Insurance companies are just one part of how US health care is becoming dominated by a smaller number of vertically integrated companies. 5 ways our health care system has become utterly insane has this image:
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People on the ACA plans may have less access to healthcare during traditional office hours. Those who work low wage jobs often don’t have flexibility to leave work, and they may work multiple jobs to make ends meet. This leads to putting off care until it becomes unavoidable - and the only option after hours is emergency rooms.
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Laid Off After 50, and No Health Insurance? Here’s What to Consider.
At best, older workers will struggle to find health insurance that bridges the years before they qualify for Medicare at age 65.
gift link What to Do If You’re Laid Off and Too Young for Medicare - The New York Times
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Timely article. I hear rumors it is coming and that is my concern as someone with a pre existing condition. No matter your wealth, it’s still scary.
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My H was laid off/retired from his job before he was 65. His employer of 40 years offered retiree health insurance. As his qualified spouse, I also had those benefits
Before we were eligible for Medicare the company changed how they funded retirees healthcare. We had to go on an ACA plan.
It’s not the $1250 a month cost which the company subsidizes. It’s the $10,000 per person deductible that’s the issue. You really have to think about seeking out help. Or getting the care you need other than that which is very minimal.
Since my H has Medicare, that visit to the ED, the costs we didn’t think about. If it had been me with my $10,000 deductible, I’m not sure I would have gone.
And that’s a problem for even those of us who can afford it. What about those who can’t?
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This concerns us too. DH would be offered healthcare should he retire at 63, but the deductible keeps rising (currently about $5K) and the monthly cost does too. So now we are re thinking his exit date because with a cancer dx, we’re worried we can’t afford their insurance (but also worried he can’t work until he’s 65)
Adding insult to injury – first time in 30+ years he used up all his paid time off in 2026, even the extra he had carried over. I don’t know what regular people are expected to do.
As for the issue of ACA members in the ED : I had a suspicious mammogram. DIagnostics advised a special scan, but warned me that if I didn’t have cancer, insurance would not pay for the $445 test at all. We had the money for me to have the test, but that’s how a less-advantaged woman ends up in the ED with a lump and cancer.
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When looking for health insurance to bridge that gap, you need to carefully weigh COBRA vs the ACA marketplace vs the offering of “retiree” insurance from your employee.
When my husband was laid off at 60 we did COBRA for the rest of that year and then switched to ACA plans until each of us became of Medicare age. He was also offered a "retiree’ plan, but it was not cost effective.
ACA plans vary so much by state. We were lucky that in both NJ and MA the plans were fine for our needs. It did ouch a little that the NJ plan would not allow us to be covered if we sought treatment in NYC (very close to where we lived).
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Health insurance is what keeps people working here. A couple of weeks ago, I was talking to a longtime co-worker (different dept)/acquaintance/friend (He grew up across the street from H, so it’s been awhile) who is thinking about retiring. His wife already retired (or was pushed out) from the school system. They are roughly 60-61 years old and their income will be similar to ours. He said COBRA for the both of them with the $5000 per person deductible is $2800/month. A similar ACA plan was going to be $2500 - but that comes with the caveat that all your healthcare must be in state. As I’ve mentioned before, we are in a small city (40K) on the state line. Everyone goes across the state line for health care of moderate to major importance. He’s getting all of the surgeries done while he’s still working, but hopes to retire next year.
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I got the package last year - several years to go before 65. H is still employed, so we switched to his insurance for now. He can get medicare next year - so if he loses his job or retires, he will likely switch to medicare. And I will have to find a marketplace plan for the next few years.
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I posted about this awhile ago (maybe on another thread?) – but DH and I are both 53 and “retired.” We’ve been purchasing insurance through the marketplace for our family of five for many years, and it was expensive for crappy plans, but it was fine.
That kind of blew up when the company we had stopped offering plans in our state at exactly the same time the discounts expired – so every plan through the marketplace doubled or tripled in price.
So, I started taking a couple of online classes as a post-baccalaureate student (meaning not degree-seeking) through our local community college – which is tied to a larger public state university – in order to purchase student health insurance. I’m required to take minimum six credits in both fall and spring semesters to be eligible.
It costs me about $1,000 per semester to do this, including books and what not. And the premiums for the student health insurance – for our family of five – are $19,000 a year.
That is still almost half of what a marketplace plan would cost us, for a much, MUCH crappier HMO with extremely high deductibles. The student health insurance is a PPO with $500 deductible (80/20 after it’s met) – so far, it’s been decent.
I don’t always love having to do schoolwork, lol, but it’s been pretty good this semester. I’m taking a creative writing class and a linguistics class. My eldest just graduated with a linguistics degree (and is now getting her SLP masters) – so she is loving hearing about the things I’m learning!
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$5,000/person deductible? Wow, I wish I could afford that. I can’t even afford the $11,000 deductible. 
I’m using the cost sharing program, which I know sucks, believe me. I’m supposed to have an annual mammogram, but since the recommendation is to have one every two years, I feel comfortable waiting until July, when I’m on Medicare.
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My daughter works for a large engineering firm. Her health insurance is at no cost to an employee, and her husband has his own through his employer, so they thought great, free. He’s had a few out patient surgeries and it was low cost to him so they never questioned it. One mistake they made was assuming since they are both Cigna, they were the same plan (nope).doct
My daughter went to a doctor’s appt and got the bill, including one test at the office. She got a very large (IMO) bill. That caused me to read her policy. She has a $3400 deductible with the only benefit until she meets that is the negotiated rate discount (which wasn’t much) and after that 80/20% split until the OOP max of $12,000 (I think that’s right). To me, that seemed really high. She can afford it, but I assume an office assistant making a lot less would also have that deductible and split. I guess that’s only $5000 OOP/yr, but it seemed like a really big bill for just a doctor’s appt. (it was like $800 after the discount).
Colorado has a weird law that if parents have different insurance and have a baby, the parent whose birthday is first in the year pays the hospital bill for the baby. If they should ever have a baby (from my lips to God’s ear), she’d pay her whole deductible for herself and then his insurance would pay the baby’s costs, so they could get stuck with two deductibles for the same birth (H’s birthday is April, hers Dec).
I don’t know what the cost of a ‘family plan’ is on either employer’s plan is, but they are going to compare for next year. Free might not be the best choice.
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My daughter is also on a low cost, high deductible plan but her company makes a yearly contribution equal to the max OOP to the employee’s HSA account. She maxes out what she’s allowed to contribute as well. (We do the same for ourselves).
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My D’s husband works in healthcare. With his employer, what you pay for healthcare insurance is on a sliding scale based on your income.
I’ve never heard of that before.
My D works for a large corporation, her healthcare insurance is self funded as most large corporations do. She has really good insurance for a low cost.
She keeps working at this job because the insurance is so good. One of the perks.
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It’s not a weird law. It was the same here when our kids were born. We had coverage through both my job AND my husband’s. My birthday is the closest to the start of the year so my policy was primary. And paid.
The state has to have some way to determine whose insurance covers a newborn when both parents have coverage.
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That’s not Colorado, it’s insurance convention and applies in (nearly?) all states when both parents have dependent coverage. Which plan is primary depends on the earliest birthday of the parents.
Essentially, the mother’s plan pays for the newborn in the hospital delivery room (~ 2 nights) which gives the parent or parents time to add the child to their plan. Mom doens’t have to add the child to her plan, Dad could add it to his, assuming his employer allows dependent coverage. But if both add the dependent, then in your case, Dad’s plan would be primary for any baby medical bills beyond the normal delivery fees. (And mom’s would be secondary.)
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Yes, you really need to pay attention and compare because plans can be so different. The family premiums for his insurance may be better than having the free insurance from her company once you consider the deductables.
Also, not all family plan offers are the same. Some companies offer employee+ spouse at a lower cost than full family (which includes spouse and children).
Many companies (my husband’s was one) would not let you carry your spouse if that spouse had credible coverage.
Didn’t matter if the spouse’s healthcare insurance isn’t good
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Back in the day, it was sort of valuable to have double coverage. BUT now with insurance paying the allowable cost, it’s not such a great thing anymore. When that became the standard, we looked at both of our plans and chose the one with the better coverage for the cost…and it was mine. We did carry double dental because it was allowed, it was cheap, and we could use both policies to cover dental work.
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I had not realized the birthday rule was still a thing. For years coverage for our kids was through my husband (earlier birthday). Then my husband had layoff, and I covered the family. His next job year later was contractor, so I continued coverage. When he did get rehired, I think(?) I kept the kids. Hard to recall since I did all the paperwork regardless of which plan. (We were working at same company, til his had sell off)
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