'early retiree' Floridians ... can you share you health insurance experiences??

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mr_brightside
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'early retiree' Floridians ... can you share you health insurance experiences??

Post by mr_brightside »

looking to make the move into early retirement (pre-Medicare)...

could you share your health insurance procurement insights??

i have surfed the Healthcare.gov website and it looks like the are three main providers: Ambetter, Molina and various BCBS offerings.

would appreciate any 'lessons' learned'. will claim no higher than $75K income for 2021 so there are some subsidies available at that income level

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Pixafari
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by Pixafari »

Retired 5 years ago at 58 in central Florida. Found local Florida Blue agency we liked. We use relatively little services and are happy with Florida Blue Bronze 1735 high-deductible plan with HSA. We max out HSA each year and pay as we go since we don’t meet deductible (thankfully). Annual physicals and vaccinations are covered. We qualify for premium tax credit based on our MAGI. You can enroll through healthcare.gov yourself, but it was easy letting the Fl Blue agent do it for us - same result.
PaunchyPirate
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by PaunchyPirate »

I'm not from Florida, but I think a huge part of your selection process is verification whether your existing doctors (PCP and specialists and preferred hospitals) and any prescriptions you take are going to be covered by that company's plans. ACA plans often come with a restricted physician/hospital network. And prescription costs will vary as well by company as well as the bronze/silver/gold tiering used by all policies. Even networks may vary within the same insurance company various policies. You need to examine the details of every policy available in order to do a fair compare.

In my location in Pennsylvania, one company floated to the top based on these considerations. Of course, I only have 2 companies here selling ACA policies, so it was a pretty easy float to the top.
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cockersx3
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by cockersx3 »

Pixafari wrote: Tue May 04, 2021 12:08 pm Retired 5 years ago at 58 in central Florida. Found local Florida Blue agency we liked. We use relatively little services and are happy with Florida Blue Bronze 1735 high-deductible plan with HSA. We max out HSA each year and pay as we go since we don’t meet deductible (thankfully). Annual physicals and vaccinations are covered. We qualify for premium tax credit based on our MAGI. You can enroll through healthcare.gov yourself, but it was easy letting the Fl Blue agent do it for us - same result.
For some reason I was thinking that you had to go through the exchange to get the premium tax credits. Do you send your payments directly to the provider or indirectly through the exchange? Would definitely be nice to just go direct to the provider and have an actual human being walk us through the signup process.

Also - does your Florida Blue provide any coverage from Blue Cross / Blue Shield providers in other states, or is it limited just to Florida?

Thanks to the OP for posting - thinking about the same plan, so this is good data to have.
Pixafari
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by Pixafari »

You do have to go through the exchange to get premium tax credit. We sat at the agent’s desk and she logged on healthcare.gov on our behalf and completed the application with us answering the pertinent questions. There is a field in which she documents that she completed the application for us. Once the application is complete, you then select the insurance plan you want. If you supply your expected income, you see the amount of your credit up front and can choose if you want it applied to your monthly premium or later at tax time. Our preferred doctors and facilities are in network except for one specialist my wife chose after we enrolled. It hasn’t made much difference since it’s a high deductible plan anyway so we’re paying pretty much all out of pocket since we haven’t met the annual deductible yet. The coverage doesn’t extend to other states except for emergency care.
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cockersx3
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by cockersx3 »

Pixafari wrote: Tue May 04, 2021 8:28 pm You do have to go through the exchange to get premium tax credit. We sat at the agent’s desk and she logged on healthcare.gov on our behalf and completed the application with us answering the pertinent questions. There is a field in which she documents that she completed the application for us. Once the application is complete, you then select the insurance plan you want. If you supply your expected income, you see the amount of your credit up front and can choose if you want it applied to your monthly premium or later at tax time. Our preferred doctors and facilities are in network except for one specialist my wife chose after we enrolled. It hasn’t made much difference since it’s a high deductible plan anyway so we’re paying pretty much all out of pocket since we haven’t met the annual deductible yet. The coverage doesn’t extend to other states except for emergency care.
Thanks! This is good info. Didn't realize that the providers had staff that will walk you through the exchange process. Also totally agree with you on the value of the deductible. For me the two biggest benefits of health insurance is 1) the protection against catastrophic health expenses if something terrible happens to you, and 2) agreed-upon pricing so that you're not stuck paying the usurious "rack rate" at the provider. You'd get both of these with any exchange health plan from a national provider I think.
GTBuzz
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by GTBuzz »

Health insurance can be a fantastic deal for early retirees if they are able to structure their income appropriately. Because of the way subsidies are calculated, the premium you pay for a Bronze plan can actually decrease as you age. The "sweet spot" is if you can get your taxable income between 100% and 200% of the Federal Poverty Level, which is $12,880 - $25,760 for a single retiree or $17,420 - $34,840 for a couple. In that range, you are eligible for a Silver plan with Cost Share Reductions that increase the value of the plan to that of a Platinum plan. And the expanded subsidies under the American Rescue Plan would make these enhanced Silver plans available for little or no monthly premium. Also under the American Rescue Plan, if you received any unemployment income in 2021, you are eligible for premium subsidies and cost-share reductions as if you were at 133% of the FPL.

If your income is over 200% FPL (and it sounds like you will be), your best bet is probably to just look for the cheapest Bronze plan that includes any doctors or hospitals you would likely visit in its network. It depends on your age, county, and projected income, but you might be able to find plans available as low as $0 / month. You'll probably need to attest to your projected income since it would likely be lower than what they have on file from your last tax return, but the American Rescue Plan limits what you would have to repay if you do end up having a higher income than projected (particularly by eliminating the "cliff" at 400% FPL which, prior to this year, could have resulted in you paying back your entire subsidy amount at tax time).

All else being equal, Florida Blue is probably the best choice as they are based in the state and have a good presence in the community.
Topic Author
mr_brightside
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by mr_brightside »

thanks very much for the useful insights everyone

really appreciate it :sharebeer

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GonFIRE
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by GonFIRE »

mr_brightside wrote: Tue May 04, 2021 7:38 am looking to make the move into early retirement (pre-Medicare)...

could you share your health insurance procurement insights??

i have surfed the Healthcare.gov website and it looks like the are three main providers: Ambetter, Molina and various BCBS offerings.

would appreciate any 'lessons' learned'. will claim no higher than $75K income for 2021 so there are some subsidies available at that income level

Of those 3 choices. I’d go for the best Bcbs plan. The first two leave a lot to be desired if you get sick...

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atwood
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by atwood »

We have the Florida Blue Silver PPO plan. We went through an agent that was listed on the government website. He's in another city but has supplied great service. The amount of government subsidy varies by county and seems to fluctuate yearly. Our rates increased dramatically this year but went back down after the stimulus bill passed.

Started with an HMO but the PPO makes everything easier. IMO it's worth the extra money.
Finnegan
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by Finnegan »

I learned that Florida Blue operates three networks, and my preferred hospital is only included in the higher priced network plans. Recommend checking that your MDs and hospitals are included in the plan you pick.
MarkerFM
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by MarkerFM »

Yes, networks are a huge factor in the cost of a plan. I've found that the biggest difference in networks is the quality of the hospitals, so you have to be very careful if you don't want to get stuck in a bad place for a catastrophic problem. The last time I looked, this was the case, but the dirty little secret of Blue plans used to be no matter how lousy the network you pick in-state is, once you cross state lines every provider is in-network. This would bear re-checking before relying on this statement.
Topic Author
mr_brightside
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by mr_brightside »

just resurrecting this to see if anyone else had any great insights -- thanks !

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JAusten
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by JAusten »

All states have an 'Area Agency on Aging' for different groups of counties which one can go to for advice on health insurance. They will walk you through the process and sign you up. If I did not have health insurance through my employer I retired from I would go to the Area Agency on Aging.

Just google 'Area Agency on Aging' to pull up the one closest to you.

JAusten
trueblueky
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by trueblueky »

We have BCBS. Seems every doctor takes it. Florida Blue has a storefront in town, which we have used to fax documents to their home office. Great service.
JohnFiscal
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by JohnFiscal »

Since I retired a few years ago, with Medicare, my spouse has been on a private policy (ostensibly ACA, long story). Into the 4th year now with Florida Blue. A "BlueOptions" Bronze plan (1707s, fwiw).

As described by our former FloridaBlue representative, the "BlueOptions" provides a better selection of physicians and services than does "BlueSelect". I investigated this on my own and agree with that view. Several specialists spouse sees do not accept the BlueSelect plans.

I also investigated the few other insurers listed on the ACA exchange, these are quite limited. The exchange lists only FloridaBlue, Ambetter, and "Oscar". I had checked out Ambetter in the past and was not impressed (and on the exchange you can check if your medical places accept the insurance), "Oscar" is new this year on the exchange but doesn't sound impressive.

I consider my spouse's plan (1707S) to be a pretty decent one. I hadn't found FloridaBlue to be easy or simple to deal with. However, I have been very impressed with the staff at the Customer Care Center at a special phone number.

I mention our "former" FloridaBlue representative. A buffoon. He was to set my spouse up for the ACA and all that. It turns out that he did not do this (as the Marketplace indicates can be done, and as buffoon said he was doing) but never did this. So lost out on possible ACA tax credit for two years. For 2021 I dealt solely with the marketplace, healthcare.gov, obtaining the same Plan. This change in mode still caused FloridaBlue some hiccups but these were worked out with the Customer Care Center.

I also had FloridaBlue as a Medicare add-on; or actually I had was a Medicare Advantage plan. It seemed to be okay until a large local health care system at which I see several (3-4) physicians terminated their acceptance of the Advantage plan. I then went with a traditional Medicare "medigap" policy from AARP United Healthcare and have been more confident with this policy. It seems to be not unusual for Advantage plans to have this issue.

Dealing with FloridaBlue for my spouse's policy is pretty easy. But I will never deal with the local representative again.

Good luck!
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sperry8
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by sperry8 »

Pixafari wrote: Tue May 04, 2021 12:08 pm Retired 5 years ago at 58 in central Florida. Found local Florida Blue agency we liked. We use relatively little services and are happy with Florida Blue Bronze 1735 high-deductible plan with HSA. We max out HSA each year and pay as we go since we don’t meet deductible (thankfully). Annual physicals and vaccinations are covered. We qualify for premium tax credit based on our MAGI. You can enroll through healthcare.gov yourself, but it was easy letting the Fl Blue agent do it for us - same result.
Similar here. Use Florida Blue PPO. Works fine. I prefer BCBS to the others. Mostly stay in-network but with PPO it's nice to know I can go outside. As others have said, BlueSelect has limited providers - but it is cheaper and with planning, I've been able to get access to some great specialists. I've actually found primary doc hardest to get a good one. But primary is mostly for checkups so specialists are of greater concern to me.
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JohnFiscal
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by JohnFiscal »

cockersx3 wrote: Tue May 04, 2021 7:11 pm For some reason I was thinking that you had to go through the exchange to get the premium tax credits. Do you send your payments directly to the provider or indirectly through the exchange? Would definitely be nice to just go direct to the provider and have an actual human being walk us through the signup process.
See my "tale" in post below. You do have to go through the exchange to get ACA tax credits. However, you can have local assistance with this from an agent, guide, etc. Just make certain they are competent, not like ours. This year we went through the Marketplace to register with FloridaBlue (same plan my spouse has had for several years), payment is made directly to FloridaBlue and there is no other difference with this year going through the Marketplace versus previous years.
Also - does your Florida Blue provide any coverage from Blue Cross / Blue Shield providers in other states, or is it limited just to Florida?
My spouse's FB policy (Plan 1707S) covers out of state. Saw an emergency ophthalmologist on Christmas Eve out of state, no problem. (I was surprised)
Topic Author
mr_brightside
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by mr_brightside »

thanks again for all the replies -- we will be picking a plan in the next day or two

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Dude2
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by Dude2 »

I too will put in a vote for Florida Blue. It took me two years of Obamacare to figure that out...was living in the Panhandle. Tried other plans first, but they had me going to doctors a) in questionable parts of town, or, b) lead to strange experiences regarding insurance. One takeaway was the difficulty with knowing how to accomplish lab work that would be covered in network. Allegedly the provider will see who you have insurance with and hopefully provide you with instructions as to where to go/send the lab request to the right place. This was not the case for me twice, with $700 lab bills a result (which I didn't pay, and they didn't come after me for). Ultimately, Florida Blue with their "strip mall" kind of location had lab work right there on premises, x-ray, etc. You/they couldn't screw up what was in network. Also they sent me to a nurse practitioner, the smallest level of what I needed, which was the right answer. Of course, just the other day in the mail there was some class action lawsuit paperwork against them that I could become a member of. All of the above was with me as a forced early retiree, trying to save money. Let's just say there can be some weird experiences with the "marketplace", and it's good to ask around...
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susa
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by susa »

JohnFiscal wrote: I also had FloridaBlue as a Medicare add-on; or actually I had was a Medicare Advantage plan. It seemed to be okay until a large local health care system at which I see several (3-4) physicians terminated their acceptance of the Advantage plan. I then went with a traditional Medicare "medigap" policy from AARP United Healthcare and have been more confident with this policy. It seems to be not unusual for Advantage plans to have this issue.
We had family member in same situation until we discovered the odd spruiking of AARP vis a vis United. Terminated the gap in favor of just plain A and B and had no issues with original group of doctors and the best S Florida hospitals from Miami..Ft Lauderdale..West Palm Bch. Family member eventually succumbed to illness but not until well over one million in hospital and doctor billings, all which were settled at a little over one thousand dollars cash.
MrCheapo
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by MrCheapo »

I'm curious what are people paying for Bronze, Silver, Gold and Platinum plans?

My company will charge me just $500 a month to continue my health care if I stay in-state. But if I move out of state they give me $6K to offset any cost. So I'm curious what $6K a year will get me in Florida.
Dude2
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Re: 'early retiree' Floridians ... can you share you health insurance experiences??

Post by Dude2 »

MrCheapo wrote: Wed May 26, 2021 10:27 am I'm curious what are people paying for Bronze, Silver, Gold and Platinum plans?

My company will charge me just $500 a month to continue my health care if I stay in-state. But if I move out of state they give me $6K to offset any cost. So I'm curious what $6K a year will get me in Florida.
Not sure if age and other items contribute to the total. My FL bronze plans of various providers in the recent past was in the $300's: age 50's, non-smoker, single policy, not family.
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