What’s a smart way to buy health insurance? Health care is horrendously expensive, so without good insurance you can lose everything, your retirement savings, your house. But you really don’t know how your insurance works until you try to use it. You don’t know if you’re going to get hit by a bus and need rehab or get cancer and need chemotherapy. So you need a policy that covers everything that is medically necessary. The best way to get that is to work for a big employer who provides a good, comprehensive plan. On the individual market, stay away from plans that are cheap only because they cover so little, only a few doctor visits a year, no prescription drugs, no rehab.
Any advice for near retirees and retirees? Don’t even think about retiring early without considering health insurance. If you can stay on an employer’s group plan as a retirement benefit or through your spouse, or can qualify for good public coverage, then fine. If not, you will have to get insurance on the individual market. In most states, you will be medically underwritten and may not be able to get insurance at all. Even if you can, it will have exclusions, high cost sharing, and tremendously high premiums. Although the new private Medicare advantage plans may look like a good deal, you may be surprised by high cost-sharing for services like chemotherapy, or a very limited choice of doctors. Check before you sign up.
Any tips for handling claims? Save everything, but pay nothing right away. Match each doctor or hospital bill with a statement from your insurance company. If claims are not paid right away, call or write your insurer. Be polite, ask specific questions, and write down whom you talked to and what you were told. If you think the claim was denied inappropriately, appeal. Also, consider reaching out to your state insurance regulator, State Attorney General, or health insurance ombudsman program.