Tuesday, July 3, 2012

Affordable Health Care for Early Retirees

     The Affordable Care Act is now, apparently, the law of the land, and while I'm no expert on health-care legalities, it does seem that Obama's ACA extends a very welcome helping hand to those of us who, by force or by choice, are among the ranks of the early retired -- the "lost generation" of people who have left work but are too young to qualify for Medicare.

     When I was laid off at age 53, I was able to stay on COBRA for a while, which covered my wife (we were separated at the time but still married) and my two kids. Eventually I had to get my own insurance. The way I did it was to find a work-related association I could join that offered health plans to its members, and through the association I was able to sign up for somewhat-reasonably-priced medical insurance. As my kids went off to college they were able to get health insurance through their universities. After I got divorced, my ex-wife qualified to join a different association and get medical insurance through them.

      I don't know why -- because she was a woman? because she moved to a different state? because she belonged to a different association? -- but she had to pay even more than I did for medical insurance. In this past year, she was shelling out more than $1000 a month for coverage . . .  just for herself!

     But at least we were able to get insurance. If your employer won't let you stay on their plan (very few do) or you're not eligible to join an organization, and have to buy medical insurance on an individual basis, your prospects are dim indeed. Some states offer medical plans for people with limited income; but a lot of people can't get medical insurance at any cost.

     (Which is one reason why I don't blame insurance companies for the high cost of medical care. If they were making so much money off medical insurance, they'd be sending us flyers in the mail, calling us on the phone, advertising on TV, in order to get us signed up. But instead, it's difficult to find an insurance company to take you on as an individual, so it can't be that profitable. Anyway, I stopped complaining about my medical insurance when they paid, in full, a $950 charge by an ambulance corps to drive my son 3 miles to the hospital when he cut his head in college. Who's ripping us off here? I asked myself. Not the insurance company. It's the ambulance corps!)

     Anyway, now starting on January 1, 2014, under the Affordable Care Act, states will be required to set up insurance exchanges where you can buy your own individual medical insurance. Indeed, unless you qualify for an exemption (are you Amish?), or are already covered under another plan, you will be required to get insurance.

     So, finally, those of us in our 50s and 60s who are no longer on the company payroll, and who are too young for Medicare, can do the responsible thing -- we can afford to buy reasonably priced medical insurance

     If your income is limited, the government will help you buy insurance. Medicaid will cover people under 65 who have incomes up to 133% of the poverty level -- which, today, would be $14,856 a year for one person or $20,123 for a couple.

     People with incomes up to four times the poverty level would qualify for assistance in buying health care. An estimate by the U. S. Department of Health and Human Services says a couple earning the poverty level of $15,130 a year would pay an annual premium of $303 for health coverage. A couple with an income at four times the poverty level -- an annual income of $60,520 -- would pay $5,750 a year for health insurance, or $480 a month.

     When you consider that my ex-wife is paying over $1,000 a month for her health insurance, that sounds like a good deal. I pay less than that, but not a lot less, and $480 a month sounds like a good deal to me, too.

     All along, I've personally have been supportive of the government trying to do something about health care. The medical-hospital-insurance complex is just too big and complicated for individuals to negotiate by themselves, especially if they're sick or injured. I do worry that Obama's plan does not really address the high costs involved with medical care, and that ACA is going to end up costing us all a lot more than we've been told. But that's an issue for another day.

     In the meantime, if you really want to educate yourself, go read all 974 pages of the Affordable Care Act (unless you think the Republicans are going to repeal and replace, in which case it would be a waste of time, but I'm betting that doesn't happen.)

     Or, for a brief summary, go to "Consumer Questions on Health Care Act, and the Answers" from the Sunday New York Times, or for a slightly more jaundiced view check out this other report "How Obamacare Could Help You Retire Earlier (or Destroy Itself Trying)" from AOL Daily Finance.


Olga said...

I will check out the NYT summary. I don't want my head to explode from TMI. My husband had to pay for his insurance for 4 years before he was eligible for Medicare. He now has a supplemental drug coverage policy, but still paid over a thousand dollars this month for his medications--would have been around 200 dollars in Canada.(But can I nag him into dropping some pounds, wearing sun screen, getting some exercise?? Or even taking a trip to Canada??) A year ago he took blood pressure medication and prilosec and he wondered if he even needed the drug coverage. You just never know what is going to happen, but i hate insurance on principle because it means you have to gamble that whatever happens will be bad.

Stephen Hayes said...

Thanks for this useful information. Mrs. C and i are among those who will soon be looking to buy healthcare.

Retired Syd said...

The only question mark now is what state you live in. 20+ states were involved in the lawsuit that made it to the Supreme Court, and on the issue of extending Medicare to folks up to 133% of the poverty level, this will now be a state-by-state decision. (In other words, those states were successful in their arguments that that piece was not constitutional.) Which in effect means the court made this aspect of the law optional now, so it will depend where you live as to whether you will benefit from this Medicaid expansion.

June said...

My God, man! Do you know what this means? It means I might actually be able to retire before I'm dead!

Dick Klade said...

The charge by an ambulance service to carry me 12 miles a while back was $1,200. However, I somewhat disagree with you about the cause of this sort of highway robbery (pardon the pun.) Providers jack up prices when they know people have insurance, a good reason to opt for "single payer" or "medicare for all" plans in the future.

The recent go around didn't solve the basic problems, it just removed some of the most blatant injustices.

Linda Myers said...

I've got a couple of grandchildren whose parents don't have health insurance. I'm glad it will be available.

Arkansas Patti said...

Thank you so much for this clear explanation of the Health Care Act as it effects the average man. So nice to hear an actual account and not a politically biased version.
I was so lucky that with my buyout at 54, I was given free insurance from my company till I reached Medicare age. I have yet to pay for health care in my lifetime and don't know how people did it and ate too.

schmidleysscribblins,wordpress.com said...

I agree with some of what Dick said...as usual. Many of the more egregious problems were solved like keeping kids on parents health insurance, but would have been solved anyway if the Democrats worked with Republicans.

The side effect of the child-parent ruling is that many kids are giving up their own insurance to get on parents policies.

The pre-existing condition aspect does not fully kick in until 2014.

I don't know if single-payer would work. States rights trump most aspects of the issue of health care. The "enumarated powers" of the Feds have been reined in.

Many the of states are opting out of the Medicaid part of plan and many more have decided to wait to form the "exchanges" until after November.

The Republican House can simply refuse to apportion funds for the parts of the law they don't like, now that Roberts ruled it is a "tax."

Although the media says States are foolish, they have been around the block with the federal government and know that today's free good is tomorrow's headache.

Block grants would have worked better say some, but the first thing cut is always $ to the States.

Each State wants to retain its rights, and we will see if Roberts ruling affects further interpretation of the Commerce Clause.

Very intersting legal dilemma, I'm loving the debate!!

Did you ever ask why the Pharmacos and the Insurance companies went along with the ACA?? There is a catch somewhere.

I will be waiting for updates on your insurance situation. Good luck. Dianne

schmidleysscribblins,wordpress.com said...

PS Reading the act will not help. You must read the thousands of pages of regulations that interpret the ACA. The devil is in the details, as they say. Dianne

tuck9899 said...

we have now said we will spend any amount of money..to extend quality of life for any amount of time...regardless of the cost

we have also moved further along the slope of means testing for govt programs

not saying good or bad...just saying

EcornerLearning said...

They should really come up with an ides on how to ensure the good feedback of people to their updated healthcare plan. health insurance continued education

Dollie Meder said...

Indeed, it will be a great help not only for seniors like you, but in general, for the whole medical health system. It will keep medical costs down, which every American needs to have. For retirees, it can save $20,000 for their medical bills. Who will not want to have that? :)

Elnora Cowger said...

Early retirees, just like everyone, should have the privilege of having their own health insurance. I must say, this act is sorely needed today, and it’s a good thing that this is now in the books. Let's hope for the best because this will benefit not only early retirees like you, but also the rest of America.


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