ACA Plan until medicare? (supplement, 2015, states, relative)

[stagman]

Hi

My wife and I hope to retire soon. We will need health insurance until Medicare. Getting some confusing feedback on what level (bronze,silver,gold) to get. What are thoughts? thanks

[Gator Fan 79]

Retired 7 years ago and have 2 more until Medicare. Budgeted $1500/month for ACA and have averaged about $650/month in premiums. I chose one of the lower cost bronze plans with a very high deductible and it has really paid off. My out of pocket has been less than $500 since retirement. BTW, not too early to start thinking about Medicare. DW has a high deductible G supplement plan that cost $67/month. She can see any doctor that accepts Medicare without a referral.

[Sand&Salt]

Get a professional to help you wade through it. We found ours advertised in the local paper. We weren't sure what we could qualify for or afford, but ended up with a good plan that was way cheaper than we thought.

Sure was a lot simpler than Medicare, lol.

[TheShadow]

It will be different for different people. If you use healthcare a lot, due to chronic conditions, you might want a different plan with lower co-pays and lower deductibles. If you rarely see a provider except in extreme situations, you might be happier with a higher deductible, and higher co-pays, something more like catastrophic coverage only. Your financial situation could also bear on the decision. If you are on a more constrained budget, a high deductible could prove to be a problem, while a low out-of-pocket cap would be essential.

Even between family members, the choice might be different. My husband has 2 forms of cancer and 2 highly problematic issues (also related to different cancers) that must be tended to multiple times a year, so a low co-pay, and low O-O-P cap are important as he has a minimum of 9 office visits (amongst 4 Drs.) per year, and that's if he DOESN'T get sick all year. Other than cancer, he's as healthy as can be. He takes no meds, so prescription co-pays and coverage are a moot point for him. I usually have 2 visits annually with my PCP (required for prescription renewal), but I have multiple prescriptions I will be taking for life, so that's more important for me.

[TMSRetired]

I went on ACA until medicare.

If you are healthy and not on prescription meds then go with the bronze.
That's what I had for about 8 years...BCBS of Texas and then BCBS of South Carolina.
Since I was retired already the credit was pretty big since my income was much lower.
They only consider your taxable income...no assets.

[heySkippy]

I retired at the beginning of 2020 both at age 63 and we had ACA coverage for a couple years. Our income was very low those first couple years so we got a nice subsidy and it all worked out pretty well.

[StealthRabbit]

Depends on your health, and the state (options). State plans are widely different. So states are great (WA), some states have terrible coverage (texas)

Bronze is fine if you're relatively healthy and can cover co-pay / deductible.

Keep your income (MAGI) under the threshold.

Kaiser foundation has some helpful tools for healthcare planning.

[Dire Wolf]

One thing to be aware of that if your MAGI is low enough, you can fall into the CSR (cost sharing reduction) sweet spot where you get what’s called a Silver Enhanced plan. Effectively, you get a Platinum level plan for Silver level premiums, but you’ll also get a hefty subsidy. Your premiums, deductible, out of packet max, and copays are all relatively inexpensive.

The flip side of this is that the govt (under the last administration) quit reimbursing the actual CSRs, so the providers do what’s called Silver Loading, pricing the base silver plans higher to cover this. If you don’t get a sizable subsidy, it can make silver plans unattractive, so you may end up just wanting to spend a bit more and get gold since the gap is narrower. If you have no subsidy at all, you may want to see what your preferred insurance provider has “off market”. For instance, a silver plan that isn’t loaded.

[Wile E. Coyote]

A bit unrelated. But, a friend of mine recently turned 65 and was discussing signing up for Medicare. He started to rail on me about how my work plan I can take into retirement is really just a disguised Advantage plan. So, he told me what he was considering signing up for and I went home and took a look at it. I texted him to say that I would never sign up for anything where there is no out of pocket maximum. So, then he realized that was a key factor. So, he says he can afford $6,000 but, not $1 million.

Okay, some people Can afford $1 million...

I had a $100,000 year in 2015; but my out-of-pocket maximum was $5,000.

[recycled]

OP you left out an important piece of info. What is your age? Is ACA something you need for one or two years, or are you one of those who retire at a younger age and need a decade or more of ACA coverage?