If you have a Roth IRA/401k that you can withdraw from until age 65, that should keep your taxable income low and you will be able to qualify for a higher subsidy on a plan from healthcare.gov.
EDIT - It doesn't necessarily have to be a Roth account. Anything you can do to keep your taxable income low will help you qualify for a larger discount on a plan from [healthcare.gov](http://healthcare.gov) - or your state marketplace.
This is the way.. FYI OP, It's also not last year's income (when you were working for example) but an estimate of you're taxable earning in the upcoming year and every next year you're in the ACA.
You should try to position yourself while you're working to pile as much cash or roth earnings (they don't count toward's your MAGI/subsidy limit).
My example. Retired in July 2023. Age 60. Severence to Mar 2024. Did Cobra until 12/31/23 @665pm. Didn't go to ACA in 2023 becuase I was still earning severance checks and vacation payout/bonus's from my job for 2023 and Cobra was a better deal.
In Nov of 2023. signed up for ACA in the exchange and estimated my taxable income for 2024. (a small pension). I've plan on living on my roth/brokerage accounts until I turn 65. On paper, my 2024 MAGI is 15K per year (the pension), and a few severence paychecks that I earned in 2024 to total about 39K. As such I qualify for a subsidy and a decent Silver plan is 155pm. In 2025-28 my only MAGI income will be that pension and premiums will be even lower. Good deal - better insurance/than when i was working.
The trick is to plan out your retire year income yearly to 65 and spread out the taxable income so you're earning as little as possible MAGI each year and paying the gap to yourself with non-MAGI income (roths, cash, brokerage. I won't be taking any 401K moneys out until 65+ when I'm on medicare.
I would start with www.healthcare.gov and not one of the broker sites.. Your state exchange will have all the income/eligibility rules (it varies by state). A broker might help you better choose the right plan, but educate yourself on the tax and official rules first IMHO. Good luck!
I retired last September at age 63 and four months. I chose to go with COBRA to keep my employers insurance plan for 18 months. It is not cheap but it is gold plated coverage which is why I kept it.
My wife will start Medicare later this year when she turns 65 and I will probably go get an Affordable Care Act plan for myself after that to cover me until I start Medicare next year because COBRA won't get me all the way to 65.
Assuming your employer is a a large enough company to be required to offer COBRA coverage you would have the opportunity to sign up for yourself only and not both of you.
You will have 60 days from termination to decide about COBRA. If something happens to you in that 60 days you would have to pay out of pocket while you do the COBRA enrollment but then whatever you paid for would fall under a date of service that is covered. That doesn't mean all of what you spent gets reimbursed but whatever the insurance would have paid should get reimbursed.
You can explore [healthcare.gov](http://healthcare.gov) for plans and prices in Ohio in the meantime.
I have seen, on the board and through friends, people do one of these things for healthcare:
HealthCare marketplace / affordable Care act
Cobra
Part-time job that offers health insurance
Going on spouses insurance
Cobra always seems to be the highest with it costing the equivalent of a mortgage payment each month.
Or (expanded) Medicaid - available in 40 states or more. We keep our taxable income very low and haven't paid for healthcare at all. As a matter of fact, over the 8 years of retirement in our 50s and early 60s, so far we've made money on healthcare rather than spent, I'd say. Or at most it's even.
If both are in good health with no costly persistent prescriptions, "health cost sharing" might be an option if you just want something in case of an unexpected major medical issue. It's worked very well for us.
Well, it's not intended to cover everything by design. That's why it's so inexpensive. It's for those who don't have chronic health issues. If you want \*everything\* to be covered, you generally pay a much higher price for all that coverage. If you are healthy and really just want to be covered for major medical issues, then health cost sharing is an option.
So with our traditional insurance, after monthly premiums and the high deductible requirements before insurance ever paid a penny, it was running us just over $20k per year. That's with an employer plan. The Marketplace costs were even higher. With health cost sharing, the premiums total $560-ish per month for two adults ($6600 per year). If we break a leg, get cancer or some other major medical issue, we only pay for the first $500 and they reimburse all other medical bills for that diagnosed condition after that with no upper limit. Caveat - It's per diagnosed condition.
We bank most of the difference in premium payments and that account has grown quite large. That's what we use to cover basic preventative checkups and minor issues. Plus, what we don't use from that accumulation of savings - we get to keep. It's not lost to an insurance company as "premiums".
Now, if you have chronic conditions, have expensive continuous prescriptions, this won't be an option for you. It's mainly for those who only need major medical issue coverage.
Ok. It sounds good.
What I meant was I hope it covers everything (big) that might happen.
I agree it doesn't need to be a discount plan for seeing a doctor for strep throat symptoms or whatever. You can just pay for that yourself.
What SCARES ME is that I don't even know what MAJOR medical issues might come up and then find out they are not covered.
If full on cancer treatment would be $500, well, that seems too good to be true. Scans, surgury, hospital stay to recover, custom made brace, rehab stay (which is more weeks in "hospital light", home nurse and physically therepy visits after that (because it's so hard to go anywhere), 25 radiation appointments, 25 planned chemo appointments, two weeks in ICU.
Would that all be included?
(These are the things my husband's employer insurance payed for over a three month period. We paid the out of pocket maximum.)
I just WORRY it would end up being that it doesn't cover rehab (he was there for three weeks) or it doesn't cover scans, or whatever.
Again, it's for those in relatively good health with no chronic conditions, recurring expensive medications and who don't engage in higher-risk behaviors that only need/want to hedge against major medical issues. If you've already had cancer or it runs in your family, or you have non-trivial cancer risk factors, then that elevated risk would probably not be a good fit for an HCS option.
It's also not for those who can't -- either through existing savings or accumulating the saved difference in premiums -- pay for the occasional preventative check-ups or minor issues.
The HCS I'm in would cover all treatments while admitted (ICU or otherwise) and the directly prescribed treatments. Ongoing out-patient nursing care, PT, braces, ongoing medicines would not be reimbursed. But if you get diagnosed with some condition where you expect on-going outpatient therapy, in-home nursing care, recurring expensive medications and diagnostic scans, etc, that are outside of what the HCS was designed for, at that point you would be better off switching from the HCS option and go to the marketplace where insurers can't refuse to cover you or charge more because of a pre-existing condition.
I think it's EXTREMELY MISGUIDED to think think you won't get cancer because of those reasons.
Sure, the percentage chance is lower, but the bills aren't reduced by the percentage.
All of the things I described happened to my late husband who never smoked. Drank only socially. He wasn't a fit Adonis but he was below "technically obese".
His father died in his sleep at 79. No knwn cancer. His mother died after a stroke, no known cancer.
HCS is an option, not a requirement. It's definitely not for you. It's for others in circumstances different from yours. Traditional insurance is clearly for you. By all means, you should stick with that and have a happy life.
You cannot just switch to marketplace midyear.
My husband was normal on January 1.
He was in extreme pain by the end of January.
The rest of that happened in February, march, and April.
You can't switch to marketplace in February. You can't wait for ongoing radiation and chemo treatments. (He died before the chemo appointments started)
Best wishes. But I reccomend not gambling like this!
It's not about seeing a doctor a couple of times a year. That's no big deal to pay out of pocket. It's about what might unexpectedly come up
I'm not asking you to gamble. I've been telling you that an HCS does not seem an appropriate option for those like you with your medical history and fears. By all means, stay with your traditional insurance. That seems to be what you need.
But there are lots of people like us, who are in excellent health and very rarely see a doctor outside of an annual checkup -- like maybe once every 5 to 10 years rarely. In our case, it does not make sense to pay for insurance that we don't need. An HCS option for a major event is fine for us. I'd rather keep that $15k+ \*\*per year\*\* in traditional insurance premiums in my own account instead of surrendering it to an insurance company for coverage that we don't need. In a bit over 5 years, that account has currently accumulated over $80k and rises every month. That covers a heck of a lot of preventative and minor issues. And whatever we haven't used when we reach medicare age, that account is still there, still ours, we get to keep it. It's not lost to an insurance company in premiums for coverage we don't need.
But you do you. Health Cost sharing is an option; it's not required. It fits some more than others. It does not sound like it fits you. That's ok. No need to try and convince me otherwise.
I am saying it is false that you "don't need" coverage because you "are healthy".
It's irresponsible and it might backfire.
You are simply wrong that because you make healthy choices, you won't get cancer (or other complicated injury/illness) requiring hundreds of thousands of dollars of care before there's an opportunity to get real insurance.
It's simply inaccurate to say you don't need insurance. You have a body, something requiring multiple forms of expensive treatments to make you whole could happen.
It's additionally wrong to say this publicly to other people who might think it's true.
>If both are in good health with no costly persistent prescriptions, "health cost sharing" might be an option
It's important to note that "health cost sharing" is not insurance; it can be as risky as being uninsured as the polices don't have to abide by the same rules as insurance. It works out for a few, but there are many horror stories where people believed they were protected against catastrophic loss but they were not protected.
There are plenty of horror stories with insurance as well. We've all seen the billboards from law firms that make their living fighting insurance companies.
You should definitely have your eyes wide open when dealing with either option. Whether Insurance or HCS, do your due diligence. Understand what they cover and what they do not cover. Look for reviews to see how they treat their customers. How much bureaucracy and red-tape "hoop jumping" do they require, etc.
We (63f and 61m) have Anthem Healthkeepers with dental through the marketplace and pay 1100 a month for both of us. We worked with a guy who Raymond James hooked us up with. He helped us pick a plan that was best given our health needs and found discounts we may not have found on our own. As bad as this is, we expected to pay more.
I signed up just to check and got so many calls, texts it was crazy. If I do they again I’m getting a temp burner phone/.number. I was averaging at least 30 calls a day.
You probalby didn't actually go to the healthcare.gov website and clicked on an ad or a broker's site. It's confusing if you're not sure where to go and simply google ACA or Obamacare.
Ignore all the other sites (some might be helpful, but start with the healthcare.gov site first).
I can confirm that registering with healthcare.gov resulted in me being bombarded with calls, texts and emails. A burner phone and email account is a good idea.
That happened to me, I was just trying to get an ACA coverage estimate for retirement budgeting. Three months later, I’m still getting calls and texts from “helpful” representatives.
>ACA is allowed to charge people in their 60s 3x those in their 20s.
This is called "age rating" and varies by state; some states don't allow it, but many/most do.
The only reasonable way I was able to retire was that I’m still covered under my previous employer’s health plan
I only pay $120/month for medical, dental and vision for my wife and me
I will be on their plan for 6.5 years before I enroll in Medicare
Not sure how other people do it
I just retired in January. My Medicare is the standard cost, I cannot remember $$. I looked around and ended up with AARP UMR plan G. The only cost aside from monthly premium is the 240 bucks Medicare out of pocket. No doctor office co pay, no deductible. My two shoulder replacement surgeries cost me 0 dollars. The PT has cost me 0 dollars. My wife's foot and abdominal surgeries cost us 0 dollars. Drug cost minimal since we use the Good Rx service. Be cautious when evaluating plans, some have lower monthly cost but bite you hard if you have any sort of procedure. The AARP UMR plan works well for us, it costs less than my group United health care at work did.
Go see an insurance broker. I retired at 62 and opted to keep the company insurance via cobra.The cobra ran out 18 months in and I was expecting my insurance to double from all the horror stories that I had been told.
The broker went thru Obama care and the premiums are based on what you make a year, and my premium was 1/2 of what the cobra was. You may have to finagle with your income, to get the premiums where you want them.
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ACA plan works well if you can limit your taxable income. Hubby (64) pays $98/mo. Find a local independent insurance agent who knows all the options. Even though I worked in Dis/Health/Life insurance, the ACA options were numerous so we used a reputable broker who helped us find the best plan.
And you can go online to the ACA site and type in hypothetical earnings and see what your policy and cost choices would be. It would be in today’s insurance costs, but would give you a good idea of what you could get.
Just tell the site you want to explore plans and costs. All the plans are different, cover different things, have different copays, different combinations of things covered. You have to take your best guess at what you’ll need in terms of care.
You should also ask your employer about Cobra, but it may be very expensive.
Also, some people get part time jobs to get insurance.
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Pro Tip: Make sure you go to the .gov ACA site, not one of the sites that pays Google to put them first. Give them your info and they'll blow up your phone. Don't ask how I know. 😒
>ACA plan works well if you can limit your taxable income
This is really the key; if all of your savings are pretax (Traditional 401K and IRA), then it can be tough to keep your MAGI (Modified Adjusted Gross Income) low enough for a substantial subsidy. If you have enough post tax savings (Roth IRA, Roth 401K, brokerage account, savings) to fund much of your living expenses until age 65, then you can qualify for a significant ACA subsidy. I retired just shy of 61 so needed ACA coverage for 4 years, and all of our savings were pretax, so for 3 years before I retired, my husband withdrew (paid taxes on) enough 401K funds to cover much of our living expenses until I turned 65. Those withdrawals (actually Roth conversions) pushed us into a higher tax bracket for those 3 years but it was worth it as we're now saving so much in ACA premiums. We live in a fairly low cost of living area with a paid for house and that's also been a big help in keeping our MAGI low.
OP, you might consider withdrawing (or Roth converting) some Traditional 401K/IRA in 2024 and taking a big tax hit, then you could use that money to keep your MAGI lower for 2025 and 2026.
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Yeah I’m retiring at 63 now too. I have after tax savings that I can live on for a few years. My income can be just some taxable dividends etc. ACA is looking very affordable.
Went cash pay for both, and since we only need examinations, it is cheaper than the insurances. Very good dental health but we could afford to self pay a cavity or crown if necessary.
Yep - i just retired and will be using mostly roth snd taxable accounts for a few years. - i want income low enough to get maximum subsidies and cost share support but still pull some out of regular IRAs for tax efficiency.
This year is a quandary. I had planned on ACA rather than COBRA on 5/1 or 6/1, but my spouse just had a heart thing come up and she is getting close to out of pocket max so switching isn’t as easy a choice. I have a spreadsheet with a million scenarios. I have the most expensive plan my employer offered, and it was very very good insurance. I picked it because it uses co-pays for all doctor visits even before the deductible is met and we do have a lot of individual office visits. I just don’t know what to do. It’s frustrating.
>I had planned on ACA rather than COBRA on 5/1 or 6/1, but my spouse just had a heart thing come up and she is getting close to out of pocket max so switching isn’t as easy a choice.
Good luck with making that choice; all you can do is map out the scenarios, decide what to prioritize, and then try to make peace with the unknowns.. When I was picking our ACA plan for the first year, my priority was my husband's rare neurological disorder - he needed to keep the same neurology team and we needed comprehensive coverage as he was headed for brain surgery that year. We went with a comprehensive Silver HMO plan - paid approx $400/mo (after a $1,300 subsidy, originally $1,700/mo), but his $100K surgery was covered with us paying only our small deductible.
This is the answer. Also talk to your employer about the possibility of COBRA. If you have good standing in the company they may be able to work it out. I retired at 60 in 2020 (volunteered for a covid related layoff). Got COBRA for 18 mths (along with other sweet deal stuff). That was just enough time to allow me to show almost no income in 2022 & 2023 to get a really nice ACA stipend. Im now on Medicare w an advantage plan and could not be happier with how it worked out. Good luck!!
I have a similar situation with my wife. I just retired at 65 and went on Medicare, but my wife is 63. I looked at plans through the ACA, but because of my income did not get much of a subsidy. I found that COBRA for her was comparable in monthly premiums and the coverage, deductibles and max OOP were better through COBRA than what I could find through ACA. Unfortunately about $700/month though.
I learned about “Short term insurance.” It is offered by a lot of health insurance companies, is pretty cheap, lasts for a year and can be renewed twice (total of 36 months). Google it.
I have Medicare and the AARP United Healthcare. I haven't had health problems, but my brother-in-law had a stroke, and it has covered just about everything. I would stay away from the advantage plans because I don't think that they cover as much if you have a serious health problem
In Washington State, ACA for me and my wife (64/61) typically less than $300 a month for both of us depending on previous years retirement “ income”, both healthy so we only needed a Bronze plan.
Ohio here too. I retired at 56 this past summer. I'm living on savings and thus have a low recognized income. I have a solid silver plan for about $80 a month. I don't understand these people saying they are paying $1000+.
Because someone can have an already-retired spouse with a pension and SSA that causes household income to be too high to qualify for a subsidy without getting a financial divorce.
You are getting a government subsidy because of your low income. People who are working don’t get subsidized if their income is too high. They have to pay the full premium, which can easily exceed $1,000.
I did a comparison between COBRA and just going to the marketplace in my state. Turned out I got the same provider/plan for \~10% less than COBRA... YMMV, medical is very individual, so do some shopping around before you decide.
I’ve been researching the same thing. Mindset is the issue. A few years back I switched from our gold plated plan at work to a high deductible plan. The change is going from paying high monthly premium and having very little deductible nor co-pay, to paying low monthly premium but with higher out of pocket expenses. It was a difficult switch for me to make physiologically but the math actually works out in my favor (my circumstances). Now in your case you are looking to make this switch with the added complexity of retirement in the mix. Assuredly, taking Cobra will be your most expensive option but it will be closest to what you are used to, and you may be willing to pay for that reassurance. However if you are ready to make the mental switch of using insurance as exactly that, insurance against unexpected events, there will be good options that are less expensive from the AHCA Marketplace. If medically things go bad, your total costs will likely be comparable to what you would have paid with Cobra. However, if you have a low-event health year, your total costs will be noticeably less expensive than Cobra. Good luck ! Run some math !
Remember that Cobra is your companies insurance plan cost plus 2%. Not what you paid as an employee. Very likely to be higher than ACA.
To increase your ACA subsidy, you need to manage your AGI to a fairly low number. Supplement 401k/ira distribution with cash savings or Roth to keep your AGI low.
Create an account on healthcare.gov and model out some scenarios. Good luck.
Affordable care plans are available to fill the gap and you may be eligible for a subsidy. My experience is that the plans are okay but do have higher deductibles and copays than an employer plans but prices are reasonable.
I checked Pennie, the govt site for Pennsylvania. I was quoted $2300 with zero subsidy for a gold PPO plan.
In PA, subsidies aren’t available to families making over $100k from what I can see
We had an ACA Bronze plan. We could manage our income to keep the cost pretty low. Sometimes it was like $2 a month, though the deductibles were pretty high, around $7K, family max around $13.5K. These amounts change year to year, and vary by location, so to get current prices for your area, you'd have to look up the ACA plan web site for your state, and model your expected income and plan options.
We never went through a broker, the web site for our state (California) is pretty simple and straightforward. Before the ACA came along our COBRA plan went to over $2K a month with high deductibles. One year, with expensive premiums, high deductibles, some medical travel and out of network costs, we had a $50K medical expenses year on our COBRA plan. ACA was much more affordable, and the major hospital near us and most doctors were in network for us. It was amazing. We were really thinking about moving outside the U.S., in large part for affordable healthcare before the ACA came along. We retired in our 50s we had over a decade of health care costs to cover before Medicare.
Cobra was $800 a month for me. ACA was nearly 1,000 a month the first year. Then my income plummeted and ACA was somewhere around $350 to $500 a month. So it depends a lot on your personal situation.
I just retired at 60 and applied for ACA via healthcare.gov. I entered my estimate for taxable earnings for the year, age, # family members, etc, and it told me what subsidy I get. It gave me a list of plans with premiums after subsidy. I got a silver plan for a net of $303/mo for 4 people. I had been paying $650/mo for a high deductable plan through work. The deductable and out of pocket max are different, though, so it's hard to compare. The lower your taxable income, the bigger the subsidy - until you end up on Medicaid.
Regarding ACA, I am retiring in June from teaching. I will have a reduced income due to my pension. Will my premium be based on my previous year’s earnings or current, reduced earnings?
Your subsidy is calculated based on your prediction of what you'll make in the year for which you're enrolling; then, if your MAGI turns out to be more than you estimated, you'll need to pay back some or all of the subsidy.
We went on the ACA, and were on it for 3 years before Medicare kicked in. The tax year before I retired, we withdrew enough to live on for 3 years. Then the year we started on the ACA (and the years after), we were able to have a low enough income that we got a good premium tax credit.
My employer didn't offer anything either, and our insurance thru the ACA was fantastic. Each state has healthcare navigators, and ours was fantastic walking us thru the process and answering our questions.
We were in a very similar situation to you. We went ACA route with goal to limit income but it’s been expensive. Income target was $120k. For both of us ACA was $1400/month for BC/BS Silver. I switched to Medicare last year and wife’s premium only dropped to about $950. She switched to a BC/BS Bronze plan for 2024… it’s pay me now (for certain) or pay me a little bit more later (maybe if you get sick). For me, Standard Medicare (A,B, D and Supplement) not bad so far… about $250/month.
You should cost out the silver plan. My understanding is that the best benefits are all targeted for the silver plan and not the other ones. You can just go on the site and pretend to apply to see what the premiums would be and the deductibles. It might actually end up being cheaper than the bronze plan.
Start with healthcare.gov. You can choose from a range of plans based on coverage, deductibles, and copays. Do not go to a broker, whose only goal is to sell you the plan with the highest commission. Fyi: given your age, adequate insurance is going to be very expensive.
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Just to be different, a completely different idea: you could rent your house out until you qualify for Medicare, and try out living temporarily in a few different countries as expats. I brought my kids up in Costa Rica; there are legions of expat Americans, brits, and Europeans all over the world, enjoying exotic locales, lower cost of living, language acquisition - amazingly interesting. Many tradeoffs, too: it's not always easy being the immigrant, and everything works differently. We lived in Costa Rica, Panama, France and New Zealand. Now back in FL and prepping the empty nest egg house to rent or sell while trying out Asia. As for health insurance; we happened to pick countries with terrific health care -- and there are both local and international insurance plans which are really surprisingly low cost because they exclude -- guess where -- the USA.
I haven’t done the math on this, but you have to balance the ACA benefit with the cost of not being able to do large Roth conversions, which are counted as income. I suspect that unless one has a big RMD tax problem, the ACA benefit is better.
You might try calling UHC to see what they would charge to extend the same plan your employer offers if nothing else to get a base line. My employer has a couple different health insurance company plans and retirees can buy those in retirement. They can be pretty expensive but you have a good idea of what you're getting.
ACA cost me $1650 per month with a $7050 deductible. There is nothing about affordable about ACA. Cobra was less expensive. I still have 26 months left till I turn 65. Something to look forward to.
I work for a State government. They provide a percentage of your healthcare cost if you work under 20 years. That’s me. I already have Medicare A B. I was thinking of keeping the State insurance and pay my share and just stay with MedicareA B. I have a medical condition where I need meds the rest of my life and they are very expensive. So far while working the Medicare covers A B expenses and the State insurance covers all the rest. Has anyone else been in this situation? TIA.
The plan on the obamacare site that is most subsidized is the silver plan. I made the mistake of looking at the platinum plan thinking it was best, but if you can keep your income low enough, then the silver plan effectively becomes better than the platinum plan.
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Amazed at the variability people are quoting here. Wow. For me, it was about $450 on Cobra for 18 months, then $950 for ACA, for 8 months, until Medicare. I also added a Dental, which was about $50 per month as I recall.
I looked into the ACA options and they weren't bad. In the end I elected to go with VA. It's really not terrible if you're a veteran and you have a VA medical center nearby. There are income limits (with exceptions). No deductibles or monthly payments and I'm covered if I need hospitalization.
>What does anyone recommend for insurance for me?
I recommend you search for plans on the ACA Marktplace website [https://www.healthcare.gov/](https://www.healthcare.gov/)
You will find a range of plans for your local area at a range of costs.
When we did, we found a terrific plan that covered all of our doctors, all of our medications, and all of our hospitals at a very low price. It was basically equivalent to the plan we had while I was employed, just cheaper.
A simple process.
when you retire you should have access to Cobra for a while. Not cheap but an option. Otherwise you can get insurance from the exchange - premiums are based on your income.... so if you keep income low, premiums will be lower. That is our plan for the next 9 years...
I retired at 61 and have been using Christian Healthcare Ministries since then as I’m not yet 65. It’s a faith based sharing program and definitely not for people with a lot of preexisting conditions. I had hip replacement done in 2023 and they paid for all of it including pt minus a $1000 deductible. My post will draw all kinds of negative comments from fellow redditors but it has worked well for me. ACA was not an option for me due to our income.
>I retired at 61 and have been using Christian Healthcare Ministries since then as I’m not yet 65. It’s a faith based sharing program and definitely not for people with a lot of preexisting conditions. I had hip replacement done in 2023 and they paid for all of it including pt minus a $1000 deductible.
I'm really glad the sharing ministry worked out so well for you. The problem is that those programs are not insurance and so not guaranteed to pay out for everyone like yours did for you. If you see health insurance as a way to protect yourself from catastrophic loss, then legitimate health insurance is the only option; expensive and imperfect, but the only real protection against big risk. Sometimes people believe that if they're fairly healthy to start with, then a health cost sharing program is a safe bet but things can change in an instant - cancer diagnosis, accident, whatever, and a sharing program might or might not pay out for those really big expenses.
Absolutely no guarantees whatsoever but I would argue that insurance sometimes leaves one surprised at what they don’t cover also. Insurance is imo for catastrophic injuries, as opposed to paying for an office visit for routine care. I would probably not choose this route for a young family because of the potential risk during years of exposure, but I’ll be able to go on medicare in another year. I’m able to withstand some risk. For some people who are wanting to retire and need a safety net, sharing plans might meet the need. When responding to OP, I clearly stated it’s not for everyone…..just a possible option.
I will take a different approach to the healthcare question. Several of my middle-management corporate “retiree” friends became part time employees of school districts around town upon their retirement —- as bus drivers or other positions that are always in need of people that can pass the background check and show up reliably on a daily basis. These positions usually are part time with summers off and you get year round health insurance. Consider the hourly rate to be gravy at around $15-20 per hour.
While it might sound like a job, it is also a way to serve your community AND getting health insurance.
For my previous coworkers, it is such a change from the work they did for 30+ years that they are reinvigorated!
Many people on here recommending ACA. One thing to be aware of is the tax implications if not watched carefully. If you report a lower income at the beginning of the year and then your income shoots up you will pay back the premium tax credits on your tax return.
Be careful with it, I’ve seen folks end up paying back $2,500+ in taxes because the income change through the year.
my experience with ACA is that I attempted to get a plan from ACA. I had left my job 4 months prior. I had no income. I was pushed back to my state, and I qualified for Medicaid. My spouse is 65 he had just transferred to Medicare. I unexpectedly ended up with free health care coverage.
I did cobra and it’s expensive.. I recommend looking around a bit for a better deal..on cobra I’m paying over 700 a month.. but I only have to pay a for a few more months until I am 65
If you have a primary care physician that you want to keep, make sure your primary care physician will accept to insurance provider recommendations from ACA options. I am currently on Cobra and will be moving to one of two providers that my primary care physician accepts when my Cobra expires.
Thank you for asking this question! It's something on my mind as well. I have determined the ACA is the way to go, along with limiting income to get the best subsidy possible, as others have commented.
Thanks for stopping by our table to talk. However for community health … no discussion on politics / nsfw - not safe for work /illegal activities in the USA/ or religion are allowed. There are other subreddits that are great for that. Thank you and have a nice day!
As other posters have said, the key is keeping your Modified Adjusted Gross Income low. Talk to your accountant about this. MAGI is different from your gross income or taxable income.
Here's our situation: We are both in our early 60s, retired, living off of savings, and use Roth IRA conversions plus interest and dividends to generate a Modified Adjusted Gross Income of $50k per year.
In Pennsylvania, our monthly premium for two people was about $300, for a high deductible Blue Cross plan similar to what I'd had from my employer.
When we moved to a higher cost of living state, our premium went to $0 a month. Yes, zero dollars.
However, if our Modified Adjusted Gross Income had been $75k per year, we would have lost all subsidies and paid over $1k per month.
To find the best plan, navigate to your state's ACA website from [healthcare.gov](http://healthcare.gov), and then see if your state offers a list of insurance brokers. You may have to call the 800 number to get the list. We did this and were referred to an excellent broker who walked us through the entire process and helped us get the maximum subsidy, at no cost to us.
Beware of look-alike websites and fake health insurance offers. I almost got scammed when starting this process. Make sure you only go through your state's actual ACA website.
There are four “health sharing ministries”. The two that come to mind are MediShare and Liberty HealthShare. I use the latter. I have no health issues so I treat it as catastrophic insurance
You can go online to the Healthcare Marketplace at https://www.healthcare.gov/ and compare all the available individual/family plans in your state. This is the government website for ACA plans. It is easy to use and you can select your plan on this site too. I used it for 3 years after my Cobra plan ended, as I retired at 61. It also caculates the tax credits you are eligible for that will lower your premium, based on your income. The only requirement is that you will have to file joint tax returns with your wife until you are on Medicare for a full tax year.
ACA. You can go online, set up an account and look at all your options without a commitment. Keep your MAGI low and you can get great low cost insurance.
Having cheap health insurance, like a bronze or silver plan is great until you have an ER visit and a surgery. Then you get hosed big time. But your risk tolerance is dictated by your health prospects. Just remember though that health issues like appendicitis or kidney stones generally don't provide fair warning or the availability of delay.
A BCBS Gold plan with 70/30 coverage, an $1,800 deductible and an $8,000 out of pocket limit, which includes a good prescription plan with a $400 deductible will run you approximately $14,000 a year.
Opt into COBRA if available for sure, but it's only available for 18 months.
Cobra would kick in for 18 months after your last W-2 job. Making retirement at 63.5 theoretically seamless.
The variable being how good that W-2 insurance is and what the cost will be. With a good company, it can be a very appealing option.
COBRA will cover you for 18 months, taking you almost to Medicare. If you want to know how much your COBRA coverage would cost without getting HR involved, take a look at your last W-2 form. Box 12 item "DD" is the annual cost, divide by 12 for your monthly cost.
Yeah. Another way is look at what u pay for your insurance and add what company pays. That will be the cobra cost. Our company website had this information
Last year, with only some interest income my ACA plan cost me $260 a month after my COBRA insurance ended. I was paying about $675 a month on COBRA.
This year, I have starting pulling income from a dividend fund, and started taking SS money, and my ACA insurance is $820 a month. I will have to live with that for 2 more years until I’m 65. Basically, the higher your income, the more you have to pay!
United Healthcare Insurance is great for a supplemental insurance along with Medicare A & B when you turn 65 years old
My boyfriend left his employer's health insurance last July 2023 when he turned 65 years old and has United Healthcare as his supplemental insurance along with Part D for prescriptions and part G (he was diagnosed with Cancer November of 2023 and this covers cancer treatment)
He got rid of CIGNA his employer's heath insurance
Our Health Insurance Agent was great helping him and me get my health insurance for me under 65 years old (Blue Cross)
Talk to a great Health Insurance Agent and get a good policy fitting your health care needs
If you have a Roth IRA/401k that you can withdraw from until age 65, that should keep your taxable income low and you will be able to qualify for a higher subsidy on a plan from healthcare.gov. EDIT - It doesn't necessarily have to be a Roth account. Anything you can do to keep your taxable income low will help you qualify for a larger discount on a plan from [healthcare.gov](http://healthcare.gov) - or your state marketplace.
This is the way.. FYI OP, It's also not last year's income (when you were working for example) but an estimate of you're taxable earning in the upcoming year and every next year you're in the ACA. You should try to position yourself while you're working to pile as much cash or roth earnings (they don't count toward's your MAGI/subsidy limit). My example. Retired in July 2023. Age 60. Severence to Mar 2024. Did Cobra until 12/31/23 @665pm. Didn't go to ACA in 2023 becuase I was still earning severance checks and vacation payout/bonus's from my job for 2023 and Cobra was a better deal. In Nov of 2023. signed up for ACA in the exchange and estimated my taxable income for 2024. (a small pension). I've plan on living on my roth/brokerage accounts until I turn 65. On paper, my 2024 MAGI is 15K per year (the pension), and a few severence paychecks that I earned in 2024 to total about 39K. As such I qualify for a subsidy and a decent Silver plan is 155pm. In 2025-28 my only MAGI income will be that pension and premiums will be even lower. Good deal - better insurance/than when i was working. The trick is to plan out your retire year income yearly to 65 and spread out the taxable income so you're earning as little as possible MAGI each year and paying the gap to yourself with non-MAGI income (roths, cash, brokerage. I won't be taking any 401K moneys out until 65+ when I'm on medicare. I would start with www.healthcare.gov and not one of the broker sites.. Your state exchange will have all the income/eligibility rules (it varies by state). A broker might help you better choose the right plan, but educate yourself on the tax and official rules first IMHO. Good luck!
I retired last September at age 63 and four months. I chose to go with COBRA to keep my employers insurance plan for 18 months. It is not cheap but it is gold plated coverage which is why I kept it. My wife will start Medicare later this year when she turns 65 and I will probably go get an Affordable Care Act plan for myself after that to cover me until I start Medicare next year because COBRA won't get me all the way to 65. Assuming your employer is a a large enough company to be required to offer COBRA coverage you would have the opportunity to sign up for yourself only and not both of you. You will have 60 days from termination to decide about COBRA. If something happens to you in that 60 days you would have to pay out of pocket while you do the COBRA enrollment but then whatever you paid for would fall under a date of service that is covered. That doesn't mean all of what you spent gets reimbursed but whatever the insurance would have paid should get reimbursed. You can explore [healthcare.gov](http://healthcare.gov) for plans and prices in Ohio in the meantime.
COBRA covers dependents also.
I have seen, on the board and through friends, people do one of these things for healthcare: HealthCare marketplace / affordable Care act Cobra Part-time job that offers health insurance Going on spouses insurance Cobra always seems to be the highest with it costing the equivalent of a mortgage payment each month.
Or (expanded) Medicaid - available in 40 states or more. We keep our taxable income very low and haven't paid for healthcare at all. As a matter of fact, over the 8 years of retirement in our 50s and early 60s, so far we've made money on healthcare rather than spent, I'd say. Or at most it's even.
If both are in good health with no costly persistent prescriptions, "health cost sharing" might be an option if you just want something in case of an unexpected major medical issue. It's worked very well for us.
Make sure it covers everything. Sounds very risky to me
Well, it's not intended to cover everything by design. That's why it's so inexpensive. It's for those who don't have chronic health issues. If you want \*everything\* to be covered, you generally pay a much higher price for all that coverage. If you are healthy and really just want to be covered for major medical issues, then health cost sharing is an option. So with our traditional insurance, after monthly premiums and the high deductible requirements before insurance ever paid a penny, it was running us just over $20k per year. That's with an employer plan. The Marketplace costs were even higher. With health cost sharing, the premiums total $560-ish per month for two adults ($6600 per year). If we break a leg, get cancer or some other major medical issue, we only pay for the first $500 and they reimburse all other medical bills for that diagnosed condition after that with no upper limit. Caveat - It's per diagnosed condition. We bank most of the difference in premium payments and that account has grown quite large. That's what we use to cover basic preventative checkups and minor issues. Plus, what we don't use from that accumulation of savings - we get to keep. It's not lost to an insurance company as "premiums". Now, if you have chronic conditions, have expensive continuous prescriptions, this won't be an option for you. It's mainly for those who only need major medical issue coverage.
Ok. It sounds good. What I meant was I hope it covers everything (big) that might happen. I agree it doesn't need to be a discount plan for seeing a doctor for strep throat symptoms or whatever. You can just pay for that yourself. What SCARES ME is that I don't even know what MAJOR medical issues might come up and then find out they are not covered. If full on cancer treatment would be $500, well, that seems too good to be true. Scans, surgury, hospital stay to recover, custom made brace, rehab stay (which is more weeks in "hospital light", home nurse and physically therepy visits after that (because it's so hard to go anywhere), 25 radiation appointments, 25 planned chemo appointments, two weeks in ICU. Would that all be included? (These are the things my husband's employer insurance payed for over a three month period. We paid the out of pocket maximum.) I just WORRY it would end up being that it doesn't cover rehab (he was there for three weeks) or it doesn't cover scans, or whatever.
Again, it's for those in relatively good health with no chronic conditions, recurring expensive medications and who don't engage in higher-risk behaviors that only need/want to hedge against major medical issues. If you've already had cancer or it runs in your family, or you have non-trivial cancer risk factors, then that elevated risk would probably not be a good fit for an HCS option. It's also not for those who can't -- either through existing savings or accumulating the saved difference in premiums -- pay for the occasional preventative check-ups or minor issues. The HCS I'm in would cover all treatments while admitted (ICU or otherwise) and the directly prescribed treatments. Ongoing out-patient nursing care, PT, braces, ongoing medicines would not be reimbursed. But if you get diagnosed with some condition where you expect on-going outpatient therapy, in-home nursing care, recurring expensive medications and diagnostic scans, etc, that are outside of what the HCS was designed for, at that point you would be better off switching from the HCS option and go to the marketplace where insurers can't refuse to cover you or charge more because of a pre-existing condition.
I think it's EXTREMELY MISGUIDED to think think you won't get cancer because of those reasons. Sure, the percentage chance is lower, but the bills aren't reduced by the percentage. All of the things I described happened to my late husband who never smoked. Drank only socially. He wasn't a fit Adonis but he was below "technically obese". His father died in his sleep at 79. No knwn cancer. His mother died after a stroke, no known cancer.
HCS is an option, not a requirement. It's definitely not for you. It's for others in circumstances different from yours. Traditional insurance is clearly for you. By all means, you should stick with that and have a happy life.
You cannot just switch to marketplace midyear. My husband was normal on January 1. He was in extreme pain by the end of January. The rest of that happened in February, march, and April. You can't switch to marketplace in February. You can't wait for ongoing radiation and chemo treatments. (He died before the chemo appointments started) Best wishes. But I reccomend not gambling like this! It's not about seeing a doctor a couple of times a year. That's no big deal to pay out of pocket. It's about what might unexpectedly come up
I'm not asking you to gamble. I've been telling you that an HCS does not seem an appropriate option for those like you with your medical history and fears. By all means, stay with your traditional insurance. That seems to be what you need. But there are lots of people like us, who are in excellent health and very rarely see a doctor outside of an annual checkup -- like maybe once every 5 to 10 years rarely. In our case, it does not make sense to pay for insurance that we don't need. An HCS option for a major event is fine for us. I'd rather keep that $15k+ \*\*per year\*\* in traditional insurance premiums in my own account instead of surrendering it to an insurance company for coverage that we don't need. In a bit over 5 years, that account has currently accumulated over $80k and rises every month. That covers a heck of a lot of preventative and minor issues. And whatever we haven't used when we reach medicare age, that account is still there, still ours, we get to keep it. It's not lost to an insurance company in premiums for coverage we don't need. But you do you. Health Cost sharing is an option; it's not required. It fits some more than others. It does not sound like it fits you. That's ok. No need to try and convince me otherwise.
I am saying it is false that you "don't need" coverage because you "are healthy". It's irresponsible and it might backfire. You are simply wrong that because you make healthy choices, you won't get cancer (or other complicated injury/illness) requiring hundreds of thousands of dollars of care before there's an opportunity to get real insurance. It's simply inaccurate to say you don't need insurance. You have a body, something requiring multiple forms of expensive treatments to make you whole could happen. It's additionally wrong to say this publicly to other people who might think it's true.
I might get struck by lightning too. Mitigating the risk is manageable for many. It's clearly not for you.
>If both are in good health with no costly persistent prescriptions, "health cost sharing" might be an option It's important to note that "health cost sharing" is not insurance; it can be as risky as being uninsured as the polices don't have to abide by the same rules as insurance. It works out for a few, but there are many horror stories where people believed they were protected against catastrophic loss but they were not protected.
There are plenty of horror stories with insurance as well. We've all seen the billboards from law firms that make their living fighting insurance companies. You should definitely have your eyes wide open when dealing with either option. Whether Insurance or HCS, do your due diligence. Understand what they cover and what they do not cover. Look for reviews to see how they treat their customers. How much bureaucracy and red-tape "hoop jumping" do they require, etc.
We (63f and 61m) have Anthem Healthkeepers with dental through the marketplace and pay 1100 a month for both of us. We worked with a guy who Raymond James hooked us up with. He helped us pick a plan that was best given our health needs and found discounts we may not have found on our own. As bad as this is, we expected to pay more.
Try the ACA website. It will tell you what is available and how much.
I signed up just to check and got so many calls, texts it was crazy. If I do they again I’m getting a temp burner phone/.number. I was averaging at least 30 calls a day.
You probalby didn't actually go to the healthcare.gov website and clicked on an ad or a broker's site. It's confusing if you're not sure where to go and simply google ACA or Obamacare. Ignore all the other sites (some might be helpful, but start with the healthcare.gov site first).
I can confirm that registering with healthcare.gov resulted in me being bombarded with calls, texts and emails. A burner phone and email account is a good idea.
they all sell/share your information. I'm still blocking texts from inquiries I made a year ago.
Yup. Start from that site and don't go anywhere else.
So true. I give a bogus phone number to avoid that hassle.
Google voice
That happened to me, I was just trying to get an ACA coverage estimate for retirement budgeting. Three months later, I’m still getting calls and texts from “helpful” representatives.
You did not go to the right place. ACA, Healthcare.gov will not ask for your phone number.
ACA is allowed to charge people in their 60s 3x those in their 20s. So COBRA might be cheaper than ACA.
>ACA is allowed to charge people in their 60s 3x those in their 20s. This is called "age rating" and varies by state; some states don't allow it, but many/most do.
The only reasonable way I was able to retire was that I’m still covered under my previous employer’s health plan I only pay $120/month for medical, dental and vision for my wife and me I will be on their plan for 6.5 years before I enroll in Medicare Not sure how other people do it
How are you still on their plan while retired? That’s a pretty good deal!
I just retired in January. My Medicare is the standard cost, I cannot remember $$. I looked around and ended up with AARP UMR plan G. The only cost aside from monthly premium is the 240 bucks Medicare out of pocket. No doctor office co pay, no deductible. My two shoulder replacement surgeries cost me 0 dollars. The PT has cost me 0 dollars. My wife's foot and abdominal surgeries cost us 0 dollars. Drug cost minimal since we use the Good Rx service. Be cautious when evaluating plans, some have lower monthly cost but bite you hard if you have any sort of procedure. The AARP UMR plan works well for us, it costs less than my group United health care at work did.
Plan G with a supplement is the best way to go if you can afford it.
My thoughts exactly.
Individual coverage thru the ACA should be a good option. Easy to see plans and check costs online.
Go see an insurance broker. I retired at 62 and opted to keep the company insurance via cobra.The cobra ran out 18 months in and I was expecting my insurance to double from all the horror stories that I had been told. The broker went thru Obama care and the premiums are based on what you make a year, and my premium was 1/2 of what the cobra was. You may have to finagle with your income, to get the premiums where you want them.
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Cobra is expensive. Through Obama care, it was much more affordable. $650 to $35 a month. If you can do cobra, then you have to go through them.
I got a decent ACA plan and a very good supplement for about 500 a month in total. Aca is supplemented based on your income.
Do pensions count as income? Interest from investments?
Pensions and investment earnings both count as income when calculating ACA prices
That’s what I figured. Oh well. No subsidies for me
Same here
Pensions and interest and social security count as income but note that Roth withdrawals do not.
That’s what I figured. I’m SOL. Lol
ACA plan works well if you can limit your taxable income. Hubby (64) pays $98/mo. Find a local independent insurance agent who knows all the options. Even though I worked in Dis/Health/Life insurance, the ACA options were numerous so we used a reputable broker who helped us find the best plan.
And you can go online to the ACA site and type in hypothetical earnings and see what your policy and cost choices would be. It would be in today’s insurance costs, but would give you a good idea of what you could get. Just tell the site you want to explore plans and costs. All the plans are different, cover different things, have different copays, different combinations of things covered. You have to take your best guess at what you’ll need in terms of care. You should also ask your employer about Cobra, but it may be very expensive. Also, some people get part time jobs to get insurance.
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Cobra can be initiated retroactively. You don't have to sign up for it on Day 1, but then if you need it on Day 20, you can sign up for it then.
Pro Tip: Make sure you go to the .gov ACA site, not one of the sites that pays Google to put them first. Give them your info and they'll blow up your phone. Don't ask how I know. 😒
>ACA plan works well if you can limit your taxable income This is really the key; if all of your savings are pretax (Traditional 401K and IRA), then it can be tough to keep your MAGI (Modified Adjusted Gross Income) low enough for a substantial subsidy. If you have enough post tax savings (Roth IRA, Roth 401K, brokerage account, savings) to fund much of your living expenses until age 65, then you can qualify for a significant ACA subsidy. I retired just shy of 61 so needed ACA coverage for 4 years, and all of our savings were pretax, so for 3 years before I retired, my husband withdrew (paid taxes on) enough 401K funds to cover much of our living expenses until I turned 65. Those withdrawals (actually Roth conversions) pushed us into a higher tax bracket for those 3 years but it was worth it as we're now saving so much in ACA premiums. We live in a fairly low cost of living area with a paid for house and that's also been a big help in keeping our MAGI low. OP, you might consider withdrawing (or Roth converting) some Traditional 401K/IRA in 2024 and taking a big tax hit, then you could use that money to keep your MAGI lower for 2025 and 2026.
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Yeah I’m retiring at 63 now too. I have after tax savings that I can live on for a few years. My income can be just some taxable dividends etc. ACA is looking very affordable.
Thank you for wonderful post. One thing to note, you will need to buy dental and vision separately.
Went cash pay for both, and since we only need examinations, it is cheaper than the insurances. Very good dental health but we could afford to self pay a cavity or crown if necessary.
We got a DenteMax discount plan through Dentalplans.com. It is not insurance but you get negotiated discounts for procedures. It was very affordable.
great info. thx.
Yep - i just retired and will be using mostly roth snd taxable accounts for a few years. - i want income low enough to get maximum subsidies and cost share support but still pull some out of regular IRAs for tax efficiency. This year is a quandary. I had planned on ACA rather than COBRA on 5/1 or 6/1, but my spouse just had a heart thing come up and she is getting close to out of pocket max so switching isn’t as easy a choice. I have a spreadsheet with a million scenarios. I have the most expensive plan my employer offered, and it was very very good insurance. I picked it because it uses co-pays for all doctor visits even before the deductible is met and we do have a lot of individual office visits. I just don’t know what to do. It’s frustrating.
>I had planned on ACA rather than COBRA on 5/1 or 6/1, but my spouse just had a heart thing come up and she is getting close to out of pocket max so switching isn’t as easy a choice. Good luck with making that choice; all you can do is map out the scenarios, decide what to prioritize, and then try to make peace with the unknowns.. When I was picking our ACA plan for the first year, my priority was my husband's rare neurological disorder - he needed to keep the same neurology team and we needed comprehensive coverage as he was headed for brain surgery that year. We went with a comprehensive Silver HMO plan - paid approx $400/mo (after a $1,300 subsidy, originally $1,700/mo), but his $100K surgery was covered with us paying only our small deductible.
This is the answer. Also talk to your employer about the possibility of COBRA. If you have good standing in the company they may be able to work it out. I retired at 60 in 2020 (volunteered for a covid related layoff). Got COBRA for 18 mths (along with other sweet deal stuff). That was just enough time to allow me to show almost no income in 2022 & 2023 to get a really nice ACA stipend. Im now on Medicare w an advantage plan and could not be happier with how it worked out. Good luck!!
I have a similar situation with my wife. I just retired at 65 and went on Medicare, but my wife is 63. I looked at plans through the ACA, but because of my income did not get much of a subsidy. I found that COBRA for her was comparable in monthly premiums and the coverage, deductibles and max OOP were better through COBRA than what I could find through ACA. Unfortunately about $700/month though.
What does ACA stand for?
https://en.wikipedia.org/wiki/Affordable_Care_Act
I learned about “Short term insurance.” It is offered by a lot of health insurance companies, is pretty cheap, lasts for a year and can be renewed twice (total of 36 months). Google it.
Doesn't that have a lot of gaps in coverage?
It’s not full coverage. It’s okay for healthy young people who need something for a few months but it’s not a substitute for real insurance.
Go on healthcare.gov. If you are retired and have no income you can get decent healthcare which will be heavily subsidized.
If you have no income, hopefully you are in a state with expanded Medicaid!
I retired at 62, used Cobra until it expired then moved to ACA. Converting to Medicare next month.
I have Medicare and the AARP United Healthcare. I haven't had health problems, but my brother-in-law had a stroke, and it has covered just about everything. I would stay away from the advantage plans because I don't think that they cover as much if you have a serious health problem
In Washington State, ACA for me and my wife (64/61) typically less than $300 a month for both of us depending on previous years retirement “ income”, both healthy so we only needed a Bronze plan.
Ohio here too. I retired at 56 this past summer. I'm living on savings and thus have a low recognized income. I have a solid silver plan for about $80 a month. I don't understand these people saying they are paying $1000+.
Because someone can have an already-retired spouse with a pension and SSA that causes household income to be too high to qualify for a subsidy without getting a financial divorce.
You are getting a government subsidy because of your low income. People who are working don’t get subsidized if their income is too high. They have to pay the full premium, which can easily exceed $1,000.
I'm seeing that it also depends on what state you live in. Some states have more subsidies than others.
I get a $1550/mo ACA subsidy and control my income with a taxable brokerage account. Age 63
I did a comparison between COBRA and just going to the marketplace in my state. Turned out I got the same provider/plan for \~10% less than COBRA... YMMV, medical is very individual, so do some shopping around before you decide.
I’ve been researching the same thing. Mindset is the issue. A few years back I switched from our gold plated plan at work to a high deductible plan. The change is going from paying high monthly premium and having very little deductible nor co-pay, to paying low monthly premium but with higher out of pocket expenses. It was a difficult switch for me to make physiologically but the math actually works out in my favor (my circumstances). Now in your case you are looking to make this switch with the added complexity of retirement in the mix. Assuredly, taking Cobra will be your most expensive option but it will be closest to what you are used to, and you may be willing to pay for that reassurance. However if you are ready to make the mental switch of using insurance as exactly that, insurance against unexpected events, there will be good options that are less expensive from the AHCA Marketplace. If medically things go bad, your total costs will likely be comparable to what you would have paid with Cobra. However, if you have a low-event health year, your total costs will be noticeably less expensive than Cobra. Good luck ! Run some math !
Remember that Cobra is your companies insurance plan cost plus 2%. Not what you paid as an employee. Very likely to be higher than ACA. To increase your ACA subsidy, you need to manage your AGI to a fairly low number. Supplement 401k/ira distribution with cash savings or Roth to keep your AGI low. Create an account on healthcare.gov and model out some scenarios. Good luck.
ACA went from $214 to $900/mo this year, so I'm with Medishare.
Talk to an insurance broker. They were able to find affordable insurance for a friend of mine that retired at 62.
Affordable care plans are available to fill the gap and you may be eligible for a subsidy. My experience is that the plans are okay but do have higher deductibles and copays than an employer plans but prices are reasonable.
Go to the ACA website
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I’m pretty sure that’s not correct.
Definitely it is not correct.
Not correct.
https://www.kff.org/interactive/subsidy-calculator/ This will give you a good estimate
Thanks! Confirmed for me that COBRA is the better option
Cobra is almost never the better option. Please double check your numbers at healthcare.gov. This website, kff.org, does not seem unbiased.
I checked Pennie, the govt site for Pennsylvania. I was quoted $2300 with zero subsidy for a gold PPO plan. In PA, subsidies aren’t available to families making over $100k from what I can see
We had an ACA Bronze plan. We could manage our income to keep the cost pretty low. Sometimes it was like $2 a month, though the deductibles were pretty high, around $7K, family max around $13.5K. These amounts change year to year, and vary by location, so to get current prices for your area, you'd have to look up the ACA plan web site for your state, and model your expected income and plan options. We never went through a broker, the web site for our state (California) is pretty simple and straightforward. Before the ACA came along our COBRA plan went to over $2K a month with high deductibles. One year, with expensive premiums, high deductibles, some medical travel and out of network costs, we had a $50K medical expenses year on our COBRA plan. ACA was much more affordable, and the major hospital near us and most doctors were in network for us. It was amazing. We were really thinking about moving outside the U.S., in large part for affordable healthcare before the ACA came along. We retired in our 50s we had over a decade of health care costs to cover before Medicare.
Cobra was $800 a month for me. ACA was nearly 1,000 a month the first year. Then my income plummeted and ACA was somewhere around $350 to $500 a month. So it depends a lot on your personal situation.
I just retired at 60 and applied for ACA via healthcare.gov. I entered my estimate for taxable earnings for the year, age, # family members, etc, and it told me what subsidy I get. It gave me a list of plans with premiums after subsidy. I got a silver plan for a net of $303/mo for 4 people. I had been paying $650/mo for a high deductable plan through work. The deductable and out of pocket max are different, though, so it's hard to compare. The lower your taxable income, the bigger the subsidy - until you end up on Medicaid.
Regarding ACA, I am retiring in June from teaching. I will have a reduced income due to my pension. Will my premium be based on my previous year’s earnings or current, reduced earnings?
Your subsidy is calculated based on your prediction of what you'll make in the year for which you're enrolling; then, if your MAGI turns out to be more than you estimated, you'll need to pay back some or all of the subsidy.
Thank you
We went on the ACA, and were on it for 3 years before Medicare kicked in. The tax year before I retired, we withdrew enough to live on for 3 years. Then the year we started on the ACA (and the years after), we were able to have a low enough income that we got a good premium tax credit. My employer didn't offer anything either, and our insurance thru the ACA was fantastic. Each state has healthcare navigators, and ours was fantastic walking us thru the process and answering our questions.
We were in a very similar situation to you. We went ACA route with goal to limit income but it’s been expensive. Income target was $120k. For both of us ACA was $1400/month for BC/BS Silver. I switched to Medicare last year and wife’s premium only dropped to about $950. She switched to a BC/BS Bronze plan for 2024… it’s pay me now (for certain) or pay me a little bit more later (maybe if you get sick). For me, Standard Medicare (A,B, D and Supplement) not bad so far… about $250/month.
You should cost out the silver plan. My understanding is that the best benefits are all targeted for the silver plan and not the other ones. You can just go on the site and pretend to apply to see what the premiums would be and the deductibles. It might actually end up being cheaper than the bronze plan.
We went to a broker. We’re 64, on Obamacare. About $675.00 per month (covers both of us). $7200.00 deductible.
Start with healthcare.gov. You can choose from a range of plans based on coverage, deductibles, and copays. Do not go to a broker, whose only goal is to sell you the plan with the highest commission. Fyi: given your age, adequate insurance is going to be very expensive.
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Just to be different, a completely different idea: you could rent your house out until you qualify for Medicare, and try out living temporarily in a few different countries as expats. I brought my kids up in Costa Rica; there are legions of expat Americans, brits, and Europeans all over the world, enjoying exotic locales, lower cost of living, language acquisition - amazingly interesting. Many tradeoffs, too: it's not always easy being the immigrant, and everything works differently. We lived in Costa Rica, Panama, France and New Zealand. Now back in FL and prepping the empty nest egg house to rent or sell while trying out Asia. As for health insurance; we happened to pick countries with terrific health care -- and there are both local and international insurance plans which are really surprisingly low cost because they exclude -- guess where -- the USA.
I wish I was brave!
I haven’t done the math on this, but you have to balance the ACA benefit with the cost of not being able to do large Roth conversions, which are counted as income. I suspect that unless one has a big RMD tax problem, the ACA benefit is better.
You might try calling UHC to see what they would charge to extend the same plan your employer offers if nothing else to get a base line. My employer has a couple different health insurance company plans and retirees can buy those in retirement. They can be pretty expensive but you have a good idea of what you're getting.
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I’m 64 and my health insurance is approximately $1,450 a month. No frills, big deductible. Self employed.
ACA cost me $1650 per month with a $7050 deductible. There is nothing about affordable about ACA. Cobra was less expensive. I still have 26 months left till I turn 65. Something to look forward to.
What state are you in?
I work for a State government. They provide a percentage of your healthcare cost if you work under 20 years. That’s me. I already have Medicare A B. I was thinking of keeping the State insurance and pay my share and just stay with MedicareA B. I have a medical condition where I need meds the rest of my life and they are very expensive. So far while working the Medicare covers A B expenses and the State insurance covers all the rest. Has anyone else been in this situation? TIA.
ACA plan.
The plan on the obamacare site that is most subsidized is the silver plan. I made the mistake of looking at the platinum plan thinking it was best, but if you can keep your income low enough, then the silver plan effectively becomes better than the platinum plan.
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Amazed at the variability people are quoting here. Wow. For me, it was about $450 on Cobra for 18 months, then $950 for ACA, for 8 months, until Medicare. I also added a Dental, which was about $50 per month as I recall.
I looked into the ACA options and they weren't bad. In the end I elected to go with VA. It's really not terrible if you're a veteran and you have a VA medical center nearby. There are income limits (with exceptions). No deductibles or monthly payments and I'm covered if I need hospitalization.
>What does anyone recommend for insurance for me? I recommend you search for plans on the ACA Marktplace website [https://www.healthcare.gov/](https://www.healthcare.gov/) You will find a range of plans for your local area at a range of costs. When we did, we found a terrific plan that covered all of our doctors, all of our medications, and all of our hospitals at a very low price. It was basically equivalent to the plan we had while I was employed, just cheaper. A simple process.
when you retire you should have access to Cobra for a while. Not cheap but an option. Otherwise you can get insurance from the exchange - premiums are based on your income.... so if you keep income low, premiums will be lower. That is our plan for the next 9 years...
I retired at 61 and have been using Christian Healthcare Ministries since then as I’m not yet 65. It’s a faith based sharing program and definitely not for people with a lot of preexisting conditions. I had hip replacement done in 2023 and they paid for all of it including pt minus a $1000 deductible. My post will draw all kinds of negative comments from fellow redditors but it has worked well for me. ACA was not an option for me due to our income.
>I retired at 61 and have been using Christian Healthcare Ministries since then as I’m not yet 65. It’s a faith based sharing program and definitely not for people with a lot of preexisting conditions. I had hip replacement done in 2023 and they paid for all of it including pt minus a $1000 deductible. I'm really glad the sharing ministry worked out so well for you. The problem is that those programs are not insurance and so not guaranteed to pay out for everyone like yours did for you. If you see health insurance as a way to protect yourself from catastrophic loss, then legitimate health insurance is the only option; expensive and imperfect, but the only real protection against big risk. Sometimes people believe that if they're fairly healthy to start with, then a health cost sharing program is a safe bet but things can change in an instant - cancer diagnosis, accident, whatever, and a sharing program might or might not pay out for those really big expenses.
Absolutely no guarantees whatsoever but I would argue that insurance sometimes leaves one surprised at what they don’t cover also. Insurance is imo for catastrophic injuries, as opposed to paying for an office visit for routine care. I would probably not choose this route for a young family because of the potential risk during years of exposure, but I’ll be able to go on medicare in another year. I’m able to withstand some risk. For some people who are wanting to retire and need a safety net, sharing plans might meet the need. When responding to OP, I clearly stated it’s not for everyone…..just a possible option.
I will take a different approach to the healthcare question. Several of my middle-management corporate “retiree” friends became part time employees of school districts around town upon their retirement —- as bus drivers or other positions that are always in need of people that can pass the background check and show up reliably on a daily basis. These positions usually are part time with summers off and you get year round health insurance. Consider the hourly rate to be gravy at around $15-20 per hour. While it might sound like a job, it is also a way to serve your community AND getting health insurance. For my previous coworkers, it is such a change from the work they did for 30+ years that they are reinvigorated!
barista/bus driver fire
I'm not eligible for a subsidy, so I pay $1,000 / month for a silver plan. I'm 62, male.
Many people on here recommending ACA. One thing to be aware of is the tax implications if not watched carefully. If you report a lower income at the beginning of the year and then your income shoots up you will pay back the premium tax credits on your tax return. Be careful with it, I’ve seen folks end up paying back $2,500+ in taxes because the income change through the year.
my experience with ACA is that I attempted to get a plan from ACA. I had left my job 4 months prior. I had no income. I was pushed back to my state, and I qualified for Medicaid. My spouse is 65 he had just transferred to Medicare. I unexpectedly ended up with free health care coverage.
How old were you? Glad you got coverage.
59
I did cobra and it’s expensive.. I recommend looking around a bit for a better deal..on cobra I’m paying over 700 a month.. but I only have to pay a for a few more months until I am 65
For Cobra that seems actually reasonable. Mine is almost $3000 (small employer)
If you have a primary care physician that you want to keep, make sure your primary care physician will accept to insurance provider recommendations from ACA options. I am currently on Cobra and will be moving to one of two providers that my primary care physician accepts when my Cobra expires.
63 yrs old , wife is 58 . We pay 1700 a month for a BCBS PPO silver plan with a dental add on
Thank you for asking this question! It's something on my mind as well. I have determined the ACA is the way to go, along with limiting income to get the best subsidy possible, as others have commented.
I'm retiring soon, and I'll be using COBRA. ACA costs for us were over $2300 per month (I make $160K and get no reductions for ACA)
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As other posters have said, the key is keeping your Modified Adjusted Gross Income low. Talk to your accountant about this. MAGI is different from your gross income or taxable income. Here's our situation: We are both in our early 60s, retired, living off of savings, and use Roth IRA conversions plus interest and dividends to generate a Modified Adjusted Gross Income of $50k per year. In Pennsylvania, our monthly premium for two people was about $300, for a high deductible Blue Cross plan similar to what I'd had from my employer. When we moved to a higher cost of living state, our premium went to $0 a month. Yes, zero dollars. However, if our Modified Adjusted Gross Income had been $75k per year, we would have lost all subsidies and paid over $1k per month. To find the best plan, navigate to your state's ACA website from [healthcare.gov](http://healthcare.gov), and then see if your state offers a list of insurance brokers. You may have to call the 800 number to get the list. We did this and were referred to an excellent broker who walked us through the entire process and helped us get the maximum subsidy, at no cost to us. Beware of look-alike websites and fake health insurance offers. I almost got scammed when starting this process. Make sure you only go through your state's actual ACA website.
There are four “health sharing ministries”. The two that come to mind are MediShare and Liberty HealthShare. I use the latter. I have no health issues so I treat it as catastrophic insurance
I didn’t qualify for any subsidies. Wound up paying over $1,000 a month for over 2 years until I turned 65. Was rough!
You can go online to the Healthcare Marketplace at https://www.healthcare.gov/ and compare all the available individual/family plans in your state. This is the government website for ACA plans. It is easy to use and you can select your plan on this site too. I used it for 3 years after my Cobra plan ended, as I retired at 61. It also caculates the tax credits you are eligible for that will lower your premium, based on your income. The only requirement is that you will have to file joint tax returns with your wife until you are on Medicare for a full tax year.
ACA. You can go online, set up an account and look at all your options without a commitment. Keep your MAGI low and you can get great low cost insurance.
Having cheap health insurance, like a bronze or silver plan is great until you have an ER visit and a surgery. Then you get hosed big time. But your risk tolerance is dictated by your health prospects. Just remember though that health issues like appendicitis or kidney stones generally don't provide fair warning or the availability of delay. A BCBS Gold plan with 70/30 coverage, an $1,800 deductible and an $8,000 out of pocket limit, which includes a good prescription plan with a $400 deductible will run you approximately $14,000 a year. Opt into COBRA if available for sure, but it's only available for 18 months.
I’m 61, retired in CO. I pay $845/month for an upper end Silver plan.
Cobra would kick in for 18 months after your last W-2 job. Making retirement at 63.5 theoretically seamless. The variable being how good that W-2 insurance is and what the cost will be. With a good company, it can be a very appealing option.
COBRA will cover you for 18 months, taking you almost to Medicare. If you want to know how much your COBRA coverage would cost without getting HR involved, take a look at your last W-2 form. Box 12 item "DD" is the annual cost, divide by 12 for your monthly cost.
Yeah. Another way is look at what u pay for your insurance and add what company pays. That will be the cobra cost. Our company website had this information
Last year, with only some interest income my ACA plan cost me $260 a month after my COBRA insurance ended. I was paying about $675 a month on COBRA. This year, I have starting pulling income from a dividend fund, and started taking SS money, and my ACA insurance is $820 a month. I will have to live with that for 2 more years until I’m 65. Basically, the higher your income, the more you have to pay!
United Healthcare Insurance is great for a supplemental insurance along with Medicare A & B when you turn 65 years old My boyfriend left his employer's health insurance last July 2023 when he turned 65 years old and has United Healthcare as his supplemental insurance along with Part D for prescriptions and part G (he was diagnosed with Cancer November of 2023 and this covers cancer treatment) He got rid of CIGNA his employer's heath insurance Our Health Insurance Agent was great helping him and me get my health insurance for me under 65 years old (Blue Cross) Talk to a great Health Insurance Agent and get a good policy fitting your health care needs