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Approximate cost of the ACA for early sixties

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Posted 6/19/2015 5:51 PM (GMT 0)
I am having trouble finding out information on how much insurance would be prior to Medicare using the ACA plan.
My wife and I want to retire in 2016 at 62. We would like to know how much does a bronze or silver plan cost and what do the deductibles look like.

I am surprised how difficult this has been to find out. I called the Kentucky Exchange and they told me to wait until I was going to retire. I'm sure his concern was a change in rates that inevitably occurs.
If the cost is too great, we may have to wait so I hate to plan. No need to plan if I can't afford it.

I believe COBRA would cost me $1800/month for the 2 of us. This would only take us to 63 1/2. My benefits person believes the Kentucky Exchange should be less expensive. I'm not so sure.

I would assume that we have a few guys out there that have retired early. Any help would be greatly appreciated.

Paul
Posted 6/19/2015 6:30 PM (GMT 0)
I retired early back in 1998 when I was 54, but luckily I still had my company plan until age 65. I would not like to have to rely on ACA and have no idea how to get bids. I don't know why you were told to come back when you're 65; that's nuts! You should be able to get price quotes based on the ACA plans available in your state. If it were me I would google the topic.
Bob
Posted 6/19/2015 7:11 PM (GMT 0)
Just go online and "pretend" to sign up. It will show you all the plans available to you and what your subsidy will be based on your income. I pay less than $200/mo after subsidy for a silver HMO plan. Prices differ markedly from state to state.

- Allen
Posted 6/19/2015 8:03 PM (GMT 0)
One other tip as you look at the plans available under the ACA in your state.  You and your wife are not required to buy insurance jointly.  You should price plans for both of you together and for each of you as individuals.  Depending on your health care situations, you may not need each need the same level of coverage right now.  Also, for some strange actuarial reason, a two person adult plan costs more than 2 single plans.  For example, a single plan at my workplace costs $569/month (that is actual premium, not employee cost).  A two person plan costs $1,533/month.  That is a difference of $407/month.  In the workplace, you have to insure as a two person family, but in the marketplace you do not.  I am not saying you will find the same thing in the marketplace, but I advise all employees who are looking at COBRA in a situation such as this, to look at all configurations.  My husband and I are retiring in December at age 63 1/2 and will be needing to make these same decisions at that point as we transition for 18 months to Medicare.  Although I am a novice at this prostate cancer business, my husband was diagnosed a year ago this month and operated on in August, I have been a VP of Human Resources for over 30 years and have considerable understanding of health insurance benefits!

Good luck.  Read the small print - the devil is truly in the details for all of these plans, either through your employer or in the marketplace.

Posted 6/19/2015 8:14 PM (GMT 0)
Hi Paul,

I had a plan that I got through the healthcare.gov and it was a gold plan. I do not recall the particulars but right after getting enrolled I had a heart attack. I paid about $2400 as my share of the hospital costs and never paid another dime the rest of the year for doctors or meds. The cost of that plan was $648/month and my share was $250/month. I believe the costs have gone up a little this year. Costs are based on your current year income. They let you estimate your income and figure your share when you sign up. I paid a bit more through the year as my income had some variables and I did not want to owe taxes. I actually wound up getting a bigger refund when ACA was calculated. It was the best insurance I have ever had including my policy during my working years with a Fortune 500 company.

I actually pay more now out of pocket for less coverage with my Medicare and supplemental than I paid for the ACA policy. Best of all they can not turn you down for preexisting conditions and you do not have to provide any information about them. I can not say enough good things about my experience. What a relief to have good coverage and not fear going broke from medical bills.

Good luck with your search.
Don
Posted 6/19/2015 8:26 PM (GMT 0)
Keep in mind the premiums will vary not just based on your plan, but on what your income will be. If you have a pension, plan on taking social security early and you are making taxable withdrawals from an IRA, your income will likely be high and you may not qualify for a subsidy. OTOH, if you can live mainly off after-tax savings prior to age 65, you may pay very little. (However, if you earn too little you may be pushed into Medicaid...it's a fine line.)

See if you can find an ACA-certified agent or enrolled. The California exchange has a link to resources...presumably Kentucky does as well.

I'm a financial planner that focuses mainly on helping people retire and generally I find that the ACA is very helpful for people that want to retire prior to age 65. But that also depends on personal situation and if your resources are flexible enough so that your income can be adjusted to hit the right levels. Good luck!
Posted 6/20/2015 4:43 AM (GMT 0)
My brother is 64, lives in NYS, has a small pension and socical security,  also  a wife on social security. He does not qualify for a subsidy. He pays $616/month for a silver plan, he can't wait until December 26, his birthday this year when he turns 65 and goes on medicare and pays $107/month for medicare part A + B. Medicare part D, the drug plan will cost him another $30/month. Who thought we'd be cheering when we turn 65? I have 5 years, 10 months, 2 days to go, whoopee!
Posted 6/20/2015 12:41 PM (GMT 0)
My husband just went on Medicare this month. The cost for part B (part A is free) is $138 per month (we just paid the bill from Medicare for 3 months of premiums). Add into that his Medicare supplement plan, which includes prescription drug coverage so he didn't need to sign up for Part D, and we're looking at a monthly cost of about $385 for him. Since Medicare generally covers 80% of reasonable and customary expenses, the supplemental plan is used to pick up the 20%. What many people do not realize is that Medicare supplemental insurance plans only pick up Medicare-eligible costs. If Medicare doesn't cover an expense (such as hearing aids), the supplemental plan pays nothing.
Posted 6/20/2015 2:16 PM (GMT 0)
/kynect.ky.gov

The website above can offer hypothetical estimates by going to Individual and family, then Check for Eligibility, etc.
Posted 6/20/2015 4:20 PM (GMT 0)
@ Tall Allen - how is the coverage? Do you find that they recognize and are willing to pay for the latest PCa drugs and treatments?

This is a great post, I'm learning a lot. Right now I'm doing good and working and have employer health insurance, once I have to move on to the next line of treatment I am seriously going to think about retiring. I have LTD thru my employer and would likely opt for that when that time comes. I turn 57 later this year.

Ed
Posted 6/20/2015 5:16 PM (GMT 0)
Ed-bar-

That isn't a concern for me, so I went with the cheapest plan. There's no consistency in what various plans will cover. Some plans publish detailed statements online of what they cover, others, you have to ask, and they often won't tell you unless you have the specific code for it. It's a hot mess.

- Allen
Posted 6/20/2015 6:47 PM (GMT 0)

Tall Allen said...
Ed-bar-

There's no consistency in what various plans will cover.

- Allen

Toss in the fact that you really don't know what the future holds for you and you quickly see that insurance is just another form of legalized gambling but the stakes can be very high.
Posted 6/21/2015 11:28 AM (GMT 0)
You should also look at plans outside the federal/state exchange if you expect little or no subsidy. You are likely to get much broader choices of companies and premium options. A very reliable site is www.ehealthinsurance.com. They will show the plans on and off the exchanges and compare coverage, networks, and premiums. You will also find a calculator to help you determine whether you qualify for any subsidy. The only advantage on the exchange is that if you qualify for the subsidy it is calculated and paid to the insurance company monthly. Then when you file your return there will be a reconciliation of the subsidy. This year over half of the people getting subsidies got too much and had to pay the difference back to the IRS. If you buy coverage off the exchanges, you still qualify for the subsidy and it is figured at tax time.

Remember, all qualified plans must follow the PPACA whether they are purchased on or off the exchanges. My personal and professional view (I am a financial advisor) is that it is best to look at coverage off the exchanges as they have not yet proven to be as effective, accurate, or complete as the coverage available off the exchanges. Again the only advantage to the exchange is the availability of getting a current subsidy rather than getting it at tax time. You can also call local health insurance brokers and have them provide professional advice and coverage. They generally get paid the same commission whether they provide you with a policy on or off the exchange.
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