Workers who find themselves unexpectedly laid off in middle age or forced into early retirement have many worries. One of their greatest fears is about finding health insurance coverage. Some 21 percent of baby boomers ages 45 to 64 report they are not confident they will be able to afford medical care this year, according to a new AARP survey. “The boomers are at a high risk of being uninsured, and they’re particularly worried. They’re concerned about losing their job-based coverage or not keeping up with the high premiums of individual coverage,” says Cheryl Matheis, AARP senior vice president. “And they don’t have the safety net that Medicare provides for older people.”
Here’s a look at your health insurance options before you qualify for Medicare.
Retiree health insurance. Most workers will never receive health insurance from their former employer. Only 31 percent of firms with 200 or more workers offer retiree health benefits in 2008, less than half the 66 percent that did so in 1988, according to the Kaiser Family Foundation. And even if you have a promise from your former employer to provide health coverage, don’t count on receiving it. Most companies maintain the right to change or revoke the coverage at any time. Kodak, for example, announced in August that it will shift more health insurance premium costs to retirees and phase out employer-paid medical coverage for dependents over 10 years. Edward Gartz, 57, a retired Kodak manufacturing manager in Greece, N.Y., says it will require half of his $22,000 annual pension to insure his wife when medical coverage for her is fully phased out. “Many of my former coworkers are getting another job where they can earn enough money to pay for their benefits so they can use the money from their pensions for living expenses,” says Gartz. “You need to prepare for retirement knowing that your corporation may bail out on you.”
Continuing coverage. Employers are required by federal law to offer COBRA continuation health coverage for up to 18 months when you leave your job. But you have to pay the entire cost of the insurance out of your own pocket plus a 2 percent administrative fee. The average annual cost for retirees under age 65 is $13,308, according to a Towers Perrin survey of 321 primarily Fortune 1000 companies. And if your former employer goes out of business, COBRA doesn’t apply.
For better, worse, and health insurance. Getting health coverage through a spouse’s employer is another option. “Retirees ages 55 to 64 are becoming more likely to get employment-based coverage through another family member and less likely to get it through a former employer,” says Paul Fronstin, director of the health research and education program for the Employee Benefit Research Institute. “You may need to be part of a family where they work while you retire.”
Back to work. Many Americans try to stay on the job until they qualify for Medicare at age 65 to keep their health insurance. If you’re laid off before age 65 or choose early retirement, working just 20 hours a week at some companies will make you eligible for group health benefits. Some professional organizations also make you eligible for more inexpensive group coverage.
Do it yourself. If you can’t get health insurance from an employer or spouse, you will have to insure yourself. Americans with chronic medical conditions will almost certainly pay higher rates, and they may be denied coverage related to the pre-existing condition or turned down altogether. More than half of older adults who purchase coverage on the individual market spend $300 or more per month on premiums, or at least $3,600 annually for single coverage, the Commonwealth Fund found.
Early retirees who are healthy and have significant assets saved for retirement may want to consider a high-deductible health plan. These relatively new plans often have lower premium costs and protect against sudden illnesses or accidents. But out-of-pocket costs can be high. A recent EBRI survey found that adults enrolled in a high-deductible health plan with single-person coverage reported deductibles of between $1,000 and $1,999 (58 percent), $2,000 and $4,999 (29 percent), and even $5,000 or more (8 percent). “Basically, the only way you can protect yourself from truly catastrophic costs is to have more money so that you can afford these costs or to have better insurance so you don’t bear as great a share of the costs,” says Richard Johnson, a principal research associate at the Urban Institute.
A roll of the dice. Americans who truly can’t afford health insurance often go without necessary care. More than 70 percent of adults with gaps in their health insurance coverage reported not getting needed healthcare because of the cost, up from just over half in 2001, according to the Commonwealth Fund. If you decide to seek care without insurance coverage, you’ll be stuck paying the entire bill yourself. When Kodak announced in August that it would no longer pay for dental coverage or life insurance for retirees, Frank Allen, 72, a retired Kodak mechanical engineer and manager in Rochester, N.Y., decided to go without dental insurance. “The full cost of the dental plan is more expensive than I want to pay,” says Allen. Now he will pay the full cost of two dental cleanings a year and any other dental costs that occur completely out of pocket. “The loss of the dental and the life insurance was completely unexpected,” says Allen.
Keep up the good work. Continuing to get preventive care and staying healthy may be the best way to keep health costs in check, before and after qualifying for Medicare. Says Johnson: “Living a healthy lifestyle, watching what one eats, and staying active could at least delay the onset of the expenses.”