Health Insurance for Younger-than-Medicare-Age Spouse?

December 22, 2012 11:32 AM

I'm 51, spouse is 58. When he retires at SS age (let's say 68), he will be eligible for Medicare (age 65). I won't. Spouse currently gets good group health insurance, which covers both of us, through his full-time job. I don't work for money and haven't for 20 years. If he retires in 10 yrs, at 68, he will be covered by Medicare (assuming anyone is by then ...). But I will be only 61 then, so I won't be eligible for Medicare for 4 more years. What are my health insurance options? (We live in NH now.) Believe me, thinking about this keeps me up at night.
posted by mmw to health & fitness (11 answers total)

Hopefully no one overturns ObamaCare and you will be able to get on that. That or look at other low-income state plans, if you qualify.
posted by wocka wocka wocka at 11:33 AM on December 22, 2012 [4 favorites]

Under current COBRA rules, I believe a younger spouse is entitled to keep a retiring spouse's health insurance (though at the full premium) for up to 36 months. So that covers 3 years, during which you should be able to find an individual plan to buy until you reach Medicare eligibility, or find a plan through your state. The ease and affordability of being able to buy that plan will depend on what happens to Obamacare, but even if it's overturned entirely -- which I don't think it will be -- you would still qualify for COBRA and access to individual plans under HIPAA (the health care law from 1996).
posted by scody at 11:43 AM on December 22, 2012 [2 favorites]

Private insurance (if you can afford it) or medicaid (if you qualify) are generally the usual options.
posted by greta simone at 11:44 AM on December 22, 2012

I would look at COBRA. In my experience COBRA was better than what I could find independently in terms of coverage and co-pays (like, independent coverage would keep me out of bankruptcy, maybe, but would hit me hard if I got sick, while COBRA would just cost a lot monthly but would actually cover things).

This all depends on what kind of plan the employer has gotten, but employers seem to have much more leverage than us.
posted by zippy at 12:05 PM on December 22, 2012

Obamacare contains something called the Reinsurance Program for Early Retirees. I don't know much about it but as I understand it, it's intended to temporarily pay for some of the health insurance costs for people who retire at age 55 or older but don't qualify for Medicare yet, if employers set everything up right.
posted by XMLicious at 12:14 PM on December 22, 2012

To be bluntly honest, one of you will have to continue working.

As it stands in the U.S., the cheaper option almost always is health care though an employer plan. Individual plans can be purchased, but are significantly more costly.
posted by Kruger5 at 1:01 PM on December 22, 2012

My guess is that there will be something similar to the Massachusetts Health Connector in New Hampshire by then (my brother is a journalist who covers New Hampshire politics and public policy).
posted by Sidhedevil at 2:06 PM on December 22, 2012

Kruger5 has the right idea - Either he needs to keep working, or you need to start.

Even if you have great health and assume nothing all that bad will happen to you in the five years between retirements, it makes more financial sense for him to just keep working (retirement would likely mean something of a pay cut for him anyway, and if you need to pay an extra $400 a month for insurance on top of that, your finances will seriously suffer as a result).

That said, if you haven't needed to have two incomes for the past 20 years, perhaps you have enough saved away that it really won't matter. Since you worry about it, though, I would guess that does not count as the situation here.
posted by pla at 2:18 PM on December 22, 2012

Perhaps your husband's employer offers retiree medical insurance, so you can both stay on his group plan with Medicare supplementing (or perhaps primary) for him.
posted by Joleta at 2:37 PM on December 22, 2012 [1 favorite]

New Hampshire Health Plan is important to know about, a private company established by the legislature (or maybe just contracted by them, I don't know the details) as a fallback for people without other options; you have to meet certain conditions to be eligible (listed on the home page there) but that includes exhausting your COBRA, for example. Of course, it's pretty expensive and has crappy benefits.

If you have a small business or are thinking of starting one, see this note I wrote in a previous health insurance thread.

If you think someone at an insurance company or broker is trying to jerk you around, I found the state insurance department very responsive and professional. They can't necessarily help in every situation but getting them involved seemed to make the insurance company I was dealing with much more informative and prompt in calling me back.
posted by XMLicious at 6:40 PM on December 22, 2012

Thanks to all. Very helpful to know about the NH Health Plan, XMLicious. scody, your answer was especially helpful, too.

We have substantial savings but I know how quickly medical care without insurance could wipe it out. I worry not so much about the cost of insurance but about the availability of it -- of developing some condition that will keep me from being allowed to buy insurance at any price, if the Affordable Care Act's provision for not being denied insurance is overturned.
posted by mmw at 1:54 PM on December 24, 2012