Actually, traditional Medicare does have a “network” – providers who accept traditional Medicare. Fortunately for those on traditional Medicare, it is still very large, since 72% of primary care physicians accept new patients with traditional Medicare, and an additional 21% accept Medicare for existing patients.
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I agree if one is fairly healthy and wanting to travel and have good options in many states with providers in network, going on the Medicare under traditional plan B choice (Medigap) and plan D drug choice - the drug choice as plan D and the part B plan can be changed by participant from year to year (on the drug plan, you look up your drugs and decide on the best plan by cost or whatever other factors are important to you during open enrollment) but depending on your health you may have to pay a premium on it for part B changes, versus having a guaranteed right to buy during open enrollment and if you have a guaranteed issue right - the ‘best’ decision when you are initially eligible is important IMHO. Licensed in your state. If you plan a trip out of the country, can purchase the foreign travel insurance for out of country emergency - they have it with Blue Cross and I am sure there are others obtainable through independent insurance agency. If you stay in the same plan B from year to year you pay the rate they have for everyone in your age category (for example the BCBS Medigap policy we are looking at, in AL we are looking at C Plus Plan G has age 65, age 66-69, and age 70 and above for monthly premium with the Medigap). It seems can every year during open enrollment you can go on the Medicare advantage plan of choice but not go back into Medigap (this is directly out of the government info: “You may be able to buy a Medigap policy at other times, but the insurance company can deny you a Medigap policy based on your health. Also, in some cases it may be illegal for the insurance company to sell you a Medigap policy (like if you already have Medicaid or a Medicare Advantage Plan)” There are rules for coverage in 3 states (Mass, MN, and WI). Also Medigap for People with a Disability or ESRD (end stage renal disease). Some people are on Medicare that are under age 65 - rules for them.
The gov’t document has a separate heading “Why is it important to buy a Medigap policy when I’m first eligible?”
Medicare Advantage is also known as Medicare Part C.
It is annoying that BCBS of AL has its Medigap Policies called C Plus.
Way too much confusion for anyone wanting to be sure they really understand it all.
I think once one is not really traveling anymore and pretty much going to be staying put, a Medicare Advantage Plan with a lot of local services can be very cost effective for the participant with a big number of services, no copays.
However reading again it doesn’t sound like one can go from “Original Medicare” to Advantage plan - but as time goes on or maybe different from state to state or rule changes.
Who knows on the future - just jumping in with the health insurance coverage we are comfortable with to start.
A Medicare Advantage Plan can be with or w/o drug coverage.
On Social Security, I crunched the numbers as our ‘full retirement’ with year of birth 1956 (for both of us) is 66 years and 4 month. The penalty cost for taking out SS early is “a benefit is reduced 5/9 of one percent for each month before normal retirement age, up to 36 months. If the number of months exceeds 36, then the benefit is further reduced 5/12 of one percent per month.” So we are going to have H wait until full SS retirement age for full benefit. I have to check my understanding of taking out under my SS and then later taking out as spouse benefit. I am looking to wait until 65 and 4 months, and then switching to spouse benefit with his change goes into effect if my rate goes up to what I think it will.
“CLEAR AS MUD”
@pbcparent There are many threads on Bogleheads about people retiring early and trying to manager their MAGI to qualify for subsidies.
@bloomfield88 ah, yes, my parents did the same thing, I think three times, watched and waited and listed as or after the market turned. I guess they’d be about ready to paint the house gray now 
When we had ACA insurnance we had a PPO and could pretty much use any Dr anywhere even OOS. I think if you have ACA that’s an HMO type that is where you will run into problems if you’re out of town.
We currently were able to get on a group plan through an LLC business I own with a family member. That qualified us as a group and we were able to get fantastic PPO BCBS coverage. We have any number of plans to choose from but we purposefully chose an HSA with a higher deductible but no copay. We did the analysis based off of a different plan we had last year where I had a lower deductible, higher premium and 20% copay. So, I had to pay 20% after meeting my deductible up to my out of pocket max which I hit. This year our premium is $1,000/mo less for my husband and me, the deductible is what our out of pocket max was last year so the big cost savings is in the premium and not having to pay that 20% out of pocket. Even if we hit the out of pocket max we save on the premium. If we don’t hit it we save overall. The HSA is a nice perk as well because we take money out of it and my husband can put the extra $1,000 in his. I don’t know what happens when he turns 65 in a few years with medicare and out group policy as far as whether I need to keep him on it or just get the medicare B (or whatever it is) but I’m hoping then I won’t have to worry about that part with him because the cost of insurance is really the one thing it would be nice to never have to worry about.
What state are you in, that allowed you to purchase an ACA insurance with OOS providers?
Also, in the case of LLC, if you are the owner and your spouse an employee of the LLC does that qualify as a group?
Illinois
As for the LLC mu husband doesn’t work for it nor is he an owner but no it cannot be a married couple. It would be great if it could be. But if you had someone else you should look into it. My family member has a small non equity share of the LLC so it works perfectly. My LLC is in a different state so our plan is through that state. I have a Corp as well but there were other issues with that which even though the insurance would’ve been way less we couldn’t get a group policy on it due to it being a Corp and not meeting other criteria.
We had the aca plan maybe 5 years ago so it’s been awhile already and maybe things are different now with the OOS coverages.
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No, it is not that simple, which means you’re proving my point.
First They Faced the Virus. Now Come the Medical Bills. - The New York Times (nytimes.com)
“Today, only 17% of private-sector workers have access to one, according to the Bureau of Labor Statistics’ [2018 National Compensation Survey]”(ECI Home : U.S. Bureau of Labor Statistics).1
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You cannot purchase an Exchange plan with network providers nationwide in CT. You can purchase a PPO with a plan design that pays a small amount for out-of-network providers, but in addition to lower level of reimbursement (ranging from 50% to 70% after a deductible that is twice the in-network deductible), the 50 or 70% reimbursement is using R&C or the carrier’s allowed rates. OON providers are not contractually obligated to accept the carrier’s allowed rates, so the member is responsible for the difference between the charged and allowable + the 30 or 50% coinsurance, after the separate OON deductible. Also, amounts credited toward in-network deductible or coinsurance limit do not credit toward OON limits, but this is true of employer plans also.
It is best to consider ACA plans as in-network only as one will incur significant bills OON.
Editing to say that the plan details described above are for Marketplace plans offered in CT. These plans vary tremendously by state.
I don’t recall the details, but there are age brackets and each family member is rated based on age, and the entire family is rated based on location.
The premium tax credits have all been changed for the remainder of this year and 2022, so it is not possible at this moment to see what the true effect of each additional member would be in a regular year. At the moment, premium cost is limited to 8.5% of MAGI for the second lowest cost Silver plan. That amount can be used to purchase a Gold or Bronze plan. The income caps have been removed until the end of 2022.
Simple answer: yes, there are family plans. The family deductible and OOP are twice the single levels.
I just don’t understand how people can afford to retire “early” before Medicare kicks in. That is our major, major issue. Both of us are in fairly decent general health but DH has had (successfully treated) stage 2 cancer and I am in watch status for another form of cancer with expensive diagnostic screenings. We are 57 and 56. My employer spends 27K for our joint policy (my employer insurance is better than his so we use mine). It’s a BCBS EPO (we had a PPO but it was much more expensive so we switched).
The Medicare thread was valuable to me because I know that you need to apply for Medicare when you’re 65 or face penalties, regardless of your employment or insurance status. But I know we will need to get supplemental insurance and the Medicare Advantage plans are in-network only, so you have to be local and not plan on any move. This is a problem because we don’t really know where we will end up post-retirement. The plan is to move to MA or NH to be close to our daughter and her family. But we don’t know exactly where. I understand that if you choose Medicare Advantage from the get-go, it is hard to transfer geographically. So I guess we will choose a more expensive traditional Medicare supplement that is geographically portable. Neither one of our employers offers a retirement healthcare subsidy so we’ll be paying for it. This cost figures into our planning.
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@NJSue, at this time,
Medicare has open seasons and you can change into or out of advantage plans annually. Also, if you relocate and lose your plan d/t geographical restrictions, that is considered a life event and you can select a new plan that works in your new location.
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How can people afford to retire before Medicare? They have enough savings to afford to buy private health insurance during those years. It’s not cheap, but it’s doable for some.
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Well yes, rich people can do rich people things. We can’t. No bitterness. We are probably in the 95th income percentile in the US but the cost of healthcare is still a major issue for us.
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I retired at 60 from a federal job I held for over 20 years and that allowed me to continue the insurance at the same lower rate. There is a way I believe if you work for 5 years in the federal government starting at age 57 or older to also carry it at a lower rate, unless that has changed recently. Otherwise I would have worked until COBRA began (63.5) and then medicare began (65).
Some state and local governments offer plans that are similar. It was the main reason I stuck it out. That said, I was rooting for a national plan that could be portable for all, including my kids.
I have no idea why, but our internal medicine doctor’s office this year stated that they stopped billing medicare advantage.
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Thanks for the info re Medicare Advantage. It works for some, but the devil is in the details and is worth looking at. Both DH and I work in private sector so we will not be getting access to any government plans.
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I retired earlier this year at age 63 1/2. The company I retired from offers a retiree health care benefit. I pay just over $400/month for BCBS coverage for us. This is offered for employees with 10 years of service age 55+.
I don’t know how many other private companies offer a similar benefit, I suspect some do, but not most.
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One person I know had a health savings account for a number of years. She contributed to it, but so did her employer. She had enough money in it to pay for health insurance for a while before she was Medicare eligible.
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HSAs are great. We are trying to amass enough to self fund caregiving later in life but it could definitely be used if H decides to retire early. We max out what we can contribute every year and there is an employer contribution.
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