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How Do I Get Health Insurance When I Retire?

Plan ahead, health insurance in retirement can be expensive.

If you’ve held a stable job for most of your career, it’s likely you haven’t had to give much thought to your health insurance plan. Instead, it’s been a benefit consistently offered through your employer. With retirement approaching, now what? Follow the steps below to evaluate your health insurance retirement options.

Learn about your group health retirement benefits

First, learn about your existing health insurance benefits and how they change in retirement. Do you have the option to continue with your group plan? Have you worked there for enough years, or reached an age where you become vested in certain health insurance benefits? Attend workshops and read all the literature your employer provides on health insurance in retirement. If your employer does not offer a retiree health benefit plan, will you be eligible to stay on the current plan under COBRA provisions? If so, find out for how long, and how much it costs.

Explore your choices

If you are retiring before age 65, the good news is you can't be denied coverage for pre-existing conditions due to the Affordable Care Act, which went into effect January 2014. However, the "Affordable" part of the Affordable Care Act didn't come about, so although you can get coverage, you may pay $1,000 a month or more if you are between the ages of 55 and 64. Trump is likely to alter the healthcare landscape, but the ability to get coverage regardless of pre-existing conditions is likely to stay.

If you're planning on retiring before age 65, that's a good thing.

When you’re age 65, you should become eligible for Medicare, but you’ll still have choices to make. For example, you may want original Medicare or a Medicare Advantage Plan. Each has its pros and cons. The most accurate information you can find is on Medicare.gov, but after learning all you can you may still want professional help in making such an important decision, which means talking to an agent.
From road trips to day trips and everything in between, a car is your ticket to living life on your terms. Here are the tips, tricks and advice you need to ensure that your bases are covered.

While you are exploring choices, make sure you build in estimated health care costs into your retirement budget. How much should you plan on spending? It depends on your insurance coverage. According to Fidelity, a 65 year old couple will need to save $285,000 after taxes to cover their healthcare expenses.
If you know little about Medicare, it's time to learn. Read up on the basics of Medicare and then spend some time at medicare.gov. If you fear government websites, you're not alone, but you'll find the Medicare site to be very user friendly.

Also consider talking to a Medicare expert to help you sort out the additional coverage you need on top of original Medicare.

Talk to an agent contracted with most major carriers

Your best choice will be to talk to a health insurance agent who is contracted with most major health plans in your area. Particularly, look for a health insurance agency that specializes in health insurance in retirement; they can conduct a complete analysis of your options by asking you about your existing doctors and medications and then tell you which plans will provide the most cost-effective benefits based on your personal medical situation.

One option for advice is to talk to Allsup's Medicare Advisor team. Another option is to find your state's State Health Insurance Assistance Program (SHIP), which will have volunteers who can help.

Review plan choices each year

Whether over or under age 65, once you have secured health insurance in retirement you should be proactive about evaluating it by conducting an annual review of your coverage options during open enrollment each fall. Benefits and costs change, and it is possible a new plan may offer you better coverage at a lower price; you won’t know unless you look. Once again, you’ll want to talk with an agent who is contracted with all major carriers to get an objective analysis.

Dana Anspach, www.thebalance.com, May 21, 2019

States Join Fight to Lower Prescription Prices

Faced with rising prescription drug prices, dozens of states have moved aggressively over the past year to propose ways to turn back the tide.

That's not just out of the goodness of their hearts. States themselves are hit by drug costs via public employee health plans, Medicaid and other programs.

"States have balanced budgets, and they're reeling from unpredictable and rapid drug price increases,” says Trish Riley, executive director of the National Academy for State Health Policy (NASHP), a group of policymakers. Fixes at the federal level might not be speedy enough, she says. “States can't wait."

Last year state legislators introduced 178 bills related to prescription drug costs, the NASHP reports. In the first three months of 2019, 220 such bills were filed in 43 states, Riley says.

But only a fraction of bills ever become law. And in February activists suffered a setback: The U.S. Supreme Court let stand a lower court decision striking down a Maryland law that would have let the state prosecute generic drugmakers for “unconscionable” price hikes. The lower court had ruled that the law, endorsed by AARP Maryland, violated the constitutional prohibition against states regulating commerce beyond their borders.

The ruling did not bode well for similar bills that had been introduced in a dozen other states. But it may have a silver lining.

"It was a rallying cry,” says Elaine Ryan, AARP's vice president of state advocacy and strategy integration. “Our state office and advocates are back trying to formulate a law that will actually pass muster."

Here are some of the most promising state-level tactics for reining in drug costs.

Bills aimed at different aspects of the drug-price problem:

AARP/NASHP - Numbers as of March 29, 2019

Rate ceilings

Some policymakers want to establish affordability commissions that would set payment ceilings for some expensive brand-name or biologic drugs. Insurers would typically not be permitted to pay more than the amount set for such drugs. These bills have already been introduced this year in 14 states, including Maryland, Minnesota and New Jersey.

Supply-chain oversight

The largest number of state bills filed in 2019 would regulate pharmacy benefit managers, the corporate middlemen that administer drug plans for insurers or companies. PBMs — often at odds with drug companies for their role in negotiating prices for insurers — have come under fire for pricing and other practices. Legislators had filed 96 bills in this area by March 29, according to the NASHP. Also popular are “transparency bills” that would require manufacturers, insurers or PBMs to disclose drug prices or other information.

Drug Importation

In February, Florida Gov. Ron DeSantis made a splash when he proposed allowing his state to import prescription drugs wholesale from Canada. Vermont enacted such a law last year, and a handful of other states have considered this approach. But it requires federal approval, which Vermont has yet to obtain.

But importing drugs from Canada has its limits. “We can't rely on the Canadian health care system to fill all the gaps for us,” says Stacie B. Dusetzina, an associate professor of health policy at Vanderbilt University School of Medicine in Nashville, Tenn. “[Canada] may not have the supply to do so if more states decided that importation is a good solution."

Bulk Purchasing

California Gov. Gavin Newsom has another plan: leveraging the buying power of his state — by far the most populous in the nation — to negotiate with drug companies when buying drugs for the state Medicaid program, prisons and government workers, among other groups. Still in the proposal stage, the idea has attracted the interest of other states, which may join forces with California.

By the end of March, seven of the 220 bills filed in 2019 had become law. Last year five states approved new laws related to transparency. And 27 states passed laws prohibiting PBMs from imposing gag clauses that prevent pharmacists from telling consumers about cheaper drug options, says Katie Gudiksen, a senior health policy researcher at The Source on Healthcare Price & Competition. In an indication that policymakers at the national level can think along the same lines, President Trump signed two federal laws establishing gag clause protections as well.

Michelle Andrews, AARP, April 30, 2019 

“Affordable” Health Insurance vs Health Care

There is no such thing as affordable health insurance, because on a purely moral basis, no one should have to pay for administration costs to deny coverage, and to generate a profit for such a universal basic human need.

Insurance 101 teaches us that making small regular payments to build up a buffer for a large emergency expense is a good and prudent idea, even if that large expense never materializes. On a personal level this is called self-insurance. So why don’t we all just insure ourselves?

Clearly, the wages most people make, and the costs of modern health care, do not balance out. A group of people making regular payments can pay for a wide array of services for the entire group, including a few very expensive ones, as long as there are some very healthy people paying in to build up a large enough fund. Additionally, a large fund can be managed professionally to generate interest through short term investments to help grow the fund. The larger the group, the better this works.

The largest group we have in the US is, in fact, the entire population, from infants to elders. For-profit insurance divides this larger group and attempts to cherry pick healthy members to avoid the most expensive cases. Government subsidies designed to cover the least desirable members for the industry go to the industry, not the patients.

The ACA, for all of its immediate benefits for a small subset of the population is a Heritage Foundation, right/moderate-republican wing plan that should be called RomneyCare. The efforts of Max Baucus in heading the ACA creation, who was allowed by Barack Obama to ignore any kind of public option, were directly supported by the Health Insurance and Drug lobbies to maintain their stranglehold on Health Care in America.

Health Care is the delivery of services to those in need. Progressive services include wellness education and prevention. They can bring the total group expenses down, but nothing can reduce the costs as well as removing wasteful administration and profit. Large non-profit health groups keep administration at less than 3% of costs compared to 35% overhead and profit of many pre ACA plans, and the 20% cap with the ACA.

There is nothing new about universal non-profit Health Care, except in the US. Every other major country has it and in many places for-profit health insurance is illegal.

The term litmus test to choose candidates is cliché and actually debases the argument to one of political correctness of choice. Logic, reason, and the very basis of Capitalist thought says that a more efficient, better quality service or product will beat the competition and creative destruction will sweep away the weaker player.

A 40% cheaper product that works for everyone and provides improved outcomes is the hands-down winner. The way we pay for it? We stop paying for insurance. Single payer, Medicare for All, is the cleaver that will divide the 2020 candidate field.

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