Health Insurance

[thirdeye]

Investopedia lays out SS break even this way:

If we assume the full retirement age for a retiree is 65, and the retiree chooses to begin receiving Social Security income at age 62, their full retirement age benefit of $1,000 may be reduced by 20%, leaving the retiree with $800 each month.

If the retiree's co-worker with the same birth date and similar earnings history elects to receive their benefit at full retirement age three years later, the benefit may equal $1,000 each month. For the first three years, the first retiree received a total of $28,800 (or $9,600 per year), while the second received nothing. Once the second retiree starts receiving benefits, he or she receives $200 more each month, or $2,400 more each year than the first retiree.

The Social Security breakeven age is 77, or 15 years after the first retiree elected to receive benefits. After this point, the second retiree earns more over his or her lifetime than the first.

Although mortality is an unknown, retirees who think they may live past the breakeven age may want to defer taking Social Security benefits until full retirement age, while those who do not expect longevity may want to start benefits early.

 

[sandyut]

66 1/2. Before then you get less

I did the math on this. you get less per year, but after some number of years (I forget ho many like 10-15 its a break even. Its less for more months or more for less months...from the rough math I did on my pay outs of starting immediately vs waiting 5 or more extra years to start.

 

[thirdeye]

Another school of thought.... you take the lower amount at 62 and invest it monthly into an index fund, for example something mirroring the S&P 500. Now you have dollar-cost averaging on your side, and let's say you get a 9.5% return. If you let it ride you will beat the 8% return from Social Security. And if an emergency arrises and you need the money, you have it to cash out.

 

[tallbm]

I didn't read all the post but I have been self employed and depending on my contracts, I have picked up Obamacare plans (weren't other options) as needed when not on W2 contracts that offer me a plan.

The long and short is that Obamacare has been jacked with so much (one way or the other) that unless you qualify for credits it's just going to cost what it costs.
These days there are individual plans from the insurance companies but not a lot of options. I'm actually on an individual plan I liked better that wasn't on Obamacare. Many insurance providers just provide Obamacare plans only but worth checking their websites and comparing vs Obamacare plans.

With Obamacare plans It took me the 4th try as the charm to learn that in TX the doctors ONLY want to accept Blue Cross Blue Shield plans. If you pick BCBS then you have greater chances of keeping your doctor.
Do NOT listen to what any of the website says about your doctor accepting the plans and always call your doctor and ask them 10 times minimum to confirm that they accept the EXACT PLAN and PROVIDER you are looking at in Obamacare exchange. Tell them 10X in a row its from the Obamacare exchange so u arent told they accept something they then don't when you show up. AGAIN, beat this dead horse and have them confirm and send you proof of confirmation because I was burned 3 years in a row like this hahaha.

Avoid all other offerings besides BCBS or you will end up driving across the metroplex to find the 1 doctor that accepts whatever you pick that is not BCBS.

I have never qualified for Obamacare credits/discounts and the Obamacare plan pricing and options are comparable to individual provider offerings so its basically all the same when no credits/discounts are available.
I'm on an individual plan with BCBS that had a better configuration than the plans on Obamacare but honestly the cost wasn't very different. The cost is just what it is going to be Obamacare or not.

If this new supreme court justice is confirmed it is almost guaranteed that Obamacare is going to get killed.
If/when Obamacare is killed, us self employed folks or folks in your position will just have to pick through whatever the insurance companies provide and hope the insurance companies offer something acceptable. If they don't offer a sensible option then we pay an arm and a leg to be covered or we go with out.

I'm fortunate and will be ok no matter what. I just hope the insurance companies are ethical enough to provide something acceptable for those who are not in my shoes.

These are our options and this is immediate future for those of us who are self employed or those who are in your shoes.

 

[thirdeye]

You are correct. Check, check and double check. The Healthcare.gov site does have a database so you can look-up each of your doctors. Do this first before calling them so you have information in front of you. Also check surgical centers and rehab facilities too.

Maybe the sitting President thinks that because he appoints a Supreme Court Justice (for life by the way), they will rule in any decision in his favor, however the purpose of the judicial branch of government is to interpret laws. Normally, this is relatively clear-cut, but by selecting a Justice that may be more conservative for example it might be assumed their rulings would be consistent in that direction, but it's not a shoe-in by any means. 30 million people are at stake in the ACA game, so it's political suicide for the President to take away their insurance. Imagine how many Senators, Congressmen and downstream politicians that would be out of a job. too. Even if the SCOTUS rules against the ACA there will have to be a replacement plan.

 

[radioguy]

I just retired 2 years ago. We opted to stay and buy private insurance from my employer. The ACA choices while $4k cheaper, offered poor or no coverage out of state. Traveling is on our bucket list. We will review when I turn 65 in 2 years.
We are enjoying life and spending our kids inheritance...cant take it with you

RG

 

[bill1]

...I just want all American citizens to be able to get medical care when they need it. That doesn't sound like such a radical idea to me.

And it's hard to see how such a healthcare approach gets abused. If I give the needy money, or even just food, I suppose that could be seen as a disincentive for them to work hard and provide it all for themselves. But having folks around me being healthy seems like a win-win for us all.

 

[pineywoods]

Lets keep politics out of this or we will have to remove this thread.
If you go to a hospital any hospital with a life threatening condition they must treat you they can't turn you away. That goes for citizens or not it doesn't matter they can't turn you away.
As for Blue Cross Blue Shield we have had them or what they have become in our case Florida Blue for over 35 years straight and they get worse and worse about every year.
The premiums go up every year and the coverage gets worse.

 

[bill1]

Lets keep politics out of this or we will have to remove this thread.
If you go to a hospital any hospital with a life threatening condition...

I think it only gets political if you express a preference for govt-supplied health insurance vs. private insurance. (One political party states they prefer less government involvement in our lives--we certainly shouldn't support or oppose that here.) Opposition to private health insurance (well, insurance of any kind) was a position held by certain highly religious groups a century ago (shows you don't trust God!) but I can't believe either of the two major political parties wants to make that part of their platform today. My state has mandated liability insurance before you can register and drive a car, and neither Party opposes that as an invasion of personal liberty. Everyone recognizes that without it, the roads would be filled with smashed-up cars with metal appendages sticking out like Ben Hur hubcaps.

And from a personal-freedom standpoint, I can certainly understand leaving those with life-threatening conditions outside the hospital to die...they can't hurt me if they're dead. (And besides, some bleeding-heart Good Samaritans will come by and pay for their health care just like in Jesus' parable of the same name.)

No, the guy I worry about is the minimum-wage cook or chef who can't get healthcare (emergency room or otherwise) for a persistent cough. He's the guy coughing in my lunch, makes me sick, and thus I miss a week of work. From a pro-business standpoint, I gotta' wonder if there's not an economic payback in mandating that guy get some basic coverage, even if the public has to chip in a bit for him to afford it.

 

[thirdeye]

Lets keep politics out of this or we will have to remove this thread.
If you go to a hospital any hospital with a life threatening condition they must treat you they can't turn you away. That goes for citizens or not it doesn't matter they can't turn you away.
As for Blue Cross Blue Shield we have had them or what they have become in our case Florida Blue for over 35 years straight and they get worse and worse about every year.
The premiums go up every year and the coverage gets worse.

Have you shopped around with other insurers to compare costs against benefits? Or had your agent give you a quote to bundle your auto, health, and homeowners?

 

[BrianGSDTexoma]

So far the Affordable Health Care been working out great. I have a $25,000 income and get a plan with very low deductible and OOP.

 

[Gonna Smoke]

So far the Affordable Health Care been working out great. I have a $25,000 income and get a plan with very low deductible and OOP.

I was about to ask you Brian how things were working out. Have you had to use the plan, yet?

 

[bill ace 350]

i am sooooo thankful that I served honorably for 21+ years and have Tricare Prime.

 

[BrianGSDTexoma]

I was about to ask you Brian how things were working out. Have you had to use the plan, yet?

Yes. They seem to cover everything. Have not had to pay for hardly anything last couple years. I just lucky I have some savings to supplement my $25,000 income. Have to keep this up few more years.

 

[tallbm]

So far the Affordable Health Care been working out great. I have a $25,000 income and get a plan with very low deductible and OOP.

Just a pro tip about using Healthcare . gov and the Affordable Healthcare Act benefits.

ALWAYS call up your Dr.'s office and triple or quadruple check that your doctor will accept whatever plan you are thinking about getting!!!!!
Tell them its from the ACA and healthcare . gov and for them to reply in writing that they accept the exact plan you are looking to get if they say they accept it.

I work for myself as a 1 many company and took me 3 years to get this right and figure out the quirks.

The issue is that the doctor office clerks/receptionists don't realize that your plan is coming form ACA or they goof up and tell you they accept the plan when the only accept the corporate version of the healthcare provide/plan, not the ACA versions!!!

ALSO, the healthcare . gov site will tell you all kinds of doctors accept the plans but that information is almost always wrong and they fail to remove doctors listings OR the doctors just want more exposure even if they don't accept the plans.

In Texas, doctors only seem to want to deal with ACA plans that are Blue Cross Blue Shield of Texas. If you get a different ACA provider and your doctor confirms they accept it then fantastic!
If not, then it is an act of God to find that one doctor near your area that actually accepts the plan.

To be fair to the doctors here in TX, dealing with Blue Cross Blue Shield is easy and worth their effort. Most of the others are a nightmare for them to deal with so they simply don't work with them.

It took me 3 years/3 attempts to get this figured out then I was good to go. Please use this info to your advantage and get a good cost effective plan your doctor or an acceptable doctor will support.

I went through the following ACA providers:

1. Molina, year 1 - it was super affordable BUT found out its was the "dollar store" of doctors offices that accepted it. Bad areas, bad facilities, etc. The doctors were actually ok but would not do it again and thank goodness I have like no medications or issues to really test the care
2. Aetna, year 2 - upgraded to a real healthcare provider and the girl on the phone of my doctors office said they accepted it even though I was sure to tell her it was through ACA. I show up for an appt and they tell me they don't accept the ACA version.... pissed off! I was told that the confusion was they accept all Aetna from employer insurance plans but not from ACA.... back to the Molina doctor because yep they accept Molina so they accept much better providers lol. Was told they and other doctors accept BCBS through ACA because they are easy to work with so kept that in mind for year 3.
3. Blue Cross Blue Shield of Texas, year 3 and beyond - triple checked and yep accepted! Issue here was that first visit had to be with a different doctor in my area for the plan. Then from there I could switch to my doctor of choice in the plan.
   The new doctor was better! I stayed with the new doctor so that was a blessing in disguise. Confirmed with the new doctor that for ACA in Texas the doctors really only want to deal with BCBS of TX. Never had a problem since :)

So if you made it this far congrats! I'm not knocking the ACA or affordable healthcare, it's a good thing for people to have options and access vs the old days of having no possibility in a number of cases. As with all things you have to educate yourself to navigate the system so you make it work for you instead of you working for it. We do this with our smokers all the time :)

On a final note. I make good money but just need a healthcare provider being a 1 man business but it makes no sense to pay for crazy business healthcare plans.
If you can get subsidized plans or affordable plans through ACA go that route.
If you are not able to get a subsidized plan (my case) it seems the healthcare companies have caught up and offer individual healthcare plans that they often do not list on the ACA exchange.
The cost is often about the same or a little less and the benefits seemed a little better.

So in my case I check for both Blue Cross Blue Shield of Texas plans across ACA and from the actual BCBS website and I pick what works best.
The last couple of years the individual plans (not ACA plans) have been a hair more expensive but provided a few more meaningful benefits. I know the doctors here in TX take the individual BCBS plans so I have been going with those. Early on with ACA the healthcare providers didn't do this in my area but they slowly came along with individual plans.

I hope this info helps some folks out there :)

 

[BrianGSDTexoma]

So in my case I check for both Blue Cross Blue Shield of Texas plans across ACA and from the actual BCBS website and I pick what works best.

This how I found my plan. Nothing decent using the GOV site but went direct to BCBSTX and found a great plan.

 

[TripleLindy]

I’ve been using ACA plans for the past 5 years since I retired. I still have 5 years to go before Medicare, so I’m glad that the ACA is available, along with coverage for pre-existing conditions. I think I’ve met my deductible only once in 5 years, so the insurance is really for something catastrophic, like a car accident or cancer. I’ve had years where I had to pay the subsidy back, which sucks, but now that premiums are capped at 8.5% of income, it’s less of a concern.

tallbm be careful about lumping all BCBCSTX plans together. There are lots of different BCBSTX plans on the healthcare.gov site and each one has its own provider network. Specialists, like orthopedic surgeons, are particularly hard to find on their HMO plans.

 

[jcam222]

So far the Affordable Health Care been working out great. I have a $25,000 income and get a plan with very low deductible and OOP.

Brian if you don’t mind me asking is that your social security and any 401K draws combined? I’ve been looking through using the estimator combining what I estimate for both combined in the low $50’s and the decent Silver level seem to be around $375 per month. I’ll need 2 1/2 years worth to bridge from the end of my 18 months of insurance given for an early retirement package and 65 / Medicare. I’m considering taking out enough in a lump draw to supplement the SS for the 2 1/2 years so I can report SS income only for those.

 

[jcam222]

I’ve been using ACA plans for the past 5 years since I retired. I still have 5 years to go before Medicare, so I’m glad that the ACA is available, along with coverage for pre-existing conditions. I think I’ve met my deductible only once in 5 years, so the insurance is really for something catastrophic, like a car accident or cancer. I’ve had years where I had to pay the subsidy back, which sucks, but now that premiums are capped at 8.5% of income, it’s less of a concern.

tallbm be careful about lumping all BCBCSTX plans together. There are lots of different BCBSTX plans on the healthcare.gov site and each one has its own provider network. Specialists, like orthopedic surgeons, are particularly hard to find on their HMO plans.

I assume you had to pay back because your income ended up grossly higher than your estimate?

 

[tallbm]

I’ve been using ACA plans for the past 5 years since I retired. I still have 5 years to go before Medicare, so I’m glad that the ACA is available, along with coverage for pre-existing conditions. I think I’ve met my deductible only once in 5 years, so the insurance is really for something catastrophic, like a car accident or cancer. I’ve had years where I had to pay the subsidy back, which sucks, but now that premiums are capped at 8.5% of income, it’s less of a concern.

tallbm be careful about lumping all BCBCSTX plans together. There are lots of different BCBSTX plans on the healthcare.gov site and each one has its own provider network. Specialists, like orthopedic surgeons, are particularly hard to find on their HMO plans.

Good point to bring up. It reiterates the need for people to confirm with their doctors, specialists, etc. that the plan is accepted.

I absolutely look at ACA BCBS plans as well as the individual BCBS plans. I want the best deal and coverage combo possible.

I'm fortunate that my healthcare needs are minimal. I have about 2-4 doctor visits a year and that's about it. Specialist visits are even rarer and I make sure to see if they accept my insurance or are in my network before I make any plans.

Other's with a number of healthcare needs would have to do more checking than I do. I just hope my health and everyone's health holds up to not have to fight with this on top of new health issues :)