Halfway through next year I’ll make the switch to Medicare (I’ve already started to recieve the informational mailings from insurers) so I’m not sure what the best deal will be at all.
This is a damn good problem that my mother had last year. She had employer sponsored insurance through late spring and then became Medicare eligible in early summer. Choosing the right initial insurance when you know you’re switching mid-year to either Medicare or a new job or anything else is a challenging task. The biggest factor to consider is you’re going to face two out of pocket limits that don’t interact with each other. This may matter a lot depending on your health status and how long you need to have your first coverage.
We’ve looked at scenarios where individuals who know that they are going to be very high cost should choose a low premium high deductible/high out of pocket maximum plan (subject to network availability). These plans, in some counties and for some age groups, are on net, less expensive than high premium, low out of pocket maximum plans. However, this only works when the person is on the plan for most if not the entire year. It may make sense for someone who knows that they have $20,000 months every month to go Bronze if they are going to pay the $7,500 deductible in January and then nothing else while they bank the difference in premium between the Bronze plan and the Gold plan. The break-even between Gold and Bronze may be September. This decision is different if that person knows they get a new insurer in March; then the higher monthly premium for the lower out of pocket maximum might be a better decision.
This is an extreme example.
Conversely, if someone knows that they are primarily insuring against meteorites for several months and they have the ability to pay off a meteorite event, then a low premium plan to bridge them to the new insurer makes sense. The gamble is that they will stay healthy and barely use any services. If they use services, it will be very little so that the cost sharing between a low premium plan and a high premium plan will be the same. For instance a $1,000 deductible plan and a $5,000 deductible plan will each have the same out of pocket payment of $180 for an urgent care visit.
These are not easy choices. It is a calculation based on your risk tolerance, ability to handle an unexpected shock, and current health status.