Health Insurance for those under 65
 

Moving in a few weeks to my new home in TV from another state. I am under 65, so too young to qualify for Medicare. My earnings last year exceeded the cap for Obamacare. I will need to get insurance through the Florida exchange. Is this something I should try to navigate on my own through Florida’s healthcare website, or are their brokers I could go to help me choose a plan. I don’t even have a doctor yet in Florida, and need to make sure that the eventual plan I get will be honored by my primary care provider as well as a few specialists (dermatologist and cardiologist) I will see a few times a year.

I would contact SHINE and see if they can help you. They offer free, unbiased advice.

SHINE - Home

Ouch, get ready for some serious financial pain (I share your pain). Unfortunately, somebody has to pay for all the people getting free and highly subsidized insurance. I’m not in any hurry to get older, with the exception that I am highly anticipating becoming eligible for Medicare.

You’re right - in a bizarre sort of way I’m looking forward to turning 65 to become Medicare eligible (still 4 years off). I retired at 59, and my former employer reimburses me each month for a good chunk of my medical premium, so that helps, but I have to find my own coverage on the open market.

Also moving to the Village of Richmond and under Medicare age. Hi neighbor.

Unable to help with the question of where to source plans but can share our experience over the last 3-months.

We were rejected by the Villages Healthcare System because the few primary care doctors that accept non-Medicare patients have a full patient load. We pleaded our case to a “Villages Healthcare Coordinator” but only qualified for one primary care doctor who eventually rejected us anyway because he does not treat patents under age 60.

Exploring in a 5 mile radius outside VHS, we found a few primary care practices that accept new non-medicare patients and we are on a 6-month first appointment waitlist. Until then, we will drive to Lady Lake or use the Urgent Care in Wildwood. For specialty docs, same issues so we will drive outside the 5 mile radius to Lady Lake or Clermont (2 and 3 month waitlists)

We were advised by helpful local sources that United Health is widely accepted but, as luck would have it, one of our preferred docs rejected same. Blue Cross/Shield PPO plans are more costly (for us) but appear to provide greater access to local primary care and specialty doctors accepting non-medicare patients.

Best of luck in your search. I hope you find excellent healthcare.

Also a Michael, age 61!

Luckily the company I retired from supplies insurance at $145 a month. I retired at 56, turning 59 soon so I have a few years before I need to worry about it. Good luck finding something.

1. There's no such thing as "Villages Healthcare System." There is The Villages Health, which is a large group with several locations in The Villages and includes GPs, Internal Medicine doctors, specialists, PAs, their own lab and x-ray machines, and access to other specialists at The Villages Regional Hospital.

2. I just did a quick search on their website and see that Dr. Hugo Boise is welcoming new patients with individual insurance plans.

You can probably also call them directly, since sometimes those websites aren't 100% accurate or up to date.

My wife and I are in the same boat (60 and 63 years old). We logged into healthcare.gov and we eligible for 11 pages of various plans. Thankfully, we were referred to Robert Buckmann with Mid-Florida Agencies. He asked questions about our particular needs and quickly narrowed it down to two plans. You can Google both Robert Buckmann and Mid-Florida Agencies to read what others have to say about them. His number is: (352) 630-9996. He’s only taking referrals now during open enrollment so feel free to use our names (Jerry & Carol Hambley) as an introduction. Good luck!

If he's not available you can ask for Leonel Barron - he just helped me figure out which of the Florida Blue options were best for us. Turns out we've been paying WAY too much for a Silver plan that doesn't cover as much as a cheapo Bronze plan covers. That's on the exchange with our tax credit, based on our income.

Thank you for these referrals - I’ll be transitioning between Colorado and Florida for the next several months, so hanging onto my Colorado coverage until March or so - but want to get the ball rolling now (finding both coverage as as well as a doctor) - Since moving is a life-altering event, I’ll be able to switch out my insurance to Florida when the time comes.

Obamacare eligibility is based upon next year's projected income. Thus looking for insurance for 2023 you project your income for 2023. The risk is if you go over your projection you will owe a penalty. The benefit is based upon "earned income". You should read the definition of earned income in the Obamacare rules. There are ways to limit your next year's income. For example if you are planning on drawing from a retirement account next year consider drawing it out this year. Compare Obamacare benefit to what extra tax will be this year Vs next year which you are going to pay on it anyways but perhaps in a different tax bracket.

Unfortunately, what is considered earned income is not limited to wages and drawing from a taxable retirement account. It also includes interest (including interest from tax exempt municipal bonds), dividends, and realized capital gains (which can be offset by only $3 K in realized capital losses for a couple filing jointly). So as usual, responsible people who saved their money for retirement are penalized by the Obamacare definition of earned income. Many under 65 retirees now have a new dilemma, they should be happy that they can finally earn some interest on their savings, but then learn that the increased interest will be more than offset by the loss of Obamacare tax credits
because the increased interest puts them over the eligibility cap.

Regarding looking for a primary care physician, I don't claim to be better than google. But over time, I have created a list of primary care groups in this area. Maybe this will help a little.

If under 65, you pretty much need to buy a plan listed on Healthcare.gov, which lists the ACA plans, meaning no preexisting conditions and the like. You can buy them off the exchange, but might as well buy them on the exchange in case you qualify for a subsidy. Income limit for subsidy was pretty high lately due to Covid. A broker can help you and will not affect your cost. Expect to pay a high premium (due to age) with an extremely high deductible.

You also have the option of a non-obamacare compliant plan for catastrophic coverage at a lower cost.