What kind of medical insurance?

[OkeeDon]

This got started on another thread, but there seemed to be some interest, so I decided to start a new one.

To bring it up to date:

TerryInMD said: <font color="green"> After being off for 8 months and doing what I wanted to do, going back to work does two things - albeit important things. Making money and having medical benefits....At least 7 more years of this stuff!!! Unless we can work something out to replace some of the income and have reasonably priced medical care. But, alas and alec, this will be lot.... </font>

I said: <font color="blue"> The funny thing is, I did some basic research on jobs that a 63 year-old can get, part-time, and have some access to medical insurance, and WalMart comes up on top. </font>

Bird said: <font color="green"> I've been thinking about the possibility of applying for a job there myself; not for the health insurance, which I already have, but could use some help in paying for the insurance we already have. This year, they finally decided to skip a year of raising the premiums; instead they're just raising the deductible from $300 to $1,000 per person. </font>

Bob_In_MN said: <font color="blue"> While they (Walmart) do have medical insurance available, the benefits I've seen leave a lot to be desired. I reviewed one of their policies when my father-in-law took a job there. In this instance (Minnesota) he could get much better coverage by buying an individual coverage.

I'm sure the managers have a better plan available, but the rank and file employees plan didn't look that good to me. Again--this may be different from state to state, but I doubt it.
</font>

My wife and I have always been self employed and had individual coverage. It didn't use to be a terrible burden. Our best friend is a Nationwide agent, and we had all of our insurance with him. Over several recent years, however, the rates kept climbing, and finally they stopped writing the insurance in Florida, and we had to find a new company.

We went with Mutual of Omaha, but the rates went up 50% at the end of the first year, and then (just a few months ago), they informed us that they will also stop writing the insurance in Florida sometime next year. We have to find yet another company.

We are in very good health with minor exceptions. I have a mild cholesterol problem (about 250) and my wife has mild blood pressure problems (probably from the stress of caring for her 99-year-old Mother) that is completely controlled with medication. On our latest attempt to replace the insurance, BC/BS accepted me but rated me up, and rejected my wife. I rejected their coverage in order to keep looking - or take the aforementioned job at WalMart or someplace similar, just to get coverage for us both.

We are currently paying almost $1,200 per month for catastrophic coverage. This is $5,000 deductible, 80/20 to $5,000, $2M cap. No prentative care, no drug coverage, no ER, no nothing until the $5K deductible (each!) is met. Since we are paying over $14K per year just to get this, we don't particularly worry about the possibility of up to another $12K out of pocket if we were both to get sick...

...but, it is really tough to face this on reduced income. As discussed elsewhere, I have retired, and my wife (a home-health physical therapist) has cut back on her patient load.

What do we have to look forward to? Once we reach 65-1/2 (in about 2 years), will it be any better on Medicare? How are other TBN'ers handling this?

 

[fivestring]

<font color="red">"What do we have to look forward to? Once we reach 65-1/2 (in about 2 years), will it be any better on Medicare?" </font>

Probably not.

It's a shame that our own government has devised a system to make people dependent on said government (welfare system).
This system has really screwed our older citizens. My parents, 71 & 70, worked their entire lives (until 65 and/or bad health) and what is their reward? BC/BS/Medicare premiums out the wazoo and high prescription prices!
Meanwhile, teenagers are having babies every 9 months and getting paid more money for each one they produce. /forums/images/graemlins/shocked.gif The average citizen better wake up and see the problems with the system and demand changes!
Case in point:
20-something female with two small children came into our building 2 days ago. She was dressed in Tommy gear from head to toe, Timberland boots, kids were dressed the same. Now get this.... she asked where she could apply for WIC and welfare!!!! /forums/images/graemlins/blush.gif /forums/images/graemlins/mad.gif She did not have a job and was told by friends that she could make a good living staying at home and drawing a "gummint check". /forums/images/graemlins/shocked.gif /forums/images/graemlins/mad.gif
She doesn't have to worry about medical care... it's free. /forums/images/graemlins/mad.gif
You worked your entire life and now pay more in medical care than she'll make in a year. She's happy as a pig in slop.

America... the only country that pays a woman to produce and a man not to. /forums/images/graemlins/mad.gif

 

[Bob_In_MN]

Don,

A flat $5000 deductible in MN (through Blue Cross of MN) would run $180 per month for each person who is between the ages of 60 and 64. So if you and your wife did not smoke, the monthly cost for both would be $360. This assumes non smoker. A smoker would pay $226.50. Also--in MN, Blue Cross would not rate you up, they would either take you or not and if they declined, you can go on a plan that is similar for about the same money. This plan is subsidized by small companies doing business in MN. Very good for individuals, but adds to the cost of insurance for the small business owner.

This is a $5000 deductible plan. The plan does not kick in until you hit $5K in expenses and then it pays 100% of expenses.

I realize this does not help you, but it gives you an idea of what you can buy in this state.

Once you hit 65, you can go on Medicare part A and B at a current cost of approximately $59 per month. You would supplement that with a medicare supplement policy. In Minnesota, a policy that fills in the gaps of Medicare and covers prescriptions at 50% runs about $236/month.

Hope this helps.

Bob

 

[MadReferee]

This is a post I copied from the rv.net forum. It talks about medical insurance options for self employed people. The specific insurance mentioned is only available in some states.

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I have what a lot of people have never heard of that is available for the self employed and or small business owners. It is call a Medical Savings Account Health Plan (MSA) and it is by far the best insurance plan I have ever heard of. Go to www.goldenrule.com and look under MSA medical insurance. Golden Rule is the highest rated MSA Insurance company in the US. MSA Insurance is what the US Gov. allowed back in 1997-98 that was intended to help out small business owners/self employed who were having trouble finding afordable insurance. Here is the big plus for going MSA. Unlike other types of health insurance, MSA monthly premiums are 100% tax deductable no matter what % of your total income it represents. (Normally medical costs have to exceed I believe 7-8% of your earned income before you can deduct a dime) The second just as big feature is that you can pre pay your deductable into a interest bearing account that currently pays 4% (more than most 5 year CD's are paying now) and the prepayment is also tax deductable. My family rates with conventional PPO coverage was approaching $750/month but with my new MSA account it dropped to under $350 with comparable coverage. Plus you are given a check book to allow you to write checks for medical expenses such as dental and eye care, which are not covered by regular health insurance. No I am not a agent for selling this insurance - I am just a very excited consumer who has found one of the finest most cost effective health plans ever. Check it out with your Insurance Agent.
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[OkeeDon]

Bob - that's almost enough to make me want to move to MN, if only it didn't get so cold up there! /forums/images/graemlins/wink.gif I've always admired MN's seeming ability to better care for folks (and to actually care about people) than more conservative states.

Mad - I have heard of MSA's, but made the assumption (and we all know what that means) that one would have to be younger to make them pay off. I don't know if they are available in FL or not (see my comments about MN /forums/images/graemlins/crazy.gif), but I'll certainly do some research. Thanks.

 

[MadReferee]

According to the Golden Rule web site:

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These health insurance plans are available as group coverage only to members of FACT ( web page ). If you're not already a member, you must join FACT.
When you join FACT and sign up for insurance with Golden Rule, you enjoy group benefits and maintain your independent status!

FACT Plans are available in the following states: AK, AZ, AR, CO, FL, GA, IL, IN, IA, MD, MI, MS, MO, NE, OH, OK, PA, SC, TN, TX, VA, WV, and WI. Plan Benefits vary by state. For details on your state, call 1-800-444-8990.
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[Bob_In_MN]

Don,

Being the 4th highest taxed state in the union (according to most lists) does allow our local government to spend some money in areas other states only dream of.

In Minnesota, if you're uninsured, you must not know how to read because if you can afford it and are healthy, we have an insurance plan for you. If you can afford it, but aren't healthy, we have an insurance plan for you and if you're not healthy and you couldn't afford it anyway, we have an insurance plan for you.

One more thing Don--when you turn 65, you are set-up on Medicare part A automatically and B as well unless you elect not to start Part B. The main issue here is that the start-up of Part B also starts a 6 month clock. During the 6 months after you start Part B, you can purchase a medicare suplement regardless of your health conditions and cannot be rated or turned down.

I believe (but am not sure) that this is a federal rule so you would want to check with a Florida agent. If it works the same way in FL, it can be important to buy your plan during this "guarantee issue" period.

Yup--it gets a little cool up here. Still close to 80 today, but they are predicting a high of 41 one week from Saturday. Time to get the ice fishing equipment ready.

Bob

 

[OkeeDon]

Golden Rule is also the provider for insurance plans approved by the American Physical Therapists Association. Back when Nationwide cancelled everyone in Florida, we applied. Betsy was rejected due to her high blood pressure, the same thing that BC/BS just did. Mutual of Omaha accepted her, but rated it up. This despite the fact that we have not had a claim of any sort, for even $1, in the past 15 years, and despite the fact that her blood pressure is more than adequately controlled. FACT looks great, but they have this disclaimer:"Coverage is not automatic--every application is medically underwritten prior to the issuance of an insurance certificate." Because Betsy has been rejected by Golden Rule within the past couple of years, there's no point in applying again.

Knowing that Golden Rule would probably not accept her, I checked a few other MSA plans. Most have age limitations that range from 60 to 63-1/2 - Betsy is just over that limit, and I will be in another month or so; may be over it now the way insurance companies figure ages.

It is a fact that medical insurance companies share information, and the more times you apply, the harder it is to get.

My conclusion is that insurance companies just do not want to insure someone in our situation. Insurance depends on long-term reationships with few claims. Even though we have not had any claims, that is to another company's benefit, not to any future company, which knows that we will be on Medicare in 2 more years. They can't squeeze us for enough money to make it worth it for them. So, they either reject us outright for the thinnest of medical reasons, or they use even thinner reasons to increase the rates so they can squeeze more money from us.

We thought we were set when we went with Mutual of Omaha - it was about $750/month when we signed up, we only had 3 years to Medicare, and MofO has a good Medicare Supplement plan. After less than one year they kicked it up to over $1,100, and then sent notice they were no longer going to insure anyone in Florida. We have about 9 months left at the high premiums, and after that it looks like no one will write us at any price until we go on Medicare.

Our choices appear to be to go "naked" for about 1-1/2 years, or to go to work for someone with a guaranteed acceptance group plan, no matter how thin the coverage might be.

Or, we can begin now to divest ourselves of all assets and go on the same care plan as other indigents - ultra-expensive emergency room care at no cost to us. It makes no sense.

As a health care professional, Betsy sees patients every day who are truly ill or disabled. They get care without regard to ability to pay. It just doesn't seem fair that we have not cost one red cent to anyone, but we can't even get high-deductible insurance.

We pay in full, from our own pockets, for every doctor visit, every mammogram and such, every dental visit, every pair of glasses (over $600 just last week), every prescription, every cent. We are able to continue that. All we want is major medical coverage in the event of, for example, cancer. Neither of our health records reflect cancer, and neither have a genetic history of such.

If we gamble, and go "naked" from age 64 to age 65-1/2, we are liable to lose every asset we have struggled for so long to get hold of. I'm an honorable man, a true "Straight Arrow", but God help me, it leads to thoughts of how to cheat the system.

 

[OkeeDon]

<font color="blue"> Being the 4th highest taxed state in the union (according to most lists) does allow our local government to spend some money in areas other states only dream of. </font>

I have never complained about paying taxes when services are commensurate. I have always been against tax cuts, because I'm so well aware of how they hurt many more people than they benefit. Federal tax cuts just put the load on the States. State tax cuts just put the load on local taxes. All tax cuts result in higher deficits, with higher debt service expenses.

Politicians will not (or cannot) legitimately reduce spending or make spending more efficient. One party has always been known as "Tax and Spend", the other is rapidly becoming "Cut Taxes and Still Spend". The only difference is for what they propose to spend.

I am a registered non-partison (in a state which penalizes independents) simply because I cannot lend my name to any party.

I'm using a lot of bandwidth to vent my frustration, and I apologize. It only helps me.

 

[Bob_In_MN]

Don,

We definately have some programs in this state that go above and beyond that of our neighbors. The national COBRA law (allowing employees to continue on a health plan after they leave employment) was modeled after our continuation laws.

I agree with you regarding either party's inability to spend wisely. It's a complicated issue and one that would break the no politics guideline if we went into it. So--I will say good luck with your search for insurance. Even if you can find someone to give you a $10,000 deductible, at least you would be protecting your major assets.

Bob