View Full Version : Health insurance decisions
I’m looking at options/cost comparisons for health insurance for 2021. Assuming I am still not able to work.
(Update: I’ll be completing long term disability paperwork soon. I’m stalled at about 80% recovery from covid. Good enough for a quiet life at home. Able to cook and do light housework. Not good enough yet to work. Still need so much rest ... both night and day.)
I’m comparing the 3 options below for insurance. If I’m approved for disability, I’ll be earning enough that options 2 and 3 will both cost the same - somewhere between $1500-2500 a month for the two of us depending on the plan. I haven’t yet explored the cost of cobra, although I hear it’s usually one of the more expensive options. SO will be 61 in January. I’ll be 59 next week. Many years until the magical Medicare age of 65. At which time we could both be insured for well under 1000 a month for a good plan.
(If I do not qualify for disability and still can’t work, we can get an Obamacare plan for less than 500 a month.)
The options:
1. Cobra
2. Plan via the pension’s disability policy
3. Obama care
The thoughts that have me awake after midnight:
A. I would like any input you have.
B. I’m learning firsthand how devastating it can be to not be able to work these last 5-6 years before my planned retirement date.
C. If we would be civilized like Canada this would not be a concern. My benefits would continue, regardless of employment.
Is insurance through your SO not an option? Do you carry coverage for SO or only yourself?
catherine
10-30-20, 8:51am
C. If we would be civilized like Canada this would not be a concern. My benefits would continue, regardless of employment.
Isn't it a b*tch?? It is SO RIDICULOUS that we are still linked to healthcare through our employers! And then, if we aren't employed we have to pay through the nose, just when we don't have the income. Does that make any sense at all??? And your circumstances were thrust on you because you were a servant of the people, keeping other people healthy.
OK, you got my heart rate up this morning.
Can you compare the benefits you would have for options 2 and 3 and then decide? Also, check out COBRA rates but you are right, they don't save you much, if anything, over just going out on your own. It will not be cheap.
You will have to see what your income level is going to be before you'll be able to find out what your ACA subsidies are.
iris lilies
10-30-20, 9:45am
Isn't it a b*tch?? It is SO RIDICULOUS that we are still linked to healthcare through our employers! And then, if we aren't employed we have to pay through the nose, just when we don't have the income. Does that make any sense at all??? And your circumstances were thrust on you because you were a servant of the people, keeping other people healthy.
OK, you got my heart rate up this morning.
Can you compare the benefits you would have for options 2 and 3 and then decide? Also, check out COBRA rates but you are right, they don't save you much, if anything, over just going out on your own. It will not be cheap.
You will have to see what your income level is going to be before you'll be able to find out what your ACA subsidies are.
Tammy I can’t help you because we didn’t consume much healthcare at all because we didn’t have conditions and so when we were considering Health insurance I was mainly looking at insurance against catastrophic events which of course Obamacare has denied me. So we went with my employer’s COBRA option for the maximum time we could which was super expensive but it was just easier for me to do that then talk DH through an ACA option. Then when COBRA ran out for us, we went to an ACA policy and it was much much much cheaper.
catherine, Truly don’t understand your rant about having to pay through the nose because ACA policies are heavily subsidized if you don’t have much income. The one full year we were on ACA we paid little to nothing. The second year we ended up paying quite a lot, settling up at tax time, because we had a big family inheritance but that’s fine it’s all smoke and mirrors.
Bottom line is that the ACA exists to help people with low income. Our president, Barack Obama, deemed it affordable regardless of income. So whether you take a bronze or silver or gold plan depends on how much/what kind of healthcare you consume and so you have to look at what you’re going to use and how those policies benefit your consumption of healthcare services.
catherine
10-30-20, 9:52am
catherine, Truly don’t understand your rant about having to pay through the nose because ACA policies are heavily subsidized if you don’t have much income. The one full year we were on ACA we paid little to nothing. The second year we ended up paying quite a lot, settling up at tax time, because we had a big family inheritance but that’s fine it’s all smoke and mirrors.
It's a rant because even Obama said that Obamacare is just step one to get us to a more sensible healthcare plan that makes healthcare affordable for individuals AND the country. It's just a very convoluted, wasteful system. Clinging to this system when all other countries have found a better way is like saying, "You may have those fancy Mercedes-Benzes and Lexuses but WE have our horse and buggy!!"
iris lilies
10-30-20, 10:34am
Ok.
the complaining about ACA policies that obviously work well for many people is what makes me skeptical of there EVER being healthcare that satisfies everyone, a world where I dont have to listen to complaints about what gubmnt isnt handing out.
ACA policies fit early retirees very well. Of course, they have to pay something in some way. I guess it is all supposed to be “ free.”
Tammy, my suggestion is going to be to contact an independent insurance agent. I have friends who are self-employed and that’s how they obtain their insurance.
iris lilies
10-30-20, 11:22am
Tammy, my suggestion is going to be to contact an independent insurance agent. I have friends who are self-employed and that’s how they obtain their insurance.
Sure, I have many friends who are self-employed and who have private insurance because they make more than the ACA cliff. Depends on Tammy’s Income. The cliff for getting no subsidies on an ACA policy was at one time around $63,000 for two people. I don’t think that has changed much if any.
Just last week one of those friends said they pay $16,000 a year. I’m not sure if that’s for one person or two but he implied it was for one person. You are NOT going to pay that much on an ACA policy with subsidies.
edited to make sense.
It was just a suggestion. See what rates are, compare plans.
catherine
10-30-20, 11:28am
I guess it is all supposed to be “ free.”
So are roads, fire and police, and libraries.
iris lilies
10-30-20, 11:35am
So are roads, fire and police, and libraries.
I can show you both my tax bill and my paycheck from a library that prove these services are not free. They are government provided.
catherine
10-30-20, 11:42am
I can show you both my tax bill and my paycheck from a library that prove these services are not free. They are government provided.
That's my point. I believe that universal healthcare should be put in the same bucket as public education and public safety.
That's my point. I believe that universal healthcare should be put in the same bucket as public education and public safety.
I’ve talked with a number of people of all ages who think govt provided healthcare is free. When you explain that there is no cost at point of service, but it’s paid for through taxes, they just don’t get it.
That's my point. I believe that universal healthcare should be put in the same bucket as public education and public safety.Those other things are traditionally provided by state and local governments although our increasingly behemoth federal government has intruded into some areas by providing money received from one state to help fund things such as education in another state. I think we've given up an awful lot of autonomy in hopes of receiving other peoples money and would hate to see our federal government have so much power over us. But maybe that's just me.
JaneV2.0
10-30-20, 12:36pm
I have never had a problem paying taxes that solve a genuine problem that citizens have. I have a big problem funding graft and war.
rosarugosa
10-30-20, 12:53pm
I don't like "free" and I don't like "government provided." I think "publicly funded" is more accurate.
ApatheticNoMore
10-30-20, 1:41pm
I guess I'd compare the coverage network, deductibles etc. between options 2 and 3 and if one has doctors they are heck bent on keeping which plans they are "in-network" for. Coverage networks in the ACA can be a pretty small network, "narrow networks", so that's one thing to look out for. Deductibles for say a silver plan are over 2k. Does taking #2 affect the amount you would get in pension in any way? I mean my general experience is employer provided plans are much better plans than ACA plans, but much does depend on the details.
ACA may work well for early retirees, what I've said many times is it doesn't work well for the unemployed, because it requires one to estimate yearly income because one can earn too much money for ACA subsidies but one can also earn TOO LITTLE money for the ACA (and yet to get Medicaid one needs no assets pretty much - is that a hole in the safety net or what?). When one is looking for work by definition they can't estimate this, it' the very nature of looking for work, the unpredictability of income. But a lot of people are pandemic unemployed now, and so the constituency for single payer only grows. I suspect many people just drop healthcare coverage altogether when unemployed, certainly I know those who do and they aren't all young and in great health either.
iris lilies
10-30-20, 2:26pm
I guess I'd compare the coverage network, deductibles etc. between options 2 and 3 and if one has doctors they are heck bent on keeping which plans they are "in-network" for. Coverage networks in the ACA can be a pretty small network, "narrow networks", so that's one thing to look out for. Deductibles for say a silver plan are over 2k. Does taking #2 affect the amount you would get in pension in any way? I mean my general experience is employer provided plans are much better plans than ACA plans, but much does depend on the details.
ACA may work well for early retirees, what I've said many times is it doesn't work well for the unemployed, because it requires one to estimate yearly income because one can earn too much money for ACA subsidies but one can also earn TOO LITTLE money for the ACA (and yet to get Medicaid one needs no assets pretty much - is that a hole in the safety net or what?). When one is looking for work by definition they can't estimate this, it' the very nature of looking for work, the unpredictability of income. But a lot of people are pandemic unemployed now, and so the constituency for single payer only grows. I suspect many people just drop healthcare coverage altogether when unemployed, certainly I know those who do and they aren't all young and in great health either.
APN, you are wrong about needing to have no or low assets to jump on the Medicaid train.
The program known popularly as “expanded Medicaid” looks at income, not assets. There are MANY multimillionaires on Medicaid in “expansion” states. Just skim the thread on Mr. Money Mustache to see all of the high asset/low income people who use the ACA and Medicaid because those programs work in their financial favor.
It was, er, quaint when due to the fked up way the gubmnt run ACA exchange couldnt recognize DH as a joint income person. he was poor! In their eyes. And since he had no income, They insisted he should take Medicaid services.
This was a laughable experience for us, and all we had to do to humor them for a few months was to keep sending the income tax returns until he could hop onto the other gubmnt program, Medicare. I pity the poor fools who actually had to deal with the ACA bureaucrats for a length of time longer than a few months. They are ridiculous. But sure, let us have “them” fund And run the whole shebang. Ugh. Inflexible and idiotic are two words that come to my mind.
But back to Tammy’s question: if she has regular income stream, APN is right that it is easier to Estimate if an ACA policy works for her.
Is insurance through your SO not an option? Do you carry coverage for SO or only yourself?
I carry coverage for both of us. He retired a year ago but isn’t old enough for Medicare.
Ok.
the complaining about ACA policies that obviously work well for many people is what makes me skeptical of there EVER being healthcare that satisfies everyone, a world where I dont have to listen to complaints about what gubmnt isnt handing out.
ACA policies fit early retirees very well. Of course, they have to pay something in some way. I guess it is all supposed to be “ free.”
If I don’t qualify for long term disability and still can’t work, then yes Obamacare is good. Less than 500 for two of us.
If I qualify for disability the cost of any of these 3 options will eat up at least half of my disability income.
Maybe it’s sticker shock but that seems wrong. Insurance will cost 3 times as much as my house payment in this situation.
iris lilies
10-30-20, 2:57pm
If I don’t qualify for long term disability and still can’t work, then yes Obamacare is good. Less than 500 for two of us.
If I qualify for disability the cost of any of these 3 options will eat up at least half of my disability income.
Maybe it’s sticker shock but that seems wrong. Insurance will cost 3 times as much as my house payment in this situation.
so how much is your disability income?
and you are paying for 2 people, not just 1, out of this income.
How is it relevant to tie the cost to your house payment?
you worked in healthcare and made a pretty nice salary, right?
just sayin.
If there wasn’t a pandemic then one of us could get a part time job at Starbucks et al just for health insurance.
(He has diabetes and hypertension and I have asthma, so we’re trying to avoid the general public at least through this winter. Once I feel better if I still can’t return to regular work, I plan to explore work from home nursing jobs. I also wish we knew if one is immune and for how long after having it.)
But if there wasn’t a pandemic I wouldn’t be off work recovering from it.
All of your input is helpful. I’m trying to be sure I don’t miss an obvious alternative to a monthly $2000 bill.
I guess I should be grateful for the possibility of long term disability through my pension, even if it takes a huge chunk of it to pay for health insurance. Most people don’t have that option.
If this had happened to me prior to 2010 we would be bankrupt by now. We were always careful with our money, but we never had a lot. Raising 3 kids is expensive. Being a pastor is low paid. Keeping one parent at home/easily available most of the time for 25 years to monitor the kids (teens are scarier than toddlers) had a big cost. We freely chose all those things and don’t regret them.
Since 2010 we’ve been playing catch up - big income but catching up as fast as we could. I just needed 5 more years in my grand plan. I think I’m grieving that loss, but at the same time, I’m one of the lucky ones in our country. I had 5 months of accrued time off when this started so I’m in a paid status until mid December. I never had that kind of situation before. We bought a house 3 years ago for 1/3 of what the bank would have loaned us and have paid many thousands toward principle since then. I was on track to pay it off in 5 years. We can live on half of my income.
I’m struggling, and I’m one of the lucky ones. Our country is suffering so much.
so how much is your disability income?
and you are paying for 2 people, not just 1, out of this income.
How is it relevant to tie the cost to your pay payment?
you worked in healthcare and made a pretty nice salary, right?
just sayin.
Relevant: If we get insurance through the pension system they deduct it from the disability payment.
Disability is 2/3 of my salary.
Just enough that we probably won’t get a break on ACA prices. Not quite enough to pay all the bills. Our only debt is our house.
But like I said it’s something most people don’t have. So I should be grateful. We would use savings to get through the next 5 years. Including probably having to take some IRA payouts.
I’m grieving for my plan for a comfortable retirement. Instead it will be ok but not great. We know how to stretch a dollar but I thought those days says we’re behind us, we did that for 30 years already.
Once the pandemic settles down, and hoping I recover further, we’ll have more options for part time income. But that seems like a long way off.
Teacher Terry
10-30-20, 4:11pm
I am so sorry Tammy. Many people end up retired sooner than planned and it hurts financially. At one point our HI was a fourth of our gross income. A few years ago we were able to get on a PPO plan for 600/month with a huge deductible. We have tried not to use it but both my husband and myself broke bones and his needed surgery. We are 7k out of pocket. 3 1/2 years and I can dump my retiree insurance for Medicare for my husband.
iris lilies
10-30-20, 4:37pm
Relevant: If we get insurance through the pension system they deduct it from the disability payment.
Disability is 2/3 of my salary.
Just enough that we probably won’t get a break on ACA prices. Not quite enough to pay all the bills. Our only debt is our house.
But like I said it’s something most people don’t have. So I should be grateful. We would use savings to get through the next 5 years. Including probably having to take some IRA payouts.
I’m grieving for my plan for a comfortable retirement. Instead it will be ok but not great. We know how to stretch a dollar but I thought those days says we’re behind us, we did that for 30 years already.
Once the pandemic settles down, and hoping I recover further, we’ll have more options for part time income. But that seems like a long way off.
I meant to say how is it relevant to tie it to house payment.
It IS too bad that, at this stage, a comfortable retirement does not look possible.
I have to ponder this mix of disability, pension, and insurance since that is a new mix for me.
Oh I must have just been thinking that we will have a house payment for about 20 more years, if I can’t return to my prior plan of paying it off before retirement. I was paying a few thousand a month extra on principle. Having a house payment in retirement is a burden.
You all are a virtual support group for me, for both finances and emotions. Thank you
Also I’ve been talking with our son who is an accountant. He also does our taxes.
He has a scheme where if we contribute about 10,000 to IRAs, it drops us into an income category where we only pay 9% of AGI for ACA insurance. Instead of paying 31%.
He’s brilliant and I should have called him sooner instead of worrying.
I have been wondering if you have any kind of workman's comp claim, given he circumstances of what happened. I googled that question and apparently some in Michigan are saying yes to that question. I also wonder why your employer cannot hire you back to work at home in some capacity, at your full salary. Or even at less salary, but then you would keep your pension. It seems to me that might be worth looking into, more than getting a job at Starbucks--you might want to consult with an attorney.
Background on workers comp and Covid:
https://www.insurancejournal.com/news/national/2020/07/13/575233.htm
Background on Arizona law:
https://www.azhurtonthejob.com/blog/work-injury-illness/workers-comp-coronavirus-arizona/
Background on my situation:
In the 10 days before symptoms I had my teeth cleaned, donated blood, had a medical appointment, and worked. So it would be hard to say where I got it.
Additionally, my work does not involve direct patient care. I was working behind the scenes that whole week, 12 hour days, to get a new unit opened up for covid positive psych patients. But I had no direct patient interaction. Also additionally, I wore the appropriate PPE at all times at work. We all wore masks anytime we were in a building, whether we cared for patients directly or not.
My feeling is that I got it the dentist (mouth wide open ...), but there’s no way to prove it either way.
And yes, once I feel well enough to work, I’ll explore returning to company first. At this time I can only work a few hours from home before needing to rest. I’m hoping I continue to recover more as time goes on.
iris lilies
10-30-20, 8:05pm
Ok, I give up on the pension/disability/health insurance angle because
I do not understand that health insurance and who is requiring you use a particular policy. That is ok! I don’t need to understand it.
If you can get your MAGI down (not AGI) Then yes, that’s probably the way to go. I’m sure your accountAnt son knows that the ACA looks at MAGI. I honestly never figured out what all goes into MAGI even though I look at it on my income tax statement, but when we used the ACA our income was so low anyway I never worried about it. It was $30,000 for 2 people.
So great you have a son who is up on all of this and can help you to reach a good decision. It sounds like the decision cannot be made yet, not enough information. Hoping your health just gets better and better and you do not have to go on permanent disability. With other serious illnesses, it can take a lot of time to feel back to normal, often a year.
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