My older brother finessed this by retiring abroad. I have that option, through a somewhat different path, and it may turn out to be a good idea (not really comfortable saying more here). My big healthcare expenses so far have not been mine but connected to one of my kids, and I’m sure the insurance companies just “love” us. I don’t even try to think what it would cost out of pocket. It’s also a big benefit to be able to keep the kids on insurance till they’re 26, but again, I am just not sure I want to work that long. (First world problems here. I am doing very well thank you.)
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I am very intrigued by this. Your COBRA plan should be the same as the company plan, and the rate you pay for it should be no more than 102% of the amount the company pays for the coverage.
Oh, I just realized that your company may offer a retiree medical option, and that its rates would reflect the retiree risk pool.
When switching from COBRA to the HDHP, keep in mind that charges incurred toward the deductible and OOP while on the COBRA plan will not apply toward your new plan, so schedule known medical expenses accordingly. Or enroll in the HDHP during open enrollment for Jan 1, 2023.
The American Rescue Plan that was announced in March eliminated the subsidy cliff of ACA plans for the remainder of this year and all of next year. It resets for 2023, as of today.
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As long as “rich people things” does not include buying health insurance that matches good employer-provided insurance. In many states, even the best ACA insurance has limited provider network (no OOS providers) compared to good employer-provided insurance. So it doesn’t matter how rich you are, unless of course you are so rich that you don’t even need insurance.
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Many employer medical insurance plans have limited out-of-state/area coverage or provider networks as well.
My husband’s company would have done this…but since he is Medicare age, he is on Medicare which is less costly than his coat share for his employer insurance.
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True, but that’s why I said good employer-provided insurance.
That’s all true, but there is something else you are missing: In the absence of negotiated rates you will be paying LIST PRICE, which is often an arbitrary large number 3x or more higher than the NEGOTIATED PRICE that insurance companies pay for the same service.
I got bit by this once when my insurance company declined to pay for a test because it is experimental. You may think, if the insurance company doesn’t pay then you can just pay what the insurance would have paid if they covered it, but no, when you pay, you pay LIST PRICE, because there is no negotiated price. I was charged 3x what insurance companies typically pay for the test. The most the lab would do is to put me on a payment plan. How nice!
Even with ACA healthcare in this country is really messed up. I am hoping they will lower medicare age to 55.
Actually, I did not miss that part when I said this:
“the member is responsible for the difference between the charged and allowable + the 30 or 50% coinsurance, after the separate OON deductible.”
The charged amount, the rack rate, if you will, can be three times the negotiated rate, or even an higher multiple for lab and X-ray, and of course, any hospital-based service.
What I said above is the member is responsible for his OON coinsurance, often 30-50% plus the difference between the charged and the allowable. Further, these higher amounts do NOT accumulate toward the OON out-of-pocket limit. So if an insured thought he would go OON because he wanted a specific provider for an expensive surgery or cancer treatment and he would just pay up to the OON out-of-pocket limit, that is not the case. The financial obligation could be far in excess of the OOP limit.
Unfortunately in your case with the experimental test, anything you paid wouldn’t accumulate toward the OOP either AND you are paying the full rack rate. Sadly this is true with employer plans and ACA plans, and I agree that something needs to change, but I don’t have a solution.
And the sad part is if you had gone to the lab and said you didn’t have any insurance prior to the test, you could have paid the cash rate which is often even significantly lower than the negotiated rate. But once you say you have insurance, that option goes out the window. H got bit by that when he went to Lab Care for some blood work. Difference between $18 and $165. We have such a high deductible ($5000 per person) and use insurance so little that it’s often better for us to go that route.
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“Has anyone ever managed to work out a partial retirement deal where you can cut hours and pay but hold onto full health coverage?” - I worked for a large corporation that offered two ways to do this (part time employee, I think with some health insurance co-pay at lower hours OR more of a short term pre-retirement gig).
I had considered part time in my last year of work, when older hubby was already retired. But my job would have been hard to that way, and I realized I’d likely get paid less but still work a lot. So I vowed, with some success, to stick to 40 hour weeks without the usual unpaid overtime. Working from home a lot (and 100% during Covid) made it not so bad.
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You mean “get paid for part time with the same workload” plan? 
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We are hoping that my husband will be able to do this. He only has to work half time to keep his health insurance and vacation and sick leave benefits. We are planning for him to fully retire in March if his employer says “no” when he proposes a switch to half time employment (which he be able to do seasonally), but he thinks they will go for it because his employer could get someone half my DH’s age for (literally) half the salary. Working in his favor is the fact that his department is on a very tight budget and desperately need someone with a slightly different skill set. They will not make him retire or reorganize him out of a job, so as long as they think the alternative to him cutting back to half time is to continue full time for another 5 years, they may seize the opportunity. Fingers crossed.
I think if you can figure out a way that your transition to half time is a benefit to the employer, they would consider it.
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Congrats busdriver11. I hope you enjoy it as much as I have so far.
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Take a look at whichever “nationwide” plan is cheaper. For feds you get a rebate or something.
You are correct, CT1417. Our Cobra is likely the same amount for all employees, no matter what plan they are on. Fortunately we’re on one that is very good, which we can keep for $680/ person per month. When we switch to retiree healthcare, it’s based upon our union negotiated rates, and they haven’t renegotiated it since 1993, so our company pays $4813/yr per person, no matter what the cost of health care is. High deductible plan would end up being $612/ month, High coverage plan $1080. Of course, who knows what it would increase to!
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Working at a hospital, I have been able to reduce my hours while maintaining benefits prior to retirement. I don’t see many doing this beside me, but I find it ideal. Though the work is still stressful and harder on the back every year.
If someone really wanted to do this, there are CNA and other jobs that could potentially be part time, if you were willing to put up with hospital shift scheduling. Every hospital system does this differently.
The school district staff in my area, as well as university employees save sick time and are able to turn that into health insurance in retirement, sometimes lasting for a few years. Most of my friends who worked in education retired well before 65.
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@petilon Our country cannot AFFORD to drop Medicare from 65 to lower. And IMHO SS will not change by much either. There are some cost of living increases with SS but that will reach the point of perhaps cuts in SS in future years. The ‘big’ most recent ‘cut’ was having people after being born in a certain year to work beyond age 65 to qualify for ‘full SS’ - H and I born in 1956 need to wait until 66 and 4 months to draw full SS.
Already our country is speeding itself deeper and deeper into what the next generations have with national debt. Scary.
France has many national union people with maybe age 60 retirement, and that has been somewhat the ‘standard’ retirement age in France. They may not have as long average life span as US, IDK. There have been times over the past where some municipal workers that had a lower retirement (maybe pension at age 60? and it got moved back to maybe age 62 by Macron’s leadership) - I will say for example it was metro/RR workers - and they were on strike etc to not have the change to add years before retirement/pension – which was very disruptive to France at the time. France is in worse financial shape overall than the US, but who knows on how US Federal spending that has been going on and if our economy will continue to be as strong as it has been despite Covid (and not to say many sectors and many people have not had job losses and business losses from Covid). Being forced out of work and out of a job (especially over a certain age) is a terrible thing whatever the circumstances.
There are people on this thread that either work for Federal or other entities that have retiree health insurance rates. H and I don’t. COBRA when H retired (before both he and I were 65)would have cost us out of pocket over $1K/month for the two of us over what I now pay $157 every two weeks out of my paycheck (we both have very good coverage Blue Cross Blue Shield) as I work enough hours to qualify for health insurance with my health care employer group. Over the 10 months coverage that is $10K in savings; H also stopped working 10 months earlier than ‘the plan’ for both of us to retire together when we both can be on Medicare (so work some of Sept as we can both be on Medicare Oct 2021). Good thing I did not ‘retire early’ and draw SS at age 63 - health care company offered me a job with less responsibilities and therefore a more pleasant job for me/less stress – so I can save H and I money now with the health insurance.
I am ready for ending my job and on the count down. My sister was the same way with her job - she was able to retire before age 65 and pay through her school system for her insurance, but her H is 16 years older than she is and he was long retired.
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Life expectancy in France (82.5 at birth, 25.3 at age 60) is higher than in the US (78.5 at birth, 23.1 at age 60).
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Or is it more like our country cannot afford medical care, whether individually (self-pay medical care or self-purchased medical insurance), collectively (government programs like Medicare), or through businesses (employer provided medical insurance that is a large extra cost to hiring someone)?
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@ucbalumnus France may have lower birth rates than US or other aspects of shrinking population and shrinking taxpayers. IDK. But in part maybe these lower retirement ages had been set so many years ago when everyone did have lower life expectancy.
Covid has changes life expectancies now too.