Recommend individual medical coverage

15 years ago

DH & I would like to retire by the end of the year, but neither will have any medical coverage when not working. DH would have 6 years before Medicare would start and I would have 8 years. We must make sure we can afford the major medical insurance costs before making the decision.

I would like similar coverage to what I have with my current company (especially for any catastrophic accident/illness), but I expect a higher deductible. I am beginning to research the big names (Aetna, Blue Cross, AARP, United Health Care)and get quotes.

Do you have any recommendations? What do you have?

Thanks.

Comments (8)

stargazzer
15 years ago
i don't have any suggestions except to semi retire. get part time jos to pay the insurance costs.
jakkom
15 years ago
Just so you know - AARP just licenses its name to companies that will pay for the privilege. It doesn't mean much.

Check with your local state dept. of insurance for statistics on how many consumer complaints an insurer has generated.

Aren't either of you eligible for continuing your medical coverage for 18 months under COBRA? The cost, however, can be extremely high. Many working Americans are spoilt by the company picking up the majority % of healthcare costs. For instance, my DH's employer charges us $75/mo for coverage that costs $1070/mo for 2 people.

Most people get catastrophic coverage only to save $$. Good luck with your search.
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hilltop_gw
15 years ago
We have Assurant Health with a high deductible of $10,000. It runs around $7000 annual, but includes 2 college kids as well (one will get dropped soon). It has an $8 million lifetime max. I can't remember actually getting money from the company because we haven't had any major issues; however since we used their preferred providers, it has reduced the office charges, procedure fees and med costs. My husband had an out-patient hernia surgery last year & the costs were reduced by about 1/3 thru the insurance and a prompt pay discount because the doctor & facility were on their preferred provider list (we never met the $10,000 deductible on that little trip).

My husband is on a board of directors and we're contemplating switching to a plan available there. It's a $250 deductible but premiums would jump to about $11000 annually without the college kids. I think the lifetime max was $5 million for this policy. Seems silly to get more coverage thru lower deductible & then pay more $$ when we're healthy and take no meds & I fall in the preferred category. But things can change overnight and as we get older it may make more sense.

We've avoided the doctor for over 6 months in hopes that if we switch insurance providers they will won't put any riders on it.

Check to see what their policy is regarding end of year procedures or cut-off dates. Years ago our son injured his knee around Thanksgiving & had surgery in December. Our carrier at the time had a Dec. 31 cut-off so we had to meet the deductible in December for doctors & surgery and then the new deductible in January February with the therapy & follow-up doctor visits.

Check with your physician to see if they have a provider they like using. Or, if you know someone who has had medical issues, ask them what they think of their current provider.
chisue
15 years ago
Ha-ha about AARP. My DH christened it 'Greedy Geezers' -- and that dates back to before they started shilling for various insurance companies. Too bad such a good idea went so sour.

I don't know if the OP has any expensive meds, but that was a consideration of mine when chosing medical coverage before and with Medicare. I have asthma and use Advair, which is over $2000/year retail. Two different insurance companies we've used contract with Medco for mail order drugs. This year my Advair will be $45 per 90 day supply under a Coventry AdvantraRX plan that costs $306/year. My DH has only two generic meds, so he will use the Costco pharmacy plan. Advair has patent protection through 2010; if I don't have any other expensive meds by then and a good generic is available, perhaps I can just use Costco (or Walgreens or Osco) too!
pandora
Original Author
15 years ago
Thank you all so much for taking the time to reply. I really appreciate your ideas. Every "first" of life events shows a whole new set of questions.

Stargazer, thanks, but we want to retire completely. Our jobs are physically easy enough and pay fairly well. We would be better off just staying where we are a couple years, but do not want to.

jkom51, thanks, I thought that about AARP, but was not sure. That is a good idea about checking complaints. Yes, my company offers Cobra, but I do not want to go that way. I want to pick an insurance company and stay with it. In those 18 mos something could happen and then we would have a "pre-existing" condition and could never get other coverage. We have in mind $800-1,000 per mo for 2 of us.

Hilltop, thanks, good to know about cut-off dates. I am on high BP pills, and DH takes no meds. So far so good.
I know that the staff at my DRs office is relieved when they see my Medical Mutual of Ohio(current coverage). I'll ask around some more.

Chisue, thanks, tally up another smirk for AARP. I will make sure to ask each company about their coverage of meds. Sorry about your asthma. My mother had asthma.

Thanks again everyone. Maybe I'll get some more good advice from others. I received 2 packets in the mail yesterday. Each company has so many plans - YIKES! I guess I will start a spreadsheet of my own to compare.
Meghane
15 years ago
When DH was out of work, he had BCBS.

You also need to investigate the hospitals, doctors, and urgent care facilities covered in each plan. My work provides 100% health insurance, but the nearest in-plan urgent care facility is 25 miles away, the nearest hospital 30 miles away. I live 4 blocks from an urgent care facility and 6 blocks from a hospital, but they aren't in my plan so I have to pay up-front and get reimbursed. My co-pay for an out of network urgent care is the same as an in network urgent care, so yesterday I did go to the local facility since my back was *killing* me (I have a pinched nerve) and I didn't want to drive for an hour to an in network facility. Luckily it wasn't too expensive and we aren't struggling financially so paying up front didn't hurt us. But it is definitely something to consider as well. I am going to switch to my husband's plan as soon as this back issue is resolved since the local services are covered with his plan (BCBS again) even though we'll have to pay a part of it.

Good luck with the search, and congratulations on retiring!
stargazzer
15 years ago
we were lucky ours was completely free the 37 years with his employer. i was even covered (10 years) until i turned 65 after he retired.
jane__ny
15 years ago
I agree with meghane, make sure your doctors and hospitals are covered by whatever you choose. Also, make sure you have 'out-of-network' coverage in case you need specialists who do not participate in your plan. Many specialists are dropping many plans and you want to make sure you get coverage.

We pay $1,100 a month for Aetna. Haven't used it yet except for routine check-ups.

Recommend individual medical coverage

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stargazzer

jakkom

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Recommend individual medical coverage

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stargazzer

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