2011-01-12 / Seniors

Health Insurance Help For Early Retirees

Dear Savvy Senior,

I’ve read that Uncle Sam recently developed some new programs that can help early retirees who aren’t yet eligible for Medicare, as well as high-risk uninsured people. What can you tell me about this?

Wanting To Retire

Dear Wanting:

For early retirees who aren’t old enough for Medicare and who can’t afford or don’t qualify for an individual health insurance policy, help is now available through two new programs. Here’s what you should know.

Early Retirement Help

If you’re looking at retiring before you’re eligible for Medicare, the federal government recently developed a temporary new program called the Early Retiree Reinsurance Program (ERRP) that may help you keep your employer’s health coverage.

As part of the healthcare reform law, this new program will dole out $5 billion to employers, public, private and nonprofit, to help offset their costs of providing healthcare coverage for their early retirees ages 55 to 64 and their families. The program began in July and will continue until Jan. 1, 2014 when health insurance reform kicks in. At that point you’ll be able to buy affordable health insurance from insurance exchanges, and you can’t be turned down for pre-existing health conditions. Ask your benefits manager or human resources department about the ERRP.

If, however, your employer is not offering early-retiree health coverage, you may be able to purchase an individual or family policy if you’re healthy, go to www.healthcare.gov or www.ehealthinsurance.com to search for policies and costs, or if your health isn’t so good, you can use the COBRA law.

Under COBRA, companies that employ 20 or more workers must let employees, after they leave the job, continue the same group coverage for themselves and their families for up to 18 months. But, it’s very expensive. You’ll have to pay the full monthly premium yourself, plus a two percent administrative fee. If you have COBRA coverage for at least 18 months, with no breaks in coverage for 63 days or more, you’ll then qualify for rights under HIPAA (Health Insurance Portability and Accountability Act), another law that gives you the right to buy individual health insurance that doesn’t exclude or limit coverage for pre-existing medical conditions. Contact your state insurance department, you can find the number at www.naic.org, or visit www.coverageforall.org for details.

High-Risk Plans

The second new government program you should know about is the Pre-Existing Condition Insurance Plan (PCIP). This program helps people with pre-existing medical conditions that have been unable to get affordable health insurance.

The PCIP, which is also a result of healthcare reform, started in July and will go to 2014. To be eligible you must be a U.S. citizen or be residing here legally, be uninsured for at least six months, and show that you have had a problem getting insurance due to a pre-existing condition.

Currently, 35 states already offer highrisk health insurance pools to their residents with pre-existing conditions who can’t get coverage, but it’s very expensive with premiums costing up to 200 percent the cost of private insurance, go to www.naschip.org.

The new PCIP, which is available in every state, will run alongside the existing state pools but will provide better and more affordable coverage. While premiums will vary by state and are age adjusted, those enrolled in a PCIP won’t pay more than a healthy person would pay in that state. A 50-year-old, for example, may pay between $320 and $570 per month. For more information on how the PCIP works in your state, or to apply go to www.pcip.gov or call your state department of insurance.

The Gazette does not endorse the contents of The Savvy Senior. Check with professionals about the contents of this column.

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