Finding Health Insurance Before Medicare Kicks In
I will be retiring in a few months and my wife and I will need health insurance until we can enroll in Medicare. What are my options?
There are several places early retirees can find health insurance coverage before becoming eligible for Medicare. The best option for you and your wife will depend on your income level and your healthcare needs. Here are some options to consider.
If your yearly income falls below 400% of the poverty level after you retire, the Affordable Care Act (ACA) marketplace may be your best option for getting health coverage because of the premium subsidies offered under the ACA. These subsidies reduce the amount you will have to pay for a policy.
The ACA marketplace offers major medical insurance that covers essential health benefits with no annual or lifetime coverage maximums. In addition, you cannot be charged more or be denied coverage because of a pre-existing health condition.
To qualify for the subsidies, your household's modified adjusted gross income for 2019 must be under $48,560 for an individual, or $65,840 for a couple. If your income is just above these thresholds, you should talk to a tax advisor about perhaps making a larger IRA contribution or strategically timing retirement account withdrawals to help you qualify.
To shop for marketplace plans in your state, visit HealthCare.gov or call the toll-free helpline at 800-318-2596.
If you find that you are not eligible for the subsidies and the premiums seem unaffordable, look into ACA-compliant plans that you can purchase of the marketplace directly from an insurance carrier or through a broker. In some states, you might find plans with lower premiums, especially on silver plans.
To find off-the-marketplace policies, see health insurance shopping websites like eHealthInsurance.com, or contact a broker or agent to assist you. Visit LocalHelp.HealthCare.gov to locate a broker or agent in your area.
Short-Term Health Insurance
If you cannot find an affordable ACA plan, you may want to consider short-term health insurance, which can be much cheaper. These plans, which are not available in every state, are bare-bones health plans that provide coverage for three, six or 12 months, depending on state and federal rules. Be aware that short-term plans are not required to comply with the ACA. As such, these plans can deny coverage, do not cover preexisting conditions and can exclude coverage essentials like prescription drugs.
To shop for short-term health insurance, visit eHealthInsurance.com or contact a local broker or agent via LocalHelp.HealthCare.gov.
If you need health insurance coverage for less than 18 months, another option you may want to consider is COBRA, which allows you to remain on your former employer's group health plan. Note that not every employer plan is COBRA eligible. Contact your employer benefits administrator to find out if your employer's plan qualifies.
In most cases COBRA is expensive and you are required to pay the full monthly premium. However, if you have already met, or nearly met, your employer plan's deductible and/or out-of-pocket maximum for the year, it may make sense to keep your current coverage under COBRA if you do not want to start over with a new plan or if you find your employer's health plan to be better or more affordable than other options.
Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.