I am curious to hear about the experiences from other Type 1 diabetics who have retired early and paid for health insurance. My wife and I may be able to do this, but am skeptical how to afford health insurance and deal with the limitations (sensors and pump supplies covered). Medicare will not be available until 65 and from what I can see plans within NYS marketplace or any state market place are extremely expensive.
Any perspectives and experiences welcome.
Thanks,
Andy
Thanks for starting this thread. While my insurance Should cover whatever I need (at least a significant amount of it), I’m not sure it actually will when the time comes. And my daughter may also face this issue in not too long. Helpful post!..Judith
Is there any way you qualify for early coverage through Medicaid?
I retired early. We were covered under my husband and he had reached Medicare coverage already. We paid the Cobra amount for me for about 6 months. Once Medicare kicked in on my husband and then me the employee health plan automatically turns into a supplement plan. In our case because Medicare pays the majority of the bill, that supplement coverage not only pays copays, it also pays for the Medicare charge too and we don’t have a monthly bill for the supplemental or Medicare. Feasibly if Medical costs/insurance goes up enough over time we could end up paying a portion or all of the Medicare charge, but that’s it.
If you are retiring from a larger company sometimes they have nice retirement packages, you might check into that at your wife’s or your workplace.
What will your income be in retirement? You may qualify for a subsidy that will significantly reduce your premium under the ACA.
My retirement income was from my 401K so I could control the withdrawals to keep my income below the subsidy threshold which made it very affordable.
Or use Cobra if that is still an option. May have lower cost.
When I was shopping for an ACA plan many years ago google found me a big PDF will all the plans in my state and all the plan prices by age. Prices went up by age. A lot. What was cheap and affordable someone in their thirties would be a serious chunk of change for someone in their fifties to sixties.
Thanks for the responses.
My wife and I are fortunate to be able to retire early. Meaning our finances will be too much to qualify for Medicaid or subsidies. However, as LJAZ mentioned in their post it depends on how I set up the withdrawals from our retirement account.
This may be too nuanced, but does anyone know what the ACA reviews to determine income in retirement (what does/does not qualify)?
Cobra is also a short-term solution as I don’t believe it extends more than 2 years.
My wife and I ended in a “forced” early retirement before age 65. She became disabled and a T1D. We applied for SSI, denied, appealed (3times) and after 5.5 years she was placed on Medicare. Prior to being placed on Medicare we private paid for insurance. Eeeexxxxxpensive! Once she got on Medicare we needed a supplemental plan for her to make sure we didn’t have to pay through the nose for T1D related stuff (insulin, pump & cgm supplies). Unfortunately because she was not yet 65 the supplemental plans were all around $2000 per month or more. We ended up using Part C, Medicare Advantage but that was a nightmare for someone with a chronic condition like T1D plus her medical disability, not to mention turned down referrals, claim denials, unnecessary tests and more. We waited several years until she was 65 and jumped back on Original Medicare with a GAP or Supplemental plan that was less than $150 per month. We could go back to all her old private pay doctors that we worked so hard to establish relationships with.
Basically without having vented above I could have just said choose carefully. You have to “become an expert” on your own by researching which seems like a crazy way to run a healthcare system.
There are so many rules and caveats plus then once you have coverage you may find out that the carrier does not abide by their own policies and you can almost be certain that providers will not always do right by their patients. The doctors are constantly being pressured by the organization they work under to do what is most profitable. If you haven’t noticed, private practice doctors are going away. The big corporate healthcare cartels want to have total control. It seems that the only way to have a private practice doctor will be a concierge arrangement.
Our situation was somewhat unique which made it far more difficult. Sounds like your situation is also somewhat unique, which probably means you will have to wade through all kinds of options and rules. Best of luck
The ACA uses whatever income you claim on your federal income taxes.
Thank you Steve. This is very helpful. I’m sorry you and your wife had to go through years of that nonsense. At least now it seems like you are in a good place.
I retired at 59, but continued as a consultant to pay for insurance coverage which also covered my wife who did not have employer provided insurance. The details became a little complicated but it ended up as a win-win for both my former employer (engineering consultant) and me.
I worked out a deal with my employer (which was a small business with flexible management willing to work something out) to continue as a paid “on call” employee until age 65. I was on call for enough hours every week to qualify for the health insurance (in our case it was around 18 hours weekly) but I was only paid hourly for billable work which was usually 20-25 hours per month. The health + dental insurance premium (around $1700/month but rising every year) was covered by the company markup on my hourly rate when they billed the client, meaning I was obligated to work enough billable hours to make it above break even financially. They paid me out of regular payroll with tax withholding etc at an hourly pay rate of about 35% of the rate they billed the clients and no other benefits, no paid holidays etc.
One thing I would advise if possible for you: Private dental insurance before you go on Medicare which does not cover dental. If you can take care of big ticket items like crowns before you are uninsured for dental you will save some money there.
Thank you so much John. I would have never thought Medicare does not cover dental. Good to know. I’m thinking the best route for me and many people who have the means to retire early would be to simply work less. Meaning keep up enough hours (part-time, or some similar deal as what you describe) to at least maintain medical/dental coverage until age 65.
My fear now is what could possibly happen to Medicare and the ACA with a new administration.
I timed my retirement so that COBRA would cover my wife and I till I reached 65 and Medicare for me and continued COBRA for my wife till she reached 65. COBRA was (slightly) less expensive than any private plan I found. It is all in the timing.
Under my co. plan, I had small co-pay for insulin and pump supplies. Under Medicare + supplement $0 for pump, pump supplies and insulin.
You may want to continue working till you can do what I did. The benefit from working a bit longer is a fatter retirement account.
A word about Medicare and dental insurance. Do a comparison to see if the policy is worth it. My dentist told me before I went on Medicare to NOT look for a policy that contained dental coverage. He said that many times WHAT those policies covered was very limited anyway, and that I would be better off to take what extra money I would pay for such a policy each month and just set it aside as my personal “dental” fund. I have found that this has worked very well for my husband and for me. We do NOT have any dental insurance, but our primary dentist gives us 10% off the bill if we pay at the time of the visit, and our fund has grown enough each month that we can cover the cost of any major dental bills like root canals and crowns. You have to calculate how much you would need to put aside based on your location and your history of dental work, but a little each month goes a long way and avoids lots of hassles with insurance companies when you need to see a dentist.
Good to know. Thanks SherryAnn
I have private dental insurance through work and it sort of works in the opposite way that you’d want insurance to work. It pays for check ups and maybe a filling or two but then it just stops paying. So, fine for expected expenses but if you have a large unexpected expense, you’re on your own. The whole point of insurance to me is to pay for large unexpected expenses.
Yes, I agree. It was once explained to me as getting your regular dental work tax free. Not really insurance in traditional terms. Probably be in same position just putting it into a HSA.
Yeah, chiming in with the last two. Dental “insurance” (often actually labeled “dental plan”) is not insurance. I see it as a scam. I’ve known a number of people who plan their necessary dental work years in advance due to the small annual coverage.
My insurance that changed to a supplemental plan at retirement also offered the exact same coverage of the dental plan we had when my husband was working. It runs about $15 a month.
But dental coverage has never really been that good and they haven’t changed the max amount since I can remember. It pays for two exams and two teeth cleanings a year, but it maxes out what they pay of a total of $1500 each year for any other work. Considering that dental work has gone up significantly over time it’s easy to “max” out. But the good thing is the plan puts an acceptable charge the dentist is supposed to abide by. So what the dental plan says is your co pay is what you are supposed to owe. And once you reach the max amount, they can only charge you what the insurance says should be the amount that is allowed to be charged for that procedure. I read in our coverage that is what the dentist agrees to when they take their insurance. I did have one dentist here we saw for a couple of years though that would bill for the difference of “his charges” versus their acceptable charges. We did switch dentists when we found another one we liked, it sure made a difference in costs!!!
I was one that made sure I got in a few months before the end of the year if I hadn’t used my max up yet.