Q. My wife and I are both 60 and looking to retire. We will be giving up our employee group plans and will need to buy insurance on our own. One of us has high blood pressure and the other had a stent put in three years ago. Which companies should we look at?
A. I have the proverbial good news and bad news for you.
The good news is that July 1, 2012 was what I like to call "freedom day" for people who would like to quit a job to retire or start a small business, but hesitate for fear they won't be able to find an individual plan that covers their pre-existing conditions.
That is because it is now, for the first time ever, possible for Americans in that situation (including you) to let go of their employee health plans without fear of being left without health insurance down the road. You can accomplish this by continuing your group coverage under COBRA (which you probably already know will probably cost an arm and a leg). The 18 months it lasts will be just long enough to see you through to Jan. 1, 2014, when the full provisions of the Affordable Care Act take effect.
On that date, you will no longer have to worry about being turned down or charged extra because of your pre-existing conditions. You will be able to go on your state's health insurance exchange, select good-quality coverage from a menu of plans, and even get a subsidy to help pay for it if your post-retirement household income is less than 400 percent of the Federal Poverty Level.
The bad news is that in the meantime, the probable answer to your question about which carriers to look at for non-COBRA coverage is: whichever one, if any, will take you. Unless you live in one of the handful of states that already ban insurers from discriminating against people with pre-existing conditions (Maine, Massachusetts, New Jersey, New York, and Vermont) the one of you who has a stent is likely to be summarily rejected for coverage.
It is possible that an insurer might be willing to cover whichever one of you takes blood pressure pills, as long as the pills keep your blood pressure within normal limits and you are otherwise in absolutely perfect health, not overweight, and not a smoker, though likely with a premium surcharge and coverage nowhere near as good as what you are giving up when you leave your jobs. The best way to find out is to consult a reliable, knowledgeable independent insurance broker who can shop your business informally to various carriers in hopes that one will agree to take you on.
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