Health insurance handcuffed

[OMYer]

Hello,

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

We always have MEGAcorp provided HI, never dealt with HI ourselves. We are relatively healthy. But heard most of ACA coverage are not as good as those provided by megacorp, or much worse. We are financially sound, would have been FIREed if HI is not a concern. For sure we are not going to work till 65. But it’s hard to pull the plug with the HI uncertainty.

I’d like to hear how you overcome the hurdles. Any surprise?

Thanks,
OMYer

 

[SevenUp]

We always have MEGAcorp provided HI....

Does MEGAcorp offer retiree health insurance?

 

[Dtail]

Have you actually checked out the ACA coverage in your area? It can truly be different even county by county.
In Tampa FLA, there were multiple providers with full PPO plans at very reasonable rates (low MAGI) with inclusion by all the doctors I wished to see.

 

[PaunchyPirate]

Hello,

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

We always have MEGAcorp provided HI, never dealt with HI ourselves. We are relatively healthy. But heard most of ACA coverage are not as good as those provided by megacorp, or much worse. We are financially sound, would have been FIREed if HI is not a concern. For sure we are not going to work till 65. But it’s hard to pull the plug with the HI uncertainty.

I’d like to hear how you overcome the hurdles. Any surprise?

Thanks,
OMYer

You’ve “heard” about ACA coverage. Have you actually looked into what is available to you in your location? Most ACA exchanges allow you to browse the specific, current plans, coverage, and pricing without having to create an account.

My ACA coverage for my 6 year of early retirement have been comparable or better than what I had at megacorp. I’ve paid less than $400/month (one person) most years. It is $263/month this year. Northwest Pennsylvania.

 

[RunningBum]

I've always been able to find a plan with my preferred doctors, going back even before ACA. Sure, I pay more and have a higher deductible, but that's just a financial issue to plan for. If you qualify for a subsidy the cost isn't bad at all. It doesn't handcuff you with no way out. The risk is the ACA going away and you not being able to get private health insurance due to an existing condition. I don't think ACA or something similar will go away but you have to make your own take on that.

 

[rodi]

The passage, and then implementation of the ACA was a game changer for my decision to retire.

You might be confusing quality of market insurance (vs employer provided) and net COST of market insurance.

With my employer we had low copays for the same health care network. After retirement to get a similar copay I would have had to pay a *lot* more... That's because I worked for a large corporation that subsideized employees and families at 80% of their cost - and they had a lower cost because of negotiated rates. But the quality would be exactly the same. - same network, same doctors, same everything... just more expensive.

I chose to stay in the same network/provider - but go with a high deductible version. Quality is exactly the same, premiums are pretty low, but I have to hit a pretty high deductible before they cover as much.

BUT I get the negotiated rates. I've had some big healthcare years - like the years my son had to have maxilofacial surgery to remove ameloblastomas. (Recurred 5 years after the first one). Yeah - hit his personal OOP max both years there. But the $30k-ish surgery was negotiated down to $9k before they applied the deductible/OOP.

You are not limited to purchasing market health insurance through the ACA... You can buy directly from the insurer. But you can only get ACA tax credits (aka subsidies) if you purchase through the ACA.

 

[OMYer]

Does MEGAcorp offer retiree health insurance?

No, they don’t, unfortunately.

 

[Koolau]

No, they don’t, unfortunately.

I still give thanks that Megacorp offered health insurance supplementation. I retired before ACA was even thought of, so the help was most appreciated.

 

[big-papa]

Hello,

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

We always have MEGAcorp provided HI, never dealt with HI ourselves. We are relatively healthy. But heard most of ACA coverage are not as good as those provided by megacorp, or much worse. We are financially sound, would have been FIREed if HI is not a concern. For sure we are not going to work till 65. But it’s hard to pull the plug with the HI uncertainty.

I’d like to hear how you overcome the hurdles. Any surprise?

Thanks,
OMYer

You should spend some time looking at ACA plans in your area before deciding or assuming anything.
I retired last summer, but stayed on COBRA through the end of the year, primarily because we had met the annual deductible earlier in the year (a rarity).
I started on an ACA plan in January and I'm happy with it. With subsidies, our premiums are less than half what they were on COBRA (but of course more out of pocket than when I was working). But affordable for us.
I did spend quite a bit of time researching the various plans before making a decision. That was time consuming vs. what was available during our working years.
Early next year my DW goes on Medicare, but I'll still be on an ACA plan for all of 2025 and half of 2026.

Cheers.

 

[Aerides]

Hello,

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

We always have MEGAcorp provided HI, never dealt with HI ourselves. We are relatively healthy. But heard most of ACA coverage are not as good as those provided by megacorp, or much worse. We are financially sound, would have been FIREed if HI is not a concern. For sure we are not going to work till 65. But it’s hard to pull the plug with the HI uncertainty.

I’d like to hear how you overcome the hurdles. Any surprise?

Thanks,
OMYer

This is where you have to do the work and research, just as you did with your investments. Remove the uncertainty with facts.

Assuming yourself handcuffed is premature. For us, moving to the ACA was not a big deal at all, and we have no quality or gap issues. It was no different than the times when Mega would sometimes change providers one year. Most of our docs were the same, some different, and we've been on the same plan for years now with the aca.

We do have a larger deductible, but that is mostly by choice. So that's in our budget.

 

[big-papa]

This is where you have to do the work and research, just as you did with your investments. Remove the uncertainty with facts.

Assuming yourself handcuffed is premature. For us, moving to the ACA was not a big deal at all, and we have no quality or gap issues. It was no different than the times when Mega would sometimes change providers one year. Most of our docs were the same, some different, and we've been on the same plan for years now with the aca.

We do have a larger deductible, but that is mostly by choice. So that's in our budget.

Similar to our experience. All of our current providers are in network as well as most of the prior specialists that we've used. Coverage is in a multi-county area where I live, but it's a large metro area with plenty of providers of every type in-network. And of course, with ACA plans, emergency services are covered no matter where you are in the country.

Cheers.

 

[Rianne]

ACA requires you keep your MAGI at or below a level. Personal experience:
We were relatively healthy. Our ACA plan had a high deductible and we contributed to HSA to keep income low. DH had a parttime consulting gig.
Monthly premiums for both combined: $8-$12/month
Our healthcare system gave good discounts. Dr appts., bloodwork, yearly health exams ran about $2K each. We spent approx $5000/year on all healthcare from 2014 - 2022. A couple of years maybe $1000 more. I think we spent less on healthcare than when DH was in megacorp world with gold standard healthcare.

A lot depends on your state, even your zip code. There were several good plans to choose from in our area. If a catastrophic health issue happened during those years, the maximum we would have paid was $9K. Once the deductible is reached, you owe 0.

 

[a60dan]

Definitely do the research.

Here in NY I was fearing ~$17K/year COBRA costs. A friend told me about the Essential Plan in NY. It’s not a typical ACA plan in that there are no tax credits.

By carefully managing our taxable income, we’ve paid no premiums with better HMO coverage than my employer’s HD PPO plan.

My wife had emergency surgery out of state- all covered.

Since 2022 we’ve not hit the $2000 MOOP.

I always thought I’d be looking forward to Medicare because it was less expensive but not as it turned out.

 

[big-papa]

ACA requires you keep your MAGI at or below a level. Personal experience:
We were relatively healthy. Our ACA plan had a high deductible and we contributed to HSA to keep income low. DH had a parttime consulting gig.
Monthly premiums for both combined: $8-$12/month
Our healthcare system gave good discounts. Dr appts., bloodwork, yearly health exams ran about $2K each. We spent approx $5000/year on all healthcare from 2014 - 2022. A couple of years maybe $1000 more. I think we spent less on healthcare than when DH was in megacorp world with gold standard healthcare.

A lot depends on your state, even your zip code. There were several good plans to choose from in our area. If a catastrophic health issue happened during those years, the maximum we would have paid was $9K. Once the deductible is reached, you owe 0.

The ACA used to require that you keep your MAGI at or below a certain level to avoid the "cliff", above which you would receive no premium tax credits. This feature remains through the end of 2025, after which time the cliff will once again return unless new legislation is passed.

Cheers.

 

[harllee]

I found the ACA insurance to be superior to what was offered where I worked, you just need to check out the ACA plans for your area.

 

[Texas Proud]

Not sure about others but my ACA plans were much worse than what I had at mega... and even mini corp... things got better over the years and some plans are much better, but the premiums were really high for any plan that came close to the megacorp plan...

 

[RunningBum]

ACA requires you keep your MAGI at or below a level. Personal experience:

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.

 

[pacergal]

Yes.
I was fully vested, 30 years in at age 54.
Had a union contract that paid most of my insurance until age 65, if I worked until age 60.
Our work insurance was very inexpensive, $200 for family full coverage, low deductible, Blue Cross , MODA, or Kaiser. ACA choices in our area are very good, but cost more than $200 for us.
It was worth it to work longer in order to continue with that coverage until Medicare. We pay more for medicare now.
Working 6 more years put us in an even better financial situation, and retiring at 60 was still pretty good!

 

[Kings over Queens]

I feel this.

Health Insurance will be my single largest expense in retirement. The benefits will be comparable to what's offered by mega corp, but without the mega corp subsidy. It's going to be plus/minus $2,000 per month with a high deductible HSA type plan.

 

[MichaelB]

This is where you have to do the work and research, just as you did with your investments. Remove the uncertainty with facts.

Assuming yourself handcuffed is premature.

Exactly. Instead of making your plans based on assumptions or what you’ve heard, look into the options you have available and get the details. How the ACA plans you have available compare with your employer coverage doesn’t matter, What does matter is how well the ACA plans meet your needs.

 

[HtownRose]

Me! I review the ACA options for my zip code every year & they are all HMOs or EPOs which I don't want. I also didn't want to stay in my then-current job until 65, so at 49 I found a much easier, less stressful job that came with fantastic employer-sponsored health insurance. Since covid it's been a work from home job & even though I will be eligible for retiree medical at 61.5, I'll probably not retire until 65 or later unless the job gets substantially less tolerable or they make me a voluntary separation offer I can't refuse.

 

[RetiredHappy]

As long as you are willing to pay more for private individual off exchange health insurance, you can get as good as mega corp health insurance plans. I have been buying such a health insurance plan since the age of 55 and I am 61 yo now. I retired at 53, and bought 1 year of "best available" ACA health insurance when I was 54 and learned that some of the top specialists did not accept the plan. So I switched to an off exchange insurance. It costs quite a bit more than unsubsidized ACA plans but it is worth every penny to me. All top specialists accept my plan with no referral needed. I buy a Silver plan to keep it more affordable, with premium of about $16K a year, deductible of $5.500 and maximum out of pocket of $9K. PCP co-pay of $25 and specialists of $50.

My husband was Medicare age when we retired so his health insurance plan is separate from mine.

Since you are financially sound, you just have to plan to pay more for better health insurance plans. They are available off-exchange.

 

[jim584672]

For me ACA is better than work insurance. NY has $0 plans under $37,650 ($2K MOOP). Under $30,120 ($360 MOOP), under $22,590 ($200 MOOP).

 

[Toast]

Me! I review the ACA options for my zip code every year & they are all HMOs or EPOs which I don't want.

This our story as well. I started a similar thread about a years or so ago posing a similar question. We just can’t bring ourselves to risk the ACA because all options in our zip code are HMOs or EPOs. DH has a tolerable job and plans to work until 63 1/2. Then, we’ll COBRA until we become eligible for Medicare at 65.

 

[big-papa]

Me! I review the ACA options for my zip code every year & they are all HMOs or EPOs which I don't want. I also didn't want to stay in my then-current job until 65, so at 49 I found a much easier, less stressful job that came with fantastic employer-sponsored health insurance. Since covid it's been a work from home job & even though I will be eligible for retiree medical at 61.5, I'll probably not retire until 65 or later unless the job gets substantially less tolerable or they make me a voluntary separation offer I can't refuse.

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.