Any FIRE folks with chronic health conditions?

[Shade00]

Hey guys, I have a ways to go before FIRE and there is still a ways to go before we see what will happen to the Affordable Care Act. Still, it has me thinking. Right now I have excellent coverage through my employer. I am a very expensive member because I have to take a biologic medication (Humira) twice a month to control my psoriasis/psoriatic arthritis. The medication is billed to my insurance at something like $3500 for two injections. Of course, if I retire early, I will need my own coverage. I could certainly get on my wife's insurance if she is still teaching (and she likely will for a while after I quit working). But after that, coverage would be unavailable or extraordinarily expensive to me due to my preexisting condition(s) in the absence of the ACA or some replacement that addresses preexistings. Even with a high deductible policy, though, I am sure I'll be looking at 500+ a month for coverage (if the subsidy goes away), plus at least the deductible to cover the first few rounds of my medication. That could be $12k annually right there.

Any other FIREers have chronic conditions like mine? How do you handle it? How are you preparing, if at all, should the ACA go away?

[cj25]

I can't answer your specific questions, but have you looked into Paleo / Autoimmune Protocol Diet for putting the condition into remission?  Google it.

[Shade00]

I can't answer your specific questions, but have you looked into Paleo / Autoimmune Protocol Diet for putting the condition into remission?  Google it.

I have not, but I'll look into it. Thanks for the suggestion.

[frugaldrummer]

Second that.  One third of psoriatic arthritis patients have antibodies to gluten, and of those patients, most improve on a gluten-free diet.  The gut immune system is the root of many autoimmune disorders.

Also look into www.lowdosenaltrexone.org.  Very inexpensive low dose medication that is helpful for some autoimmune patients (although it is unlikely to work while you are on the biologics).

As for insurance - I'm not FIREd but I am self-employed and buy my own insurance, age 60.  I have a bronze plan with an HSA which costs me $575 (with dental insurance included.)  For you, you would probably be better off buying a silver or gold plan with lower deductibles and lower max out of pocket - that would cost me 750-875 a month or thereabouts.  You have to crunch the numbers but with your high usage and risks it would probably pay to buy the more expensive plan.

The biggest problem for you will be if the Republicans completely mess things up and allow insurers to go back to charging your rates based on your medical history.  Then your rate might be 2-3 x that.  Since they keep talking about keeping the good parts of ACA and getting rid of the things people don't like (a mathematical IMPOSSIBILITY, btw, for those of you gullible enough to believe them) it is highly likely that the system will collapse.

It's hard to predict what will happen, the safest position to be in is to have an individual policy now which at least couldn't be cancelled, but in the bad old days before ACA they would just jack up your premium if you had medical conditions.  Secure employment with a large entity with good insurance is great but then you are tied to them forever if things go back the way they were.

(Incidentally, I read a sad article yesterday about a young man in the midwest with Hodgkins lymphoma.  He had been covered on his mom's insurance until age 26 - his mother was so ill-informed that she actually thought Obamacare was responsible for kicking him off the insurance at 26, she didn't know that Obamacare was the reason he COULD be on her insurance until 26.  He then didn't apply for insurance on the exchanges even though he would have qualified for a subsidy because he had heard it was too complicated and didn't understand the potential benefit.  When he was diagnosed with cancer he was able to get on Medicaid due to the expansion - luckily for him, he didn't live in one of the many (mostly southern, Republican governor states) that refused the Medicaid expansion or he would have no treatment.  Several states do NOT offer medicaid coverage to single adults without children no matter how poor they are. )



Given the tremendous