the confidence to pull the ejection handle.. Not quite there yet, but approaching it quickly!

 

[Jerry1]

Similarly, my MC HI would not kick in until 55, and we retired way before that.

Yeah, there’s a breakpoint there somewhere. I didn’t really hit my number until 50ish so waiting until 55 to lock in that benefit was a no brainer. At 55 I went part time and retired at 57. My next breakpoint was probably around 65. Basically, I would have had to work 5 to 10 more years to significantly change my retirement lifestyle. That just wasn’t worth it. This lifestyle is just fine.

 

[EastWest Gal]

The ACA did a number of things that helped everyone's insurance situation. It meant that screening colonscopies and mammograms and various screening labs are provided at no cost to the consumer. This aspect of the ACA was applied to all major insurance plans, not just the ACA. Your children under age 26 could remain on your plan. Very helpful for grad school kids (including dental and medical school). The ACA also requires not just ACA plans but also most employer-based plans to cover maternity care.

Keep looking at the plans, as they change every year. Each year I've seen more and more plans showing up.

The best insurance I had was way back in the 1980s and 1990s. I had several short hospitalizations during my pregnancy for preterm labor, and had frequent visits, which increased after preterm labor in 1991. The only thing I had to pay was doctor visit copays and a small amount for medication. Insurance has been getting worse and worse.

 

[Dtail]

ACA planning is helpful before pulling the trigger. Under the current system, there is no cliff, but there is a strong incentive to keep taxable income just above Medicaid income levels. We put a chunk of post-tax money into Treasuries to cover expenses during the pre-Medicare years. We have less than two years to Medicare, and our plan seems to have worked out. Whether the current system is good policy is another question, but these are the rules we play by.

As @pb4uski has pointed out in the past, this ACA MAGI income monitoring for tax subsidies is a known tax loophole and despite many users on this forum, it is not a widely used loophole.
I am 64 currently and thus my last of usage. I have saved 20k+ yearly for 2 members of my family and have no issues doing so.

 

[explanade]

I worried about health insurance and costs.

Now my ACA premiums are approaching 5 figures a year and I've spent thousands out of pocket too.

Fortunately it's been manageable for me.

There has to be some health benefits, including financial benefits, from not having to continue the grind for more years than necessary.

 

[sengsational]

This is definitely not the same for the poor states, we have friends/acquaintances in a few of those and they have very different stories. They are regretting moving there just because they thought it was cheaper. It pays to live in a more prosperous state. Remember this is the USA, you only get what you pay for.

This would hold especially true for Medicare Advantage and ACA plans, but maybe not was much for traditional Medicare? With ACA and MA, you are likely to get stuck in a limited network plan with too many patients and not enough doctors. With traditional Medicare, if you're concerned enough about your health, you get in the car and drive, or even fly to the Mayo. Or maybe you live in a "poor state" but near one of the healthiest communities. I wonder if the Medigap rates are all that different, though.

My mom was floored by the difference between rates in Port St Lucie vs Pompano. I thought the access to care was great in PSL. I read something a while back that showed the cost of care was proportional to the concentration of doctors, not the concentration of people. I guess that makes sense if it's because people in geographies with a low concentration of doctors aren't getting "enough" care and treatment.

 

[AllDone]

I start MC in 9 days and my husband is finishing his 12th month! However, we had no trouble with the ACA and it was a lot cheaper than COBRA even though we only qualified for a subsidy during Covid. I had a knee replacement on the ACA which met the $3500 deductible that year. Surgery for my arm fracture set me back about $300 last fall and some copays for physical therapy this year. We do live in SoCal so the networks are extensive and our state keeps a pretty tight grip on insurance companies.