Early Retirement and ACA insurance costs? 60-65 yo.

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B. Wellington
Posts: 256
Joined: Fri Mar 30, 2012 10:10 am

Early Retirement and ACA insurance costs? 60-65 yo.

Post by B. Wellington »

60 yo couple hoping to call it quits from the workforce. We need to "bridge the gap" until 65.

Would any retirees care to share the real world costs of their health insurance?

Any other information would be greatly appreciated.

Monthly premiums? Silver or Gold plans? Total yearly costs after factoring in tax deductions etc.?
PaunchyPirate
Posts: 1163
Joined: Sun Nov 30, 2014 6:58 pm

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by PaunchyPirate »

It varies widely by location. Have you visited your state's ACA exchange (or healthcare.gov if your state doesn't have its own exchange)?

You can get all the information you ask for without even having to create an account or reveal your personal information. Simply put in your zip code, ages, smoking status, etc. You can also do multiple tests and put in 60, 61, 62, 63, 64, 65 ages to see how rates currently increase by age. That will change with time, but it will give you a pretty good estimate. The last couple years, premium pricing hasn't had awful increases in many areas.

Your out-of-pocket costs will largely depend on how much medical care you need -- prescriptions, doctor visits, blood tests, etc.

I'm single, age 58, and pay $325 per month for a gold policy (including an ACA subsidy). This should decrease to about $220/month when the most recent passed legislation with higher subsidies kicks in (hopefully for June premiums). I manage my income to keep it low enough to obtain that level of subsidy. I pay about $75 every 3 months for prescriptions. I pay $50 each time I need blood work done. I pay $10 copay to my doctor for visits. $50 to see a specialist. These details are all specific to the policy you pick and pay for.
mtwhmemn
Posts: 482
Joined: Tue Jul 03, 2018 12:07 pm
Location: NC

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by mtwhmemn »

PaunchyPirate wrote: Thu Apr 29, 2021 6:11 am It varies widely by location. Have you visited your state's ACA exchange (or healthcare.gov if your state doesn't have its own exchange)?

You can get all the information you ask for without even having to create an account or reveal your personal information. Simply put in your zip code, ages, smoking status, etc. You can also do multiple tests and put in 60, 61, 62, 63, 64, 65 ages to see how rates currently increase by age. That will change with time, but it will give you a pretty good estimate. The last couple years, premium pricing hasn't had awful increases in many areas.

Your out-of-pocket costs will largely depend on how much medical care you need -- prescriptions, doctor visits, blood tests, etc.

I'm single, age 58, and pay $325 per month for a gold policy (including an ACA subsidy). This should decrease to about $220/month when the most recent passed legislation with higher subsidies kicks in (hopefully for June premiums). I manage my income to keep it low enough to obtain that level of subsidy. I pay about $75 every 3 months for prescriptions. I pay $50 each time I need blood work done. I pay $10 copay to my doctor for visits. $50 to see a specialist. These details are all specific to the policy you pick and pay for.
I'm around 58 as is my wife and we want to call it quits in the next year or so. We can keep our income low to get minimum subsidy. Would any couples around our age reading this please give a similar synopsis as PaunchyPirate has done here? Much appreciated.
260chrisb
Posts: 1281
Joined: Wed Apr 28, 2010 7:26 pm

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by 260chrisb »

mtwhmemn wrote: Thu Apr 29, 2021 6:25 am
PaunchyPirate wrote: Thu Apr 29, 2021 6:11 am It varies widely by location. Have you visited your state's ACA exchange (or healthcare.gov if your state doesn't have its own exchange)?

You can get all the information you ask for without even having to create an account or reveal your personal information. Simply put in your zip code, ages, smoking status, etc. You can also do multiple tests and put in 60, 61, 62, 63, 64, 65 ages to see how rates currently increase by age. That will change with time, but it will give you a pretty good estimate. The last couple years, premium pricing hasn't had awful increases in many areas.

Your out-of-pocket costs will largely depend on how much medical care you need -- prescriptions, doctor visits, blood tests, etc.

I'm single, age 58, and pay $325 per month for a gold policy (including an ACA subsidy). This should decrease to about $220/month when the most recent passed legislation with higher subsidies kicks in (hopefully for June premiums). I manage my income to keep it low enough to obtain that level of subsidy. I pay about $75 every 3 months for prescriptions. I pay $50 each time I need blood work done. I pay $10 copay to my doctor for visits. $50 to see a specialist. These details are all specific to the policy you pick and pay for.
I'm around 58 as is my wife and we want to call it quits in the next year or so. We can keep our income low to get minimum subsidy. Would any couples around our age reading this please give a similar synopsis as PaunchyPirate has done here? Much appreciated.
Showing a low income makes a big difference, question is; are you set up to show income below the threshold for the subsidy for 5-6 years? That's a long stretch. OP; don't forget to check with your HR to determine your cost of COBRA as it's available for 18 months after you leave and the cost can be covered from money in a HSA if you have one. For me (and I'm a year out), COBRA coverage is affordable for my first 18 months. It won't bridge the gap but helps until I have to show a low income for a year or two and then have higher costs for a couple years since I'll lose the subsidy.
mtwhmemn
Posts: 482
Joined: Tue Jul 03, 2018 12:07 pm
Location: NC

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by mtwhmemn »

260chrisb wrote: Thu Apr 29, 2021 6:33 am
mtwhmemn wrote: Thu Apr 29, 2021 6:25 am
PaunchyPirate wrote: Thu Apr 29, 2021 6:11 am It varies widely by location. Have you visited your state's ACA exchange (or healthcare.gov if your state doesn't have its own exchange)?

You can get all the information you ask for without even having to create an account or reveal your personal information. Simply put in your zip code, ages, smoking status, etc. You can also do multiple tests and put in 60, 61, 62, 63, 64, 65 ages to see how rates currently increase by age. That will change with time, but it will give you a pretty good estimate. The last couple years, premium pricing hasn't had awful increases in many areas.

Your out-of-pocket costs will largely depend on how much medical care you need -- prescriptions, doctor visits, blood tests, etc.

I'm single, age 58, and pay $325 per month for a gold policy (including an ACA subsidy). This should decrease to about $220/month when the most recent passed legislation with higher subsidies kicks in (hopefully for June premiums). I manage my income to keep it low enough to obtain that level of subsidy. I pay about $75 every 3 months for prescriptions. I pay $50 each time I need blood work done. I pay $10 copay to my doctor for visits. $50 to see a specialist. These details are all specific to the policy you pick and pay for.
I'm around 58 as is my wife and we want to call it quits in the next year or so. We can keep our income low to get minimum subsidy. Would any couples around our age reading this please give a similar synopsis as PaunchyPirate has done here? Much appreciated.
Showing a low income makes a big difference, question is; are you set up to show income below the threshold for the subsidy for 5-6 years? That's a long stretch. OP; don't forget to check with your HR to determine your cost of COBRA as it's available for 18 months after you leave and the cost can be covered from money in a HSA if you have one. For me (and I'm a year out), COBRA coverage is affordable for my first 18 months. It won't bridge the gap but helps until I have to show a low income for a year or two and then have higher costs for a couple years since I'll lose the subsidy.
Yes, we are set up to show income below the threshold for the subsidy for 5-6 years.
chw
Posts: 1315
Joined: Thu May 24, 2012 4:22 pm

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by chw »

Well, that depends...

Retired at age 59/61. Used COBRA initially (18 months)- premiums for a Hi Deductible plan were 1500/mo. Went into an ACA Bronze plan after that- we found it was far less costly (compared to Silver plans) when considering expected out of pocket costs including premiums ($1,400/mo). Initial 18 months on the ACA plan were unsubsidized due to being over the income cliff from deferred compensation that paid out for 3 years. This year our premiums for the ACA Bronze plan are $350/mo.

We budgeted all in medical costs without subsidies to be 25k/year. With subsidies we are budgeting about 10k/year. One nice benefit of the Bronze plan is that it is HSA eligible which has provided a nice tax credit the last 3 years. Also our medical expenses during the unsubsidized years allowed us to continue to itemize deductions, though this was a minor benefit.

The ACA Bronze plan is with a top tier health plan, and top provider network that we had when working. Our income this year did qualify us for a Medicaid type plan which we declined due to the limited provider networks in such plans. The Medicaid plan would have saved us about $300/mo all in(compared to the Bronze plan we chose) but we would have limited access to no access to the health providers we see now. We live in MA.
Last edited by chw on Thu Apr 29, 2021 9:08 am, edited 3 times in total.
Exchme
Posts: 1335
Joined: Sun Sep 06, 2020 3:00 pm

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by Exchme »

The other thing to check is the network for your ACA plan of choice before signing up. We live in SE Texas and the network for the ACA plans are abysmal here.

All the choices are HMO's and most have super narrow groups of providers (and I'm guessing those are not the top docs!). Though we live in a populated suburban area, the nearest hospital for the ACA plans is 45 minutes away.

Maybe the real problem is little demand in our area as most early retirees are smart enough to go somewhere else to beat the heat!
Hockey10
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Joined: Wed Aug 24, 2016 12:20 pm
Location: Philadelphia suburbs

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by Hockey10 »

Use the KFF calculator to get an estimate:

https://www.kff.org/interactive/subsidy-calculator/
OnTrack2020
Posts: 1422
Joined: Mon Mar 20, 2017 10:24 am

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by OnTrack2020 »

B. Wellington wrote: Thu Apr 29, 2021 4:27 am 60 yo couple hoping to call it quits from the workforce. We need to "bridge the gap" until 65.

Would any retirees care to share the real world costs of their health insurance?

Any other information would be greatly appreciated.

Monthly premiums? Silver or Gold plans? Total yearly costs after factoring in tax deductions etc.?
Gold plan, just started, not many choices in regards to insurance companies.

Four family members on plan--late 50s, early 60s, two teens. After the premium tax credits, around $300 per month for the premium--this was with the American Rescue Plan in place which dropped it down from $500 per month. The gold plan prescription plan is no different really than it was at my husband's former employer in that it is fairly good. Am thinking that our prescription meds will be around $1,300 for the year (that's with the gold plan), and we will use some of the money in our HSA from previous employer to pay for those for the next few years. The co-pay will be around $40 to see a doctor, $75 to see a specialist. Out-of-pocket max is around $16,000, and deductible is a little over $3,000. The plan, overall, is very similar to what you are going to see if you currently have insurance. It's probably going to be just as good in terms of what is offered, but the co-pays, deductibles, and out-of-pocket expenses are going to be more expensive.

I'm not sure we will be able to manage our income for the next several years in order to get subsidy--we'll have to see. We will draw from traditional IRA, use some cash, and sell some mutual funds in order to manage income, plus if you have dependents that are on the plan, they can only make so much also, although I think the "cliff" has been eliminated for this year and next.?

We had a horrendous 2020 in terms of health care. After husband retired, I had an emergency surgery and then later in the year had an accident and another surgery which involved a fairly long recovery. We had to spend quite a lot of money on some supplies and other items to make our home functional, as well as several months of physical therapy. At the time, we were on COBRA, and had total out-of-pocket expenses of $6,000. I'm not expecting any of those types of expenses this year, but you never know what can happen. We are using some of our tax refund money to help pay for the premiums.

I had originally budgeted a little over $25,000 for the year, between premiums, deductibles, and out-of-pocket expenses, but I don't think we will be anywhere close to that this year--at least am hoping not. :)
flyingaway
Posts: 3908
Joined: Fri Jan 17, 2014 9:19 am

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by flyingaway »

PaunchyPirate wrote: Thu Apr 29, 2021 6:11 am It varies widely by location. Have you visited your state's ACA exchange (or healthcare.gov if your state doesn't have its own exchange)?

You can get all the information you ask for without even having to create an account or reveal your personal information. Simply put in your zip code, ages, smoking status, etc. You can also do multiple tests and put in 60, 61, 62, 63, 64, 65 ages to see how rates currently increase by age. That will change with time, but it will give you a pretty good estimate. The last couple years, premium pricing hasn't had awful increases in many areas.

Your out-of-pocket costs will largely depend on how much medical care you need -- prescriptions, doctor visits, blood tests, etc.

I'm single, age 58, and pay $325 per month for a gold policy (including an ACA subsidy). This should decrease to about $220/month when the most recent passed legislation with higher subsidies kicks in (hopefully for June premiums). I manage my income to keep it low enough to obtain that level of subsidy. I pay about $75 every 3 months for prescriptions. I pay $50 each time I need blood work done. I pay $10 copay to my doctor for visits. $50 to see a specialist. These details are all specific to the policy you pick and pay for.
You wrote: "I pay $10 copay to my doctor for visits. $50 to see a specialist."

I guess these quotes are AFTER the deductibles?
J295
Posts: 3401
Joined: Sun Jan 01, 2012 10:40 pm

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by J295 »

Retired from full-time in 2013 at 53 and we’ve been on the ACA since it was ruled constitutional. Married couple, with wife generating self-employment income.

We managed modified adjusted gross income to stay below the cliff, and our net annual cost for a bronze plan has been $0 per year. For an example the premium cost would’ve been $25,000 last year, but that was all absorbed by the premium tax credit.

We fund an HSA, so keep track of all medical expenses, and since 2013 our health expenses have totaled approximately $22,000.
mkc
Moderator
Posts: 3291
Joined: Wed Apr 17, 2013 2:59 pm

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by mkc »

The best way to research this is, as others have said, to go to healthcare.gov or your state's exchange.

Insurance costs (and available plans and insurers) are 100% county/zip code dependent. These also change every year during open enrollment.

Also understand there are premium credits available with no "cliff" in 2021 and 2022 for which the rules may change for 2023. Prior to the 2021/2022 cliff suspension, a couple in our zip code in their late 50's paid $1685/month for an HSA-eligible HDHP Bronze plan. We currently pay $0 for the same thanks to the temporary ACA cliff elimination, but in our experience for the past 6-8 years, we have averaged around $1500/month, with premiums increasing 10+% or more every year.
Last edited by mkc on Thu Apr 29, 2021 1:15 pm, edited 1 time in total.
PaunchyPirate
Posts: 1163
Joined: Sun Nov 30, 2014 6:58 pm

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by PaunchyPirate »

flyingaway wrote: Thu Apr 29, 2021 9:36 am
PaunchyPirate wrote: Thu Apr 29, 2021 6:11 am It varies widely by location. Have you visited your state's ACA exchange (or healthcare.gov if your state doesn't have its own exchange)?

You can get all the information you ask for without even having to create an account or reveal your personal information. Simply put in your zip code, ages, smoking status, etc. You can also do multiple tests and put in 60, 61, 62, 63, 64, 65 ages to see how rates currently increase by age. That will change with time, but it will give you a pretty good estimate. The last couple years, premium pricing hasn't had awful increases in many areas.

Your out-of-pocket costs will largely depend on how much medical care you need -- prescriptions, doctor visits, blood tests, etc.

I'm single, age 58, and pay $325 per month for a gold policy (including an ACA subsidy). This should decrease to about $220/month when the most recent passed legislation with higher subsidies kicks in (hopefully for June premiums). I manage my income to keep it low enough to obtain that level of subsidy. I pay about $75 every 3 months for prescriptions. I pay $50 each time I need blood work done. I pay $10 copay to my doctor for visits. $50 to see a specialist. These details are all specific to the policy you pick and pay for.
You wrote: "I pay $10 copay to my doctor for visits. $50 to see a specialist."

I guess these quotes are AFTER the deductibles?
No, my plan does not apply the deductible to office visits (some may, but the plans I've had for the last 3 years haven't applied the deductible). I simply pay the co-pay. In actuality, my last $10 appointment should actually have been free as my plan covers one free wellness appointment per year. I should not have had to pay the $10 co-pay according to my insurance. But the Doctor's office collected it at time of service. They may credit it to my account. But I'm not going to worry about it since it's only $10.

Also, the $50 blood test co-pay is also outside of any deductible. The same for my prescriptions. Neither has to have any deductible being met before my pricing.

You really need to look closely at the policy terms to see what applies to deductibles and what doesn't. Different companies use different terms on their various levels of policy coverage.
Last edited by PaunchyPirate on Thu Apr 29, 2021 10:38 am, edited 1 time in total.
cshell2
Posts: 1204
Joined: Thu May 09, 2019 10:29 am

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by cshell2 »

PaunchyPirate wrote: Thu Apr 29, 2021 10:33 am
flyingaway wrote: Thu Apr 29, 2021 9:36 am
PaunchyPirate wrote: Thu Apr 29, 2021 6:11 am It varies widely by location. Have you visited your state's ACA exchange (or healthcare.gov if your state doesn't have its own exchange)?

You can get all the information you ask for without even having to create an account or reveal your personal information. Simply put in your zip code, ages, smoking status, etc. You can also do multiple tests and put in 60, 61, 62, 63, 64, 65 ages to see how rates currently increase by age. That will change with time, but it will give you a pretty good estimate. The last couple years, premium pricing hasn't had awful increases in many areas.

Your out-of-pocket costs will largely depend on how much medical care you need -- prescriptions, doctor visits, blood tests, etc.

I'm single, age 58, and pay $325 per month for a gold policy (including an ACA subsidy). This should decrease to about $220/month when the most recent passed legislation with higher subsidies kicks in (hopefully for June premiums). I manage my income to keep it low enough to obtain that level of subsidy. I pay about $75 every 3 months for prescriptions. I pay $50 each time I need blood work done. I pay $10 copay to my doctor for visits. $50 to see a specialist. These details are all specific to the policy you pick and pay for.
You wrote: "I pay $10 copay to my doctor for visits. $50 to see a specialist."

I guess these quotes are AFTER the deductibles?
No, my plan does not apply the deductible to office visits (some may, but the plans I've had for the last 3 years haven't applied the deductible). I simply pay the co-pay. In actuality, my last $10 appointment should actually have been free as my plan covers one free wellness appointment per year. I should not have had to pay the $10 co-pay according to my insurance. But the Doctor's office collected it at time of service. They may credit it to my account. But I'm not going to worry about it since it's only $10.

Also, the $50 blood test co-pay is also outside of any deductible.

You really need to look closely at the policy terms to see what applies to deductibles and what doesn't. Different companies use different terms on their various levels of policy coverage.
Before switching to a HDHP in 2020, my PPO plan was all copays. It only had a $750 deductible but except for the years I had a pregnancy/birth, I never met the deductible because it was all copays and none of them applied to the deductible just the max out of pocket.
flyingaway
Posts: 3908
Joined: Fri Jan 17, 2014 9:19 am

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by flyingaway »

cshell2 wrote: Thu Apr 29, 2021 10:35 am
PaunchyPirate wrote: Thu Apr 29, 2021 10:33 am
flyingaway wrote: Thu Apr 29, 2021 9:36 am
PaunchyPirate wrote: Thu Apr 29, 2021 6:11 am It varies widely by location. Have you visited your state's ACA exchange (or healthcare.gov if your state doesn't have its own exchange)?

You can get all the information you ask for without even having to create an account or reveal your personal information. Simply put in your zip code, ages, smoking status, etc. You can also do multiple tests and put in 60, 61, 62, 63, 64, 65 ages to see how rates currently increase by age. That will change with time, but it will give you a pretty good estimate. The last couple years, premium pricing hasn't had awful increases in many areas.

Your out-of-pocket costs will largely depend on how much medical care you need -- prescriptions, doctor visits, blood tests, etc.

I'm single, age 58, and pay $325 per month for a gold policy (including an ACA subsidy). This should decrease to about $220/month when the most recent passed legislation with higher subsidies kicks in (hopefully for June premiums). I manage my income to keep it low enough to obtain that level of subsidy. I pay about $75 every 3 months for prescriptions. I pay $50 each time I need blood work done. I pay $10 copay to my doctor for visits. $50 to see a specialist. These details are all specific to the policy you pick and pay for.
You wrote: "I pay $10 copay to my doctor for visits. $50 to see a specialist."

I guess these quotes are AFTER the deductibles?
No, my plan does not apply the deductible to office visits (some may, but the plans I've had for the last 3 years haven't applied the deductible). I simply pay the co-pay. In actuality, my last $10 appointment should actually have been free as my plan covers one free wellness appointment per year. I should not have had to pay the $10 co-pay according to my insurance. But the Doctor's office collected it at time of service. They may credit it to my account. But I'm not going to worry about it since it's only $10.

Also, the $50 blood test co-pay is also outside of any deductible.

You really need to look closely at the policy terms to see what applies to deductibles and what doesn't. Different companies use different terms on their various levels of policy coverage.
Before switching to a HDHP in 2020, my PPO plan was all copays. It only had a $750 deductible but except for the years I had a pregnancy/birth, I never met the deductible because it was all copays and none of them applied to the deductible just the max out of pocket.
I guess you guys have not had an endoscopy or colonoscopy yet.
mhalley
Posts: 10432
Joined: Tue Nov 20, 2007 5:02 am

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by mhalley »

When my wife and I hit 64, the cheapest hsa compatable plan cost us over $2800 a month, with them not paying a penny until 6k out of pocket. We didn't get a subsidy as I did roth conversions so income was too high. Plans are very different with zip codes. Go to your healthcare.gov site and put in your birthday as if you are 64 and see what you will be looking at in the future for your area.
cshell2
Posts: 1204
Joined: Thu May 09, 2019 10:29 am

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by cshell2 »

flyingaway wrote: Thu Apr 29, 2021 12:18 pm
cshell2 wrote: Thu Apr 29, 2021 10:35 am
PaunchyPirate wrote: Thu Apr 29, 2021 10:33 am
flyingaway wrote: Thu Apr 29, 2021 9:36 am
PaunchyPirate wrote: Thu Apr 29, 2021 6:11 am It varies widely by location. Have you visited your state's ACA exchange (or healthcare.gov if your state doesn't have its own exchange)?

You can get all the information you ask for without even having to create an account or reveal your personal information. Simply put in your zip code, ages, smoking status, etc. You can also do multiple tests and put in 60, 61, 62, 63, 64, 65 ages to see how rates currently increase by age. That will change with time, but it will give you a pretty good estimate. The last couple years, premium pricing hasn't had awful increases in many areas.

Your out-of-pocket costs will largely depend on how much medical care you need -- prescriptions, doctor visits, blood tests, etc.

I'm single, age 58, and pay $325 per month for a gold policy (including an ACA subsidy). This should decrease to about $220/month when the most recent passed legislation with higher subsidies kicks in (hopefully for June premiums). I manage my income to keep it low enough to obtain that level of subsidy. I pay about $75 every 3 months for prescriptions. I pay $50 each time I need blood work done. I pay $10 copay to my doctor for visits. $50 to see a specialist. These details are all specific to the policy you pick and pay for.
You wrote: "I pay $10 copay to my doctor for visits. $50 to see a specialist."

I guess these quotes are AFTER the deductibles?
No, my plan does not apply the deductible to office visits (some may, but the plans I've had for the last 3 years haven't applied the deductible). I simply pay the co-pay. In actuality, my last $10 appointment should actually have been free as my plan covers one free wellness appointment per year. I should not have had to pay the $10 co-pay according to my insurance. But the Doctor's office collected it at time of service. They may credit it to my account. But I'm not going to worry about it since it's only $10.

Also, the $50 blood test co-pay is also outside of any deductible.

You really need to look closely at the policy terms to see what applies to deductibles and what doesn't. Different companies use different terms on their various levels of policy coverage.
Before switching to a HDHP in 2020, my PPO plan was all copays. It only had a $750 deductible but except for the years I had a pregnancy/birth, I never met the deductible because it was all copays and none of them applied to the deductible just the max out of pocket.
I guess you guys have not had an endoscopy or colonoscopy yet.
I had a colonoscopy 2 years ago. It was 100% covered as a preventative procedure.
marcopolo
Posts: 8445
Joined: Sat Dec 03, 2016 9:22 am

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by marcopolo »

B. Wellington wrote: Thu Apr 29, 2021 4:27 am 60 yo couple hoping to call it quits from the workforce. We need to "bridge the gap" until 65.

Would any retirees care to share the real world costs of their health insurance?

Any other information would be greatly appreciated.

Monthly premiums? Silver or Gold plans? Total yearly costs after factoring in tax deductions etc.?
You will get answers all over the place, and it will be it be very helpful because the actual price paid is location specific, income specific. The best way to get a handle on this is to go to the healthcare.gov web site and find the "compare plans" section. Put in your specific information. You will get exact cost for your situation. No need to guess based on other's situation.

But, just in case. We are a married couple aged 54 with a 20 year old college student dependent. Our premium for a bronze plan is now $16.92. It was $202.32 prior to the the Covid relief law lowering the costs for subsidized plans.
Once in a while you get shown the light, in the strangest of places if you look at it right.
PaunchyPirate
Posts: 1163
Joined: Sun Nov 30, 2014 6:58 pm

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by PaunchyPirate »

flyingaway wrote: Thu Apr 29, 2021 12:18 pm
cshell2 wrote: Thu Apr 29, 2021 10:35 am
PaunchyPirate wrote: Thu Apr 29, 2021 10:33 am
flyingaway wrote: Thu Apr 29, 2021 9:36 am
PaunchyPirate wrote: Thu Apr 29, 2021 6:11 am It varies widely by location. Have you visited your state's ACA exchange (or healthcare.gov if your state doesn't have its own exchange)?

You can get all the information you ask for without even having to create an account or reveal your personal information. Simply put in your zip code, ages, smoking status, etc. You can also do multiple tests and put in 60, 61, 62, 63, 64, 65 ages to see how rates currently increase by age. That will change with time, but it will give you a pretty good estimate. The last couple years, premium pricing hasn't had awful increases in many areas.

Your out-of-pocket costs will largely depend on how much medical care you need -- prescriptions, doctor visits, blood tests, etc.

I'm single, age 58, and pay $325 per month for a gold policy (including an ACA subsidy). This should decrease to about $220/month when the most recent passed legislation with higher subsidies kicks in (hopefully for June premiums). I manage my income to keep it low enough to obtain that level of subsidy. I pay about $75 every 3 months for prescriptions. I pay $50 each time I need blood work done. I pay $10 copay to my doctor for visits. $50 to see a specialist. These details are all specific to the policy you pick and pay for.
You wrote: "I pay $10 copay to my doctor for visits. $50 to see a specialist."

I guess these quotes are AFTER the deductibles?
No, my plan does not apply the deductible to office visits (some may, but the plans I've had for the last 3 years haven't applied the deductible). I simply pay the co-pay. In actuality, my last $10 appointment should actually have been free as my plan covers one free wellness appointment per year. I should not have had to pay the $10 co-pay according to my insurance. But the Doctor's office collected it at time of service. They may credit it to my account. But I'm not going to worry about it since it's only $10.

Also, the $50 blood test co-pay is also outside of any deductible.

You really need to look closely at the policy terms to see what applies to deductibles and what doesn't. Different companies use different terms on their various levels of policy coverage.
Before switching to a HDHP in 2020, my PPO plan was all copays. It only had a $750 deductible but except for the years I had a pregnancy/birth, I never met the deductible because it was all copays and none of them applied to the deductible just the max out of pocket.
I guess you guys have not had an endoscopy or colonoscopy yet.
I too just had a colonoscopy in December. I was expecting that I would to pay my portion of the expenses since it was my second colonoscopy and I had polyps in my first one 7 years ago. Even the doctor told me it would not be fully covered by my insurance due to previous polyps. He was wrong. Insurance paid for every penny of it. I can only figure that they covered it because my previous one was with a different insurance company.
tj
Posts: 9366
Joined: Wed Dec 23, 2009 11:10 pm

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by tj »

PaunchyPirate wrote: Thu Apr 29, 2021 3:11 pm
flyingaway wrote: Thu Apr 29, 2021 12:18 pm
cshell2 wrote: Thu Apr 29, 2021 10:35 am
PaunchyPirate wrote: Thu Apr 29, 2021 10:33 am
flyingaway wrote: Thu Apr 29, 2021 9:36 am

You wrote: "I pay $10 copay to my doctor for visits. $50 to see a specialist."

I guess these quotes are AFTER the deductibles?
No, my plan does not apply the deductible to office visits (some may, but the plans I've had for the last 3 years haven't applied the deductible). I simply pay the co-pay. In actuality, my last $10 appointment should actually have been free as my plan covers one free wellness appointment per year. I should not have had to pay the $10 co-pay according to my insurance. But the Doctor's office collected it at time of service. They may credit it to my account. But I'm not going to worry about it since it's only $10.

Also, the $50 blood test co-pay is also outside of any deductible.

You really need to look closely at the policy terms to see what applies to deductibles and what doesn't. Different companies use different terms on their various levels of policy coverage.
Before switching to a HDHP in 2020, my PPO plan was all copays. It only had a $750 deductible but except for the years I had a pregnancy/birth, I never met the deductible because it was all copays and none of them applied to the deductible just the max out of pocket.
I guess you guys have not had an endoscopy or colonoscopy yet.
I too just had a colonoscopy in December. I was expecting that I would to pay my portion of the expenses since it was my second colonoscopy and I had polyps in my first one 7 years ago. Even the doctor told me it would not be fully covered by my insurance due to previous polyps. He was wrong. Insurance paid for every penny of it. I can only figure that they covered it because my previous one was with a different insurance company.
Nice! I guess that's a trick people should use when they have such procedures.
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dogagility
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Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by dogagility »

J295 wrote: Thu Apr 29, 2021 9:43 am We managed modified adjusted gross income to stay below the cliff, and our net annual cost for a bronze plan has been $0 per year.
That's my plan too in a couple of years. :beer
Make sure you check out my list of certifications. The list is short, and there aren't any. - Eric 0. from SMA
Katietsu
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Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by Katietsu »

Also remember that if your income is s low enough for cost sharing to kick in, the deductibles and out of pocket listed for a given plan will not apply to you.

Consider what you would do if an acceptable ACA plan was no longer available in your area. Go back to work? Move? Find a plan off the exchange at full cost?
LivingTheDream
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Joined: Sun Oct 18, 2020 10:30 am
Location: Savannah, GA

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by LivingTheDream »

mtwhmemn wrote: Thu Apr 29, 2021 6:25 am
PaunchyPirate wrote: Thu Apr 29, 2021 6:11 am It varies widely by location. Have you visited your state's ACA exchange (or healthcare.gov if your state doesn't have its own exchange)?

You can get all the information you ask for without even having to create an account or reveal your personal information. Simply put in your zip code, ages, smoking status, etc. You can also do multiple tests and put in 60, 61, 62, 63, 64, 65 ages to see how rates currently increase by age. That will change with time, but it will give you a pretty good estimate. The last couple years, premium pricing hasn't had awful increases in many areas.

Your out-of-pocket costs will largely depend on how much medical care you need -- prescriptions, doctor visits, blood tests, etc.

I'm single, age 58, and pay $325 per month for a gold policy (including an ACA subsidy). This should decrease to about $220/month when the most recent passed legislation with higher subsidies kicks in (hopefully for June premiums). I manage my income to keep it low enough to obtain that level of subsidy. I pay about $75 every 3 months for prescriptions. I pay $50 each time I need blood work done. I pay $10 copay to my doctor for visits. $50 to see a specialist. These details are all specific to the policy you pick and pay for.
I'm around 58 as is my wife and we want to call it quits in the next year or so. We can keep our income low to get minimum subsidy. Would any couples around our age reading this please give a similar synopsis as PaunchyPirate has done here? Much appreciated.
My wife & I (no dependents) are both retired and have been on ACA plans for the last 3-4 years (initially in MN, and then in GA). As others have indicated, coverage & cost varies by state. We've kept income very low (1x-2x poverty) in order to maximize subsidy.

In 2019, monthly premium was $1272; APTC was $1253... $19 out-of-pocket monthly, income was low enough to get that refunded at year-end.
For 2020, monthly premium was $1328; APTC was $1103 (my income estimate was higher, due to one-offs).
In 2021, premium is $1488; APTC is $1453 ($35 monthly out-of-pocket). I don't remember previous year's coverage details, but current plan is $0 deductible with the following co-pays (office: $10; Rx: $30; hospital: 25% co-insurance) & $1400 pp out-of-pocket max.

Again, costs & coverages vary, but provides a data point.
Living The Dream
PaulieLilly
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Joined: Sun May 31, 2020 12:06 pm

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by PaulieLilly »

2021 is our first year in early retirement (both age 59, no dependents).
We are setup to manage our income so I'm looking at a balancing act between ACA subsidies and tIRA-to-Roth conversions each year.
I specified $60k MAGI when I enrolled for 2021 (plan was to convert up to what was the cliff) and selected a Bronze HDHP w/ HSA (my wife and I are both currently healthy and hope to stay that way). We had a number of good plans to choose from on our state's exchange. Plan cost is $1350/mo ($1050/mo subsidy ... $300/mo for our cost).
My state is due to update their exchange in May with the new legislation rolled into the numbers. With no cliff and max premiums lowered to 8.5% of MAGI, we will likely convert up to the top of the 12% Fed tax bracket which will put me at ~$105K MAGI. This would equate to a 12+8.5=20.5% marginal tax rate (tax-free state) which is a good deal for us given what we'll be facing at 72+.
Jablean
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Joined: Sat Jun 02, 2018 2:38 pm

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by Jablean »

2 adults plus kid on our ACA plan since 2016 (DH is 63). I tell them our income is $100 under the cliff number. Paid $100 a month the first year and every year since has been $zero. I go with a bronze and a HSA. It has co-pays and I pay almost 100% of incurred (after prices are dropped to those the insurance has agreed on) We've never hit the deductible. Insurance is linked to one of two main hospital systems so sometimes things like ultrasounds & MRIs have to go through the right place but doctors all seem easy to find. The out-of-network deductible is huge - that might be concerning if you are a snowbird or otherwise live in two places.
gips
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Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by gips »

family of 5, our premium is $1850 per month for a silver plan. about another $10k per year in deductibles and out of pocket costs.
gips
Posts: 1760
Joined: Mon May 13, 2013 5:42 pm

Re: Early Retirement and ACA insurance costs? 60-65 yo.

Post by gips »

family of 5, our premium is $1850 per month for a silver plan. about another $10k per year in deductibles and out of pocket costs. so about $30k per year. i had originally budgeted $20k a year so a pretty big miss but pt self employment income helps.
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