What health insurance options are there for someone near retirement

My dad is 61 and will be 62 in summer of 2012, not hitting 65 until summer of 2015. He is wanting to retire from his full time job and work part time, but can’t because his health issues are somewhat serious and he doesn’t want to lose his insurance.

He works as a pharmacist and makes a good living, so even a 25 hour workweek would be able to sustain him and my mom even w/o getting SS early (he may have to get SS early if he has to buy his own insurance though). But if he quits his job and works part time he is going to lose his health insurance. I really don’t know what options he has other than to wait until he turns 65 (my mom recently turned 63 FWIW). Since he and my mom are older they have several pre-existing conditions that will prevent them from buying individual insurance.

My mom is a homemaker so she doesn’t have insurance she can share with him.

If the affordable care act was in action he could join one of the exchanges (which can’t exclude for pre-existing conditions). But those don’t start up until Jan 1st 2014. And that is if the law stays in place, who knows if the supreme court will overturn it.

Part of the affordable care act was high risk pre-existing condition pools. But to join one of those you have to have been uninsured for 6 months. So you can’t quit your job then apply for it. You have to quit your job, wait 6 months, then apply for the pre-existing condition pool.

There is a state high risk pool program, but I am having trouble clarifying if you need to be w/o insurance for a period before you join. I don’t think so, but right now I’m just gaining info. However whatever plan he joins he needs to get one for mom too. The rates are about $1000 a month per person on that plan if you are 60-64.

In Indiana medicaid is for adults with dependent children, not adults alone. there is the Healthy Indiana Plan for adults, but they make too much money and the waiting lines are long to get on that plan anyway. I applied to get on that when I was unemployed and was turned down because the waiting list was too long.

He says he may try retiring and getting COBRA. That will cost $1500 a month or more I’m sure (I’m guessing the part of the stimulus that subsidized COBRA payments is gone now) but with a pharmacist wages and applying for SS early he should be able to cover it.

It ‘seems’ like he might be able to get COBRA for 18 months, then switch to the ICHIA (the Indiana plan) until medicare age or if the federal affordable care act is still standing he can join an exchange.

Or maybe he is better off waiting until my mom is 18 months from hitting 65, then quitting and using COBRA for 18 months. That way when his COBRA expires mom will be on medicare and he will only have premiums for himself for another 2 years or so, making it financially easier on him rather than buying pre-existing insurance for him and mom.

Are there other programs or ideas?

Depending on the laws in your state he may have access to 36 months of COBRA coverage. In NY it is a full 36 months no matter why you are going onto COBRA so he may want to check on that as an option.

I’m not sure what the question is. Is the problem he can’t afford private insurance, or he’s worried about being denied by new insurance for pre-existing conditions?

In my state anyway, pre-exist only applies if there’s a gap of 30 days or more without insurance. If he’s leaving his employers insurance and going right to an individual policy he can get a "certificate of creditable coverage) from his old insurance and fax it to his new insurance and not be subject to pre-exist clauses.

I believe in most states, for individual health insurance, a certificate of creditable coverage only waives the pre-existing condition waiting period if you actually get on individual insurance - it doesn’t prevent them from denying your application for insurance or from charging you a higher premium because of your conditions.

I agree with the creditable coverage - it should mean ‘guaranteed coverage’ as long as there are no gaps, so you probably don’t have to worry about pre-existing conditions.

Is insurance in your state subject to ‘community rating’ for premiums? If yes, then the cost is based only on age, not health status.

Does your state offer high deductible HSA insurance? That is what I took after COBRA ran out. Costs me about $275/month at 63 (I am in WA)

Finally, call a broker - they should be able to clarify things for you or your dad.