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US Health Insurance “Challenges”: HELP!

My partner and I are over 60 and no longer work full time. We can’t get employer-sponsored health insurance and are too young for Medicare. We make too much money to quality for Medicaid.

We live in two states for half of each year and we’ve been told by experts that ACA / Obamacare policies only cover you in a single state. So we’re scared to get coverage that only covers us in one state. Plus, many of our doctors don’t accept ACA insurance. We have struggled to get private insurance because of pre-existing conditions, all of which I would describe as relatively minor that many our age would face.

We did find private insurance that accepted us but the company just went bankrupt. We only learned about this when the company stopped billing us and their 800 was terminated. There has been no formal communication from them.

I’m setting aside the affordability issue for now though that is another challenge. I would say this is an eldergay issue but younger Americans may also face it if they don’t get employer sponsored insurance.

Is anyone else in this situation and if so, what do you do?

by Anonymousreply 18October 18, 2025 7:23 AM

ACA seems like your only viable option—in fact one of the reasons it was created was for those who are nearing 65 but don’t have insurance.

Not all ACA plans are restricted to one state but many are.

Could one of you get a family insurance policy in one state that covers both of you and the other get one in the other state?

If not a lot of doctors take it, just find one that does and let this only hold you over until you’re 65. Another choice is to get healthcare at your local community health center for a small fee.

by Anonymousreply 1October 16, 2025 7:37 PM

Another choice is to get an ACA plan in one state but make sure the ACA plan as some out of network coverage in case you’re in another state.

When you’re in your home state, have your annual physical. When you’re in the second state, only trigger insurance of there’s an emergency

by Anonymousreply 2October 16, 2025 7:39 PM

Or move to socialist hellholes such as: Canada, United Kingdom, Czechia, Denmark, Finland, France, Germany, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, Japan, Malaysia, Singapore, South Korea, Taiwan, Thailand, Australia, New Zealand, or Costa Rica.

by Anonymousreply 3October 16, 2025 8:21 PM

Suicide is the only option here

by Anonymousreply 4October 16, 2025 8:34 PM

You will need insurance when the Rentboy you both hire starts punching you to steal your money

by Anonymousreply 5October 16, 2025 8:35 PM

Before Obamacare, I had a Kaiser Permanente plan for myself. Kaiser exists in many locations so you may want to check that out. The drawback is you have to use all Kaiser docs, but for the year or so I had the plan it wasn't an issue

by Anonymousreply 6October 16, 2025 8:49 PM

Those ‘’ socialist hellholes’’ are looking better everyday.

by Anonymousreply 7October 16, 2025 8:58 PM

Do you have homes in two states? If that's the case, get rid of one of them.

by Anonymousreply 8October 16, 2025 10:00 PM

Can you do concierge medicine/ direct primary care and then get a policy through the exchange that would cover more major care? Health insurance is this country is a disgrace but the laws under the ACA should stop you being denied coverage for preexisting conditions.

by Anonymousreply 9October 16, 2025 10:17 PM

It’s really dependent on the state. NY ACA has out of network options - which I can use out of state. Insanely expensive but it’s a backup. What I hate is that ALL NY plans are HMOs - requiring a PCP referral for every little thing for it to be covered. It’s THE biggest expense of retiring before 65. $20,000/year and still a have lots of copays/deductibles.

The way I make it work is flying to NY for anything other than an emergency. If I ever get seriously ill, I’ll have to live in NY full time.

by Anonymousreply 10October 17, 2025 11:54 PM

OP, it disgusts me that we live in a country where we must even have this conversation. I hate it here.

by Anonymousreply 11October 18, 2025 12:31 AM

Thank God I have VA. You know youngsters should enlist just for the benefits later on.

by Anonymousreply 12October 18, 2025 12:44 AM

[quote]We live in two states for half of each year and we’ve been told by experts that ACA / Obamacare policies only cover you in a single state.

Pick one.

by Anonymousreply 13October 18, 2025 12:50 AM

r12=Pete Hegseth

by Anonymousreply 14October 18, 2025 1:53 AM

You have enough money to own and maintain two homes and travel between them, but you don’t have money for health insurance? Fucked up priorities.

by Anonymousreply 15October 18, 2025 1:57 AM

Well, no R12. If he said that I didn’t know.

by Anonymousreply 16October 18, 2025 2:19 AM

I was thinking they were rich fucks too R15.

by Anonymousreply 17October 18, 2025 2:20 AM

You should never let your health insurance lapse. Why did you let that happen?

by Anonymousreply 18October 18, 2025 7:23 AM
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