Health insurance for "gap" before Medicare
 

Any recommendations for insurance plans age 60 - 65? I just want basic emergency room, hospital. I'm in good health so would pay out of pocket for office visit if I need to go in.

Thanks!

Wow. Good luck. You also need insurance for surgery, treatment, and drugs. The hospital will only keep you for a few days and then release you.

I was in this predicament starting at age 52 when I retired from employment supplying me with health insurance. I found a Blue Cross high deductible policy. Initially the premiums weren't bad but they got higher every year. Today I would maybe opt for a $10,000 deductible. Fortunately I never had to use the policy. I was relieved when I hit 65 and got on Medicare with AARP supplemental policies.

My stepson uses Florida Blue which has a lot of plans, they may have something that would work for you. Also I have seen ads on television for this type of coverage, but i have not paid attention to these so I do not recall any details except it was a very low or 0$ deductible.....

Thank you so much for this info!!

I will check them out, thanks!!

You might be looking for "hospital indemnity insurance." You have to submit the claim, and rather than the company paying the hospital, they cut a check to you. And you're still on the hook for the hospital bill(s).

There's also critical illness insurance.

These are intended to be supplemental plans, on top of normal health insurance (non-Medicare). But it might be less expensive to just get a normal health insurance plan, that covers more, with high deductibles and co-pays.

Being "in good health" doesn't mean a darned thing. You could be in good health and discover that you have skin cancer, which can be VERY expensive to treat, and is /not/ an emergency that a hospital insurance plan would cover. Out of pocket consultation, biopsies, diagnosis, surgery, further testing to make sure they got it all, antibiotics and ointments, follow-up visits to remove the stitches, can cost upward to around $8000. And that's for just ONE malignant melanoma spot. Then you have to go back every few months because once you get one, you're at a much higher risk for more. Now, you're out $8000, and you start limping, and go to the doctor to find out why. Boom. Severe arthritis that you've been ignoring for years, has just informed you that you need a hip replacement. That's a $25,000 surgery, not at a hospital, not a critical illness, not an emergency, and not including the scans and MRIs and consultations, which will set you back another $5-10k without insurance.

If you're wealthy enough that you don't have to worry about mundane or other complex non-emergency medical expenses, then you probably can afford to not have hospital insurance. You're much more likely to need mundane non-emergency health care than you are to need emergency health care at your age.

healthcare.gov is the place. Go to the Florida Blue office about 1/4 mile behind CVS ( 466) on the left side in the strip mall. See Samantha Gump and she will enroll you.

Good luck is right!
 

From my 25 years in the health insurance industry, I know that this age range is the most expensive range from an underwriting standpoint. Claim experience during those ages is through the roof and, regardless of your personal health, insurance rates are set reflective of the collective claims for the entire group. That's why employer groups cringe as their employees enter their mid 50s and are moving toward not offering pre and post retirement insurance.

Personal hospital indemnity coverage may make you feel better initially, but hospitals and specialists may not accept the payment arrangements of the plan and may not apply the "contracted discounts" that other health insurers offer. Then, in a few years when the parts really start to wear out, insurance companys will consider you next to un-insurable and if you find one that will accept you, your premiums will rival paying off the national debt.

My advice is to contact a few trusted, reputable agencies (remember that these folks get paid commissions for selling specific policies - just the way the system works) and discuss your dilemma. I would find something to get you into the system and develop a plan going forward. HMOs are likely the most inexpensive options, but there are likely dozens of others. SHINE deals with Medicare eligible folks, but may be able to make suggestions to get you on your way too.

Healthcare.gov is obama care. You can get a decent policy with blue cross. BUT, the subsidy provided is tied to your income for the year. And that is income from both spouses. Do your research, many ins and outs. And you have to guess your income because it is calculated to future income in the next year. Totally a messed up system. But, it does help bridge the gap.

Look into health sharing plans like Medishare or Zion. Zion caps your out of pocket expense to $1,000 per incident. Like you, I am in good health and needed gap coverage from age 57 to 65. These plans worked great for both me and my wife. They are essentially catastrophic plans, but they are not insurance. I have a friend whose spouse developed serious cancer while covered by Zion and they paid the entire bill which was hundreds of thousands. The premium is about $300/month per person. Don't rush it, but you'll be 65 before you know it!

It means squat if you are in good shape or not. If you go out of your house, then anything can happen. I had a friend do some gardening and got bit by something and they almost had to amputate his leg. Do you play sports? I knew a guy who pitched and got hit by a line drive and had to get a specialist to rebuild his face. You can get bit by an animal, hit by a biker/golf cart, by a tennis racquet/pickleball paddle.
You are only in good shape until you aren’t, then it’s too late.
I never understood high deductible plans either, you are trying to save money but in the long run it could cost you more.

We have an ACA ( Obamacare ) plan thru Blue cross with really high deductible. We like it. Contact Samantha Gump at BCBS

I went with United Health Care. I chose an accident policy and a hospitalization policy for a reasonable price.

I am 57 and have had Florida Blue for 7 years. Higher deductible

I read most all of the responses here and agree with the OP's that said anything could happen. Don't take your good health for granted. Things can change over night---cancer, heart-attack, accidents etc. Years ago I was working, my health was pretty decent THEN I had a work-related back injury. It was treated for over a year. The dr. finally told me that I'd never be 100% and he was correct. I'm now (30+) years later still limited with what activities I can do. IF not for insurance---not sure what might have happened. About 14 yrs or so ago, I was diagnosed with an autoimmune disease that too is dibilitating and I wouldn't wish on anyone. You just never/ever know!!

You need price protection. Sign up for a plan that has a contracted network of providers. e.g. United, Blue Cross, Aetna, Obama Care - all the big companies. Our recent MRI experience was – list price was $1200 – contracted price was $250. Then pick your deductible. You need the price protection.

Good luck. I do not know what things are like now but when I was in this situation, I paid a fortune in premiums for health insurance which are tied to age. Even though I had a $10,000 deductible, they would not pay for urgent care and was limited to geographically limiting health care unless it was a dire emergency necessitating an ER or hospitalization. I could not wait to be 65 so I could get on medicare. Obamacare was a scam.

Believe it or not, the website healthcare.gov is extremely useful and easy to use. At one point; three of our four adult children used it to secure health insurance. Two still do (one independent consultant, one whose husband works for a small company that subsidizes their premiums rather than contrast with a single insurer). You can use it to shop and compare benefits and pricing. And then call companies individually if you want to. It’s a more unbiased view than you will get through a broker that is paid by the insurance companies. Also don’t overlook any professional organizations you do or could have belonged to as many offer some type of group insurance plans

When my kids were in graduate school, they aged out of my employer plan, and we got them insurance through Obamacare. The BCBS Gold plan with a separate dental plan was $770ish per month in NY for one child and $455 per month for the exact same plan for the other child in Texas. Not cheap, but the coverage is actually reasonable. The price spread between states seems excessive.

If you can cut your taxable income below the threshold get on Obamacare, eg healthcare.gov

"Obamacare" is a legislative act, not a health insurance plan. You picked the wrong plan, probably an HMO or a limited-network PPO or POS.

I'm on FloridaBlue PPO with a zero deductible plan, but it has a $9700 out of pocket max. I pay discounted fees and $85 co-pay for services OTHER than the main yearly checkup, labs, mammography, routine colonoscopy, pap smear. Once that total hits $9700, I'm done paying for anything other than the premium (which is paid for currently by rewards points because I participate in their rewards program).

So my $25,000 hip replacement - if I get nothing else done all year, will cost me $9700.

The network is limited, but if I'm out of state and still in the country, I have access to doctors that participate with Blue Cross/Blue Shield/Anthem nationwide.

Do not go without health insurance -- life can change in a second -- as a Manager in Benefits for a large company, I have seen healthy people suddenly faced with serious health issues.

I would recommend that you go to: Still need health insurance? | HealthCare.gov. The site will list health plans -- do not just look at the monthly premiums -- look at the deductibles, copays and other features of the plans when selecting a plan.

Florida resident? Go to Healthcare.gov where you will find the ACA (Obamcare) plans and their premiums. Many other states use it as well. You can get any plan on there without having to worry about any preexisting conditions. If you don't use this exchange, all bets on coverage are off and you can be denied anything. You are severely discriminated against due to your age alone - something you cannot control. There are very few choices, the main two are Florida Blue and Ambetter. I got the least expensive Florida Blue Select Bronze plan and the per month premium is over $800. The out of pocket max is $9K in network and $18K out of network. I think the deductible for nonpreventative services is over $6K. And almost no providers around here accept it. There is a look back on your past income of I believe two years. If you can arrange to keep your income low during these years, you may qualify for a subsidy if the subsidy is not discontinued. A full subsidy can reduce your premium to $0.

Wait until you get to Medicare at age 65 and you will need to select a plan you may be stuck with the rest of your life because preexisting conditions come back into play and you may need medical underwriting if you want to switch from an Advantage plan to a Medigap plan after the trial period. Good luck!

In my opinion, everyone should have comprehensive health insurance. You can save money with a high deductible, but limiting coverage is a bad idea.

We were in that same predicament this year. Check out healthcare.gov or healthsherpa.com. Gave us lots of options. Ended up with Florida Blue. You could also try an insurance broker

Obamacare plans can have high premiums with high out of pocket maximums. If your MAGI is low enough you might be able to get a subsidy for the premiums. You might want to consider a catastrophic plan for lower premiums. This was an option for me before going on Medicare. I found Janet Adam at Mid-Florida Agencies Florida Blue on CR101 just off of 466 to be very helpful when exploring my options.

I'm hoping to find anyone who reads this and has had issues with Aetna. I have an Aetna Medicare PPO plan in Central Florida. I made a purchase of an exercise machine mid-January 2024. The plan says I have up to $800 reimbursement for such equipment. I have been trying for SIX WEEKS to get the process done to get a check. SIX WEEKS and close to 30 message back and forth with Aetna online staffers. If I had to make a choice today I WOULD NOT EVER USE AETNA again. Nothing but every conceivable excuse and delay. Still at step ZERO, with no live person being accountable at Aetna.

DO NOT USE AETNA.

My Wife and I have used Medishare with great success. Many providers provide a discount because of membership. They do not cover pre-existing conditions so be aware of that. Share cost is very low compared to traditional insurance with similar deductible

Note that Medi-Share is not insurance and that the payment of medical bills is not guaranteed in any way.

I used a medi-share option before I got to age 65. It worked BETTER than medicare for those who believe.

I had to have cataract surgery on first eye under medi-share. Then two years later the other eye, under medicare. I had no out of pocket with the first. Was close to $500 out of pocket with medicare.
Also be forewarned: Allopurinol is a catalyst for cataracts. Documented, just search the web.

Medicare is only available to people who are over 65. I don't think that health insurance can be sold to people over 65, except for the Medicare supplement plans that the Government regulates. Because it is not insurance, Medi-Share is available to people over 65, and can be used as a secondary payment with Medicare being your primary health insurance provider.

Thank you everyone for this great information!

I'll be looking it all over very closely and it's a perfect way to start my education on all this!