If you’re planning your retirement, you're probably more excited about taking that long vacation or the sleeping in on weekdays than you are about choosing a health insurance plan. But when you consider the potential cost of being without coverage, it’s hands-down a key item for your to-do list.
Let's start with the basics.
If you’re over 65 and have worked for at least ten years in Medicare-covered employment, you'll qualify for Medicare. (You can sometimes also qualify if you’re under 65 and have end-stage renal disease or have been receiving Social Security Disability Income for 24 months.)
If you’re not yet eligible for Medicare, individual health insurance might be right for you. You’ll pay for it yourself, but you might qualify for financial assistance if you’re earning less during retirement.
First, let's estimate your income.
You can get help paying for health insurance if you qualify based on your expected household income. In general, this means taking your household’s modified adjusted gross income (MAGI) from your most recent tax return and updating it based on any big changes you’re anticipating. In your case, there’s an obvious one – you’re retiring, so you’ll want to take out the salary part. However, you’ll want to include any income you’re still getting, such as interest, capital gains, alimony, fees for consulting or project work, and IRA and 401(k) withdrawals.
Next, choose a plan.
In general, the more you pay in monthly premiums, the less you’ll need to pay for care throughout the year. Premiums increase based on a plan's metal tier — Bronze, Silver, Gold, or Platinum. Bronze plans have the lowest monthly premiums, and Platinum plans have the highest. To make the best choice, review your pattern of using services and medications over the past few years. Here’s a quick rundown to help you think about which level is right for you.
- Bronze: If you want some preventive care like an annual physical, but rarely use specialists, medications, emergency rooms, or hospitals, a Bronze plan can help you save money on premiums. Keep in mind that if you do need care, you'll pay for it out-of-pocket until you reach your deductible. If you're not comfortable with the potential for unexpected costs, a plan with a lower deductible might be worth considering.
- Silver: If you go to the doctor and get medications several times a year, or if you’re a parent and your children get sick throughout the year, a Silver plan has a slightly lower deductible that may reduce your overall costs. If you qualify for a cost-sharing reduction, you may find that the Silver plan has a reduced deductible.
- Gold or Platinum: Consider these if you expect to have routine doctor and specialist visits to monitor one or more chronic conditions. In addition, if you’re planning for blood tests, other diagnostic testing, and medication costs. Gold or Platinum plan options are likely to give you the most financial protection, but keep in mind that they have higher fixed monthly costs.
The best way to compare plans and find out if you qualify for financial assistance is to get a quote. You can also talk to an enrollment guide at 855-672-2794. We'll tell you what's included and help you choose the best plan for you and your family.