Insurance Question

[jwilliamsr]

Hi, Folks.

I'm 13+ months past my AVR surgery and I feel great. I feel that I am in excellent health again and my running (one of my passions in life) is coming along quite well also. Here's my dilemma:

I have always wanted to retire early (maybe age 55?) and my wife and I have worked hard and saved hard to make that a real possibility. The problem is that we have no idea what to expect in the way of health insurance costs after we retire but before Medicare takes over at age 65. Are we who have mechanical valves and synthetic ascending aortas considered "uninsurable"?

Have any of you had to search for private insurance like that? What problems, if any have you encountered? Where did you find the best deal?

I would appreciate hearing any of your experiences if you are willing to share them.

thanks for your time!
jimmy

 

[ALCapshaw2]

Jimmy,

Do you have insurance through an employer at this time?

If so, I recommend that you maintain that until you KNOW that you can obtain private insurance after you retire. Don't forget, that you can buy insurance through COBRA for 18 months after any former insurance is no longer in force. The KEY to insurability is Continuity of Coverage.

That said, I would begin your search, preferably ANONYMOUSLY to 'feel out the situation'. At this point, GUARDING your PRIVACY would seem prudent.

Hopefully someone with experience in this matter will be able to provide further enlightenment.

'AL Capshaw'

 

[tobagotwo]

Once you've had AVR, you must never let your insurance lapse, even for a day. Any health, life, disbility, long-term care, or other insurance you give up, you will not get back. From the standpoint of a new insurance client, you will be basically uninsurable. This, although AHA studies show that those who've had AVR have the same life expectancy as those who haven't.

If you work for a company and your benefits have an open enrollment period (a time when you can get or raise insurance levels without proving insurability, which happens less and less often), jump at it.

If you can maintain group insurance through a program with your employer, that's likely the least expensive way to go. Ny all means, at least be sure you bridge benefits with COBRA.

I know. ** ouch! **

Best wishes,

 

[jwilliamsr]

Insurance question

Insurance question

yes, I do have health insurance through my employer now and I will use COBRA when I retire. It's the after-COBRA, before Medicare time period that I am wondering about. I've heard about some high-deductible policies that are much less expensive than standard healthcare insurance.

Thanks for your responses! I guess it will be essential to have the health insurance piece carefully planned before we make our decision to retire.

jimmy

 

[ShezaGirlie]

Little info for you..

Little info for you..

From one Texan to another.......yep, you automatically qualify (as I did) with your "artificial valve" for an insurance policy from http://www.txhealthpool.org/ .. Rates are set according to your ZIP code, age and whether or not you're a smoker and the deductible you choose. I believe COBRA must be exhausted first though and if you sign on within a specific timeframe, there is NO pre-existing.. Goodluck.. Oh, it's Blue Cross/Blue Shield of Texas and has a Medco drug card with it.

We're fortunate to have this insurance available to us in Texas...thank you Texas Legislature..!

*My cousin teaches French and German in Tyler - High School*

 

[jwilliamsr]

Thanks!

Thanks!

From one Texan to another.......yep, you automatically qualify (as I did) with your "artificial valve" for an insurance policy from http://www.txhealthpool.org/ .. Rates are set according to your ZIP code, age and whether or not you're a smoker and the deductible you choose. I believe COBRA must be exhausted first though and if you sign on within a specific timeframe, there is NO pre-existing.. Goodluck.. Oh, it's Blue Cross/Blue Shield of Texas and has a Medco drug card with it.

We're fortunate to have this insurance available to us in Texas...thank you Texas Legislature..!

*My cousin teaches French and German in Tyler - High School*

Great information ShezaGirlie! I went to that website and it looks like a wonderful safety net. I hope it is still there when I need it in a few years or so.

I wish I could say I know your cousin... I know several teachers at Lee High School in Tyler, but I don't think I know the French/German teacher.

Thanks again and best regards,
jimmy

 

[Missy]

I have the same insurance in NM that Sheezagirlie has in Texas. President Clinton signed that bill in just around the time my cobra was running out. I had 60 days to get it though the NM Health Insurance Alliance but I think all states have it. I remember being so happy watching him sign it on TV. So that must be a federal thing. I don't remember alot of the political aspect of it or if it is even still done. I just know NM still requires a group of insurance for existing conditions.
I pay 502.00 per month right now and the highest it has been is 512.00 but they dropped it back down to below 490.00 last year and it went back up a little this year.

Since I am not retired and still working I belong to a group and the rates are set accordingly. But NM also has the kind that is according to income.

Good luck! I am envious that you are so prepared for retirement. I can't even thing of it for awhile. Medical problems with us both and our family really set us back a few years. But really I am happy for you. Happy retirement!

 

[OldManEmu]

USD 6k Insurance

USD 6k Insurance

Missy, for someone outside the US "I pay 502.00 per month" appears very expensive, USD 6k a year! I never cease to be amazed by the cost of all things health related in the US. The situation that health insurance as an individual is not available because of a possible congenital condition and having to rely on a benevolent employer to access to health services appears as surreal to an outsider.

 

[jwilliamsr]

Missy,

Thanks for your additional info. It's nice to see the numbers so I have a rough idea of the cost.... although I realize my costs will likely be somewhat different.

I appreciate the warm wishes for my retirement, but don't put me out to pasture just yet! If the stock market doesn't cooperate a whole lot better than it did this week, my retirement hopes could easily move from the 5 year time frame to NEVER!

Thanks again!
jimmy

 

[jwilliamsr]

Missy, for someone outside the US "I pay 502.00 per month" appears very expensive, USD 6k a year! I never cease to be amazed by the cost of all things health related in the US. The situation that health insurance as an individual is not available because of a possible congenital condition and having to rely on a benevolent employer to access to health services appears as surreal to an outsider.

OldManEmu,

Thanks for offering a more global perspective.

Hmmmm..... maybe if we do get to retire early, we should consider settling in Australia? Any idea how the Australian healthcare system handles imports?

jimmy

 

[Missy]

OldManEmu,
It is also lots of money in the US and if it gets more expensive I may not be able to afford it. But I know some people who pay more. They are not with companies who offer it as a group.

I wish the US had some sort of system in place to take care of our medical needs. But it would probably not be the best of care. I hear that our VA hospitals leave alot to be desired and do not offer the very best of care. Although I am not an expert on that.

I talked to a therapist from England who worked with my husband's knees. He was here on some sort of work program with the government to learn more in the US. He said that England offers health care but sometimes you have to wait. It is not immediate. For instance my husbands knee replacement might have been postponed a year over there. This was several years ago.

I also have friend from Canada that says their health care system is outstanding. Excellent care.

I am not an authority on any of this and what I repeated here was just hearsay.

But it would be nice to hear from you about the health care you receive in your country.

Please post for me. Maybe that could become a separate thread to let others contribute about their countries. We have members from other countries or ones who are familiar with it.

 

[maka]

Jimmy
I don?t know what kind of company you work for, but there are some companies that if you reach the ?rule of 85"...30 years of service/55 years of age" and then retire they keep you in their medical plan until you quality for Medicare. Maybe you may want to check their benefit/retirament program

 

[jwilliamsr]

Jimmy
I don?t know what kind of company you work for, but there are some companies that if you reach the ?rule of 85"...30 years of service/55 years of age" and then retire they keep you in their medical plan until you quality for Medicare. Maybe you may want to check their benefit/retirament program

Great idea, Maka.

But I've already checked with my current employer. They offer no healthcare to retirees no matter how long I work there or my age..... except COBRA, of course.

Best regards,
jimmy

 

[OldManEmu]

Insurance

Insurance

Missy, Was the US VA system always bad or is it just struggling to handle the increased workload since 2003? The little I have read about this is that the VA system was OK, but is now struggling to cope.
Australia has a national health system (Medicare) and a private health system, however only a little over 40% of the population have private health insurance. Unlike the UK NHS, Australia's Medicare doesn't cover dental treatment except for a very limited number of people with complex health problems. All citizens and permanent residents are covered by the Medicare. This is the link to the Medicare site http://www.medicareaustralia.gov.au/about/about_us/medicare.shtml
There is also the PBS which covers prescription drugs. There is a co-pay with this. This is the link to the PBS web site, if you want to read more. http://www.pbs.gov.au/html/home
Private health insurance only covers in hospital treatment; however you can get optional dental cover. Doctors office visits are covered by Medicare however some doctors charge more than the Medicare rebate so there can be a co-pay however it is usually <$20 AUD (USD$17). Private health insurance is also community rated, that is those with pre-existing conditions can’t be refused insurance and can’t be charged more. There is however a waiting period of up to 2 years on pre-existing conditions.
The health outcomes are the same between the private and public hospital systems, most doctors’ practice in both as with only 40% having private insurance there isn't enough patients in the private system.
Private hospitals can guarantee a private room and you get to schedule surgery. The public hospitals usually have a shared ward and you have surgery when they have a place in the schedule based on clinical need.
Like the UK non critical surgery such as Orthopaedic surgery can have a long wait up to 6 months, cardiac surgery however is usually done with 30 days.
All costs are covered 100% in public hospitals including any prosthesis and drugs, there is no co-pay.
Australia spends 9.7% of GDP on health, the US spends 15%.