Health insurance in Georgia - need help

[rfuerst911sc]

First off let's keep this out of parf please ! I am 63 and retired and my wife is 64 and retired . My wife can sign up for Medicare later this year . We currently have Alliant through ACA but because of our income just got hit with a huge bill when doing our taxes . It is what it is and I should have been smarter . Let's end that conversation right there .

So my questions: are there any " conventional " insurance plans available for our situation that are remotely affordable ? We both take blood pressure and cholesterol meds so those are considered pre-existing conditions . My wife has a mild case of glaucoma but it is handled/controlled with medication . Other than that we are healthy .

If the best plan is to stay with ACA should we inflate our estimated income so we get no subsidy and therefore no end of year surprises ? I have considered ending all insurance and just paying cash but catastrophic event could bankrupt so not sure it's a viable option .

If anyone has a contact in Georgia that I could talk to that would be great . I am at a point that I don't trust any website . Again let's keep this out of parf . Any advice appreciated . Thanks

[craigster59]

Not much info to offer but I keep hearing these commercials on the radio. Maybe check their pricing and see if it's competitive...

https://www.medishare.com/

[LWJ]

I’m in Oregon and don’t work in the individual market.

Connect with a local person who does individual. They will know the answer.

Good luck. Health insurance is broken.

[rfuerst911sc]

Originally Posted by LWJ

I’m in Oregon and don’t work in the individual market.

Connect with a local person who does individual. They will know the answer.

Good luck. Health insurance is broken.

Funny you say that I connected with a local about 30 minutes ago . She is reviewing our current plan then looking to see what other options are available . Appreciate your advice .

[Zeke]

Start a little company selling whatnots on eBay or out of the driveway, whatever. Hire a disabled person (that'll pay for itself and maybe help you with taxes).

Buy a group policy.

Well, on 2nd thought, the disabled person, while hiring may be a great to do, might not make a policy covering your "group" very attractive, depending on the disability, of course. But young people don't cost much insurance wise, so the costs get spread out a bit.

You may have to do a lot of shopping.

OTOH, you're not that far away from Medicare so maybe just pay up for another year. What you should be doing for yourself and your wife is looking into what kind of supplemental insurance you will get with your Medicare. There is a LOT to learn about this and I suggest getting a head start.

I actually bought a book written by a doctor about supplemental insurance to Medicare along with a complete treatise on Medicare itself. you need to know these things. it's generally called 'medigap'. That book is 12 years old now so I won't even link it.

Or you can go with an HMO and your out of pocket will be next to nothing. They even pay your Medicare coverage costs. However, HMO's are a whole 'nother conversation. You need to know.

[Googam]

If you're retired, are you still paying in to SS? If not, and you are over 62, you can begin collecting your SS$. If so, you should be able to get a Medicare Advantage plan. They deduct the premium, mine is $86 a month, from your SS payment. Got drug coverage too.

[rfuerst911sc]

Originally Posted by Googam

If you're retired, are you still paying in to SS? If not, and you are over 62, you can begin collecting your SS$. If so, you should be able to get a Medicare Advantage plan. They deduct the premium, mine is $86 a month, from your SS payment. Got drug coverage too.

Hmmm that is interesting . When I retired three years ago the payments into SS stopped , but I had paid into SS for 45 years . I am 63 and have not started collecting my SS but my wife has . I will ask the new agent we found locally about Medicare Advantage . Thanks for the suggestion .

[rfuerst911sc]

Hey Googam how old are you ? Our agent just told me Medicare Advantage not available until age 65 .

[Sooner or later]

Originally Posted by rfuerst911sc

Hey Googam how old are you ? Our agent just told me Medicare Advantage not available until age 65 .

I am pretty sure that is correct. You can draw SS early but not Medicare. To get an Advantage plan you have to be signed up for Medicare Part B. And you can't get Part B prior to 65 unless you have specific medical problems.

[fred cook]

I live in Georgia and my wife and I have United Healthcare and Medicare insurance. When she retired (schoolteacher) she was able to continue her/our state merit system policy. The policy costs us about $250 per month for both of us plus about $150 each for medicare (taken out of SS). When I retired (telecommunications engineer) I kept my Delta dental insurance at a cost of about $80 per month for both of us. By the way, we have been very pleased with the UHC coverage. Hope this helps.

[Googam]

That may be true..........sorry. I'm close to 70. I've used this pr0gram for probably for 4-5 years. I lived under my wife's old policy, until a friend told me he used an Advantage plan. We're basically the same age so I signed up & she kept her old coverage. She liked mine better & cancelled. I guess maybe our timing was optimal. Get your wife to 65 & find some single coverage you live with.

[rfuerst911sc]

Fred/Googam thanks for the feedback and clarification .

[Zeke]

Advantage = HMO.

[rfuerst911sc]

At this point I am OK with an HMO if we can continue to see our current doctors . Our new agent is pricing a HMO plan and will get back to us on Monday .

[Zeke]

Your doctors will have to be in the plan. Otherwise you see who they tell you to see. Medicare alone doesn't have any restrictions on what doc you see as long as they agree to take the agreed Medicare payment. 2nd opinions are covered.

Part A: Hospital coverage, no cost, but there will be copayments that a medigap policy will pay most of.

Part B: Doctor visits, diagnostics, etc. Even out patient surgery.

Part C: You've joined an HMO so you have no B. The Medicare fee that would normally be deducted from your SS is, in most cases, waved. Instead, Medicare sends up to $900 to your HMO monthly and from that point on, Medicare is off the hook. Your Part A is transferred to the HMO as well.

Part D: Drug coverage. It's complicated.

A lot of this can have serious implications if you're out of your service area. Worse if out of the country. Buy travel heath ins including air ambulance coverage when out of the country. Within the US, but away from home, if you have Plan C (Medicare Advantage) you may have trouble getting cleared for medical payment in an emergency. Look into that before signing up.

[rfuerst911sc]

Good info Milt . I am looking at this as a two phase plan . First phase is to stop the current ACA bleeding and find insurance to cover my wife for this year and me for two years . The 2nd plan is getting the wife on Medicare the end of this year and figure out what suplimental insurance is needed . Repeat when I turn 65 . I am much smarter now than I was last year .......... unfortunately that learning curve cost us $21,500.00 in paying back ACA credits 😠 . Again let's keep this out of parf 😁 .

[rfuerst911sc]

To wrap this up today we met with a local health insurance agent and decided to go with Care Source of Georgia an HMO policy . $1595.00 per month to cover both of us . When my wife goes on Medicare in October my policy will be 50% less and I stay with it until I turn 65 .

This week I went online to start the process of claiming my SS benefits . That will cover the cost of the health insurance with some left over to add to the toy fund . All in all it turned out ok other than the 21.5k we have to pay back for ACA subsidies due to our income level . Live and learn 😁

[LWJ]

Cool. The system sort of works. Congrats!