# Health Care in Retirement



## Gator13 (Jan 5, 2020)

My wife and I have enjoyed very good health benefits while working. As we get closer to retirement, we are unsure how to handle healthcare in retirement. (Both wear glasses, one inexpensive prescription, typical dental,etc) We are curious how others handle this. How much to budget for pay as you go? Cost and how plans work? Other options?


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## Beaver101 (Nov 14, 2011)

Retired people (before & after age 65) I know of pay out of pocket for healthcare you specified, using their pity savings, investment income, yard sales' dimes, RRSP cash-in, LOC/HELOC, and whatever pensions they have.

Since you have a very good employment contract, that part should have been spelled out for you so not sure why you need to be concerned about "budgeting" for that? In especial when you're in good health (still working) and the fact that no one knows what your future health is like.


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## Gator13 (Jan 5, 2020)

Perhaps I wasn't clear. When I retire I will no longer be able to participate in the group benefit plan my employer provides.

I am asking what others are doing or what options are available once retired and not part of a group benefit plan. For example, pay as you go, sign up for a plan through a carrier such as Blue Cross, etc. Cheers


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## Beaver101 (Nov 14, 2011)

^ Tip: Your employer should give you the option of converting to one of those private plans ... which eventually terminates at a certain age (70/75).


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## kcowan (Jul 1, 2010)

I got drugs through my former employer, those less lucky get drugs from the provincial government plan subject to a means test. Dental is lousy insurance because the costs are predictable and growing and so are the premiums.

Hospitalization and doctors is covered by the government.


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## Longtimeago (Aug 8, 2018)

Gator13 said:


> Perhaps I wasn't clear. When I retire I will no longer be able to participate in the group benefit plan my employer provides.
> 
> I am asking what others are doing or what options are available once retired and not part of a group benefit plan. For example, pay as you go, sign up for a plan through a carrier such as Blue Cross, etc. Cheers


Well, you have the choices you outline Gator13 and you make your decision. What anyone else does will depend on their own individual situation as does yours.

We 'self-insure' for anything not covered by OHIP for example. So we pay $800 for a new pair of glasses or a dental procedure etc. as we need it.


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## Gator13 (Jan 5, 2020)

Thanks. Some good information. Good point that dental and vision are fairly predictable. Prescription drug is probably the biggest variable. I will look into what conversion options are available from the group benefits carrier. Thx for the replies.


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## Longtimeago (Aug 8, 2018)

Gator13 said:


> Thanks. Some good information. Good point that dental and vision are fairly predictable. Prescription drug is probably the biggest variable. I will look into what conversion options are available from the group benefits carrier. Thx for the replies.


Don't forget to check what coverage for drugs your province provides you. Here is Ontario for example.


https://www.ontario.ca/page/get-coverage-prescription-drugs#:~:text=A%20senior%20couple%20(where%20at,have%20to%20pay%20a%20deductible


.

That does not cover every drug under the sun but it covers most. It then becomes a question of deciding that odds you want to give that you will need a 'non-covered' drug at some point. But I would also consider that same question even if paying for a private prescription drug insurance plan. Does it cover any and all drugs under the sun? I doubt it.


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## Longtimeago (Aug 8, 2018)

I should also have wrote that the same question applies to vision and dental. Will a private insurance plan buy you an $800 pair of glasses or do you have to settle for a cheaper frame and lower quality lenses, or pay the difference yourself anyway?


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## Gator13 (Jan 5, 2020)

The replies have helped a lot. I was to focused on forecasting healthcare as one solution / one number as opposed to breaking it down to vision, dental, prescription drug, etc. Breaking it down makes it easier to look for options and decide on a path forward.


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## ian (Jun 18, 2016)

My pension plan gives us $1500 a year for a health care spending account. After that we pay $3K. After the $3K the plans catastrophic plan kicks in and it pays 95 percent.

At retirement I had the option of signing up to pay for the firms supplementary benefit plan.. We did not feel it was worthwihile. Especially dental since most of the big dollar amounts are not covered or are covered up to a max. Nine years later it was the right decision.

In Alberta, anyone over 65 gets a Blue Cross drug plan gratis (also for spouse if under 65). So far this year DW has had $211.worth of prescriptions and paid $60 ( blue cross portion deducted from our payable by the pharmacy). The amounts paid vary by prescription.

Essentially we have been left with dental and eyewear. Usually the $1500 covers the bulk of that. I recall that one year we had $1600 of dental to cover. The only real spend was 2019. I had dental implants, DW had lens implants. Ouch. About 23K net of the $1500 HSA. DW won't need eyeglasses again. I get mine from Costco and have done for many years.

Not certain what your province does for prescriptions for age 65 plus. We do not pay medicare premiums...it is included in the general tax rate. Given the financial condition of the province this could change as could the Blue Cross coverage.

Our decision not to buy extended health was based on our health and our perception of the value of the plans that we looked at. You may have a different set of circumstances.


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## Spudd (Oct 11, 2011)

We just pay as we go. I budgeted 3k/year in my retirement spending calculations to cover health care. Right now this is way high since all we have is dental and vision, and we have good teeth. So dental runs us $120 per person twice a year for a cleaning/exam. This year I had to have a tooth pulled (OK, so maybe not that good?) which cost me an extra $600 or so. I went to an oral surgeon for it since it was slightly complicated. Would have probably been cheaper to have the dentist do it but I felt better this way. 

Vision is an eye doctor visit once every 2 years, $60-ish per person per year. We each get a new pair of glasses about once every 2 years but we generally buy online which makes it around $300 per pair now that I need multi-focals.

Additional costs to consider: 
drugs, obviously​physiotherapy (some is covered for 65+ but not all, at least in Ontario)​dentures/implants if needed​massage​chiropractor​devices, such as crutches, wheelchair, walker, diabetes tester, etc​​I found private insurance costs to be very high and not worth it. Dental plans are completely ridiculous. They generally only cover 50% up to a maximum cap and I couldn't see any way you'd be able to come out ahead.


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## Longtimeago (Aug 8, 2018)

In Ontario, your eye exam is free once a year after age 65. 

Buying glasses is an individual thing. I wouldn't dream of buying at Costco or online. I want a nice pair of glasses (my current pair are Oakleys) and top quality lenses.

For example, my wife got annoyed with a local opticians she had been using and went to a Hakim chain store. She ordered a pair of glasses and frames that looked OK in the store. When they arrived and she went to pick them up, the lenses were about twice as thick as her previous lenses. Yet they had told her, 'yes they will be our premium lenses and as thin as your previous pair.' Not so and she refused to accept or pay for them.

My point is that not all glasses and lenses are created equal. If someone is not as fussy as I might be, that is of course their choice to make but in terms of insurance, if it will not cover the glasses and lenses that I want, it's useless.


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## Dilbert (Nov 20, 2016)

LTA, nothing wrong with Costco glasses. Brand name frames (like Mont Blanc, etc.) and the lenses are Essilor. The only downside IMHO, is somewhat limited selection.


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## ian (Jun 18, 2016)

Our experience the first time we purchased prescription eye wear at Costco was interesting. DW picked out the frame she liked. Total price came to $325. or so. Service was excellent. When she said yes the gentleman serving her said...... "you know, if you had purchased this prescription lens and frame from my store six months ago I would have charged you $575- $600"

It turns out that he was a retired optician who had sold his store six months previous. He was working part time at Costco Optical.. We asked him about the quality. His comment...quality name brand frames, lens as good as anything that you would buy in a good optical store. He said it was where he would be buying his next pair of prescription lens.

The selection of frames can be limited because of how they buy. More than once we have looked at frames and did not see what either of us wanted. Waited a month or so and voila, new stock with exactly what we wanted. We also found that the stock of name brand or designer frames can vary between Costco locations. Plus...excellent customer service in our experience.


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## sags (May 15, 2010)

Ontario health care for seniors is a really basic plan. It doesn't cover a lot of things such as only providing "ward" hospital rooms.

We have private health care plan benefits, and it pays for most things that Ontario doesn't. It also pays the annual deductible to OHIP every year.

I used to wear glasses my whole life.....struggling to play hockey and baseball with them, and then I got old and started to develop cataracts.

Had cataract surgery and have perfect vision now. It is remarkable what they can do. Wish it was available growing up though.

Someone remarked about the GOP convention that American dentistry is really awesome. All those pearly white Hollywood smiles..........LOL.


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## Tayls77 (Dec 10, 2019)

We went through this when I retired last year. My plan wasn't convertible so for the first time in my life we were going to be without benefits. I retired early (56) so we have quite awhile until the provincial plan kicks in. We looked at several plans but in the end we are self funding as none of the plans provided any real benefits for the cost. Ontario covers anything catastrophic, so prescriptions, dental etc are costing us a couple of grand a year.


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## kcowan (Jul 1, 2010)

Yes we got a Coporate Sun Life drug coverage and has saved us plenty. Dental is mostly on our dime.

In Mexico, we take 6 months of drugs and do everything else ourselves.


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## ian (Jun 18, 2016)

The absolute best feature of my pension health coverage so far has been out of country medical. It covers us up to $5M. No medical, no pre existing exceptions. It covers us for up to 60 days outside our home province. As many times in the year as long as it is 60 days. We use it twice a year for the full 60 days each time plus the occasional week-two weeks out of the country. One of our friends mentioned the cost of their out of country medical. I suggested he check his pension plan....sure enough the had been buying unnecessary insurance for several years. His pension plan covered four weeks out of country.

I did not realize the value of this when we retired at 58/59 with no health issues. Nine years later we do.

This past year was the first year that we claimed any medical expenses on our tax returns. Heavy hit of $23K attributable to dental implants, lens implants , and some post neurosurgery cosmetic surgery. Had I been on the company retiree extended plan I would have paid out approx $33K in premiums over 9 years. BUT...this would have covered about $5K at most of that $23K.


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