Explore Your Medicare Options
You’re eligible for Medicare starting at age 65 in most cases. If you’ve worked at least 10 years , then you qualify for free Medicare Part A. You can qualify for Medicare before age 65 if you’re permanently disabled or have end-stage renal disease.
Medicare includes the following parts:
- Part A covers inpatient hospital care, limited care in a skilled nursing facility, hospice care, and some home health care.
- Part B covers other aspects of health care, including outpatient care, doctor care, and durable medical equipment. You must pay a monthly premium for Part B.
- Part D covers prescriptions. Its benefits are accessed by purchasing Part D plans through private insurance companies.
On its own, Medicare has gaps, so many retirees opt for additional coverage. The two primary options if you don’t have access to employer health coverage are:
If you want to purchase a Medicare supplement, it’s best to do so when you start Medicare Part B because you have a special open enrollment period and can’t be denied coverage. Some retirees delay enrolling in Part B if they have access to coverage through a working spouse. You may have to answer health questions and go through medical underwriting after your open enrollment period expires. You might be offered a higher-priced plan or be denied coverage.
Staying Covered Until Medicarekicks In
If you retire early, how can you replace employer-based health insurance coverage? These tips can help you bridge the gap.
WHEN YOU RETIRE EARLY, ONE MAJOR NEW EXPENSE can loom large: health insurance coverage. If youâve been relying on employer-sponsored group health insurance, that coverage will likely end â only 29% of large firms offer retiree health benefits1 â leaving you responsible for the full cost of your premiums until you become eligible for Medicare at age 65. Deciding how youâre going to cover health-care costs is one of the biggest financial issues youâll have to sort out when you retire before that age.
Itâs a common challenge: 70% of Americans retire before they become eligible for Medicare2. If youâre one of them, your financial advisor can help you estimate your health-care needs in retirement and weigh the best coverage options available to you until Medicare kicks in, including ways that you can manage your familyâs health coverage if you previously had your dependents on your employerâs plan.
and isn’t, for the most part, covered by Medicare6
Percentage of government exchange health-care plans purchased by people ages 55-647
Hereâs a rundown of what you might explore with your financial advisor to help you cover your immediate and long-term health care needs.
Factor : Your Location
Theres a big difference in price tags between the most expensive locations and the cheapest. Traditional Medicare coverage is the same everywhere, but prescription coverage , Medicare Advantage , Medigap supplemental plans, and private insurance vary, sometimes even within the same state.
For example, premiums for one supplemental plan* cost more than twice as much per year in the highest-cost area vs. the lowest-cost area in 2018.
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Is Obamacare Completely Free
Obamacare typically has monthly health insurance premiums, but you may qualify for premium tax credits that reduce your costs significantly. How much you save depends on your household income.
More than 12 million people receive advanced premium tax credits for Affordable Care Act plans, according to Kaiser Family Foundation.
Dont Be Put Off Its Time To Plan
Its certainly easy to get intimidated by these numbers. But dont throw in the towel just yet. The good news is that there are tools and strategies available to help you prepare. There are many opportunities to take proactive steps to become educated and financiallyprepared for potential health-care expenses down the road, says Cyndi Hutchins, Director of Financial Gerontology at Merrill.
Consider these proactive steps:
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Health Care Savings Tools
As the data shows, though, its one thing to know health care is expensive and another to plan for those costs. Fortunately, there are a number of ways to save, with a big one being Health Savings Accounts . These are investment accounts, typically offered by employers, which allow people to set aside pre-tax dollars for health care spending. Employers will sometimes match contributions, too.
HSAs are great savings vehicles because they come with a triple tax benefit: Contributions are made on a pre-tax basis, investments can grow tax free and withdrawals for qualified health care expenses are also tax exempt.
You can invest those dollars in a variety of vehicles, too, just like you would in a 401 or another retirement savings account.
These are great,” says Geisler. Money can carry over from year-to-year and you can build up a significant amount.”
Annual contribution limits are $3,650 a year for individuals and $7,300 for families, but since it’s not taxed, any money put into the fund should compound quickly. For instance, if you invest $100 in the account every month for 20 years, and assume a six percent rate of return, those dollars will grow to $46,000. You can withdraw money from an HSA at any time.
People should maximize any kind of tax-efficient savings vehicle as much as possible,” says Geisler.
What Medical Expenses Qualify For Hsa Plans
The IRS allows you to withdraw funds tax-free to pay for qualifying medical expenses. If you are under 65 and use the funds to pay for something that doesn’t qualify, you can expect to pay taxes at your income level on those expenses, plus a penalty. However, if you’re over 65, you will have to pay taxes at your income level, but you won’t get hit with any additional penalties.
Here are some IRS-approved medical expenses you can pay for from your HSA:
- Ambulance and hospital services
- Improvements made to your home to help accommodate disabilities, such as ramps, widening doorways and safety railings
- Chiropractor visits
- Eye exams, contact lenses and glasses
- Medicare Parts A, B and D premiums
- Qualifying long-term and nursing care
- Smoking and alcohol programs
- Transportation to and from medical care
In most cases, you can use HSAs to pay for qualifying medical expenses for yourself and those in your family, such as your spouse or children, as long as limitation rules don’t disqualify them.
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Health Insurance Options Before & Until Medicare Starts
If alternative options arent a good fit, the private marketplace offers health insurance for seniors without Medicare. The Affordable Care Act makes private marketplace plans easier and more affordable for qualifying seniors.
Through the application process, you can find out if you are eligible for Medicaid or qualify for premium tax credits. Premium tax credits can help you reduce your monthly premiums, and typically apply to households with incomes between 100% and 400% of the federal poverty level .
Generally, marketplace plans are a great option for seniors looking to bridge health insurance until Medicare starts. Unlike short-term insurance, you can enroll through the marketplace even if you have pre-existing health conditions. Keep in mind, however, that plans and eligibility can vary by state.
Some employers may offer retiree health insurance to seniors and their spouses. While seniors with this benefit can still apply for any marketplace plan, note that this forfeits any subsidies and premium tax credits. If you drop your retiree benefits to opt for a marketplace plan, you will have to wait until open enrollment as you will not qualify for a special enrollment period.
Get Your Personalized Health Care Estimate
As part of our advice service, youll receive a retirement plan that includes a personalized health care estimate for your retirement years, taking into account your health status, coverage choices, retirement location, income, and more.
If youre already a Vanguard Personal Advisor client, set up an appointment with an advisor to estimate your health care costs.
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A New Way To Calculate Retirement Health Care Costs
Key Insights
- We believe viewing retirement health care costs as an annual expense, instead of as a lump sum, makes it easier for retirees to plan for and pay for them.
- Health insurance premiums are usually fixed and can be budgeted for and funded from monthly income. On the other hand, out-of-pocket expenses can vary from month to month and could be paid from savings or a fund earmarked for those purposes.
- Retirement health care costs can vary widely, depending on the type of insurance a retiree chooses, and no type of coverage is typical. So we believe it is useful to provide these estimates based on the type of insurance coverage.
Health care costs are top of mind for every retiree or anyone who is nearing retirement. According to T. Rowe Prices Retirement Savings and Spending study , the top three spending concerns of retirees are : paying for long-term care services, health insurance premiums, and out-of-pocket health care expenses.1
While these numbers offer a good idea of how expensive retirement health care could be over several decades, they are not very helpful for individual financial planning. Heres why:
- Type of health insurance coverage
What Is The Lowest Income To Qualify For Obamacare Subsidies
Youre eligible for Obamacare premium tax credits and subsidies if your household income is at the federal poverty level or up to 400% of that level. The poverty level is $13,590 for an individual, $18,130 for a two-person family, $23,030 for a three-person family and $27,750 for a four-person family.
People at the poverty level are also generally eligible for Medicaid, which may offer similar levels of coverage found in an Affordable Care Act plan but at a lower cost. Medicaid costs are based on household income and you may pay nothing or very little if you qualify.
Most states expanded Medicaid eligibility over the past decade. The exact household income levels vary by state and situation, but you may be eligible for Medicaid if you have a household income at 138% of the federal poverty level, which is $18,755 for an individual, $25,268 for a two-person family, $31,782 for a three-person family and $38,295 for a four-person family.
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Have A Good Overall Retirement Plan
Covering your health costs whenever you retire early or late is important.
Having an overall plan for how to fund retirement is absolutely necessary.
A really good retirement plan defines how much money you have now and in the future and it describes how much you are spending now and in the future. The NewRetirement Retirement Planner is an easy-to-use tool that helps you figure this out. This tool was recently named a best retirement calculator by the American Association of Individual Investors .
How Much Will Health Insurance Cost Me In Retirement
Paying for health insurance has become a huge financial drag for American employers, Fidelity releases its annual Retiree Health Care Cost Estimate, the last thing you want is for unexpected medical bills to undo your hard work, you can use the Health Insurance Marketplace® to buy a plan, Losing health coverage qualifies you for a Special Enrollment Period., not including long-term care.We designed our guide to health insurance for retirees to help you explore your options quickly and efficiently,000 on health care costs alone in retirement but quite frankly, a healthy 65-year-old couple retiring in 2019 can expect to spend more than $387, you can use the Health Insurance Marketplace® to buy a plan,300 per year on out-of-pocket healthcare costs, it states that the average 65-year-old couple retiring in 2020 can expect to spend a whopping $295, How to Plan
According to a report by HealthView Services Financial, Estimating your potential health care costs during retirement can help you plan properly for your future.Find out your magic number the amount of money you could save on health care in retirement, estimates that a 65-year-old couple retiring this year will need $240,000
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Runner Up Best Medicare Advantage Plans: Aetna
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Ultra-low-cost Part D plans available
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Low premiums and deductibles on 2023 Medicare Advantage plans
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The most MA plans with additional drug coverage in the coverage gap
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Relatively high Medicare star ratings
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A financial strength rating from AM Best
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Deductibles run high on 2023 Medicare Advantage plans
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Below average for customer satisfaction
Aetna was our runner-up for the Best Medicare Advantage Plans for a wide variety of reasons. The companys Part D plans and Medicare Advantage plans offer good value, are well-rated, and offer a wide range of benefits. Aetnas SilverScript SmartRx plan is a very low-cost prescription drug plan, with an average monthly premium of only $5.92 for 2023. Premiums and deductibles on its MA plans are well below industry averages for 2023 as well. And most MA plans include additional drug coverage in the Medicare donut hole.
But there are two reasons why Aetna isnt our top pick for retirees. Aetna ranked 6th out of nine companies in the J.D. Power 2022 U.S. Medicare Advantage Study, which indicates issues with customer satisfaction. Plus, the average out-of-pocket maximum on its Medicare Advantage plans is $5,685.48, which is about $300 higher than the average among major insurers.
Learn more in our Aetna Medicare review.
How Much Will Private Health Insurance Cost In Retirement
Many Canadian retirees wonder, Should I take health insurance? and How much does retiree health insurance cost? The answers often depend on the health care services you need to pay for and where you live in.
If insurance costs less than the money youd have to pay, then it could definitely be worth having private health insurance. So, before taking out any health insurance for retirees in Canada, its important to do the math.
Health care insurance for retirees can range from just over $100 to over $400 per month. The price varies depending on your age, province and the extent of the coverage you may need. For example, cheaper options have a limit for prescription and dental costs and you have to pay a deductible .
Medical insurance options for early retirees are probably more attractive, given that they usually dont qualify for any financial assistance before 65. Is it worth having private health insurance if youre under 65 and spending thousands on prescription drugs? Probably, but again, it is important to do the math before signing up for any plan.
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Planning Ahead For Future Costs
After your immediate health-coverage needs are sorted out, itâs a good idea to talk with your financial advisor about ways you might prepare for your long-term health care needs, says Storey. The cost of regular health care is often dwarfed by the cost of long-term care, which can easily top six figures per year8 and isnât, for the most part, covered by Medicare. Seventy percent of Americans who are currently age 65 or older will require some type of long-term care during their lifetime9, and long-term care insurance premiums increase the older you are when you apply for coverage. If you havenât already purchased it, your financial advisor can help you determine whether long-term care insurance makes sense for you or your spouse, factoring in age, medical history and other considerations.
In addition, if you know youâre about to leave the workforce â whether youâve decided to take early retirement or you believe a layoff is imminent â itâs a good idea to ask your doctor and your dentist whether there are any procedures they would recommend you take care of while youâre still covered by your employerâs health plan.
And, of course, it canât hurt to start exercising and eating right, if youâre not already. As Storey notes, âThe best health insurance is staying healthy.â
Early Retirement Health Insurance Are You Eligible For Cobra
In certain circumstances, if you lose your job, you can still be eligible to benefit from your companys group health plan for a limited period of time. Using the Consolidated Omnibus Budget Reconciliation Act , you can expect to be paying about 2% more than the full cost of health insurance on your old companys plan, says founder and CEO of Northwoods Financial Planning, Corey Purkat.
It is going to be more expensive than if you were still employed at a company, but it will still be less expensive than paying for your health insurance on your own, He says. The only way someone wouldnt be eligible for COBRA would be in situations where there was a very good reason a person was let go, such as a criminal investigation.
Continuation coverage under COBRA is typically available for a relatively short period of time, typically 18 to 30 months.
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