[villagesglfr1]

Hello

I am 58, self pay for health insurance, open enrollment has started today and am looking for affordable health insurance for 2020. Above the subsidy limits and finding very expensive premiums and deductibles. Anyone else having the same issues and know of options ?

Thank you

[DAVES]

I'm not sure what affordable means. Our experience, like you we retired before age 65 so were not eligible for Medicare. Unlike you,
we had only one year till reaching 65.
For two of us the cost, four years ago was roughly 22,000. Due to a preexisting condition they refused to sell us a catastrophic type policy. Truth our medical bills had never been 22,000, policy cost. I tried to convince my wife that we should simply self insure.
Fortunately she won and we shelled out for the insurance.
I spent a week in the Villages Hospital. The bill was 50,000-that is what you would pay if you self insured. The insurance company
Aetna who no longer insures in Florida settled the bill in full for under 30,000.
You might consider taking a job that offers insurance till you reach 65. Even then, medicare is not free.

[Kenswing]

Interested in seeing more replies as we'll also have 5 years of having to purchase private insurance until we reach Medicare age..

[Marathon Man]

I used ACA for three years, but then my income went above the limit and that was out. I bought a policy from UHC for a year. It was pretty affordable and offered some bare bones coverage - all that I needed. This year, the cost of that policy went up, so I decided to increase risk and self-pay (along with an inexpensive hospitalization plan from UHC). So far, so good.

So, check with UHC. You might find something there.

[retiredguy123]

Originally Posted by DAVES

I'm not sure what affordable means. Our experience, like you we retired before age 65 so were not eligible for Medicare. Unlike you,
we had only one year till reaching 65.
For two of us the cost, four years ago was roughly 22,000. Due to a preexisting condition they refused to sell us a catastrophic type policy. Truth our medical bills had never been 22,000, policy cost. I tried to convince my wife that we should simply self insure.
Fortunately she won and we shelled out for the insurance.
I spent a week in the Villages Hospital. The bill was 50,000-that is what you would pay if you self insured. The insurance company
Aetna who no longer insures in Florida settled the bill in full for under 30,000.
You might consider taking a job that offers insurance till you reach 65. Even then, medicare is not free.

I'm confused. The healthcare.gov website says:

"No insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had before your coverage started."

As far as I know, this part of the ACA law is still in effect.

[bagboy]

Three years ago in Florida, the only option for non employer health insurance was The Affordable Care Act. If UHC offers non medicare insurance, it's news to me. Self insurance is extremely risky. As far as I know for the upcoming year, Florida Blue is still the only under 65 insurance option, through the ACA. If I'm wrong, please let me know of the other options.

[thelegges]

Originally Posted by retiredguy123

I'm confused. The healthcare.gov website says:

"No insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had before your coverage started."

As far as I know, this part of the ACA law is still in effect.

It’s a nice thought, but if you are in treatment of any kind, your application gets lost in the mail, so to speak. It’s in print no reject, but the fine lines are blurry

[Taltarzac725]

I have Florida Blue and it seems reasonable. Our household makes too much money for the Affordable Care Act to kick in.

[sail33or]

Florida Blue (which has a large office near The Villages) has several policies for under 65 folks. But it will cost you between $950 - $1,200 per month per person. ($3,000 deductible).

[tophcfa]

Originally Posted by sail33or

Florida Blue (which has a large office near The Villages) has several policies for under 65 folks. But it will cost you between $950 - $1,200 per month per person. ($3,000 deductible).

We insure privately through Blue Cross and Blue Shield of Massachusetts and the rates are regulated by the ACA, regardless of weather one qualifies for subsidies based on adjusted gross income. Unfortunately, someone has to pay for all the people who get free or subsidized insurance through the ACA, and that burden falls on the backs of people who buy private insurance and don't qualify for subsidizes. Before the ACA our insurance was $375 per month per person for a very good low deductible plan. That same plan, which now has an increased deductible and higher maximum out of pocket limit, now costs $1,250 per month per person thanks to the ACA. Several other plans are also offered with lower premiums but higher co-pays, deductibles and maximum out of pocket limits. The plans are all priced very efficiently so that if one requires any expensive health care, the amount they end up spending comes out almost exactly the same once you add up the premiums, co-pays, deductibles and cost sharing up to the max out of pocket. The only way I have figured out how to save money on health care is to buy the cheapest high deductible plan and try as hard as possible to stay healthy and avoid needing health care, knowing we have insurance available for catistrophic events.

As much as I hate the ACA, I count my blessings that the proposed fix to the ACA, under the current administration, was not able to pass legislation. Part of that fix would have eliminated the cap on risk adjusting the premiums of people between 55 and 65 years old resulting in more huge premium increases for seniors waiting to become eligable for Medicare.

I wish I had a better answer for the OP, but private health insurance for seniors not yet 65 is a major burden and is by far our biggest expense. I am in no hurry to get older, but at least there will be a good reason to celebrate turning 65 (assuming Medicare has not been gutted by then)?

[Marathon Man]

Originally Posted by tophcfa

We insure privately through Blue Cross and Blue Shield of Massachusetts and the rates are regulated by the ACA, regardless of weather one qualifies for subsidies based on adjusted gross income. Unfortunately, someone has to pay for all the people who get free or subsidized insurance through the ACA, and that burden falls on the backs of people who buy private insurance and don't qualify for subsidizes. Before the ACA our insurance was $375 per month per person for a very good low deductible plan. That same plan, which now has an increased deductible and higher maximum out of pocket limit, now costs $1,250 per month per person thanks to the ACA. Several other plans are also offered with lower premiums but higher co-pays, deductibles and maximum out of pocket limits. The plans are all priced very efficiently so that if one requires any expensive health care, the amount they end up spending comes out almost exactly the same once you add up the premiums, co-pays, deductibles and cost sharing up to the max out of pocket. The only way I have figured out how to save money on health care is to buy the cheapest high deductible plan and try as hard as possible to stay healthy and avoid needing health care, knowing we have insurance available for catistrophic events.

As much as I hate the ACA, I count my blessings that the proposed fix to the ACA, under the current administration, was not able to pass legislation. Part of that fix would have eliminated the cap on risk adjusting the premiums of people between 55 and 65 years old resulting in more huge premium increases for seniors waiting to become eligable for Medicare.

I wish I had a better answer for the OP, but private health insurance for seniors not yet 65 is a major burden and is by far our biggest expense. I am in no hurry to get older, but at least there will be a good reason to celebrate turning 65 (assuming Medicare has not been gutted by then)?

If you don't go through ACA, you have many more options to choose from, and can get the price down by taking on more risk. For example, UHC offered me a six month policy with no existing condition coverage. The risk, of course, is that if a condition developes it is only covered until the end of the current six month policy.

[Debbien167]

I too am looking for something go more affordable than what I have. But after seeing the above premiums, I think I’ll stay with what I have.
I’ve had private insurance through Cigna for a few yrs. Since turning 60 (2 yrs ago) I notice my premium drastically going up every year.
Just got my notice for 2020 and it jumped from $666. per month to $796!! ($130 per month increase) with a 5K deductible.
I also checked on Healthcare.gov to apply and am out of the range to qualify.