A
Bitter Pill to Swallow
The
rising cost of health-insurance coverage is forcing many baby boomers to
rethink retirement.
by
Audrey Hingley, Contributing Writer
Alice
Haithcock of New Kent County and Ron Faulconer, who lives in Hanover County,
both plan to retire at the end of 2008. They�ve worked, saved and planned.
But like other baby boomers, they must face another retirement reality:
rising health-insurance costs.
Retirees
must reach age 65 to be eligible for Medicare. Haithcock, 61, will retire
after 30 years with the Virginia, Maryland & Delaware Association of
Electric Coopera�tives.
She can keep current coverage for herself and her husband by paying the full
premium of nearly $1,200 monthly. Faulconer, 60, who has spent nearly 32
years with the Richmond City Fire Department, can continue his group plan
for himself and his wife by paying $642 monthly. Both say they are
fortunate.
�I
hope to work part-time, not necessarily due to medical insurance, but to
bring in spending money ... plus I cannot envision sitting around doing
nothing. I�ve been so accustomed to setting goals,� Faulconer says.
Haithcock says, �Health insurance was part of retirement
planning, but the fact that it has escalated like it has was not planned ...
it will not stop me from retiring, but it will cause me to look for other
options.�
Lil
Robertson, 63 and single, retired from the University of Virginia with 36
years of service in 2004, but returned to a part-time administrator job at
the university in 2005. �I can�t complain about the benefits,�
Robertson says. �My health insurance is around $200 per month because of a
credit I receive due to length of service.� Robertson says she likes
her job, her work environment and contact with people. She plans to work
�as long as I can.�
She�s
not alone: A 2006 study reported that 79 percent of baby boomers expect to
work in their later years. But those who retire before age 65 need to be
able to build a health-care bridge between early retirement and Medicare
eligibility, says Bill Kallio, AARP state director for Virginia. And for
most people, that bridge will likely be found in the private
health-insurance market.
A
four-legged Stool
�We
used to say retirement was a three-legged stool: pensions, savings and
part-time work,� Kallio explains. �That has shifted completely, with a
four-legged stool for everyone, with health insurance added to it, because
health insurance is consuming more and more of people�s income.�
He
adds, �Most don�t understand what their health insurance really costs.
Many have not been prepared for the real cost ... they have been buffered by
their employers� contribution. You have to think about your health status
and your ability to find affordable health insurance.�
Those
who buy individual insurance plans often face higher costs because risks
aren�t spread across a group, as in employer-based coverage. Insurers
evaluate those seeking individual health insurance on a case-by-case basis,
meaning that existing health conditions can affect availability and premium
prices.
Alice
Haithcock and Ron Faulconer |
The
need for health insurance is a huge issue: Currently, one million Virginians
are uninsured. But it can be particularly worrisome for the over-50 crowd,
who face spiraling age-related insurance costs and the possibility of health
challenges.
�Health-insurance
plans have to cover their own risks, so they have underwriting
qualifications. You could be deemed uninsurable; each company has its own
criteria. Once you move into the private market, premiums will not be
stable,� Kallio says. �An increasing driver for the return to work is
the cost of health insurance and, historically, it takes longer for an older
person to find work. All of this is a planning factor. Before you leave the
workplace, do your homework.�
Some
early retirees can take advantage of federal laws like the Consolidated
Omnibus Budget Reconciliation Act (COBRA), which allows workers at firms
with 20 or more employees to keep employer-provided coverage for 18 months
after both voluntary and involuntary terminations. Workers have 60 days to
apply for COBRA and must pay their entire premium (employee/employer share)
plus a 2 percent administrative fee. The Health Insurance Portability and
Accountability Act (HIPAA) guarantees that enrollees with at least 18 months
of prior coverage who exhaust COBRA coverage can buy individual insurance
without restrictions due to pre-existing conditions, but HIPAA doesn�t set
any cost limits on individual insurance premiums, meaning these plans can be
even more expensive than COBRA.
Lloyd
Leitstein, a membership representative for the National Federation of
Indepen�dent
Business (NFIB), a small-business-advocacy organization, says
health-insurance costs are prohibitive for many small businesses. NFIB says
health-insurance premiums have increased 129 percent in the past eight years
for small business. �It�s not that they don�t
want to offer health insurance [to employees], they just cannot do it,�
Leitstein explains. �We feel they [small businesses] should have access to
competitive rates just as big employers do.�
An
Act of Congress
To
that end, a bipartisan congressional group introduced the Small Business
Health Options Act (SHOP), H.R. 6210, in June 2008; endorsed by NFIB, the
National Asso�ciation
of Realtors and Service Employees International Union, the proposed
legislation is aimed at making health insurance more available and
affordable for businesses of under 100 employees. NFIB is also partnering
with AARP in its �Divided We Fail� campaign, which Kallio says is �a
call to politicians to face the twin problems of health insurance and
lifelong financial security.�
If
you want to retire before you are Medicare-eligible, health insurance is
crucial. You risk losing everything without it. Begin your research at
www.healthinsuranceinfo.net; maintained by the Georgetown Health Policy
Institute, this site offers health-insurance consumer guides in an
easy-to-understand format.
Jackie
Walters, supervisor in the Life & Health Consumer Services/State
Corporation Commission Bureau of Insurance, says many trade and professional
associations offer members insurance. Other experts suggest checking local
chambers of commerce for possible group-rate plans. AARP recently began
offering health-insurance plans for those 50 and over, via United Health
Care Insurance Company, and a quick check of the Bureau of Insurance Web
site lists 24 companies who provide individual health insurance in Virginia.
But
just because you apply for health insurance doesn�t mean you�ll get it.
One Virginia broker says about 40 percent of people in the 55-to-64 age
group are getting turned down due to pre-existing conditions. For
those unable to obtain health insurance, Waters advises contacting Anthem
Blue Cross Blue Shield Individual Health Plans (see sidebar on pg. 17).
Anthem�s Richard White says the company�s Virginia Standard plan offers
open enrollment at any time, but there�s a one-year waiting period for
pre-existing conditions. White
says individual plans vary, based on individual underwriting, in terms of
costs and choices. Many are looking at high-deductible HSA (health savings
accounts) plans.
�Our
Key Care Flexible Choice plan has co-payments like people are used to in the
group-health world. If in good health, the Level 1 (premium) rate for a
$5,000-deductible Key Care Flexible Choice plan for a 60-year-old male is
$240 per month,� he explains.
Do
your Homework
When
shopping for health insurance, Waters says, �Consumers should call their
state insurance department and make sure the agent and company are
legitimate and licensed in the state. Consumers need to know what their
insurance needs are and educate themselves on the different plans available.
When comparing plans, check plan �exclusions� first.�
She
also suggests getting information about insurance companies and checking
their ratings. Waters says the National Association of Insurance
Commissioners has a consumer-service source that provides information
consumers can use before buying insurance, including closed complaints,
licensing information and financial data.
When
you contact insurers, ask about renewal and premium increases and
out-of-pocket costs. Pay particular attention to fine-print exclusions. �Consumers
have a 10-day free-look period in which they can return an individual
health-insurance policy for any reason, or no reason at all, and receive a
full refund of premium paid,� she adds. �Always pay by check, money
order or credit card and make the check payable to the company, not to the
agent or anyone else.�
Haithcock,
who has been working since she was a teenager, is looking forward to
retirement. Because she drives 66 miles a day round-trip to her job, she
figures she�ll save �a huge amount� on gas costs alone, and her auto
insurance costs will decrease due to less driving. �My
husband and I decided a long time ago we wanted to be able to retire
(early). We consulted a financial planner. He said to free yourself of debt
and we had a choice: we chose to do that,� she adds. �Both of us are
fortunate to be relatively healthy and we get reasonable amounts of
exercise. We�ve seen the outcomes of those who have chosen not to be
physically active, and it is not pretty.�
Sound
Advice
Faulconer
said he�s developed a simple guideline for life: work, pray, plan and
save. He thinks if you leave any of these things out, you�ll be less than
successful. He advises others to set goals, work to
achieve those goals and try to become debt-free: �Some people say to keep
a mortgage for the tax deduction. Would it pay to make $15,000 a year in
mortgage payments to get back $2,000 on your taxes?� He adds, �Plan, but
at the same time don�t sacrifice everything now to the extreme where you
are a miserable pauper, waiting for some magical day of retirement. No
matter how much planning you do, you have to be flexible and not be bitter
about any changes you might have to make.�
Some
helpful resources
Virginia
AARP
(formerly
the American Association of Retired Persons)
Web
site: www.aarp.org/states/va; 1-866-542-8164
Membership
organization for those 50 and older and dedicated to their needs/interests.
www.healthinsuranceinfo.net
Informational
Web site maintained by Georgetown Health Policy Institute, including helpful
articles, information and health-insurance consumer guides.
The
National Federation of Independent Business
www.nfib.com;
(804) 377-3661
also:
www.fixedforamerica.com (NFIB�s call for health-care reform)
Small-business
advocacy organization.
Anthem
Blue Cross Blue Shield
Individual
Health Plans of Virginia
www.anthem.com;
1-800-334-7676 or
CareFirst
Blue Cross Blue Shield Individual Health Plans
1-800-544-8703
Individuals
may qualify for an open-enrollment program where they cannot be denied
insurance, but a waiting period for pre-existing conditions may apply.
Virginia
State Corporation Commission
Bureau
of Insurance
www.scc.virginia.gov/division/boi
Ombudsman
and Consumer Service Hotline toll-free:
1-877-310-6560
Listing
of authorized insurers and licensed HMOs from the Bureau of Insurance, as
well as other insurance information.
National
Association of Insurance Commissioners (NAIC)
www.naic.org/cis/index.do
This
group has a consumer-information source that individuals can use before
buying insurance. You can find information here about insurance companies
including closed complaints, licensing information and financial data.
There
are several organizations that publish insurance
company
ratings, available in your public library or on the Internet, such as:
www.ambest.com, www.moodys.com,
www.standardandpoors.com,
www.weissinc.com, www.fitchba.com.