Navigating Healthcare in Retirement: Key Strategies and Insights

1. Pre-65 Healthcare: Options Beyond COBRA

• COBRA: Lets you keep employer coverage for 18 months but at full cost (employer + employee premiums + 2% fee).

• Marketplace (ACA) Plans: Guaranteed coverage for pre-existing conditions, with income-based subsidies.

• Short-Term Plans & Healthcare Sharing: Niche options for healthy, high-income retirees.

Key Takeaway: Don’t let health insurance be the reason you don’t retire. There are always solutions.

Key Quote:
"In 2014, premiums shot up 300% overnight because insurers couldn’t medically underwrite anymore. But subsidies help bridge the gap." 

2. Medicare Demystified: Parts, Penalties, and Pitfalls

• Part A (Hospital): $0 premium for most; covers inpatient care.

• Part B (Medical): $175/month (Current Medicare Premium is $185 in 2025) (2024); covers 80% of outpatient costs (you pay 20% uncapped).

• Part D (Drugs): Part D is often a standalone policy with a private insurance carriers and is required to be carried by all Medicare beneficiaries. Not carrying Part D coverage can create penalties. Required to avoid lifetime penalties. 

• Medigap vs. Advantage:

  • Medigap: Fills Part B’s 20% gap; no networks.

  • Advantage: Bundles A/B/D; often $0 premium but has networks.

Key Takeaway: Once you miss the 6-month Medigap enrollment window, you may face medical underwriting. Start early and be sure to make an informed decision.

Key Quote:
"A million-dollar hospital stay? Original Medicare pays $800K; you’re on the hook for $200K without a supplement."*

3. Proactive Planning: Case Studies and Strategies

• Success Story: A couple retired 2 years early by optimizing marketplace subsidies, freeing them to travel and join the "Roller Coasters of America Club."

• Income Tactics: Lowering MAGI can boost subsidies, but balance with Roth conversions and lifestyle goals.

• Annual Reviews: Medicare plans change formularies yearly. "Open Enrollment (Oct 15–Dec 7) is your chance to adjust."

Key Takeaway: Healthcare costs average $320K per couple post-65. Plan conservatively, but don’t sacrifice retirement joy." 

Key Quote:
"We gave a client two extra years of retirement just by solving their healthcare anxiety. That’s what fires us up."

Final Advice

1. Pre-65: Explore ACA subsidies; avoid COBRA unless you’ve met annual deductibles or have specific healthcare needs.

2. Medicare: Review and make informed Medicare coverage decisions during your 6-month window to avoid Medicare mishaps. 

3. Partner Up: Work with advisors and healthcare experts (like Move Health) to align costs with your retirement vision.

Next Steps: Reach out to Continuum for an introduction to Move Health (we always want to point the client back to the advisor as the person making the service available. 

"The only constant in healthcare is change. Review your coverage yearly—it’s the key to confidence." —Cole Craven