BySTACEY L. BRADFORD
PLANNING ON retiring early? Congratulations. But before you take the plunge, be sure you also have a plan for how you will get health insurance.
Traditionally, folks aged 55 to 64 who are too young to qualify for Medicare, yet old enough to be considered highly risky by insurers had a hard time finding coverage. It was either prohibitively expensive, or insurers denied coverage due to preexisting conditions.
Now, thanks to the Patient Protection and Affordable Care Act signed into law in March 2010, there are more affordable options and you should be able to find coverage regardless of any preexisting conditions.
Early retirees will still pay more for coverage than 20- and 30-somethings, because they are cost insurers more, but measures are in place to protect folks who were laid off or took no-coverage early-retirement packages from their employers, as well as those who used to receive dependent coverage through an older spouse who retired and now qualifies for Medicare. Even if you retire early by choice, you will benefit, too.
If you re one of those few who feel so fit and invincible that you can postpone getting health insurance, your days are numbered. Also under the healthcare reform bill is a requirement that everyone has health insurance. If you don t have it by 2014, a penalty will be imposed starting at $95 or 1% of income, whichever is higher. By 2016, the penalty will rise to $695 or 2.5%, but no family will pay more than $2,085.
Here's how folks who don't yet qualify for Medicare can find the most affordable coverage available.
Extend Your Existing Coverage
If you currently have health insurance through an employer with at least 20 employees, you can keep it for 18 months after leaving your job, thanks to the Consolidated Omnibus Budget Reconciliation Act (COBRA). This federal law requires employers to provide former employees with the option to purchase health insurance. The main drawback: former employees have to pay the entire premium on their own, rather than share the premium with their former employers.
Once COBRA runs out, be sure to have arranged for further coverage. Start shopping around for a new policy long before your COBRA runs out. This process can be time consuming, and, naturally, you want to make sure you don't go even one day without insurance.
Buying Coverage
An individual plan is going to cost you more than a group plan, in which everyone is charged the same premium. Individual policies are underwritten based on age, smoking status and health profile. So if you have, for example, uncontrolled high blood pressure, you would pay a lot more than would someone in tiptop shape.
The good news, however, is that under the healthcare reform act, premiums for older folks can t be more than three times as high as for younger people. And anyone earning less than four times the poverty level is eligible for subsidies to help cover premiums.
Come 2014, insurers will be prohibited from denying coverage due to preexisting conditions, and until then anyone who can t find affordable coverage from an individual carrier can buy insurance through a federally-funded high-risk insurance pool administered by individual states. This will be available until 2014, when states are required to offer so-called healthcare exchanges. These are markets where private insurers can create large risk pools and offer highly transparent and more affordable coverage.
Your best bet is to work with a professional insurance broker who specializes in the older population, though you could also check out web sites such as eHealthInsurance or Insure.com to see what's available in your area and how much a person with your health profile might expect to pay.
Keep in mind a valuable resource: your state insurance commissioners office. As a general rule, consumer advocacy is a core function for these bodies. They should be able to provide you with a list of insurers that sell to individuals, as well as other useful information about how to shop for affordable coverage.
Consider High Deductible Plans
If you don t qualify for subsidies and want to keep your monthly expenses as low as possible, consider a high deductible plan, also known as catastrophic coverage. If you re willing to have, say, a $5,000 deductible, your monthly premiums start looking a lot more manageable. We know, a $5,000 deductible is steep. But you can offset some of that cost by opening and contributing to a Health Savings Account (HSA). (For more on HSAs, read our story.) These allow you to set aside pretax dollars to go toward your deductible and other uncovered health-care costs, including pricey prescription medications.
Read The Fine Print
Before you sign on with a company, make sure you read the fine print carefully. Lower-priced policies generally provide less coverage. While you're probably willing to forgo chiropractic services, some plans could ask you to give up a lot more. It's not unusual, for example, to find a plan that limits the number of days of hospital coverage or doesn't cover physical rehabilitation. With limitations like that, a broken hip can prove a major financial setback.
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