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    How Do I Get Health Insurance Before Medicare Kicks In?

    Posted by Ron Wadley on Feb 21, 2023 11:31:44 AM

    Congratulations on deciding to and being able to retire. You've spent a lot of blood, sweat, and tears to get you here, working and saving your pennies. It's an accomplishment that should not be glossed over or minimized. But if you are like countless other Texans who decide to retire a bit before the age of 65, there is one glaring question that comes up. How do you obtain health insurance until Medicare kicks in at 65?

    Click To Get Help With Health Insurance

    Many of the benefits and solutions to your retirement are neatly drawn up and planned out. Even Social Security can start prior to 65 if you want. But health insurance can definitely prove to be tricky if you or your spouse do not qualify for Medicare age wise. So the question that we get frequently from Texans, is how can I get health coverage before we qualify for Medicare. The great news for you is that Insurance For Texans has a plan to help you obtain Medical Insurance prior to turning 65 that can fit your personal needs.

    How Does An Early Retiree Get Health Insurance Before Medicare Kicks In?

    Keys To Finding A Great Health Insurance Plan

    When you begin to look at your options, we typically break them down into four main options.

    1. Health Insurance Marketplace Plans
    2. COBRA
    3. Private Insurance Plans
    4. Catastrophic Health Insurance Options

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    The key to choosing the best option for you comes down to a series of questions about your situation and needs when considering a health plan. The answers to these questions make it easy to slot into one of the four options listed above. Let's explore those questions which are the keys to finding a great health insurance plan.

    1. Do you have a pre-existing condition that requires you to have specific hospitals, doctors,  or prescription drug coverage in-network with your health insurance coverage?
    2. Are you comfortable paying for medical costs out of pocket when they arise periodically?
    3. What period of time do you need the coverage for to get you to your retiree health benefits?
    4. What is your expected household income since it can affect your health insurance premiums?
    5. How do you consume health care including doctor visits, prescription drug plans, and preventive testing?

    Pre-Existing Conditions, Networks, & Time Horizons

    The harsh reality of an on-going treatment plan for a diagnosis or a pre-existing condition that you have or are receiving regular treatment for will go a long way towards shaping  which medical insurance that you choose to utilize going forward. Private health plans and Catastrophic health plans are immediately eliminated in most cases as they utilize underwriting to determine if they will extend an offer of medical coverage. Given that reality, we are left to compare COBRA plans and plans from the Health Insurance Marketplace.

    In the state of Texas, COBRA may be your best option if your budget can afford premiums. That is because your employer group health plan is likely to have a better deductible, maximum out of pocket, prescription drug coverage, and more robust networks of providers than the marketplace plans. The downside to COBRA plans is that you will be time bound to a maximum of 18 months of coverage when you leave your employment. But if you're in the middle of cancer treatment that 18 month window being covered and knowing that your health coverage is set will provide peace of mind even in spite of a perceived substantial monthly premium.

    Conversely, the change in employment status when you retire, or the end of the COBRA time period means that you will qualify for a Special Enrollment Period and can elect to migrate to the marketplace plans at either time. That allows you to keep medical coverage via an affordable health insurance plan when the time is right.

    How Do You Use Health Care?

    How Do You Use Health Care?

    Most people who have been on employer group health plans for prolonged periods of time have a tendency to not consider how they use their health care. They know that they schedule a doctor's appointment or procedure knowing that the insurance company is going to cover the medical expenses regardless of their health conditions. As you make the transitions to retiree health plans here in Dallas-Fort Worth you begin to realize that the true costs of medical expenses become more real because premiums will likely rise and out of pocket costs may escalate. Understanding that trading a lower premium while paying out of pocket for essential health benefits may make more sense if the math works out.

    When we look at Private health plans, your well check may require you to pay something unlike your old ACA approved employer group health plan. Or maybe the premium savings on a high deductible health plan means that a quiet year for health care saves you a lot of money even though you paid for that urgent care visit. Or maybe paying cash for a generic maintenance drug because of reduced prescription drug coverage can save you money throughout the year. All of these scenarios have to be considered with choosing your new health insurance policy.

    Private health insurance policies can include short-term health insurance plans, catastrophic health coverage, and even limited benefit plans. They do not require a life event to qualify for enrollment and do not have enrollment periods. They often require underwriting to qualify for coverage or they may limit benefits that are payable to hospitals, doctors or prescription drug coverage. Their benefit can be expanded networks and lower premiums.

    How Do You Know Which Plan To Choose?

    Fortunately, the independent insurance agents at Insurance For Texans have many options available to meet your needs. Those agents use a matrix of options based around these basic questions so that you can find the right health coverage for you while limiting your out of pocket costs for medical expenses. We can help you navigate enrollment periods, premium tax credits, prescription drug plans, health savings accounts, and your retirement budget. It is essential that we work with you to understand the answers to the questions posed to you so that we can make the best recommendations possible.

    Click To Get Help With Health Insurance

    Topics: insurance for texans, North Texas, Dallas/Fort Worth, health insurance, catastrophic health coverage, Obamacare, early retirees, Amarillo, Austin