He’s a great example of how to shop for the right plan — and how the ACA gives people more choices than ever before.
Jim worked 37 years for the same company, typically putting in 50-hour weeks that included travel and working weekends. It started taking a toll and he says his health began to decline. That’s why he decided to retire at age 59 — something he could not have done without the Affordable Care Act (ACA), also known as Obamacare.
“June 28, 2012 was one of the happiest days of my life, when the Supreme Court upheld the Affordable Care Act,” Jim says. “Without the ACA, I could not get insurance at any price because my wife is a cancer survivor — she had leukemia 15 years ago — and the only way I could get insurance was through work.”
His wife’s leukemia was treated successfully and neither one of them has any chronic health conditions, but that didn’t stop insurance companies from turning people away or charging exorbitant prices because of pre-existing conditions before the ACA.
Jim retired in March 2014 after doing his homework about the plans available on the insurance Marketplace at Healthcare.gov.
The first thing I did when I went shopping was to call the company that provided the insurance through my employer. I asked them to show me what I’d spent the previous year and then I minused out the things that are covered under the ACA at no charge, like annual checkups and colonoscopies.Based on our previous spending, I chose a high-deductible Bronze plan with a Health Savings Account (HSA), which pays 3% interest — better than a traditional savings account — and we shop around for the best prescription prices to keep costs low. So far, that’s really the only thing we’ve needed to pay for.
The plan Jim chose would have cost $1,200 per month to cover him and his wife, but with a tax subsidy their premium costs just $127 per month. Their annual deductible is $8,000 for the two of them with an out-of-pocket maximum of $12,500 per year. After meeting the deductible, office visit co-pays are $30, and the primary care physician Jim and his wife like accepts their insurance.
Even with a high-deductible plan, I anticipate we’ll still come out ahead by choosing a lower premium and a higher deductible and shopping around for the best prices on prescriptions. The best thing is knowing that the most we’d have to pay out of pocket is $12,500 if we do need care.
Jim is still comparing coverage options for 2015, because doing his homework is the best way to make sure he and his wife get the right plan for their needs.
Although he still works a bit here and there, Jim is mostly drawing on his savings until his pension kicks in next year. Retiring early has given Jim and his wife the chance to travel together, with upcoming trips planned to California and Europe.
What’s more, since leaving his job Jim has had more time to focus on his health and he’s lost 50 pounds. “I’m much healthier and happier than I was before,” he says.
Plus, Jim adds, he’s helping the economy. “When I left my job they had to hire someone else,” he quips. “So I’m a job creator.”
Open enrollment is underway through February 15, 2015. Compare and enroll in coverage today at Healthcare.gov.
