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COBRA coverage begins the date your health insurance policy ends because of a qualifying event. For an employee covered under a qualifying event, COBRA coverage can last for 18 months from the date you elect coverage. However, dependents can receive up to 36 months of coverage if you switch to Medicare, get divorced, or die. Otherwise, they’re covered for 18 months as well.
Our primary residence is in Nevada, where we spend about 7 months of the year. We spend about 5 months of the year in Utah (Park City).
There is quite literally no individual/Obamacare plan available for purchase in NV that also covers us in UT. The plans available for purchase in the individual market here in NV cover emergency room visits in Utah but not non-emergency care. So a doctor's visit and a blood test, for example, are at the uninsured full-boat retail price.
Each year we look into it and discover the same thing.
One might think large nationwide insurers (UnitedHealth, Cigna, Aetna and the like) would at least get us into their preferred provider network at reduced fees, even if I pay all of it myself when I'm in Utah - but that is not the case.
Insurance brokers and ACA facilitators say, "oh that can't possibly be correct; let me find you a plan that covers you in both." Invariably, they call us back and say, "Amazing; you're correct - there are no plans available that will provide in-plan coverage in both locations." Brokers tell us, "well, you may just need to buy two insurance plans: one here in Nevada, and another for Utah."
I would do that -- if only it were legal.
However, insurance law states that I can only purchase health insurance in my official State of Residence (Nevada) and explicitly prevents me as a resident of Nevada from purchasing insurance in Utah. That is one of the "features" of Obamacare. For example, if I log on to a website to purchase insurance in Utah, once I fill in the information giving my address in Nevada, it bounces me out.
Brokers reply, "just lie and list your vacation house in Utah as your residence; they'll never know the difference." I won't do that; I suspect that would be considered insurance fraud.
We end up paying over $25,000 per year for retiree insurance rather than being able to access Obamacare plans.
Right now we have CA insurance (Kaiser) because my kids are in college in CA and it is pretty inexpensive with all on one policy but NV is out of network. It would cost another $600/yr to get in network coverage for NV and CA for my DW and I. Colleges in CA don't seem to have a good policy for students anymore - they use coverca which is California Obamacare.
ACA is income based, not asset based so if you set up your financial structure correctly until you reach 65 and medicare then you can get a subsidy. That's what I did when I knew in advance I'd be moving over to ACA 2 years ago.
Same. Most of our financial planning in retirement is related to either tax planning and managing income to take advantage of ACA subsidies. It's a fascinating tightrope to walk with a lot of decisions based on guesswork about future tax rates.
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Originally Posted by StealthRabbit
We add travel insurance, as long as we are not going to return home anytime soon. (It auto cancels when you arrive home.
If you occasionally return home you should do a bit more research on travel insurance options, we've used a few different companies over the years and they all covered some specified amount of time in USA I think about two weeks.
Right now we have CA insurance (Kaiser) because my kids are in college in CA and it is pretty inexpensive with all on one policy but NV is out of network. It would cost another $600/yr to get in network coverage for NV and CA for my DW and I. Colleges in CA don't seem to have a good policy for students anymore - they use coverca which is California Obamacare.
I think colleges may have dropped their insurance offerings for students since students can now stay on their parents insurance until age 26. No more (or very little) need for separate insurance for students.
I’m actually looking at moving there, (MA) mainly because I’m a native New Englander, but also because of the blue policies. Not only is it the best state for individual health care, but I’d probably pay half the property taxes on a back bay condo that is priced similarly to my Bay Area SFH. Plus, prop 2.5 seems to provide as much protection from tax increases as prop 13 does.
Weather sucks though.
What I am about to say is not actually about health insurance, but about retirement location; however, since you mentioned an interest in moving from SF to MA, I guess my post that follows might still be appropriate for this thread.
I think you said you lived somewhere in Marin or Silicon Valley, in any case not on SF Peninsula. Since you are not in downtown SF anyway (from which I conclude that being in the center of a large city is not important to you, but only being near the city), and you have worked out good tax/health insurance deals in CA already, and you seem to be considering getting out of Bay Area (probably due to COL, the only reason I can think of for anyone wanting to get out of Bay Area) - did you think of Sacramento? You can make it to SF in a little over 2 hours, likely even faster outside of rush hour (plenty of people commute for work), it is very much cheaper than SF, and it is actually not a bad little city. It has even better climate than SF, and is not overwhelmingly criminal, plus is the capital of the state, so has a decent library etc.
I thought of Sacramento in some ways myself, for the interesting reason that it is the third naturally safest city in the USA. Believe it or not, it is seismically very stable, it is an urban area with just about the lowest earthquake risk in the US (!!! - while being located in CA!), there is something about its geography (not sure what) that protects it from the increasingly scary California fires, and of course there is no risk of a tornado, snowstorm, or tsunami. The only natural risk is flooding, but Sac is not a.very aggressive river, and the floods are not catastrophic (one is probably totally safe anywhere in the city above the first floor). I was actually thinking of moving my primary residence to San Francisco, but keeping my belongings in storage in Sacramento - not just because my SF condo is very small, but also because the stuff in storage will not grow mold in Sacramento like in foggy San Francisco, and because it would be safe from natural risks. What do you say?
What I am about to say is not actually about health insurance, but about retirement location; however, since you mentioned an interest in moving from SF to MA, I guess my post that follows might still be appropriate for this thread.
I think you said you lived somewhere in Marin or Silicon Valley, in any case not on SF Peninsula. Since you are not in downtown SF anyway (from which I conclude that being in the center of a large city is not important to you, but only being near the city), and you have worked out good tax/health insurance deals in CA already, and you seem to be considering getting out of Bay Area (probably due to COL, the only reason I can think of for anyone wanting to get out of Bay Area) - did you think of Sacramento? You can make it to SF in a little over 2 hours, likely even faster outside of rush hour (plenty of people commute for work), it is very much cheaper than SF, and it is actually not a bad little city. It has even better climate than SF, and is not overwhelmingly criminal, plus is the capital of the state, so has a decent library etc.
I thought of Sacramento in some ways myself, for the interesting reason that it is the third naturally safest city in the USA. Believe it or not, it is seismically very stable, it is an urban area with just about the lowest earthquake risk in the US (!!! - while being located in CA!), there is something about its geography (not sure what) that protects it from the increasingly scary California fires, and of course there is no risk of a tornado, snowstorm, or tsunami. The only natural risk is flooding, but Sac is not a.very aggressive river, and the floods are not catastrophic (one is probably totally safe anywhere in the city above the first floor). I was actually thinking of moving my primary residence to San Francisco, but keeping my belongings in storage in Sacramento - not just because my SF condo is very small, but also because the stuff in storage will not grow mold in Sacramento like in foggy San Francisco, and because it would be safe from natural risks. What do you say?
Actually, I live in the Lamorinda area - east of SF. I live in the burbs because I’ve had German shepherds for a couple decades. The current dogs are 10+ now and when their time comes, I would prefer to be in a more urban area.
I find SF absolutely disgusting....much worse than the NYC I lived in in the 90s. So, I either return to Boston or NYC.
And yes, I have worked out great tax/health situations for myself. Given that MA/NY are blue states, and I’d basically be rolling all the 1+M equity in my SFH here to a condo/co-op there, I’d be able to swing the same deal there. My expenses in both Boston and NYC would be lower. Thus less income needs. Thus less realized capital gains.
Actually, I live in the Lamorinda area - east of SF. I live in the burbs because I’ve had German shepherds for a couple decades. The current dogs are 10+ now and when their time comes, I would prefer to be in a more urban area.
I find SF absolutely disgusting....much worse than the NYC I lived in in the 90s. So, I either return to Boston or NYC.
And yes, I have worked out great tax/health situations for myself. Given that MA/NY are blue states, and I’d basically be rolling all the 1+M equity in my SFH here to a condo/co-op there, I’d be able to swing the same deal there. My expenses in both Boston and NYC would be lower. Thus less income needs. Thus less realized capital gains.
Wow... well, I avoid the urine-scented Tenderloin with concentration of all the homeless mental cases, but I still find most of the city to be the most beautiful place in the world. I couldn't leave... Also, I don't think crime risk in SF is nearly as serious as in NYC.
Re CA/MA/NY being blue states, I am not sure that necessarily makes difference for your lack of tax liability and free healthcare. Although I don't quite understand how that is possible (but I am not knowledgeable about investing at all), it appears that you have zero tax liability (and therefore free healthcare) because you derive all your income from selling a % of your investments without capital gains. If that results in zero tax liability in blue states, there should be zero tax liability in red states as well - I am not aware that any state would tax you if you have no capital gains (and no other income). And I assume that you would qualify for free healthcare in every state if you do not have taxable income. As far as I know, poverty line (and eligibility for subsidized healthcare) is determined according to income, and not according to assets, in every state.
The difference between CA/MA on one side, and NY on the other, is that the really powerful welfare activists in NY would like to crucify someone like you, as a "rich privileged" person that is using what they would see a "tax loophole" to avoid paying tax and even getting a free healthcare... while CA and MA liberalisms are a different thing - both of the states are business-friendly, and it is widely understood that without investors (such as yourself) there would be no economy, so tax breaks for investors are deemed to be okay. For me personally, none of this matters financially since I am not an investor, but I do not like the current NY rabid anti-capitalism for other reasons, ie, because it is chasing the solid tax base out of the state and the city, and I am concerned that the quality of life will decline, and crime go way up, in NYC as a consequence of lost tax revenue needed to run the city properly. This has finally given me a pause with planning to have my East Coast base in NYC retirement - if the city is really going back into the 1970s urban decay, I don't want to be a part of it. Otherwise, I love NYC for its grand scale and cosmopolitanism
Regarding health insurance, my opinion is that every adult in the US should be paying a health insurance premium, the way it is done in Western Europe with mandatory contributions to national insurance system, which are required even from unemployed people. In your case, you were absurdly placed into a situation to either have to pay a doubled healthcare premium or go on MediCal, so I can't really blame you... but healthcare premiums in the US are so huge primarily because of the huge number of people who do not pay any premium. Somebody has to pay for the health care of those who do not pay anything for it, and that is why those who do pay a premium end up paying a huge amount. I was told that the health insurance premium pool in MA is determined according to the zip code, and I suspect that pretty much everyone in my Back Bay zip code pays into the health insurance pool, which keeps the premiums reasonably low. That is why I'll pay only $5,080 per year for health insurance at the age of 60, and not some ridiculous 5-digit figure mentioned in other posts. The relatively low premiums in MA are not a function of MA being a blue state (actually MA Health Connector was created by a Republican governor, ie, Mitt Romney), but of the fact that the number of MA residents who get free healthcare is relatively low compared to the number of those who pay the premium. If a larger number of people pays into an insurance pool, the amount of each individual premium goes down.
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