Author Topic: How much do you pay for medical?  (Read 6158 times)

paulinaf

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How much do you pay for medical?
« on: September 04, 2019, 08:59:36 PM »
Hi all,
It seems the one thing keeping me from early retirement is no longer having medical coverage. If I work until pension age at 60, I値l have medical for the rest of my life. I hate to work an extra 13+ years than I have to just for medical. I have enough saved to support myself if I retire early otherwise.

Please let me know ballpark what you pay for health insurance. I知 planning on retiring early between 45-50.

Thank you!

SKL-HOU

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Re: How much do you pay for medical?
« Reply #1 on: September 04, 2019, 09:46:59 PM »
I think I had come across the website below on this site. It gives you an estimate based on your situation.

https://www.kff.org/interactive/subsidy-calculator/

I don稚 know how accurate it is though.

better late

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Re: How much do you pay for medical?
« Reply #2 on: September 04, 2019, 10:48:59 PM »
I think I had come across the website below on this site. It gives you an estimate based on your situation.

https://www.kff.org/interactive/subsidy-calculator/

I don稚 know how accurate it is though.


wow that's exactly what I've been looking for - and never been able to find. Thank you! I'd love to know from people who are enrolled in the ACA how close the costs generated by the calculator are to their actual costs.

bognish

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Re: How much do you pay for medical?
« Reply #3 on: September 07, 2019, 11:45:54 PM »
Monthly ACA premiums for the best plan in out state is $0.30 per month for my family of 4 (2 adults in 40s & 2 elementary kids).  That's based on an estimated income of about $45k dividends and capital gains.

Fishindude

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Re: How much do you pay for medical?
« Reply #4 on: September 08, 2019, 06:18:44 AM »
$1,285 per month for wife and myself ages 56 & 59, non tobacco users.
We are above the income level where we can get any discounts, I think threshold is under +/- $76,000.

jim555

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« Last Edit: September 09, 2019, 11:08:08 AM by jim555 »

ontheway2

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Re: How much do you pay for medical?
« Reply #6 on: September 09, 2019, 11:23:21 AM »
healthcare.gov has it's own calculator that gives you cost for actual plans along with the cost sharing if you qualify. Go to healthcare.gov then look for plans & prices in the menu under get coverage. A few questions, and you don't have to create an acccount

spartana

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Re: How much do you pay for medical?
« Reply #7 on: September 09, 2019, 11:29:44 AM »
Its just going to depend on your taxable (MAGI) income, family size, the plan you choose and what amount of subsidy (if any) you are entitled too. There are cutoffs at income point so you'll need to determine where you fall via an online calculator. Kaisers is good or visit your states website. If you are in a Medicaid expanded state and your taxable income is low enough you may qualify for free healthcare. I use the VA for free (or low co-pay) but otherwise at my taxable income level I would pay about $1/month premium on a Bronze level ACA plan with $6500 annual deductible to approx $150/month and $75/year annual deductible Silver Enhanded level plan.

Altons Bobs

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Re: How much do you pay for medical?
« Reply #8 on: September 09, 2019, 12:24:44 PM »
$16.5k/year for our family of 3. It's preventing me from retiring also.

spartana

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Re: How much do you pay for medical?
« Reply #9 on: September 09, 2019, 12:48:29 PM »
$16.5k/year for our family of 3. It's preventing me from retiring also.
Since ACA subsidies are based on taxable income I assume that for many people just lowering your retirement expenses/income would lower your medical cost by a huge amount. I know several people here paid off homes or reduced expenses somehow to lower their MAGI and take advantage of higher subsidies.

FIRE 20/20

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Re: How much do you pay for medical?
« Reply #10 on: September 09, 2019, 10:09:12 PM »
Don't most states have their own calculators?  I went to my state's calculator and tried out a bunch of different options to see how varying our income (via Roth ladder) would impact our annual spending.  When I applied for coverage through my state's exchange, the cost was exactly identical to what the calculator gave me down to the penny.  For my state it took maybe 2 minutes to get an accurate estimate. 

Also, if you're not sure about the cost, make sure you fully understand both cost sharing reductions and subsidies and how the various steps work.  Just one extra dollar of income can cause you to jump into a significantly higher cost band if you aren't careful.  If possible, try to stay just under 150% of the Federal Poverty Level (FPL).  If you can't, try to stay under 200%.  If you can't do that - stay under 250%.  It could cost you thousands of dollars extra each year if you earn, for example, 150% of the FPL + $1. 

In addition, make sure you understand not just the premiums you will pay, but also the deductibles, co-pays, and prescription costs. 

You may or may not find the same thing that I did, but in my case I was able to drop our household's expected spending by nearly $20k / year by optimizing our income for both health coverage as well as state and federal taxes.  That's for 2 people, but it shows how important this is.   It probably took me about 5 hours to understand the system well enough to find that savings - that's a pretty solid hourly rate. 

Altons Bobs

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Re: How much do you pay for medical?
« Reply #11 on: September 09, 2019, 10:15:06 PM »
$16.5k/year for our family of 3. It's preventing me from retiring also.
Since ACA subsidies are based on taxable income I assume that for many people just lowering your retirement expenses/income would lower your medical cost by a huge amount. I know several people here paid off homes or reduced expenses somehow to lower their MAGI and take advantage of higher subsidies.

I'm not sure how to lower our dividends and capital gain to lower our income to lower than the 400% of FPL. I also don't want to give up my doctors. In our area, only HMO plans are available in the individual market and all the good docs don't want to be in any HMO networks. So I have to keep running my business so I can keep my group plan until a single payer or Medicare for all is available.

kbear

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Re: How much do you pay for medical?
« Reply #12 on: September 10, 2019, 07:18:50 PM »
We found the same issues - high cost and only HMO options.
 Right now we get our insurance through my spouse, so we are lucky and not sure we want to give it up. The people in my office discussing their choices last year were pissed, and a lot just opted out because it's unaffordable for them . Insurance before ACA was $150/mth, through the state, now the choices are $450-$540/mth and this is for assistants and front desk people with $12-$20/hr jobs. This is at a private office, and this option was costing the Dr a lot.
And you are right - all the good Docs don't want to be in the HMO networks. You are almost paying for the patient to come in. This is why corporate group practices are popping up everywhere. They hire these new Dr's with tons of debt and dictate production# and hand out bonuses on upselling, etc. It's becoming all about the $ and getting the patients in/out asap, not about patient care. A lot of people working in healthcare are very upset about the direction we have taken.
Sorry, I don't have a solution. I guess just bide our time and maybe geoarbitrage.

Malum Prohibitum

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Re: How much do you pay for medical?
« Reply #13 on: September 11, 2019, 04:39:20 AM »
Hi all,
It seems the one thing keeping me from early retirement is no longer having medical coverage. If I work until pension age at 60, I値l have medical for the rest of my life. I hate to work an extra 13+ years than I have to just for medical. I have enough saved to support myself if I retire early otherwise.

Please let me know ballpark what you pay for health insurance. I知 planning on retiring early between 45-50.

Thank you!

As the posts above show, you haven't given us enough information to answer.   I am still working, decent income, self employed, so I had choices for 2019 of between $23,000 to $48,000 annually, and none of them cover the doctors or hospitals I used (and preferred) prior to the ACA, when better insurance ran me less than $450 monthly.

If your income is below 400% of the poverty level for a family of your size, however, there are premium tax credit subsidies that offset the monthly cost.  Depending on your family size and anticipated income, that might be difficult or easy for you to meet, but, like I said, you haven't given us enough information to really help you.  Hopefully, there is enough information contained in these posts from other members to help you figure it out. 

FIRE 20/20

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Re: How much do you pay for medical?
« Reply #14 on: September 11, 2019, 12:40:38 PM »
It's disheartening to see all of these high cost plans with restricted networks.  I've been amazed at how good my options are locally - every doctor I put in was in all networks and the costs are surprisingly reasonable.  With my income this year I'm paying about $240/month for a great plan that includes all of my doctors.  We'll see what it costs next year, but I expect it to be significantly lower.  I had already planned to remain in my current location now that I'm FIREd, but if we decide to move we'll need to really pay attention to the availability of ACA plans wherever we move. 

kbear

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Re: How much do you pay for medical?
« Reply #15 on: September 11, 2019, 05:36:57 PM »
Fire 20/20,
Where do you live? We would totally move if we could get a plan like that. Sounds like you just solved our problem :)

FIRE 20/20

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Re: How much do you pay for medical?
« Reply #16 on: September 11, 2019, 06:49:05 PM »
Fire 20/20,
Where do you live? We would totally move if we could get a plan like that. Sounds like you just solved our problem :)

PM sent.

fattest_foot

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Re: How much do you pay for medical?
« Reply #17 on: September 12, 2019, 11:10:25 AM »
Don't most states have their own calculators?  I went to my state's calculator and tried out a bunch of different options to see how varying our income (via Roth ladder) would impact our annual spending.

Not yet to early retirement, but this is the conundrum I see upcoming. How to convert retirement accounts via a Roth ladder without getting destroyed by either taxes or health insurance? Seems like one of the two will inevitably be a huge draw.

If things remain how they are over the next several years, it seems like taking the 10% early withdrawal penalty will become the best option.

Dicey

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Re: How much do you pay for medical?
« Reply #18 on: September 16, 2019, 10:30:31 PM »
At present, we pay almost nothing. No premium, no deductibles, miniscule copays. When DH retires in about two years, the premium will be $1180/month for both of us. He will receive $550/month (non-taxable) for healthcare as part of his retirement package, and we will be able to stay on his company's fantastically generous healthcare program. So our net cost will be $315 each, which I think is pretty good for the level of coverage we have. When we're old enough to qualify for Medicare our rates will drop again.

The biggest challenge is it's Kaiser, which is fairly location specific. We could change providers, but the costs would go up.

Malum Prohibitum

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Re: How much do you pay for medical?
« Reply #19 on: September 17, 2019, 03:02:51 PM »
It's disheartening to see all of these high cost plans with restricted networks.  I've been amazed at how good my options are locally - every doctor I put in was in all networks and the costs are surprisingly reasonable.  With my income this year I'm paying about $240/month for a great plan that includes all of my doctors.  We'll see what it costs next year, but I expect it to be significantly lower.  I had already planned to remain in my current location now that I'm FIREd, but if we decide to move we'll need to really pay attention to the availability of ACA plans wherever we move.

Wow, FIRE 20/20, that's great for you! 

One thing about "paying attention to the availability of ACA plans wherever we move" is that, at least here, it is literally different each and every year.  In other words, your options won't necessarily be the same in 2020 as they are right now, and they are different right now than they were last year.  It was last year or the year before that we had only one option (one!).  This year two companies came back, but they were offering plans drastically different from their group plans and prior plans, so we still could not get the doctors and hospitals we wanted with that company (even though we had used them before years ago just because of this).

So it makes it hard to make any plans based even on research into an area where you would like to move.

FIRE 20/20

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Re: How much do you pay for medical?
« Reply #20 on: September 17, 2019, 10:23:44 PM »
Don't most states have their own calculators?  I went to my state's calculator and tried out a bunch of different options to see how varying our income (via Roth ladder) would impact our annual spending.

Not yet to early retirement, but this is the conundrum I see upcoming. How to convert retirement accounts via a Roth ladder without getting destroyed by either taxes or health insurance? Seems like one of the two will inevitably be a huge draw.

If things remain how they are over the next several years, it seems like taking the 10% early withdrawal penalty will become the best option.

Can you describe the problem you're running into?  I'm interested because my ACA expenses and Tax expenses rise and fall together for us.  If we manufacture increased income via higher Roth ladder conversions then our taxes go up, and vice versa.  I'm interested to see a situation where it's either or. 

FIRE 20/20

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Re: How much do you pay for medical?
« Reply #21 on: September 17, 2019, 10:24:19 PM »
It's disheartening to see all of these high cost plans with restricted networks.  I've been amazed at how good my options are locally - every doctor I put in was in all networks and the costs are surprisingly reasonable.  With my income this year I'm paying about $240/month for a great plan that includes all of my doctors.  We'll see what it costs next year, but I expect it to be significantly lower.  I had already planned to remain in my current location now that I'm FIREd, but if we decide to move we'll need to really pay attention to the availability of ACA plans wherever we move.

Wow, FIRE 20/20, that's great for you! 

One thing about "paying attention to the availability of ACA plans wherever we move" is that, at least here, it is literally different each and every year.  In other words, your options won't necessarily be the same in 2020 as they are right now, and they are different right now than they were last year.  It was last year or the year before that we had only one option (one!).  This year two companies came back, but they were offering plans drastically different from their group plans and prior plans, so we still could not get the doctors and hospitals we wanted with that company (even though we had used them before years ago just because of this).

So it makes it hard to make any plans based even on research into an area where you would like to move.

Excellent point.  I'll try to remember to come back here to post after I look at my options for 2020. 

JoJo

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Re: How much do you pay for medical?
« Reply #22 on: September 24, 2019, 07:27:06 PM »
I'm planning on being nomadic in early retirement, getting a mailing address in an income tax free state.  This definitely needs to be a consideration.  Using the tool above, I got monthly insurance premiums of $464-821 depending on what state/zip I picked. 

Evgenia

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Re: How much do you pay for medical?
« Reply #23 on: September 29, 2019, 01:42:57 PM »
Late to this thread, but in the SF Bay Area, my husband and I pay $780/month for the two of us, with a $6k deductible each ($12k total for household) and an HSA. We put the max into the HSA each year and use that for any additional co-pays, eye exams and dental appointments not covered by insurance, sunscreen, etc.

We are both 42 and reached FIRE at age 38, at which point we procured ACA (Covered California) plans for ourselves.

The helpful factor is that we count ourselves self-employed (working part time or less on whatever we want) so we can fully deduct our monthly premium. This is key to our bottom line. We receive no premium subsidy.
« Last Edit: September 29, 2019, 01:48:55 PM by Evgenia »

BTDretire

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Re: How much do you pay for medical?
« Reply #24 on: October 01, 2019, 04:47:46 PM »
"the rent is too damn high"

ysette9

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Re: How much do you pay for medical?
« Reply #25 on: October 01, 2019, 07:09:19 PM »
I am so grateful we have kaiser in our area. That is an HMO worth it痴 weight in gold if you have the option. I知 sorry for those who struggle to find providers. We really need a better system in this country.

ysette9

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Re: How much do you pay for medical?
« Reply #26 on: October 01, 2019, 07:11:01 PM »
Late to this thread, but in the SF Bay Area, my husband and I pay $780/month for the two of us, with a $6k deductible each ($12k total for household) and an HSA. We put the max into the HSA each year and use that for any additional co-pays, eye exams and dental appointments not covered by insurance, sunscreen, etc.

We are both 42 and reached FIRE at age 38, at which point we procured ACA (Covered California) plans for ourselves.

The helpful factor is that we count ourselves self-employed (working part time or less on whatever we want) so we can fully deduct our monthly premium. This is key to our bottom line. We receive no premium subsidy.
I知 curious where you land in the MAGI bingo card and what that means for subsidies. I was pricing out plans with various levels of Roth conversions for when we pull the plug and I was surprised at how affordable they could be depending on what we choose to make our income be. Definitely less than what you are paying for a family of 5. But maybe that was the key as we have a passel or dependents?

seattlecyclone

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Re: How much do you pay for medical?
« Reply #27 on: October 02, 2019, 03:30:57 PM »
Late to this thread, but in the SF Bay Area, my husband and I pay $780/month for the two of us, with a $6k deductible each ($12k total for household) and an HSA. We put the max into the HSA each year and use that for any additional co-pays, eye exams and dental appointments not covered by insurance, sunscreen, etc.

We are both 42 and reached FIRE at age 38, at which point we procured ACA (Covered California) plans for ourselves.

The helpful factor is that we count ourselves self-employed (working part time or less on whatever we want) so we can fully deduct our monthly premium. This is key to our bottom line. We receive no premium subsidy.
I知 curious where you land in the MAGI bingo card and what that means for subsidies. I was pricing out plans with various levels of Roth conversions for when we pull the plug and I was surprised at how affordable they could be depending on what we choose to make our income be. Definitely less than what you are paying for a family of 5. But maybe that was the key as we have a passel or dependents?

Below 400% of the poverty line ($65,842 for a family of two) you're eligible for some subsidy so long as the second-cheapest silver plan in your area sells for more than a fixed percentage of your MAGI (9.86% if you're between 300-400% of the poverty line, and less at lower incomes). For someone right at this 400% level the applicable premium would have to be less than $541/month for the couple. Here in Seattle the second-cheapest silver plan for two 42-year-olds comes out to $787/month.

I'd be surprised to see rates be enough lower in California to get below $541, therefore I conclude that they're likely over 400% of the poverty line. This figure would be after any pre-MAGI deductions such as the self-employed health insurance premium deduction, HSA contributions, half of the self-employment tax, and any pre-tax retirement account contributions. Add a full HSA contribution and $780/month in premiums to 400% of the poverty line and you're looking at a gross in excess of $82k.
« Last Edit: October 02, 2019, 03:36:07 PM by seattlecyclone »

RWTL

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Re: How much do you pay for medical?
« Reply #28 on: October 03, 2019, 04:18:00 AM »
PTF

Enigma

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Re: How much do you pay for medical?
« Reply #29 on: October 21, 2019, 09:51:27 AM »
I do not qualify for subsidies and other tax payers picking up the costs of my medical.  The basic Bronze plan is $375/m and the Platnium is almost $900/month.  1 single male age 40, non-smoker

Cali4en

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Re: How much do you pay for medical?
« Reply #30 on: November 02, 2019, 06:10:57 PM »
Our numbers for 2020 are a net monthly cost of $2.47 for two people.  EPO plan that includes all of our doctors/hospitals and has a zero copay structure after deductible.  Individual deductible and max OOP of $675 each and that's it.  They are also really good (compared to previous insurers we've had) about negotiating rates from the providers we use, so everything costs less against the deductible than you might normally expect.

We are on the same exact plan this year at a net monthly cost of around $7.  Most important, the customer service has been excellent and there have been zero issues with getting claims paid properly and promptly.

Best insurance we've ever had, ACA or employer-provided.