Nightly News   |  August 10, 2013

Older Americans face tough health care decisions

When the Affordable Health Care Act goes into effect on Oct. 1, many Americans around retirement age will have some challenging choices to make: should they switch to a new kind of health care coverage? And if they do, will that mean changing doctors? NBC’s Dr. Nancy Snyderman reports.

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>>> when the affordable health care act goes into effect october 1st , retirement age will have challenges choices to make. should she switch to new health care coverage and if they do will that mean changing doctors? nbc news medical correspondent nancy snyderman reports.

>> reporter: this 62-year-old works the early morning shift at starbucks . but this previously retired woman didn't go back to work for a paycheck.

>> i am there for health insurance . about the om reason i'm there.

>> reporter: she wants to retire again but her insurance from starbucks covers herself and her husband scott, who is permanently disabled. they're too young more medicare and can't afford independent coverage that would allow them to keep their current positions.

>> we have to stay with our doctors. you know, they're specific to what he needs, specific to what i need.

>> reporter: but next year, people looking to buy their own health care will have more options through the affordable care angt new online marketplace .

>> able to compare prices for plans and see the different types of plans available to them.

>> reporter: a new study find between 500 and 900,000 people like these ch them could choose stop working or retire early based on new options. expert caution, there is more to consider than price.

>> look add see whether your physician, the specialist you use, are in the networks offered by those plans. so a plan that might look cheaper on the exchange but doesn't include your network could end up costing you more.

>> reporter: most plans vary by location, and won't one out until september. ship states like ohio report premiums could rise more than 40%. but promising news from others like new york where rates may drop more than 50%. marilyn says the new plan makes sense for her. she retired early and today pays nearly $800 a month for limited coverage.

>> a lot of people can't afford health insures and when you get it like i've done in the last year independently, it's just very costly.

>> i know what i'm getting.

>> reporter: until patty sutton learns more about arizona's plan she'll remain cautious about changing her coverage but is hopeful the exchange offer a ticket back to retirement itht want to go in there and be a starbucks customer instead of employee.

>> reporter: today she's concentrating on care. dr. nancy snyderman , nbc news, new york.