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Author: TourDeFarce Big gold star, 5000 posts Top Recommended Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 5068  
Subject: Healthcare coverage Date: 11/30/2003 1:36 PM
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Just out of curiousity, for those either planning or retired early -- how are you addressing healthcare coverage (other than if you're a vet)?

I'm already hearing that folks who have reached "full retirement" from my company (but not yet 65) talk about the burdens of healthcare coverage. For some, they face a very dismal choice of continuing to buy insurance through the company at prices which skyrocket each year or trying to find coverage elsewhere - a particularly daunting task if you have any type of existing condition.

TDeF

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Author: warrl Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1446 of 5068
Subject: Re: Healthcare coverage Date: 11/30/2003 1:44 PM
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My approach will be to scrap the sort of doctor-bill prepayment plan that employers and the government pass off as "medical insurance", and instead buy some medical insurance. The sort of policy that covers only individually unpredictable events (not routine expenses) that are financially signifigant (high deductible). Kind of like what homeowner's, auto, or liability insurance covers.

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Author: TMFDj111 Big gold star, 5000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1447 of 5068
Subject: Re: Healthcare coverage Date: 11/30/2003 1:49 PM
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for those either planning or retired early -- how are you addressing healthcare coverage (other than if you're a vet)?

You might also want to post your question on TMF's Insurance - Life, Car, Home,etc. discussion board:
http://boards.fool.com/Messages.asp?bid=100156

TriCare (the military's HMO-like system) is widely acknowledged as being cheap, but it's also widely acknowledged as being a collection of poor system. If you're interested, you can get more information from this link:
http://www.tricare.osd.mil/Factsheets/viewfactsheet.cfm?id=175

The folks I know who are not confident that TriCare can meet their needs are looking at Blue Cross and Blue Shield. The problem with Blue Cross and Blue Shield is this organization is a trade association of participating companies. The menu of plans available to you depends on the companies doing business in your geographic area. You can get more information from this link:
http://www.bcbs.com/

David Jacobs
TMFDj111

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Author: SeattlePioneer Big funky green star, 20000 posts Top Favorite Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1448 of 5068
Subject: Re: Healthcare coverage Date: 11/30/2003 5:12 PM
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<<I'm already hearing that folks who have reached "full retirement" from my company (but not yet 65) talk about the burdens of healthcare coverage. For some, they face a very dismal choice of continuing to buy insurance through the company at prices which skyrocket each year or trying to find coverage elsewhere - a particularly daunting task if you have any type of existing condition.

TDeF
>>


Those who can buy insurance through their former companies are probably lucky people. They may well be able to get better insurance, and dental insurance than they can get at any price on the individual health insurance market.

If you can get a subsidy of any kind on top of that, you are doing very well. If they are complaining that it's expensive ---tough.

Yep --- it costs money and will cost more in the future. If you can't afford to retire early ---keep working. Early retirement is a luxury.



Seattle Pioneer

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Author: GoodHindSite Three stars, 500 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1450 of 5068
Subject: Re: Healthcare coverage Date: 11/30/2003 9:46 PM
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I don't have any preexisting conditions and I'm a healthy 37 y/o. I have my health insurance through Golden Rule insurance company. It's a $2500 deductible policy - 0% up to $2500, 100% after $2500 - for about $80 a month. The idea being that I really only need coverage for a large healthcare expense - I have no problem paying on a per issue basis.

As a general rule, I think company insurance policies are too liberal for me when taking into the consideration the cost. My cobra was about $275 a month for much better coverage, but it's coverage I'm unlikely to use. The other thing that I am now incented to do is look for cheaper generics or previous generation drugs (with similar therapeutic effects). Docs will always prescribe the "best" drug, but most of the time, its predecessor is good enough for about a tenth of the price.

As an off-topic note, I suspect healthcare costs are out of control because there is little incentive for individuals to manage their healthcare costs.

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Author: jrbill94 Big gold star, 5000 posts CAPS All Star Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1451 of 5068
Subject: Re: Healthcare coverage Date: 11/30/2003 11:36 PM
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As an off-topic note, I suspect healthcare costs are out of control because there is little incentive for individuals to manage their healthcare costs.


I agree. How friggin expensive would car insurance be if people expected the insurance company to foot the bill for every little oil change, tire change, brake job, etc. The cost would be obscene. Instead it is only there to protect against catastrophic loss. Health insurance is much cheaper if it is treated the same way.

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Author: warrl Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1452 of 5068
Subject: Re: Healthcare coverage Date: 12/1/2003 2:25 AM
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I don't have any preexisting conditions and I'm a healthy 37 y/o. I have my health insurance through Golden Rule insurance company. It's a $2500 deductible policy - 0% up to $2500, 100% after $2500 - for about $80 a month. The idea being that I really only need coverage for a large healthcare expense - I have no problem paying on a per issue basis.

As a general rule, I think company insurance policies are too liberal for me when taking into the consideration the cost. My cobra was about $275 a month for much better coverage, but it's coverage I'm unlikely to use.


Assuming that the cobra coverage was first-dollar coverage, and in all other regards is identical to your current coverage, your current coverage is better for medical expenses up to $2340 per year. Below that point, the catastrophic coverage is cheaper (by $2340, if you have no medical expenses). Above that point, the cobra coverage is cheaper (by $160, if your medical expenses are $2500 OR MORE - the savings never exceed $160).

Here's the fun part: the cobra coverage is pretty much identical to the coverage you had as an employee. So the same analysis would apply there.

Some employers have tried a hybrid plan: they in effect buy their employees a catastrophic policy, and then set aside cash annually for the deductibles - with the kicker that at the end of the year, half the unused deductible gets paid to the employee. Companies that have done this have typically enjoyed substantial savings as compared to buying conventional coverage. The employees tend to like it too - they have full coverage against high medical expenses, plus a chance at a bonus.

However the companies that have tried this are running into all sorts of hassles about what money will, or won't, be counted as part of the employee's wages (and therefore subject to WHAT TAXES), and when. In other words, the government is making this profitable and sensible approach as difficult as possible. So far the government has approved, at least on a trial basis, a couple ways for the company to allow THE EMPLOYEE to BUY FOR HIMSELF this sort of plan... which of course does nothing for companies in industries where employer-provided health insurance is the norm, and does little for companies in other industries because most of their employees are rather low-income and percieve that they can't afford the plan.

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Author: nukenick Two stars, 250 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1453 of 5068
Subject: Re: Healthcare coverage Date: 12/1/2003 1:48 PM
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First off in my opinion this is a terrific thread. I am still young and have a ways to FIE but I wonder if sickness would keep me from reaching my goals.

With insurance the way it is and people making claims on drugs and everything small then it is no wonder that health insurance is so expensive. I generally think that insurance is for emergencies and not for drugs for the common cold. Someone made the great anology to a car and it maintenance.



I don't think that you can put a price on good health but I never have underestimated the effects of healthy eating and an active lifestyle.
If you take care of yourself long term then all you'll have to worry about is emergencys happening.

Nick

PS: why didn't people have all these crazy illnesses in the 50s? Why was Jack Daniels and cigarettes good for you back then?

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Author: nukenick Two stars, 250 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1454 of 5068
Subject: Re: Healthcare coverage Date: 12/1/2003 1:50 PM
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FIRE

sorry

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Author: phantomdiver Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1455 of 5068
Subject: Re: Healthcare coverage Date: 12/1/2003 2:58 PM
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I am still young and have a ways to FIRE
<snip>
I never have underestimated the effects of healthy eating and an active lifestyle.
If you take care of yourself long term then all you'll have to worry about is emergencys happening.


DH has degenerative arthritis, which you either have or you don't. It makes no difference what you eat, how you exercise, etc. He also has various psychiatric disorders, some of which were probably caused by his being abused as a child. None of this showed up until he was about 40. He still lifts weights (there's a way he can do it without straining his back, which has had several vertabrae fused surgically), walks several miles a day, eats lots of fiber, etc.

You do what you can, but some stuff just happens. When I was younger, I wouldn't have believed this, but it sure is true for us.

phantomdiver

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Author: TourDeFarce Big gold star, 5000 posts Top Recommended Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1459 of 5068
Subject: Re: Healthcare coverage Date: 12/1/2003 5:27 PM
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To elaborate on my OP....

In general, I've been looking around and generally seeing retirees below age 65 falling into one of the following groups:

(a) No coverage because they don't want to or can't afford to pay.

(b) Coverage through their former company free.

(c) Coverage through their former company, at the discretion of the company's willingness to provide coverage and the individual's ability to pay in DOLLARS whatever premium the company chooses to charge.

(d) Coverage through their former company, at the discretion of the company's willingness to provide coverage and the use of "credits" the employee has built up over the years. (That is, one earns "healthcare credits" for working at the company, but can only use these credits to buy coverage from the company.)

(e) Coverage courtesy of a spouse's employer.

(f) Coverage by purchasing a personal policy either individually or as a member of some group (e.g., AARP).

Folks in (b), (c), (d) and (e) are sitting on a timebomb; they have to plan as if these'll go away at any instant since medical benefits aren't protected -- unless, of course, a contract stipulates otherwise. Folks in (e) also have potential divorce/separation/survivorship issues as well. So it would seem that the majority of folks - the (b), (d), (d), (e) - have to plan as if their benefits could be removed at almost any time. Given that, I'm curious as to how those who have successfully retired early are approaching this problem.

As for myself, my plan is to retire prior to 65 and use up all our "d" credits (if the plan's still in existence and things keep going the way they are, this may only buy us 3yrs of coverage or so). After that, we'll get coverage under DW's employer until age 65.

TDeF

NOTE: I got some mail today which mentioned that individually purchased polices were running about $800/mo and that healthcare costs were doubling ever 6-7 years. I don't know that number is realistic because I presume that most folks belong to some type of organization which provides group discounts. I seem to get enough mailings for them!





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Author: TheBreeze Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1460 of 5068
Subject: Re: Healthcare coverage Date: 12/1/2003 6:13 PM
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I never have underestimated the effects of healthy eating and an active lifestyle. If you take care of yourself long term then all you'll have to worry about is emergencys happening.

DH has degenerative arthritis, which you either have or you don't. It makes no difference what you eat, how you exercise, etc.


That, plus eating healthy and an active lifestyle don't have much effect on the drunk driver who hits you. The active lifestyle probably INCREASES the likelihood of needing ACL surgery. (I tore mine playing volleyball, not sitting on the sofa.)

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Author: zsimpson Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1461 of 5068
Subject: Re: Healthcare coverage Date: 12/2/2003 1:12 AM
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As an off-topic note, I suspect healthcare costs are out of control because there is little incentive for individuals to manage their healthcare costs.

I whole-heartedly agree!! To add to that, the insurance companies have no incentive to offer low-cost, high-deductible policies because the folks that are healthy and do not run to the doc for every sniffle are the ones that pay for the unhealthy, and doctor-addicted others.

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Author: zsimpson Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1462 of 5068
Subject: Re: Healthcare coverage Date: 12/2/2003 1:22 AM
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NOTE: I got some mail today which mentioned that individually purchased polices were running about $800/mo and that healthcare costs were doubling ever 6-7 years. I don't know that number is realistic because I presume that most folks belong to some type of organization which provides group discounts. I seem to get enough mailings for them!

We are in group C, coverage through Hubby's former employer, but we pay for it. We have been informed that our rates will be going up approximately 30% next year. That's a stiff hit in the wallet. I do nto see it going down in the future, especially since gubmint is busy making sure that everyone that isn't on the gubmint health plan will pay through the nose.

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Author: SeattlePioneer Big funky green star, 20000 posts Top Favorite Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1463 of 5068
Subject: Re: Healthcare coverage Date: 12/2/2003 9:20 AM
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<<NOTE: I got some mail today which mentioned that individually purchased polices were running about $800/mo and that healthcare costs were doubling ever 6-7 years. I don't know that number is realistic because I presume that most folks belong to some type of organization which provides group discounts. I seem to get enough mailings for them!
>>


I currently pay $476/month for individual health insurance at age 53.



Seattle Pioneer

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Author: Evelynk Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1464 of 5068
Subject: Re: Healthcare coverage Date: 12/2/2003 11:24 AM
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I currently pay $476/month for individual health insurance at age 53.


SP- what kind of deductible is this? I'm afraid health insurance will be our biggest obstacle in retiring early. It probably be close to $1000 for DH and me (that's assuming rates don't skyrocket too).



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Author: cyberisme Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1469 of 5068
Subject: Re: Healthcare coverage Date: 12/2/2003 2:13 PM
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My approach will be to scrap the sort of doctor-bill prepayment plan that employers and the government pass off as "medical insurance", and instead buy some medical insurance. The sort of policy that covers only individually unpredictable events (not routine expenses) that are financially signifigant (high deductible). Kind of like what homeowner's, auto, or liability insurance covers.

I was just going to bring this up - my thoughts were - I wonder if healthcare seems so expensive to people cause they pay for low "co-pays" instead of just buying major medical?

C.


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Author: sevarian10 Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1483 of 5068
Subject: Re: Healthcare coverage Date: 12/4/2003 1:29 PM
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My wife and I will soon be 65-yr-old retirees, and we plan to buy back into the group policy that was previously part of our benefits package. It costs $475/mo for the two of us and includes a prescription plan with $10/$20 co-pays per perscription, but doesn't include dental of optical except at very high premiums. We'll cover those on our own.

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Author: angryjonny Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1484 of 5068
Subject: Re: Healthcare coverage Date: 12/4/2003 2:01 PM
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There is one other category that I don't see mentioned often but affects a very large number of early retirees:

g)Retiree(s) are denied and unable to get insurance at any cost, due to minor existing medical conditions!

I know of several people in the 55 -65 range, good overall health, who are unable to get individual insurance from companies like Blue Cross because of rather benign conditions such as occasional heartburn! Insurance companies are looking for any reason to deny applicants who are not 25-35 with no history of medical claims.

Insurance offered by AARP for example doesn't seem to qualify as real insurance to me, as its limits are very low. What retired people need is the ability to buy insurance (even if very high cost) to cover against the catastrophic events that can wipe out everything they have worked for 35 - 45 years!

Anyone have any ideas? How about professional groups that might offer guaranteed issue group coverage (like an employers policy)? How do they work?


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Author: karolam One star, 50 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1487 of 5068
Subject: Re: Healthcare coverage Date: 12/4/2003 5:37 PM
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A couple of companies to look at if you're interested in good quality high-deductible policies are Golden Rule (previously mentioned) and Fortis. Both the these companies can coordinate with a Medical Savings Account (if you qualify). The new Medicare legislation slightly liberalizes the availability of Medical Savings Accounts, but this part of the bill has received very little attention in the media.

I am a healthy 53 years old and have two college-aged children covered under my policy. Our family deductible is $5,000 annually. We never came close to meeting the deductible except for the year my son had an appendectomy. When that incident occured ($11,000 total) Golden Rule was marvelous to deal with and all expenses were promptly paid without hassle within a month or two of his surgery - minimal paperwork.

My monthly insurance premium is $332.73 (covers 3 people). But it's the MSA that really takes care of us. Most of our expenses are dental, optical, and chiropractic - all paid out of my MSA funds.

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Author: Roxx Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1488 of 5068
Subject: Re: Healthcare coverage Date: 12/4/2003 8:46 PM
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Have you ever heard of Asset Protection Trusts? They are entirely legal and, albeit expensive to set up and maintain(about 20k to set up and around 1k a yr to maintain), do protect your assets from potential liability. You might also cover that with an umbrella liablity policy (under you existing homeowners) that is very cheap (about 150perMperyr).

Also, you might want to take a look at Flexible Savings Accounts and Medical Savings Accounts. If you do a search at the IRS web site, you can see some of the requirements and what they cover.

rxx

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Author: intercst Big funky green star, 20000 posts Top Favorite Fools Top Recommended Fools Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1489 of 5068
Subject: Re: Healthcare coverage Date: 12/4/2003 9:07 PM
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Roxx writes,

Have you ever heard of Asset Protection Trusts? They are entirely legal and, albeit expensive to set up and maintain(about 20k to set up and around 1k a yr to maintain), do protect your assets from potential liability. You might also cover that with an umbrella liablity policy (under you existing homeowners) that is very cheap (about 150perMperyr).

Where did you find an umbrella liablity policy that covers your own health care costs?

intercst



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Author: SeattlePioneer Big funky green star, 20000 posts Top Favorite Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1492 of 5068
Subject: Re: Healthcare coverage Date: 12/5/2003 3:15 AM
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<<I know of several people in the 55 -65 range, good overall health, who are unable to get individual insurance from companies like Blue Cross because of rather benign conditions such as occasional heartburn! Insurance companies are looking for any reason to deny applicants who are not 25-35 with no history of medical claims.
>>


Under HIPPA, anyone who has employer provided health insurance has access to individual health insurance when COBRA benefits expire. In Washington State, any such person can choose ANY individual health insurance plan offered in their area and be accepted regardless of preexisting conditions.

The exact nature of this varies somewhat by state. But it's really an issue that has been solved for most people who have money and are willing to spend it on health ionsurance.



Seattle Pioneer

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Author: angryjonny Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1493 of 5068
Subject: Re: Healthcare coverage Date: 12/5/2003 1:12 PM
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Thanks for the feedback. A few comments:

Liability Umbrella's are only for liability - car accidents, someone slips and falls in your yard and sues, etc.

HIPPA where I live will take people if all else fails. It isn't very good coverage, and is expensive, and has limits, but it is probably better than many other alternatives. It is a state issued and subsidized policy, not issued by a regular carrier. It only forces regular carriers to take you on if you are deemed to be too healthy for HIPPA itself.

I have so far learned that in the good old days if you belonged to a professional organization, such as those available to Lawyers, CPA's, Engineers, you could get group coverage through them. However now it seems as most if not all of those choices are gone. Insurance companies are cutting them off to cut exposure. You now must be an employee or own a business with employees to qualify. Anyone know more about this?

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Author: SeattlePioneer Big funky green star, 20000 posts Top Favorite Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1494 of 5068
Subject: Re: Healthcare coverage Date: 12/5/2003 8:58 PM
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<<HIPPA where I live will take people if all else fails. It isn't very good coverage, and is expensive, and has limits, but it is probably better than many other alternatives. It is a state issued and subsidized policy, not issued by a regular carrier. It only forces regular carriers to take you on if you are deemed to be too healthy for HIPPA itself.
>>


I wonder if you are mistaking your state's high risk health insurance pool with Federal health insurance rules under Hippa, the health insurance portability act of a few years ago. Hippa generally requires that those losing employer provided health insurance be offered other coverage when COBRA expires.

The state have some flexibility on deciding what that offered coverage may be.

In Washington State, for example, those with expiring COBRA coverage are entitled to sign up with ANY individual health insurance program regardless of pre existing conditions and with no exclusions for pre existing conditions, and for the usual prices.



Seattle Pioneer

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Author: mcain6925 Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 1495 of 5068
Subject: Re: Healthcare coverage Date: 12/6/2003 1:51 PM
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Just out of curiousity, for those either planning or retired early -- how are you addressing healthcare coverage (other than if you're a vet)?

Retired early, triggered by the company being acquired and the entire 1700 person headquarters staff getting axed. This was in the cable/telecom field, which has been consolidating rapidly over the past ten years. One of the acquisitions put me and a small number of others in the position of being able to stay on the company (and successor firms) health and dental plans as if we were employees. So I pay the same $77 per month for family coverage (the company's share is much larger than that, of course) that I paid while I was working. This was the standard retiree deal at the company where I spent most of my 25 years before the consolidation binge started.

I figure that at some point the current company will find a way to get out of the deal and cut me off, despite the promises that were made to me for most of my career, obligations that they acquired as part of the purchase. At that point, the plan is to buy real health insurance -- we'll pay the first $XXXX in expenses each year, and the insurance company will pay beyond that. Protection against catestrophic illness, not against visiting the doctor because the spouse or I have a sore throat. I am maintaining a couple of memberships in professional societies that have group arrangements for such policies.

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