Early Retirees, Under 65
The Affordable Care Act (ACA) - also called Obamacare - is a new law helping more Americans get health insurance. This guide will help you understand how it's affecting early retirees, under the age of 65.
And if you're overwhelmed, don't worry! Just call or email us. We're trained and authorized to help.
IF YOU RETIRE EARLY, CONSIDER ALL YOUR HEALTH INSURANCE OPTIONS
Do you have COBRA or another continuation option at your job?
People who lose job-based heath insurance can choose to continue group health benefits for a limited period of time - usually 18 months, sometimes 36 months - under the COBRA law. You can be charged up to 102% of the monthly insurance premium. This option is generally only available for businesses with 20 or more employees on the group plan. If your business is too small to offer COBRA, you might have a different continuation option. This will vary by state. Or, your employer might offer a special retiree health plan.
You could be added to your spouse's health insurance plan.
If your spouse has job-based coverage through his or her employer, you can be added to that health insurance plan when you retire. "Loss of coverage" is one of the triggering events that allows you to be added to a group health insurance plan outside of the Open Enrollment time period.
Enroll in a private individual health insurance policy.
The Affordable Care Act has made changes to private health insurance policies that will make it easier for you to enroll. But you'll need to sign-up during Open Enrollment for a private plan. The exception to this rule is a triggering event (like losing group coverage), then you can enroll in a private plan within 30 days of that triggering event.
NOTICE IMPROVED BENEFITS
You can't be turned down for pre-existing conditions anymore. No, really.
No health insurance company can turn you away because you have a pre-existing condition. Pre-existing conditions are always covered. No health insurance company can drop you because you get sick.
All plans cover Essential Health Benefits.
All plans must include coverage for Essential Health Benefits, which includes doctor visits, hospitalization, tests, screenings, prescriptions, and more.
You'll get free checkups.
Health insurance isn't just for when you get sick - it's also for keeping you well so you don't get sick. You'll get free preventive exams and screenings like physicals, labs, screenings, pap smears, mammograms, PSA tests, colonoscopies, and more.
You can't run out of insurance.
New insurance policies have no yearly or lifetime benefit limits, so you can never run out of insurance for core care.
YOU'LL SEE MORE REASONABLE PREMIUMS
You can't be charged extra premium for pre-existing conditions.
Before ACA, people with pre-existing conditions like diabetes, cancer, heart problems, or high blood pressure might be charged very high premiums, or be turned down for coverage. But now, health insurance companies can no longer penalize you for pre-existing conditions.
Older adults are priced differently now.
In the past, insurance companies could charge older adults much more than younger adults - sometimes up to six times more for the same plane. But now, insurance companies can't charge you more than three times more than a younger adult, making your premiums usually lower than before ACA.
See if you qualify for discounted rates.
The new law has made it possible for about 26 million Americans to qualify for tax subsidies to lower their healthcare costs and you might be one of them. A tax subsidy is the amount of money that the government will pay directly to your private insurance company to reduce your premium and make it affordable for you. The amount of subsidy you receive is based on your family size and household income.
YOU STILL HAVE THE POWER OF CHOICE
You choose your insurance company.
Even if you accept a tax subsidy - where the government helps pay your health insurance costs - you still have the power of choice. Obamacare plans are not issued by the government. They are issued by brand-name insurance companies like BlueCross, Humana, United Healthcare and more. You choose your favorite insurance companies from the ones available in your area.
You choose your plan.
All individual and family plans will fall into one of five categories: Platinum, Gold, Silver, Bronze, or Catastrophic. Use our Plan Guide to help you decide which plan is best for you.
A FEW THINGS TO CONSIDER WHEN CHOOSING YOUR PLAN
Does your doctor accept your insurance plan?
Most all insurance plans have a network - or a list of healthcare providers who take that insurance plan. The new plans work the same way. It's important to know if your favorite doctors take the insurance plan that you're interested in before you enroll.
Plan benefits are the same, on or off-exchange.
ACA says that the plan benefits have to be identical in your area for off-exchange (no government tax subsidy) and on-exchange (government tax subsidy lowers your premium) plans. So if you accept a tax subsidy, you will not give up any benefits.
You'll probably notice fewer doctor choices under ACA.
There's always a catch isn't there? Many times you'll see the doctor network is smaller for subsizied plans, where the government is paying part of your premium. You'll want to consider if your doctor takes the plan and how much subsidy you might receive before making a final decision.
Don't forget about your prescriptions.
Remember: All new plans must cover prescriptions but not every prescription has to be covered - only one drug per class must be included. So you might want to make sure that your expensive, brand-name prescriptions are included.
Choose how you want to enroll.
You have several ways to enroll in on-exchange or off-exchange plans: 1) Enroll through the public exchange (government website) 2) Enroll directly with the insurance company 3) Enroll with a local agent 4) Enroll through a private exchange (that's us!). You'll get the same policy for the same price regardless of which method you use to enroll.