The Money Mustache Community
General Discussion => Welcome and General Discussion => Topic started by: OzzieandHarriet on June 29, 2018, 01:24:45 PM
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My husband and I have great insurance through his job (largest employer in our state). He wants to retire in October of this year. They have an option for retirees to buy subsidized health insurance for themselves and dependents, which we are going to use. It's expensive, but probably comparable in price to what the ACA would have offered in its pre-broken state -- around $1400/month for both of us. This covers everything except copays and dental.
But with the latest machinations from the Trump camp -- premiums for over-60 could be 5 times higher! Pre-existing conditions excluded! -- who knows what will happen? How much more of our nest egg will we end up spending because of this crap? Will we even be able to get insurance?
We have everything else covered, but this is out of our control. It's maddening.
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Yes, I'm somewhat freaked out. Really wondering what 51-65 will look like over the next 14 years. (And probably more like 66 or 67 since I suspect the Medicare age is going to move up.)
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Yeah... my only hope is it seems like its unsustainable. It's already at the point where i'd very painfully consider just self insuring if I were ready. If it doubles again or something ... no one will be afford health insurance it would seem to me.
Maybe amazon will lower costs who knows :P.
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Health Share Ministry?
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Yeah... my only hope is it seems like its unsustainable. It's already at the point where i'd very painfully consider just self insuring if I were ready. If it doubles again or something ... no one will be afford health insurance it would seem to me.
Yep. Going naked or going expat might be the best way to deal with it.
Maybe amazon will lower costs who knows :P.
I'm not hopeful. They'll probably find out that it's expensive because quality health care just costs more (in the US).
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wow....that's expensive healthcare. I bitch about my taxes in Canada, but we could buy deluxe medical (dental, para-medical, prescriptions etc) for a couple for under $500 a month....but that's because the governement (aka joe taxpayer) picks up the tab for the big ticket things like hospital and doctor's visits)....
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I’ve been worried to various degrees about healthcare for the past eight years. I went back to full time employment from consulting this year specifically because my biggest client offered to pay for my family’s health insurance. The ACA options in my part of the country shot up considerably for 2018. They’re not going to go up much for 2019, but who knows after that.
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I'm turning 26 next month so I am losing coverage from my parents insurance plan. My current employer doesn't offer benefits. For a god awful plan w/ 10k+ deductible, 50/50 coverage and the like, I was looking over 200/month, including gov discounts for my income bracket. Might as well not have insurance with that kind of coverage. I was going in to panic mode
Luckily we just found out my girlfriends work will allow her to add me as her partner since we've lived together over 6 months. 15 times better coverage for 10 times less the cost. Feel like I dodged a bullet there..
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I recently came to the conclusion that if I retire outside the US, I can do it with half the amount saved simply because of health care. I wasn't about to have health care be a larger expense than everything else combined. It's one thing if you got what you paid for...
The good news is that literally any other country in this world doesn't have this problem, so you have lots of options. In poor countries, you can get rich person care for a tiny cost, and in rich countries, they all have socialized healthcare, so again tiny cost.
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I pay >$1600 per month for ACA insurance, so I have already been conditioned to their regular ripoffs. I'm not happy about the state of healthcare in our country, far from it, but continuation along this road is a price that I have already accounted for. I really dont think excluding pre-existing conditions is a place we are going to go back to; if anything, companies may begin charging more for such things. After all, insurance companies are in the business of pricing risk. Not agreeing with it in the context for health insurance, but thats how the modeling works, so we should all be prepared for it.
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Chill a bit. Realistically, LOTS of people are hurting because of the state of health care and insurance. Something's gotta give, and while I don't know what or when, we can be pretty sure that something, sometime, will give. I doubt it'll take 15 years either, but we'll see.
And call your elected officials.
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Yes, freaked out. I'm 3-4 years from FIRE. My company offers a pre-Medicare plan for about $1k per month for single coverage. Not what I want to pay, but it meets the ACA standards, meaning the right services are covered and my total exposure will be contained. So there is Plan B if I remain employed with them until FIRE.
At this point I have no faith whatsoever in the future of the ACA. There has already been so much done to sabotage it and drive up costs; the pres and the republicans have made it clear they will stop at nothing to completely dismantle it. Do not be optimistic about this; be pleasantly surprised if it doesn't happen.
I also have no faith in what Amazon can come up with. If it were so easy to offer reasonably products that cover what people need within our current infrastructure someone would have done it already. The aca in the form it was meant to be was the best that could be done within our current healthcare infrastructure and system. Amazon doesn't know what it doesn't know and thinks tech will save the day.
Also would steer clear of the ministry programs. Very risky as there is no guarantee the plan will pay. You have to present a case for paying for your care and it gets voted on. Also there isn't enough money available in most of the ministry plans to be able to come through on a very expensive situation, which can happen at any time. Most are please when it's just birth of a child or broken bones, but the scheme can fall apart at some point when you get something the members might object to for some reason or it's catastrophic/ongoing.
Best bet is to see what happens in 2018 elections and also plan for an employer plan if you work for bigcorp and they offer something.
I'm in the biz so have a pretty good understanding of the overall situation.
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Yes. Me.
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I'm turning 26 next month so I am losing coverage from my parents insurance plan. My current employer doesn't offer benefits. For a god awful plan w/ 10k+ deductible, 50/50 coverage and the like, I was looking over 200/month, including gov discounts for my income bracket. Might as well not have insurance with that kind of coverage. I was going in to panic mode
Luckily we just found out my girlfriends work will allow her to add me as her partner since we've lived together over 6 months. 15 times better coverage for 10 times less the cost. Feel like I dodged a bullet there..
The premiums paid by your girlfriend's employer on your behalf will be considered taxable income to her, FYI.
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What state do you live in? My mother is 59 and pays 250 a month. I'm 35 and I pay 60 a month. We both are on ACA. Before the ACA existed I had health insurance through my state exchange for 250. If you have crappy insurance that's on you. Either move to a state that provides better health care or vote for local politicians who will implement better health insurance options.
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It's weird. I'm not freaking out. At all. I have a wife and two kids. We are FIREd for 1 year so har. Healthcare will be expensive but I'm not freaking out. Because: 1. Other people have this issue and it's hard to imagine it getting completely out of hand for a long time. 2. Other than emergency crazy OMG stuff it shouldn't be too bad and if it is then we can always goto Mexico for our annual checkups. 3. We can always just move. Latin america is fine and their health care is perfectly fine and affordable. My brother paid like $7 for a checkout of his finger, cleaned and bandaged, and antibiotics in Mexico City just a few years ago. We just do health care shitty in the US and if we want to FIRE and it gets even more out of hand here then we just leave, right?
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I've never been so glad my SO plans on working for as long as she can. We've both had preexisting conditions since childhood and mine can get quite costly at times. The need for quality health insurance has been dictating my employment decisions since I was in my early twenties, and before that it dictated the choices of my parents. Faith-based health sharing ministries aren't an option for us for many reasons (one being that we're gay).
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The only reason TheHusbandHalf is retiring is because he can buy health insurance from his employer until he reaches Medicare age. He looked for me, and I can continue to buy it for 2 years until I reach Medicare age too.
Those who are buying it now are paying $750/mo. I'm sure it will continue to go up but we think it's probably the best we can find.
The way we look at it, this is just one of the things we saved our money for.
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You know, there was a time when people didnt have health insurance and the world turned out ok. Now, this “need” has been created. You know, you will eventually die dont you? So why fret over something that people never had not that long ago?
[MOD NOTE: That was quite enough. You're done here.]
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You know, there was a time when people didnt have health insurance and the world turned out ok. Now, this “need” has been created. You know, you will eventually die dont you? So why fret over something that people never had not that long ago?
So your solution to healthcare is to just die, huh? That's what some people call the republican plan.
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I'm not even considering FIRE till the 2018 midterms because of the unknown course of healthcare. This could extent to 2020 if it looks like Trump serves a second term. The only thing that can prevent our FIRE or cause bankruptcy for us going forward is healthcare.
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I'm not even considering FIRE till the 2018 midterms because of the unknown course of healthcare. This could extent to 2020 if it looks like Trump serves a second term. The only thing that can prevent our FIRE or cause bankruptcy for us going forward is healthcare.
I'm with you on that! It's why I didn't consider FIREing this spring. I want to see the democrats take control of at least one chamber.
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You know, there was a time when people didnt have health insurance and the world turned out ok. Now, this “need” has been created. You know, you will eventually die dont you? So why fret over something that people never had not that long ago?
There was also a time when people died or were severely disabled by diseases and accidents that are easily curable now. Break your leg in 1675, you never walk again and probably die fairly soon after. Pneumonia? Death sentence. Any type of cancer? Death sentence. To say nothing of the quality of life of diseases that might have been survivable but made life miserable. Personally, I'd rather get treated and survive another 20-30 years.
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Not that I'm advocating this, but is moving to Canada a viable option here? I have a pretty good job with a global company with operations in Canada and dread the day I stop working and have to not only pay out my ass, but have to worry about what political vendetta the next moron president wants to hit this country with.
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I am not freaked out about it. You need to decide what level of healthcare you need/want/willing to budget for. Are you willing to relocate to another state or country? It is just another expense to me that I need to figure out like housing and transportation. There are options and I need to budget for them. That is what my stash is for. I also plan on having enough for care at the end if I need it. I have been inside the local nursing home that takes Medicaid in our town - no thanks. I wouldn't fire if I didn't have enough to cover these two areas in the budget just like I wouldn't fire if I didn't have enough to pay for housing or food. You might be a bigger risk taker than I am.
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I’m not freaked out at all.
It’s just money.
Take a reasonable silver ACA plan healthcare for your family, and then double it’s yearly cost. Add that to your expected yearly budget, and save for it.
MMM preaches FLEXIBILITY. If your state runs the ACA plans into the ground, move. Consider Medicaid if you have to. Work a low effort 15 hr/week job just to pay for healthcare, etc...
Make a plan. Adjust as necessary. No big deal.
Also, STAY fit and eat right. That always helps too.
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I pay >$1600 per month for ACA insurance, so I have already been conditioned to their regular ripoffs. I'm not happy about the state of healthcare in our country, far from it, but continuation along this road is a price that I have already accounted for. I really dont think excluding pre-existing conditions is a place we are going to go back to; if anything, companies may begin charging more for such things. After all, insurance companies are in the business of pricing risk. Not agreeing with it in the context for health insurance, but thats how the modeling works, so we should all be prepared for it.
Wow, that sucks. I was just looking into this as I prepare to FIRE in a year, and it looks like I'll be paying $100-200/mo. depending on the plan. I didn't know California's options were so bad.
To the OP, yes, I'm pretty worried. As it is my local ACA plans are excellent, but I don't expect it to stay that way for much longer.
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What health insurance plans cost today does not predict what they will cost next year or going forward - that's what is worrying about it. This administration has put a number of stakes through the heart of the ACA already, and they don't care how many people suffer because of it. Even if the Democrats win big in November, do you think Trump is going to sign anything they pass into law?
Our local ACA plans this year would have cost MORE than the employer-subsidized plan for similar coverage. We are in Maryland, and we may have a Democratic governor after the midterms, but who knows?
We have saved plenty, more than enough to cover everything else we will need. Our house is paid off, we have no debts. We live relatively frugally (I'm sure we could cut some things out if necessary, but so far it hasn't been). So yeah, we can probably AFFORD to pay whatever it will be -- though there is the question of whether we will even be able to buy anything. And I also worry if something happens to my husband, I will be on my own with this.
This really sucks, that something so basic is so unstable. That people who have saved a few million dollars may be faced with trying to get a job at some corporate behemoth for the health insurance.
To the people who say well, you're going to die anyway, that's not the point. The point is no one wants to suffer unnecessarily on the way there.
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I’m not freaked out at all.
It’s just money.
Take a reasonable silver ACA plan healthcare for your family, and then double it’s yearly cost. Add that to your expected yearly budget, and save for it.
MMM preaches FLEXIBILITY. If your state runs the ACA plans into the ground, move. Consider Medicaid if you have to. Work a low effort 15 hr/week job just to pay for healthcare, etc...
Make a plan. Adjust as necessary. No big deal.
Also, STAY fit and eat right. That always helps too.
Just money? $20K/yr or more in premiums can seriously jeopardize someone's FIRE plans.
Staying fit and eating right isn't the same thing as having healthcare coverage. Even very fit people can one day need significant healthcare needs.
Silver plans and subsidies will not be an option, nor will Medicaid, if the ACA is overturned or otherwise implodes, dissolves, etc. And if you already have preexisting conditions, you might not be able to get affordable coverage at all.
https://www.vox.com/the-big-idea/2018/6/8/17442238/trump-aca-obamacare-texas-department-of-justice-rule-of-law
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As long as the ACA is around then I will work the system to max advantage. If it goes away and premiums become absurd, then I could pay it, become a nomad with travel insurance, or move to Britain (have that option).
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You know, there was a time when people didnt have health insurance and the world turned out ok. Now, this “need” has been created. You know, you will eventually die dont you? So why fret over something that people never had not that long ago?
[mod note: crxpilot has been removed]
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Folks - Maybe the time has come to pick up pen and paper and write. Write to your favorite American politicians.
With Republicans, it is a lost cause, but you will feel better.
With Democrats, they will lie that they are in favor of single payer, and you will feel better.
With independents - You may have a chance, but will be voted down by the others - But you will still feel better
And,.......you will have done what you can. Tides do turn.
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So we all know circumstances will and can change. Sure ACA will probably be fully gutted within the next two years. But two years is a small blip in your lifetime. There will more than likely be proposed solutions and insurance options which will be more affordable and still work.
In the meantime contact your representatives and voice your opinion, vote, and
(https://media2.giphy.com/media/An4MkAbxeiyqY/giphy.gif)
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Or things could go back to the way they were before ACA, with worthless cheap plans and almost worthless overpriced plans if you could even buy them at all, because if you ever had so much as a hangnail you would be denied coverage.
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Health Share Ministry?
Since these are so much cheaper than insurance, I am pretty sure they either do not cover certain things or they have greatly underestimated their possible costs. My fear is that when you present them with a huge medical cost, they will either go bankrupt or tell you"the needs of the many outweigh the needs of the few,' and leave you bankrupt or untreated.
Thoughts and prayers are not healthcare.
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With Global warming Canada might not be too bad. Good beer and fishing, eh?
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For those tossing out Canada as an option, we do not have open borders. There is paperwork. Much paperwork. And you may or may not qualify.
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For those tossing out Canada as an option, we do not have open borders. There is paperwork. Much paperwork. And you may or may not qualify.
Joke's on you, some of us LOVE paperwork!
Last I checked, I was eligible for express entry and immediate permanent residency. I suspect the majority of people driven enough to retire early could jump through the very large hoops with less effort than it takes to navigate the ACA efficiently.
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For those tossing out Canada as an option, we do not have open borders. There is paperwork. Much paperwork. And you may or may not qualify.
You'll also have to learn to live in a terrifying hellscape where you're not able to walk around a Walmart with your favourite Rambo inspired armaments, or walk into a bar with a handgun. If you shoot someone (even if they're black), you're probably going to get in a lot of trouble in our country. We are a deeply oppressed people, under the boot of our tyrannical government (who, btw leans a wee bit further left than your 'left wing' party.
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Guitarman:
We are a deeply oppressed people, under the boot of our tyrannical government (who, btw leans a wee bit further left than your 'left wing' party.
Which Province do you recommend?
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For those tossing out Canada as an option, we do not have open borders. There is paperwork. Much paperwork. And you may or may not qualify.
You'll also have to learn to live in a terrifying hellscape where you're not able to walk around a Walmart with your favourite Rambo inspired armaments, or walk into a bar with a handgun. If you shoot someone (even if they're black), you're probably going to get in a lot of trouble in our country. We are a deeply oppressed people, under the boot of our tyrannical government (who, btw leans a wee bit further left than your 'left wing' party.
You should work for Canada’s tourism and immigration department. You’ve completely sold me on moving there and I’m the more conservative one in my relationship.
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Aocean:
You should work for Canada’s tourism and immigration department. You’ve completely sold me on moving there and I’m the more conservative one in my relationship
I'm ready man. I will tell them about how the frozen tundra has been transformed by peace, order and good government. I will tell them that Canada was the terminus of the road to freedom on the underground railroad. I'll get my long johns, parka and took ready.
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If you can live lean enough, you qualify for medicaid. I don't see that program going away soon.
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Yep, freaked out is a good way to describe my state of mind. If I had any confidence in what health care will cost in the future, I could retire this year. As is, I'm planning to work until at least 2020.
If Obamacare is sabotaged to the point of collapse, I'm going to cut back to the minimum number of hours my job will allow and put off retirement indefinitely. You can't stay healthy enough to be sure you'll never get hit with some cripplingly expensive fluke of bad luck, and you can't save enough to cover it when hospitals are allowed to make up any number they like as the charge.
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If you can live lean enough, you qualify for medicaid. I don't see that program going away soon.
The Medicaid expansion that allowed people under certain income thresholds to become eligible is part of the ACA, which is being threatened. Also, some states didn't expand Medicaid.
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If you can live lean enough, you qualify for medicaid. I don't see that program going away soon.
The Medicaid expansion that allowed people under certain income thresholds to become eligible is part of the ACA, which is being threatened. Also, some states didn't expand Medicaid.
The beauty of living in a large federated Republic with 300+ million people is that you have options. Seventeen states' legislatures determined that they didn't want to provide coverage to their poorest citizens, but 33 others did. States compete on earning other states' citizens business all the time, it's a feature not a bug.
If you live in a place that is constantly enacting legislation you disagree with, you should strongly consider moving.
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The beauty of living in a large federated Republic with 300+ million people is that you have options. Seventeen states' legislatures determined that they didn't want to provide coverage to their poorest citizens, but 33 others did. States compete on earning other states' citizens business all the time, it's a feature not a bug.
If you live in a place that is constantly enacting legislation you disagree with, you should strongly consider moving.
A feature yes, but it was not designed that way. Only after the Supreme Court ruled that the Medicaid portion was "coercive" did states start the opt outs.
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Not that I'm advocating this, but is moving to Canada a viable option here? I have a pretty good job with a global company with operations in Canada and dread the day I stop working and have to not only pay out my ass, but have to worry about what political vendetta the next moron president wants to hit this country with.
Honestly, that's my backup plan if shit gets really bad. I have a standing employment offer from a company in New Brunswick who creates software for my industry. Course, that may be a pipe dream, because if the situation deteriorates here so badly that I'm ready to leave, their customer base is probably already drying up. Nice to imagine that I'd have an out, though.
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Not freaked out yet, we get our insurance through wife's work. We are 5-6 years from FIRE, we may freak out when we get closer to that date, or alternatively one of us may keep working just for the insurance. Maybe we will get a "public option" by then.
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Health Share Ministry?
Since these are so much cheaper than insurance, I am pretty sure they either do not cover certain things or they have greatly underestimated their possible costs. My fear is that when you present them with a huge medical cost, they will either go bankrupt or tell you"the needs of the many outweigh the needs of the few,' and leave you bankrupt or untreated.
Thoughts and prayers are not healthcare.
I know of several people who have had significant on going health issues while on Health Share Ministry and not had any problems getting reimbursed.
A couple reasons why they are significantly cheaper:
1. They don't cover tobacco, alcohol, and other drug related expenses.
2. Don't cover most STD's, out of wedlock type expenses.
3. Some have caps, i.e. $1M per incident
4. Regular health insurance premiums for healthy people are partly subsidizing the sickly or poor (not sure about this)
I'm not religious, but when I retire I can accept those conditions. And while the person who was blocked suggested the point a little more crudely, I think there is a point to be made that as medical expenses get more costly you have to start playing the odds and saying I can either have 100% chance of paying astronomical premiums which would significantly hinder my enjoyment of life or except a small chance of a catastrophic injury/disease that won't be covered and I can't afford.
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If you can live lean enough, you qualify for medicaid. I don't see that program going away soon.
The Medicaid expansion that allowed people under certain income thresholds to become eligible is part of the ACA, which is being threatened. Also, some states didn't expand Medicaid.
The beauty of living in a large federated Republic with 300+ million people is that you have options. Seventeen states' legislatures determined that they didn't want to provide coverage to their poorest citizens, but 33 others did. States compete on earning other states' citizens business all the time, it's a feature not a bug.
If you live in a place that is constantly enacting legislation you disagree with, you should strongly consider moving.
That's true, but the poster I responded to didn't think the Medicaid option would go away, but it's just part of the ACA, so it's just as much under threat as the ACA marketplace and subsidies. If that were to happen and what might happen in specific states as a result is another matter.
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That's true, but the poster I responded to didn't think the Medicaid option would go away, but it's just part of the ACA, so it's just as much under threat as the ACA marketplace and subsidies. If that were to happen and what might happen in specific states as a result is another matter.
The Feds pay 90% for the expansion group. So if it goes away Federally it goes away for everyone.
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Lots of things states can do even if some federal funding disappears. Massachusetts had RomneyCare. Hawaii has had an employer mandate for 4 decades. Right now there are dozens of very smart bean counters and attorneys working for various state legislature committees, looking for solutions. And if all else fails, move to another country.
So relax everyone, you're going to be fine. You have money. Money buys flexibility, and politicians' hears. It's the working stiffs who have neither who should freak out.
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There are good options in the world, just not in the US. I'll probably get catastrophic coverage domestically and be willing to rely on things like MediClinics for minor ailments. There are plenty of Emergency Care clinics, but that's the grey area. If you can leverage medical tourism at that point, then maybe living in the US will still work for ER's. I'm jealous of countries with universal health and affordable private care.
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Escape Velocity @ 2020:
I'm jealous of countries with universal health and affordable private care.
It may alleviate some frustration to simply write an old fashioned letter to your representatives. The more they know people are watching what they do in this area, the more they will succumb to people's wants / needs. Right now they succumb to our corporation's wants / needs. Supreme Court says they are people too.
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DW went back to work in 2010 because we saw the ObamaCare storm clouds on the horizon. Having paid escalating self-employed health insurance costs from 2004-2010 -- and until 2012 when she became a full-time teacher -- I shudder to think what we'd be paying now.
It's a shame since my self-employed income is significant. But having had pre-ObamaCare insurance and dealing with those large deductibles and always trying to figure out what's covered and what's not, I didn't want to cringe every time one of our sons broke a bone or needed treatment. Even DW's school-provided health plan, historically very good, has huge deductibles and annoying wrinkles -- kids over 10 here in Florida, for instance, no longer can go to a pediatric dentist.
I have friends sleepwalking through government desk jobs where they do little to nothing in part because they can keep their healthcare when they retire, paying modest premiums. But those of us who are self-employed, not relying on the government for anything, get pounded not only with self-employed income taxes but also health insurance.
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With Global warming Canada might not be too bad. Good beer and fishing, eh?
And a Tim Horton's on every corner!!!!
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I am not freaked out. I expect healthcare to be expensive. I expect end of life care to be expensive. I plan for those expenses and have plans on what to do if those expenses get to be too much.
There is a peak to healthcare cost because at some potential level it will be too expensive for a very high percentage of people. For example it can not get so expensive that 90% of the population can't afford it. I think there is some more room for cost increase but I think we are getting very close to the top.
Also, I do not expect to see a single politician trying to remove the pre-existing condition mandates. This is political suicide today.
Keep in mind that those who plan on retiring very early are also likely paying very little taxes and contributing very little to the health care budget. Maybe it is time to pay our fair share for the services we use or plan to use. Obviously those making more can and should pay more, but paying close to nothing doesn't seam right either especially if we are able bodied people who can work and contribute our fare share. Today healthcare costs on average a little over $10k/person per year. How many of us have actually paid that much in taxes to cover healthcare for ourselves for our lifetime plus help cover some of our infrastructure costs? I realize this is an unpopular sentiment amongst this forum but stuff costs money and we can't expect the working class to pay for us.
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I am not freaked out. I expect healthcare to be expensive. I expect end of life care to be expensive. I plan for those expenses and have plans on what to do if those expenses get to be too much.
There is a peak to healthcare cost because at some potential level it will be too expensive for a very high percentage of people. For example it can not get so expensive that 90% of the population can't afford it. I think there is some more room for cost increase but I think we are getting very close to the top.
Also, I do not expect to see a single politician trying to remove the pre-existing condition mandates. This is political suicide today.
Keep in mind that those who plan on retiring very early are also likely paying very little taxes and contributing very little to the health care budget. Maybe it is time to pay our fair share for the services we use or plan to use. Obviously those making more can and should pay more, but paying close to nothing doesn't seam right either especially if we are able bodied people who can work and contribute our fare share. Today healthcare costs on average a little over $10k/person per year. How many of us have actually paid that much in taxes to cover healthcare for ourselves for our lifetime plus help cover some of our infrastructure costs? I realize this is an unpopular sentiment amongst this forum but stuff costs money and we can't expect the working class to pay for us.
I agree with the above. Fair is Fair. If you are FIRE'd, you should expect to pay more than 0 for HealthCare, ACA or no ACA. Put it in your budget, plan accordingly.
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Keep in mind that those who plan on retiring very early are also likely paying very little taxes and contributing very little to the health care budget.
Indeed, this is especially true for some people not paying their fair share of taxes:
https://forum.mrmoneymustache.com/antimustachian-wall-of-shame-and-comedy/you-only-max-your-401(k)-because-you-don't-have-kids/msg2060125/#msg2060125
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Wow, it sounds like my decision to do a Roth ladder and be super cheap so that I have low enough income to get FREE ObamaObamaRomneyHeritageCare Medicaid expansion was the correct move!
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You know, there was a time when people didnt have health insurance and the world turned out ok. Now, this “need” has been created. You know, you will eventually die dont you? So why fret over something that people never had not that long ago?
So your solution to healthcare is to just die, huh? That's what some people call the republican plan.
*** THIS ***
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Folks - Maybe the time has come to pick up pen and paper and write. Write to your favorite American politicians.
With Republicans, it is a lost cause, but you will feel better.
With Democrats, they will lie that they are in favor of single payer, and you will feel better.
With independents - You may have a chance, but will be voted down by the others - But you will still feel better
And,.......you will have done what you can. Tides do turn.
I think the remnants of supporters bloated insurance-based health care in the Democratic Party - i.e., Lieberman, and my former senator, Landrieu - have been exorcised from the party. They would be happy to go to single payer, but are only timid because of the reaction to ObamaRomneyHeritageCare - i.e., back before it became popular.
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I'm mere days away from retiring at age 41 with a wife and three kids. I am not worried about healthcare.
The ACA is still the law of the land, and my state's expanded coverage options are pretty good. Care is totally 100% FREE if my family shows under $40k of paper income, which is pretty easy to do with a paid off house while just drawing on your investment accounts because return of principal isn't income. Roth contribution withdrawals aren't income. Gross rental income isn't income. Spending down our massive savings isn't income.
Failing that, the subsidy is still by law capped at a sliding percentage of your household income. For a family of 5 making $50k it's about 6% of your income and the subsidy covers the rest. Even if we had some major medical catastrophe and had to pay the out of pocket max, I figure my family's healthcare costs at $50k of paper income would only be $4038 per year, according to my state's marketplace website. That's for premiums plus all costs before 100% coverage kicks in, like if we all got cancer simultaneously or something.
And honestly, the extreme backup plan for healthcare is the same as the extreme backup plan in case of generic economic collapse (and associated portfolio failure): just get another job. I have one now, and it's tolerable. I'm pretty sure I could get another one if I really really had to, and I'm not prepared to accept that doomsayer prediction that I should just never stop working, in case I someday have to go to work in the future. That seems silly.
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Did I miss something? You should be paying pennies in retirement for health insurance unless of course you are drawing a huge antimustachian wad of cash from your investments. What gives?
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I'm mere days away from retiring at age 41 with a wife and three kids. I am not worried about healthcare.
The ACA is still the law of the land, and my state's expanded coverage options are pretty good. Care is totally 100% FREE if my family shows under $40k of paper income, which is pretty easy to do with a paid off house while just drawing on your investment accounts because return of principal isn't income. Roth contribution withdrawals aren't income. Gross rental income isn't income. Spending down our massive savings isn't income.
Failing that, the subsidy is still by law capped at a sliding percentage of your household income. For a family of 5 making $50k it's about 6% of your income and the subsidy covers the rest. Even if we had some major medical catastrophe and had to pay the out of pocket max, I figure my family's healthcare costs at $50k of paper income would only be $4038 per year, according to my state's marketplace website. That's for premiums plus all costs before 100% coverage kicks in, like if we all got cancer simultaneously or something.
And honestly, the extreme backup plan for healthcare is the same as the extreme backup plan in case of generic economic collapse (and associated portfolio failure): just get another job. I have one now, and it's tolerable. I'm pretty sure I could get another one if I really really had to, and I'm not prepared to accept that doomsayer prediction that I should just never stop working, in case I someday have to go to work in the future. That seems silly.
Congrats on your soon to be retirement day. Like everyone else, we all should take advantage of any law that helps us and utilize any loophole that benefits our needs. it is human nature and we would be foolish to not do so.
I looked and had the ACA plans in our area (until we went on my SOs insurance.) I was extremely disappointed by the providers who are in network. In particular I looked at surgeons and OB/GYN physicians and was sadly discouraged by the quality of those doctors. I am looking forward to being able to purchase non ACA complaint insurance next year to have access to better specialists. I suspect I will be paying less as well for it which will be a nice perk. The law of the land has changed and I am gladly opting out of the ACA.
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The law hasn't changed at all (they tried to repeat it and failed, remember?). The current administration is simply just selectively enforcing it, while also gutting it financially and approving state by state "waivers" that allow states to break the spirit of the law without actually breaking the law.
Be wary of what you purchase EnjoyIt. Make sure your new insurance actually covers what you want it to cover, including catastrophic costs.
JGS
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The law hasn't changed at all (they tried to repeat it and failed, remember?). The current administration is simply just selectively enforcing it, while also gutting it financially and approving state by state "waivers" that allow states to break the spirit of the law without actually breaking the law.
Be wary of what you purchase EnjoyIt. Make sure your new insurance actually covers what you want it to cover, including catastrophic costs.
JGS
Indeed....I read all the fine print.
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It kinda amazes me how many financially independent Mustachians are planning to work multiple extra years of their lives in an attempt to save 25X the ever-spiraling cost of healthcare, chasing a financial mirage essentially, and yet MOST WON'T DO ANYTHING ABOUT THE SITUATION.
Unless you have a very high income, you pay more for healthcare than you do in taxes. Imagine the outrage and riots if your taxes increased 5-15% every single year? But for whatever reason, financial fiascos in the "healthcare" category are assumed to be inevitable. Well guess what: Just as high taxes are an outcome of a given political system that can be changed, so are high healthcare costs. Literally every other developed democracy has solved this problem. Any of their templates would be better than this.
So, on our way to work as anxiety-wrecked millionaire cube monkeys, let's consider how many thousands of hours we're spending in a dusty grey/beige office versus how many hours we spend on political activism (NONE you say?). Consider the thousands of dollars in commuting expenses we pay versus our resistance to writing a $150 check to support the campaign of someone willing to solve the healthcare problem. Also, consider how the uncertain payoff of actually participating in our democracy is aversive, whereas we are somehow comfortable with a status quo that, if it continues, is certain to destroy our dreams.
Finally, consider that the reason you are still working is because everyone else is just like you - too busy running on this treadmill to work toward a solution. If you're waiting for the big collapse that somehow inevitably ushers in a better system, consider how it might eventually be you choosing to either die from a treatable illness or leave your family bankrupt (or maybe you don't even get the second option). Everyone else will continue waiting around for things to get really bad.
It only makes sense to call your reps, attend meetings, write checks, join, organize, pressure, speak, and raise hell. If you're not willing to work even that hard, I have news: You're not immigrating to Canada either.
/rant
/microphone
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ChpBastrd - Absolutely agree!! All the energy devoted to hand-wringing and detailed discussions of loopholes could be redirected toward a better solution for everyone.
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It kinda amazes me how many financially independent Mustachians are planning to work multiple extra years of their lives in an attempt to save 25X the ever-spiraling cost of healthcare, chasing a financial mirage essentially, and yet MOST WON'T DO ANYTHING ABOUT THE SITUATION.
Unless you have a very high income, you pay more for healthcare than you do in taxes. Imagine the outrage and riots if your taxes increased 5-15% every single year? But for whatever reason, financial fiascos in the "healthcare" category are assumed to be inevitable. Well guess what: Just as high taxes are an outcome of a given political system that can be changed, so are high healthcare costs. Literally every other developed democracy has solved this problem. Any of their templates would be better than this.
So, on our way to work as anxiety-wrecked millionaire cube monkeys, let's consider how many thousands of hours we're spending in a dusty grey/beige office versus how many hours we spend on political activism (NONE you say?). Consider the thousands of dollars in commuting expenses we pay versus our resistance to writing a $150 check to support the campaign of someone willing to solve the healthcare problem. Also, consider how the uncertain payoff of actually participating in our democracy is aversive, whereas we are somehow comfortable with a status quo that, if it continues, is certain to destroy our dreams.
Finally, consider that the reason you are still working is because everyone else is just like you - too busy running on this treadmill to work toward a solution. If you're waiting for the big collapse that somehow inevitably ushers in a better system, consider how it might eventually be you choosing to either die from a treatable illness or leave your family bankrupt (or maybe you don't even get the second option). Everyone else will continue waiting around for things to get really bad.
It only makes sense to call your reps, attend meetings, write checks, join, organize, pressure, speak, and raise hell. If you're not willing to work even that hard, I have news: You're not immigrating to Canada either.
/rant
/microphone
hahaha! Enjoyed this rant immensely.
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Unless you have a very high income, you pay more for healthcare than you do in taxes.
I wouldn't call myself very high income.
I pay about $900 total out of pocket for healthcare insurance, deductibles, co-pays in a year.
I pay 10's of thousands of dollars in taxes.
When I FIRE, total out of pocket healthcare is still expected to be less than the total of my taxes thanks to ACA subsidies and partial CSR.
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I pay about $900 total out of pocket for healthcare insurance, deductibles, co-pays in a year.
Are you failing to include the employer portion of your premiums, and the employer-negotiated group rate discount? Because those are both part of your total compensation package, which your employer spends to pay for your healthcare instead of paying to you directly.
Everyone who gets employer sponsored health insurance "pays" a lot more for their insurance than they personally pay for their insurance.
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I pay about $900 total out of pocket for healthcare insurance, deductibles, co-pays in a year.
Are you failing to include the employer portion of your premiums, and the employer-negotiated group rate discount? Because those are both part of your total compensation package, which your employer spends to pay for your healthcare instead of paying to you directly.
I'm not "failing" to include them because I intentionally used the term "out of pocket" specifically for that reason. My employer also pays additional taxes on my behalf, but I excluded that from the comparison as well.
Also I am extremely aware of the cost to my employer and what I would have to pay for it on COBRA or LOA, but I also do not believe my employer would automatically pay me the difference if they didn't pay most of my premium. But since that hypothetical additional pay is not part of my current agreed upon salary, I certainly don't consider it "out of pocket" anymore than a larger raise or bonus that I didn't receive is "out of pocket".
Edit: Even factoring in the full cost of the premium by adding in what my employer pays, then after subtracting the tax deduction from the premium cost to get my net premium cost, the total net premium cost would still be far less than my total taxes paid. Actually, even if I don't subtract for the tax deduction to get my net premium cost, taxes are still far more than me having to pay full freight premiums for the year, albeit the difference is not as stark as it currently is for me.
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It kinda amazes me how many financially independent Mustachians are planning to work multiple extra years of their lives in an attempt to save 25X the ever-spiraling cost of healthcare, chasing a financial mirage essentially, and yet MOST WON'T DO ANYTHING ABOUT THE SITUATION.
Unless you have a very high income, you pay more for healthcare than you do in taxes. Imagine the outrage and riots if your taxes increased 5-15% every single year? But for whatever reason, financial fiascos in the "healthcare" category are assumed to be inevitable. Well guess what: Just as high taxes are an outcome of a given political system that can be changed, so are high healthcare costs. Literally every other developed democracy has solved this problem. Any of their templates would be better than this.
So, on our way to work as anxiety-wrecked millionaire cube monkeys, let's consider how many thousands of hours we're spending in a dusty grey/beige office versus how many hours we spend on political activism (NONE you say?). Consider the thousands of dollars in commuting expenses we pay versus our resistance to writing a $150 check to support the campaign of someone willing to solve the healthcare problem. Also, consider how the uncertain payoff of actually participating in our democracy is aversive, whereas we are somehow comfortable with a status quo that, if it continues, is certain to destroy our dreams.
Finally, consider that the reason you are still working is because everyone else is just like you - too busy running on this treadmill to work toward a solution. If you're waiting for the big collapse that somehow inevitably ushers in a better system, consider how it might eventually be you choosing to either die from a treatable illness or leave your family bankrupt (or maybe you don't even get the second option). Everyone else will continue waiting around for things to get really bad.
It only makes sense to call your reps, attend meetings, write checks, join, organize, pressure, speak, and raise hell. If you're not willing to work even that hard, I have news: You're not immigrating to Canada either.
/rant
/microphone
APPLAUSE
I'd add VOTE IN EVERY ELECTION as step zero to your list of activism. We have mustachians here who write in and ask for help in figuring out how to save pennies a year on clothes, groceries, soap, electricity. They are willing to spend hours on such pursuits for tiny gains, but I bet some of them don't even spend 20 minutes a year voting.
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I'm mere days away from retiring at age 41 with a wife and three kids. I am not worried about healthcare.
The ACA is still the law of the land, and my state's expanded coverage options are pretty good. Care is totally 100% FREE if my family shows under $40k of paper income, which is pretty easy to do with a paid off house while just drawing on your investment accounts because return of principal isn't income. Roth contribution withdrawals aren't income. Gross rental income isn't income. Spending down our massive savings isn't income.
That sounds like Medicaid to me, which I would rather avoid by drawing a little bit more income to get an ACA plan with PCT/CSR, which won't be difficult since my dividends and interest in my taxable accounts alone get me up around the top limit of Medicaid and into the ACA minimum income. We single people are only allowed a maximum MAGI somewhere between $16K to $17K for Medicaid, and I'm planning for about $24K MAGI in order to provide $50K spending during the ACA years. This will keep me under one of the CSR subsidy cliffs, although it's far from being free if I have to use much for health services in a particular year.
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APPLAUSE
I'd add VOTE IN EVERY ELECTION as step zero to your list of activism. We have mustachians here who write in and ask for help in figuring out how to save pennies a year on clothes, groceries, soap, electricity. They are willing to spend hours on such pursuits for tiny gains, but I bet some of them don't even spend 20 minutes a year voting.
"Both sides are the same"!, "My vote doesn't matter".
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APPLAUSE
I'd add VOTE IN EVERY ELECTION as step zero to your list of activism. We have mustachians here who write in and ask for help in figuring out how to save pennies a year on clothes, groceries, soap, electricity. They are willing to spend hours on such pursuits for tiny gains, but I bet some of them don't even spend 20 minutes a year voting.
"Both sides are the same"!, "My vote doesn't matter".
"I voted for Libertarian candidate Gary Johnson"
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Let's put some numbers down. I'm in Oregon and my wife and I do everything right (non-smokers, healthy weight, etc...) and we're young. We have an option for catastrophic insurance at $497/month (from Kaiser, which around here isn't great to say the least). This has no coverage until we hit $13k deductible for our family.
What's insidious about this is that if you pay under insurance, you're billed at twice the rate that if you come in without insurance. For instance, we're covered by 80% coverage health insurance and I recently went in for an MRI. The uninsured cost was $595. The insured cost was $1200. Luckily for us, 20% of $1200 was less than $595, and it counted towards our deductible, so it was an easy decision.
But if we had catastrophic insurance, which would we pay? It's a real pickle because we have no way of knowing if we would need more medical services for the rest of the year or not.
To get 'non-catastrophic' insurance would cost us a minimum of $804/month. And even this doesn't cover anything until you hit $3k out of pocket per year.
I re-ran the numbers as a 55 year old, and got $968 and $1566/month.
If you have a chronic condition, then you could easily hit $5-10k in medical expenses per year, if not more.
So let's assume one of us develops a chronic condition over the next couple decades and has to pay $10k/year in medical expenses. And assume we pay for non-catastrophic insurance. That comes out to an average of ~$24k/year. 25x that is ~600k/year.
And for those of you relying on some sort of public option during retirement, that could go away in an instant if they decide to start means testing.
Literally no other country has this problem, so we're moving rather than adding a decade or more to our working career for no reason.
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That comes out to an average of ~$24k/year. 25x that is ~600k/year.
And for those of you relying on some sort of public option during retirement, that could go away in an instant if they decide to start means testing.
$24k/year sounds about right, to insure a couple of old people. Being old is expensive.
Fortunately you don't have to pay anywhere near that much, thanks to the ACA, unless you are filthy rich. In which case you probably don't mind it.
You're seriously moving away because you're afraid they might change the law in the future, and not provide a replacement? That seems pretty unlikely to me.
I try to avoid making plans based on fear. You have to work with the law as currently written, as it has stood for the past eight years. They MIGHT quadruple your tax rates, they MIGHT draft you into the army, and they MIGHT destroy American healthcare. I'm not terribly concerned about it though, politicians know those things would be terribly unpopular. They just like to shout hypothetical fantasy policies during campaign season. Chances are, very little will change soon.
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Yes and no, I have employer provided health insurance and money to pay for care. But if I wasn't highly compensated I would be terrified. My asthma medication is $150/mo AFTER my health insurance. I think it retails in India for $36.
I fully plan to move to a country with universal coverage before I retire, although I guess Medicare is universal for people old enough to get it.
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I re-ran the numbers as a 55 year old, and got $968 and $1566/month.
55 is still on the young side. It will get more expensive for the unsubsidized premium until you're 65 and can get on Medicare, although that's expensive also.
And for those of you relying on some sort of public option during retirement, that could go away in an instant if they decide to start means testing.
ACA didn't include a public option, despite many people pushing for it, maybe next time.
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I fully plan to move to a country with universal coverage before I retire, although I guess Medicare is universal for people old enough to get it.
Ahhh, but Medicare can still be expensive for decent coverage. If you get plan A, B, D, and supplemental to cover everything else, someone posted in another thread it was costing over $900/mo.
https://forum.mrmoneymustache.com/welcome-to-the-forum/what-comes-after-the-aca/msg2036422/#msg2036422
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It kinda amazes me how many financially independent Mustachians are planning to work multiple extra years of their lives in an attempt to save 25X the ever-spiraling cost of healthcare, chasing a financial mirage essentially, and yet MOST WON'T DO ANYTHING ABOUT THE SITUATION.
Unless you have a very high income, you pay more for healthcare than you do in taxes. Imagine the outrage and riots if your taxes increased 5-15% every single year? But for whatever reason, financial fiascos in the "healthcare" category are assumed to be inevitable. Well guess what: Just as high taxes are an outcome of a given political system that can be changed, so are high healthcare costs. Literally every other developed democracy has solved this problem. Any of their templates would be better than this.
So, on our way to work as anxiety-wrecked millionaire cube monkeys, let's consider how many thousands of hours we're spending in a dusty grey/beige office versus how many hours we spend on political activism (NONE you say?). Consider the thousands of dollars in commuting expenses we pay versus our resistance to writing a $150 check to support the campaign of someone willing to solve the healthcare problem. Also, consider how the uncertain payoff of actually participating in our democracy is aversive, whereas we are somehow comfortable with a status quo that, if it continues, is certain to destroy our dreams.
Finally, consider that the reason you are still working is because everyone else is just like you - too busy running on this treadmill to work toward a solution. If you're waiting for the big collapse that somehow inevitably ushers in a better system, consider how it might eventually be you choosing to either die from a treatable illness or leave your family bankrupt (or maybe you don't even get the second option). Everyone else will continue waiting around for things to get really bad.
It only makes sense to call your reps, attend meetings, write checks, join, organize, pressure, speak, and raise hell. If you're not willing to work even that hard, I have news: You're not immigrating to Canada either.
/rant
/microphone
If you can show me a single candidate that is looking to do right about our healthcare problem I would be glad to contribute cash to their cause. I have yet to see a single one. And please keep in mind I do not think the ACA is or was a good solution. It is just a bandaid to a much bigger problem that was never really addressed.
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That comes out to an average of ~$24k/year. 25x that is ~600k/year.
And for those of you relying on some sort of public option during retirement, that could go away in an instant if they decide to start means testing.
$24k/year sounds about right, to insure a couple of old people. Being old is expensive.
Fortunately you don't have to pay anywhere near that much, thanks to the ACA, unless you are filthy rich. In which case you probably don't mind it.
You're seriously moving away because you're afraid they might change the law in the future, and not provide a replacement? That seems pretty unlikely to me.
I try to avoid making plans based on fear. You have to work with the law as currently written, as it has stood for the past eight years. They MIGHT quadruple your tax rates, they MIGHT draft you into the army, and they MIGHT destroy American healthcare. I'm not terribly concerned about it though, politicians know those things would be terribly unpopular. They just like to shout hypothetical fantasy policies during campaign season. Chances are, very little will change soon.
I agree with not making choices based on fear, but much of this is either reasonable fear or guaranteed to happen. It would be reasonable to expect healthcare costs to continue going up at 10% a year at least for a little while longer, and it would be reasonable to plan for *both* of us getting some kind of chronic condition. These would blow up our costs even more. I think the $600k figure is actually pretty middle of the road and a healthy balance.
I'm planning on ~$70k a year income in retirement and we won't qualify for much if any subsidy, so it's guaranteed that unless they do socialized healthcare or something I will be paying that cost. I would love to see socialized healthcare but am not willing to bet my retirement on it.
If you look at someplace like Italy or Germany, they have comparable living costs to the US, and don't have this huge healthcare problem, so it really becomes a question of what is so great that is tying us to the US. Fortunately we're young enough that we can move and put down roots somewhere else. I can't think of anything in the US that is so great we'd want to work an extra decade to stay. And once we live somewhere else, there's nothing preventing us from visiting, we could come back 4 times a year or something fairly affordably to visit friends and family and still have it be far cheaper.
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ChpBastrd:
It only makes sense to call your reps, attend meetings, write checks, join, organize, pressure, speak, and raise hell. If you're not willing to work even that hard, I have news: You're not immigrating to Canada either.
Sound like some positive actions that can eventually get some positive changes.
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In my experience, those who say anything medical is not needed because years ago people never had it, sing a different tune when they are on their deathbed. All of sudden, it's important!
Or, "I never see a doctor, who needs em, I'm not paying for anyone else to use one either." The tune changes when they need one.
This is my experience only, and makes me believe that one's experience in life forms their opinion on many things. Some opinions, I just feel sorry for that person, that he had such a life.
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You're seriously moving away because you're afraid they might change the law in the future, and not provide a replacement? That seems pretty unlikely to me.
I try to avoid making plans based on fear. You have to work with the law as currently written, as it has stood for the past eight years. They MIGHT quadruple your tax rates, they MIGHT draft you into the army, and they MIGHT destroy American healthcare. I'm not terribly concerned about it though, politicians know those things would be terribly unpopular. They just like to shout hypothetical fantasy policies during campaign season. Chances are, very little will change soon.
I get what you're saying, but for good or bad the current administration is different than normal political beasts. The individual mandate is already gone and now they are blocking payments to insurance companies that end up with above expected #s of insured sick. I suspect that this will lead to two things in the short term: 1) much higher insurance rates and 2) insurance companies pulling out of some markets and/or the exchanges altogether. We'll see how much damage they can do to the subsidies before they get voted out.
I'm not worried about social security and/or medicare cuts. Those will likely happen, but will be minor and more likely to be delays in eligibility and slower COLAs. But, health insurance from my 51-65 years? That keeps me up a bit. If healthcare costs hadn't been so distorted over the years, self insuring would be an option, but it really doesn't take a long hospital stay to destroy your stache.
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You're seriously moving away because you're afraid they might change the law in the future, and not provide a replacement? That seems pretty unlikely to me.
I try to avoid making plans based on fear. You have to work with the law as currently written, as it has stood for the past eight years. They MIGHT quadruple your tax rates, they MIGHT draft you into the army, and they MIGHT destroy American healthcare. I'm not terribly concerned about it though, politicians know those things would be terribly unpopular. They just like to shout hypothetical fantasy policies during campaign season. Chances are, very little will change soon.
I get what you're saying, but for good or bad the current administration is different than normal political beasts. The individual mandate is already gone and now they are blocking payments to insurance companies that end up with above expected #s of insured sick. I suspect that this will lead to two things in the short term: 1) much higher insurance rates and 2) insurance companies pulling out of some markets and/or the exchanges altogether. We'll see how much damage they can do to the subsidies before they get voted out.
It sounds like the usual comments same as last year. But insurers got back into the market, and I just heard that insurers were profitable and more are getting into the markets in 2019. Premiums will keep going up for those who don't get subsidies for the foreseeable future.
I'm not worried about social security and/or medicare cuts. Those will likely happen, but will be minor and more likely to be delays in eligibility and slower COLAs.
COLA is only once a year as it is. The eligibility age will probably be raised for younger workers. But there are several ways to prop up SS as I mentioned in the "ss is not going bankrupt" thread so that those in and nearing retirement aren't hurt by the changes while giving younger workers more time to prepare.
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I agree with not making choices based on fear, but much of this is either reasonable fear or guaranteed to happen. It would be reasonable to expect healthcare costs to continue going up at 10% a year at least for a little while longer, and it would be reasonable to plan for *both* of us getting some kind of chronic condition. These would blow up our costs even more. I think the $600k figure is actually pretty middle of the road and a healthy balance.
So, not to derail the conversation too much, but for a €350K investment in Portuguese real estate you could have a golden visa. But you get to keep the real estate and you would (eventually) get access to state paid for health care. Just a thought.
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It sounds like the usual comments same as last year. But insurers got back into the market, and I just heard that insurers were profitable and more are getting into the markets in 2019. Premiums will keep going up for those who don't get subsidies for the foreseeable future.
And things have gotten considerably worse in the last year with ACA. Average cheapest Silver plan is up over 30%, many locales are down to one insurer on the exchange. Obviously, it's not sustainable, the exchange market is basically collapsing. Whether it gets replaced with something better remains to be seen.
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And things have gotten considerably worse in the last year with ACA. Average cheapest Silver plan is up over 30%, many locales are down to one insurer on the exchange. Obviously, it's not sustainable, the exchange market is basically collapsing. Whether it gets replaced with something better remains to be seen.
Actually it is stabilizing despite all the efforts to sabotage it. Remember 87% on ACA get subsidies so their exposure to increases is limited. Also the millions on Medicaid do not pay premiums.
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Another reason I plan on having no debt, 100% self sustaining house with solar/wind, farm, etc so I can lower my income to as low as needed to get the best subsidies. Making too much income cuts you out of a lot of subsidies, and not just for health care. My parent is low income and we got free school lunches, low rent, college, low healthcare cost, energy discounts, water discounts, property tax discounts, dental, and the list goes on and on.
Another strategy is to get 3-6 month IT job contracts with health insurance (very common in my area), do all the non emergency health care visits, dental, etc... Then get laid off after the contract ends and can collect unemployment for 6 months and just repeat that cycle if I feel like making a little more money.
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I remember when I was in 3rd and 4th grade, we were eligible for free lunches at school. Dad wouldn't take them, it was a pride thing.
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I remember when I was in 3rd and 4th grade, we were eligible for free lunches at school. Dad wouldn't take them, it was a pride thing.
My whole childhood was free school lunches. I think I would have literally starved to death without them. There were days where that one meal was the vast majority of my calories.
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And things have gotten considerably worse in the last year with ACA. Average cheapest Silver plan is up over 30%, many locales are down to one insurer on the exchange. Obviously, it's not sustainable, the exchange market is basically collapsing. Whether it gets replaced with something better remains to be seen.
Actually it is stabilizing despite all the efforts to sabotage it. Remember 87% on ACA get subsidies so their exposure to increases is limited. Also the millions on Medicaid do not pay premiums.
So who pays for that?
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It sounds like the usual comments same as last year. But insurers got back into the market, and I just heard that insurers were profitable and more are getting into the markets in 2019. Premiums will keep going up for those who don't get subsidies for the foreseeable future.
And things have gotten considerably worse in the last year with ACA. Average cheapest Silver plan is up over 30%, many locales are down to one insurer on the exchange. Obviously, it's not sustainable, the exchange market is basically collapsing. Whether it gets replaced with something better remains to be seen.
We are on our way back to the days when people desperately hold on to jobs for healthcare, jobs they would otherwise leave and let the next generation take over. If I lose my job or the pre-medicare plans are no longer offered, that will be me, instead of leaving at 60 or 61 I will be working until 65, if a job is available to me. And I'll still be among the lucky ones compared to many others.
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I agree with not making choices based on fear, but much of this is either reasonable fear or guaranteed to happen. It would be reasonable to expect healthcare costs to continue going up at 10% a year at least for a little while longer, and it would be reasonable to plan for *both* of us getting some kind of chronic condition. These would blow up our costs even more. I think the $600k figure is actually pretty middle of the road and a healthy balance.
So, not to derail the conversation too much, but for a €350K investment in Portuguese real estate you could have a golden visa. But you get to keep the real estate and you would (eventually) get access to state paid for health care. Just a thought.
That intriguing. I hear the lifestyle in Portugal can be wonderful. Beautiful scenery, friendly people, good food, lots of culture, inexpensive in most areas. It's worth looking into.
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Been working with this guy from South America. he had to go to the doctor.
When he got back I showed him how the US ranks in terms of medicine with other countries. He just shook his head.
Then there's the ambulance story in Massachusetts.
http://thehill.com/homenews/media/395409-story-of-injured-woman-begging-people-not-to-call-ambulance-due-to-costs-gains (http://thehill.com/homenews/media/395409-story-of-injured-woman-begging-people-not-to-call-ambulance-due-to-costs-gains)
Makes me want to get alone in a dark room with some of those right wing politicians and give them the opportunity to avail themselves of THEIR excellent health care.
This health care thing can be can be fixed.
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It's an embarrassment for this country. There are plenty of working models out there in the world. Too much greed out there though including corporate, politicians and individuals. Same thing with guns. At the end of the day, money is more important than lives.
Not surprised when I see stories like this out there.
Family considering divorce to afford daughter's health care costs
https://www.wfaa.com/article/news/family-considering-divorce-to-afford-daughters-health-care-costs/287-572210331
We are looking into the possibility of moving out of the country in the future and the biggest reasons are healthcare and guns. We don't want to spend 30% of our income on healthcare and we don't want our kids to get shot at school. Those are two issues that you just don't worry about in any other developed country. My wife's mother is a Canadian citizen which may give us the option to seek citizenship for my wife. I hope we don't have to do that, but our country certainly is trending in the wrong direction for us in these two important areas.
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There is no reason to "freak out," but there is reason to be cautiously pessimistic. ;)
No one knows what will happen with US health care policy in the future, but I think the following things are likely:
+ It will matter even more how much you make. All the recent sabotage has the affect of increasing premiums for those who do not receive subsidies, so it's important to reduce your MAGI.
+ It will matter even more where you live. It's likely that we see more segmenting and fracturing of the health care system between states. Some states have expanded medicaid, some did not. If the law changes, some states may continue with robust coverage for essential health benefits, some may not. Some states may continue with community rating, some may not. If this happens, vote with your feet.
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The Trump Administration seems to be making a full court press to kill ObamaCare (better known in these circles as Affordable Care):
https://www.cnn.com/2018/07/07/politics/wsj-aca-risk-adjustment/index.html
The Trump administration announced Saturday that it will temporarily halt billions of dollars in payments under the Affordable Care Act's risk adjustment program, a move that could shake up insurance markets.
The Centers for Medicare and Medicaid Services (CMS), the agency that oversees the program, cited a recent federal court decision that found the formula for calculating the risk adjustment payments to be flawed. In a March 2018 ruling out of New Mexico, US District Court Judge Thomas Browning that the methodology used by the federal government was "arbitrary and capricious" and remanded it back to the agency, according to Lexis Legal News.
Also, https://www.cnn.com/2018/07/10/politics/obamacare-trump/index.html
"Given the continued attacks on health care, including federal rules allowing the resurgence of low-cost, junk health insurance plans, such as 'association health plans' and 'short-term plans', consumers looking for good, comprehensive coverage could be easily confused," said Frederick Isasi, executive director of Families USA, a left-leaning advocacy organization. "This is a time when consumers need more help to understand the insurance options that are available to them—not less."
And lets not forget Kavanaugh - https://www.washingtonexaminer.com/news/congress/democrats-cast-kavanaugh-pick-as-a-battle-for-the-future-of-obamacare
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There is no reason to "freak out," but there is reason to be cautiously pessimistic. ;)
No one knows what will happen with US health care policy in the future, but I think the following things are likely:
+ It will matter even more how much you make. All the recent sabotage has the affect of increasing premiums for those who do not receive subsidies, so it's important to reduce your MAGI.
Yeah. The other day I checked our states exchange website to see what this might look like down the road. A 60 year old couple would pay $24k for a $7k deductible plan today. Given that this is going up faster than inflation, by the time I get there, assuming it's still even available, this would likely be $40k-50k in today's dollars. That really blows a bit of a hole in FIRE plans.
And yes, that does mean that there is a financial cliff if you exceed certain MAGI levels, which as a high earner/high spender I need to look closely at. The other thing is that I really doubt the current subsidy model that everybody seems to be counting on is going to survive given the current makeup of Congress the administration.
One of the biggest criticisms of ACA (aside from the individual mandate) is how the middle gets squeezed. I didn't realize just how bad the situation is until I started looking more closely at it recently.
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One of the biggest criticisms of ACA (aside from the individual mandate) is how the middle gets squeezed. I didn't realize just how bad the situation is until I started looking more closely at it recently.
Insurance executives are rubbing their hands together with a big grin on their faces. "It's like taking candy from a baby," one of the executives says to another.
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There is no reason to "freak out," but there is reason to be cautiously pessimistic. ;)
No one knows what will happen with US health care policy in the future, but I think the following things are likely:
+ It will matter even more how much you make. All the recent sabotage has the affect of increasing premiums for those who do not receive subsidies, so it's important to reduce your MAGI.
Yeah. The other day I checked our states exchange website to see what this might look like down the road. A 60 year old couple would pay $24k for a $7k deductible plan today. Given that this is going up faster than inflation, by the time I get there, assuming it's still even available, this would likely be $40k-50k in today's dollars. That really blows a bit of a hole in FIRE plans.
...
This is actually part of why I'm not so concerned about it. If health care costs reach $40-50k for an old couple there is no way that is sustainable. (Even $24k is crazy without the subsidies) Maybe it would happen for a few years but rapidly no normal people would have health insurance... That would mean that whoever was currently in office would have a lot of incentive to fix the problem or be voted out in the next election.
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There is no reason to "freak out," but there is reason to be cautiously pessimistic. ;)
No one knows what will happen with US health care policy in the future, but I think the following things are likely:
+ It will matter even more how much you make. All the recent sabotage has the affect of increasing premiums for those who do not receive subsidies, so it's important to reduce your MAGI.
Yeah. The other day I checked our states exchange website to see what this might look like down the road. A 60 year old couple would pay $24k for a $7k deductible plan today. Given that this is going up faster than inflation, by the time I get there, assuming it's still even available, this would likely be $40k-50k in today's dollars. That really blows a bit of a hole in FIRE plans.
...
This is actually part of why I'm not so concerned about it. If health care costs reach $40-50k for an old couple there is no way that is sustainable. (Even $24k is crazy without the subsidies) Maybe it would happen for a few years but rapidly no normal people would have health insurance... That would mean that whoever was currently in office would have a lot of incentive to fix the problem or be voted out in the next election.
I hear what you're saying, but it seems like both sides are more bent on blaming the other side for the failures rather than sorting it out. The number of people who buy their healthcare on the exchanges without subsidies is pretty small without much clout. Corporations are focused on keeping employee benefit costs down, subsidized & Medicaid people don't really care, so there is not much of a lobby representing people who make $100k+ outside of normal employment.
"I retired early with a couple million in the bank, but can't afford healthcare" isn't going to generate much sympathy from the general population.
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The other thing is that I really doubt the current subsidy model that everybody seems to be counting on is going to survive given the current makeup of Congress the administration.
One of the biggest criticisms of ACA (aside from the individual mandate) is how the middle gets squeezed. I didn't realize just how bad the situation is until I started looking more closely at it recently.
The current Congress tried to scale down the subsidies and failed. Hopefully, the democrats will take control of at least one chamber with election in November. There's not really a mandate without a penalty, which was repealed.
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Xlar:
That would mean that whoever was currently in office would have a lot of incentive to fix the problem or be voted out in the next election.
Or,....they could make a killing (no pun intended) by making some super sweet deals with big Pharma and the insurance companies.
Anybody that could pull one of these deals would have instant FI.
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"I retired early with a couple million in the bank, but can't afford healthcare" isn't going to generate much sympathy from the general population.
THIS. Even if you can somehow get your income down low enough and then base your entire retirement plan around a low income. Then 'millionaire living off government subsidies' goes across the national news and congress immediately fixes this loophole and now your entire retirement plan is torpedoed.
To count on this situation going on for 30+ years is very optimistic IMO. And no, your representatives are not going to be fighting for you.
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"I retired early with a couple million in the bank, but can't afford healthcare" isn't going to generate much sympathy from the general population.
THIS. Even if you can somehow get your income down low enough and then base your entire retirement plan around a low income. Then 'millionaire living off government subsidies' goes across the national news and congress immediately fixes this loophole and now your entire retirement plan is torpedoed.
To count on this situation going on for 30+ years is very optimistic IMO. And no, your representatives are not going to be fighting for you.
Republicans have tried many times to scale back the subsidies and make the Medicaid expansion underfunded. Fortunately the Senate prevented it. The only thing anyone can do is remain flexible and adapt as needed. I am sure some states will step in and figure out something, so moving may be required. Becoming an expat is another option as well.
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"I retired early with a couple million in the bank, but can't afford healthcare" isn't going to generate much sympathy from the general population.
THIS. Even if you can somehow get your income down low enough and then base your entire retirement plan around a low income. Then 'millionaire living off government subsidies' goes across the national news and congress immediately fixes this loophole and now your entire retirement plan is torpedoed.
To count on this situation going on for 30+ years is very optimistic IMO. And no, your representatives are not going to be fighting for you.
to the bolded. QUIT SPENDING SO MUCH DAMN MONEY.
now on with it,
How is that a problem? MMM retired with $600k and not much in the way of health insurance plan. Assuming there is no individual mandate, just reset your clock to early 2010s and you do the same thing anyone retiring then would have done.*
BTW, if you have several million you are self insured. What do you think, you'll get into an accident, be in a coma for years and they will finally take you off the respirator after several years when your millions run out???
*Had the mandate remained and the ACA was allowed to continue as was, with companies slowly closing their doors on states, then you would have been faced with a mandate, no insurance company would take you and employer based insurance would likely have been your only option. I would have guessed the Democrats would prefer that, Republicans tend to represent the rich capitalist, so this is likely going in your favor; for now.
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There is no reason to "freak out," but there is reason to be cautiously pessimistic. ;)
No one knows what will happen with US health care policy in the future, but I think the following things are likely:
+ It will matter even more how much you make. All the recent sabotage has the affect of increasing premiums for those who do not receive subsidies, so it's important to reduce your MAGI.
+ It will matter even more where you live. It's likely that we see more segmenting and fracturing of the health care system between states. Some states have expanded medicaid, some did not. If the law changes, some states may continue with robust coverage for essential health benefits, some may not. Some states may continue with community rating, some may not. If this happens, vote with your feet.
I would also add; your two issues, to watch, tend to favor mustacians.
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In early 2016 I'd planned to be FIRE class of 2018. The election nullified that. I'm currently hoping to go class of 2019 or no later than 2020. The next elections could extent that till 2023 when I'll qualify for employer retirement benefits. Even those employer benefits aren't great but with the potential loss of the ACA they are at least some hedge. I don't expect sympathy for our situation, yes we're millionaires and we can roll the dice in FIRE. It would be much nicer however if our government would get off their ass and come up with a decent health care system. We cannot plan our retirement because we are in Limbo on a major cost. The only thing that can possibly bankrupt us at this point is a medical emergency. We've saved nearly 30 years and it's the potential to get sick that prevents our retirement. This is a fucked up situation and one party is to blame. I voted Republican like a fool for decades and now I'm paying the price.
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Corporations are focused on keeping employee benefit costs down, subsidized & Medicaid people don't really care, so there is not much of a lobby representing people who make $100k+ outside of normal employment.
"I retired early with a couple million in the bank, but can't afford healthcare" isn't going to generate much sympathy from the general population.
I agree. It's a similar situation to the "welfare Rothers" like Yours Truly who have their income as tax-free Roth distributions. As long as we don't get noticed, we'll continue to get our free stuff.
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In early 2016 I'd planned to be FIRE class of 2018. The election nullified that. I'm currently hoping to go class of 2019 or no later than 2020. The next elections could extent that till 2023 when I'll qualify for employer retirement benefits. Even those employer benefits aren't great but with the potential loss of the ACA they are at least some hedge. I don't expect sympathy for our situation, yes we're millionaires and we can roll the dice in FIRE. It would be much nicer however if our government would get off their ass and come up with a decent health care system. We cannot plan our retirement because we are in Limbo on a major cost. The only thing that can possibly bankrupt us at this point is a medical emergency. We've saved nearly 30 years and it's the potential to get sick that prevents our retirement. This is a fucked up situation and one party is to blame. I voted Republican like a fool for decades and now I'm paying the price.
Well said. My million+ sta$h won't cut it without ACA subsidies. I'm not sure how long I would have to delay FIRE without the ACA. Without ACA, premiums would continue to go up with time and age, if you can get it at all (if no guaranteed issue). As long as I keep working, I have great healthcare benefits.
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We cannot plan our retirement because we are in Limbo on a major cost. The only thing that can possibly bankrupt us at this point is a medical emergency. We've saved nearly 30 years and it's the potential to get sick that prevents our retirement.
Exactly. I'm not "freaked out" by the situation, more frustrated than anything. It's a shame that becoming an ex-pat may be the best solution.
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In early 2016 I'd planned to be FIRE class of 2018. The election nullified that. I'm currently hoping to go class of 2019 or no later than 2020. The next elections could extent that till 2023 when I'll qualify for employer retirement benefits. Even those employer benefits aren't great but with the potential loss of the ACA they are at least some hedge. I don't expect sympathy for our situation, yes we're millionaires and we can roll the dice in FIRE. It would be much nicer however if our government would get off their ass and come up with a decent health care system. We cannot plan our retirement because we are in Limbo on a major cost. The only thing that can possibly bankrupt us at this point is a medical emergency. We've saved nearly 30 years and it's the potential to get sick that prevents our retirement. This is a fucked up situation and one party is to blame. I voted Republican like a fool for decades and now I'm paying the price.
Well said. My million+ sta$h won't cut it without ACA subsidies. I'm not sure how long I would have to delay FIRE without the ACA. Without ACA, premiums would continue to go up with time and age, if you can get it at all (if no guaranteed issue). As long as I keep working, I have great healthcare benefits.
So you both can get high deductible plans, high the catestrophic stuff in case it gets bad. Done. Why the complainy pants; the government is no longer giving you free, high quality, health care as you live in bliss?
https://www.healthinsurance.org/faqs/i-have-an-individual-hdhp-and-an-hsa-will-i-still-be-able-to-have-them-under-the-aca/
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In early 2016 I'd planned to be FIRE class of 2018. The election nullified that. I'm currently hoping to go class of 2019 or no later than 2020. The next elections could extent that till 2023 when I'll qualify for employer retirement benefits. Even those employer benefits aren't great but with the potential loss of the ACA they are at least some hedge. I don't expect sympathy for our situation, yes we're millionaires and we can roll the dice in FIRE. It would be much nicer however if our government would get off their ass and come up with a decent health care system. We cannot plan our retirement because we are in Limbo on a major cost. The only thing that can possibly bankrupt us at this point is a medical emergency. We've saved nearly 30 years and it's the potential to get sick that prevents our retirement. This is a fucked up situation and one party is to blame. I voted Republican like a fool for decades and now I'm paying the price.
Well said. My million+ sta$h won't cut it without ACA subsidies. I'm not sure how long I would have to delay FIRE without the ACA. Without ACA, premiums would continue to go up with time and age, if you can get it at all (if no guaranteed issue). As long as I keep working, I have great healthcare benefits.
So you both can get high deductible plans, high the catestrophic stuff in case it gets bad. Done.
No, not done. I need reasonable premiums and deductibles that can be financed from my stash without having to reduce my lifestyle to shit, guaranteed issue and knowing they aren't going to drop me for needing healthcare. Otherwise, I would have to delay retirement as I just explained. I didn't save over a million $ just to spend it on insurance/premiums while barely scraping by on my expenses.
Why the complainy pants; the government is no longer giving you free, high quality, health care as you live in bliss?
I'm not getting anything for free. I'm still working and paying high taxes as a single person. I'll continue working rather than paying huge medical out of pocket costs. After the election, if I can be more confident in ACA PCT and CSR, then I will FIRE. We all need to do our part by voting in democrats who will protect the ACA.
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I'm worried.
Worst case is that we will need to work another 7 years. Thankfully at least we have a 55 rip-cord with pension/HC coverage regardless.
The bad news is I don't think I can handle another 7 years of working....particularly if its just to cover ridiculous $20K+ health insurance.
Expat route may be unavoidable.
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In early 2016 I'd planned to be FIRE class of 2018. The election nullified that. I'm currently hoping to go class of 2019 or no later than 2020. The next elections could extent that till 2023 when I'll qualify for employer retirement benefits. Even those employer benefits aren't great but with the potential loss of the ACA they are at least some hedge. I don't expect sympathy for our situation, yes we're millionaires and we can roll the dice in FIRE. It would be much nicer however if our government would get off their ass and come up with a decent health care system. We cannot plan our retirement because we are in Limbo on a major cost. The only thing that can possibly bankrupt us at this point is a medical emergency. We've saved nearly 30 years and it's the potential to get sick that prevents our retirement. This is a fucked up situation and one party is to blame. I voted Republican like a fool for decades and now I'm paying the price.
Well said. My million+ sta$h won't cut it without ACA subsidies. I'm not sure how long I would have to delay FIRE without the ACA. Without ACA, premiums would continue to go up with time and age, if you can get it at all (if no guaranteed issue). As long as I keep working, I have great healthcare benefits.
So you both can get high deductible plans, high the catestrophic stuff in case it gets bad. Done. Why the complainy pants; the government is no longer giving you free, high quality, health care as you live in bliss?
https://www.healthinsurance.org/faqs/i-have-an-individual-hdhp-and-an-hsa-will-i-still-be-able-to-have-them-under-the-aca/
No, I can't. I was unable to get ANY health insurance, included high deductible plans prior to ACA, for ANY price.
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I'm worried.
Worst case is that we will need to work another 7 years. Thankfully at least we have a 55 rip-cord with pension/HC coverage regardless.
That would be nice. I don't even have that, so I will depend on ACA until I'm 65 and can get Medicare (assuming the republicans don't destroy that program by moving to a voucher assistance based program or raising the eligibility age) I don't even want to think about full freight premiums for people in their low 60's if ACA goes away. And as mentioned previously, at age 65, even Medicare is expensive when you add on the supplements to get the protection you need.
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In early 2016 I'd planned to be FIRE class of 2018. The election nullified that. I'm currently hoping to go class of 2019 or no later than 2020. The next elections could extent that till 2023 when I'll qualify for employer retirement benefits. Even those employer benefits aren't great but with the potential loss of the ACA they are at least some hedge. I don't expect sympathy for our situation, yes we're millionaires and we can roll the dice in FIRE. It would be much nicer however if our government would get off their ass and come up with a decent health care system. We cannot plan our retirement because we are in Limbo on a major cost. The only thing that can possibly bankrupt us at this point is a medical emergency. We've saved nearly 30 years and it's the potential to get sick that prevents our retirement. This is a fucked up situation and one party is to blame. I voted Republican like a fool for decades and now I'm paying the price.
Well said. My million+ sta$h won't cut it without ACA subsidies. I'm not sure how long I would have to delay FIRE without the ACA. Without ACA, premiums would continue to go up with time and age, if you can get it at all (if no guaranteed issue). As long as I keep working, I have great healthcare benefits.
So you both can get high deductible plans, high the catestrophic stuff in case it gets bad. Done. Why the complainy pants; the government is no longer giving you free, high quality, health care as you live in bliss?
https://www.healthinsurance.org/faqs/i-have-an-individual-hdhp-and-an-hsa-will-i-still-be-able-to-have-them-under-the-aca/
No, I can't. I was unable to get ANY health insurance, included high deductible plans prior to ACA, for ANY price.
My comment was directed at people who were thinking they needed to work for years to come in order to pay high premiums (since they are no longer artificially low). Essentially, not early retiring. My point being, if they want to retire early, while receiving a subsidy they should lower their income to a reasonable amount. This isn't boggleheads, get on board.
Why can't you, do you have Type 1 diabetes? You are still young, presuming you were born in '84 and have plenty of time to save up for whatever plan you need to cover any preexisting condition.
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No, I can't. I was unable to get ANY health insurance, included high deductible plans prior to ACA, for ANY price.
Why can't you, do you have Type 1 diabetes? You are still young, presuming you were born in '84 and have plenty of time to save up for whatever plan you need to cover any preexisting condition.
That's a very naive view. Here's the list of pre-existing conditions that generally made health insurance unavailable pre-ACA. (And this was just one of the first lists I saw, there are additional conditions I've seen listed in other places.) The same article said approximately 25% of the population have one or more of these conditions.
AIDS/HIV
Alcohol abuse/ Drug abuse with recent treatment
Alzheimer’s/dementia
Arthritis (rheumatoid), fibromyalgia, other inflammatory joint disease
Cancer within some period of time (e.g. 10 years, often other than basal skin cancer)
Cerebral palsy
Congestive heart failure
Coronary artery/heart disease, bypass surgery
Crohn’s disease/ ulcerative colitis
Chronic obstructive pulmonary disease (COPD)/emphysema
Pending surgery or hospitalization
Diabetes mellitus
Epilepsy
Hemophilia
Hepatitis (Hep C)
Kidney disease, renal failure
Lupus
Mental disorders (severe, e.g. bipolar, eating disorder)
Multiple sclerosis
Muscular dystrophy
Obesity, severe
Organ transplant
Paraplegia
Paralysis
Parkinson’s disease
Pneumocystic pneumonia
Pregnancy or expectant parent
Sleep apnea
Stroke
Transsexualism
SOURCE: Kaiser Family Foundation review of field underwriting guidelines from Aetna (GA, PA, and TX), Anthem BCBS (IN, KY, and OH), Assurant, CIGNA, Coventry, Dean Health, Golden Rule, Health Care Services Corporation (BCBS in IL, TX) HealthNet, Humana, United HealthCare, Wisconsin Physician Service. Conditions in this table appeared on declinable conditions list in half or more of guides reviewed. NOTE: Many additional, less-common disorders also appearing on most of the declinable conditions lists were omitted from this table.
It's not a matter of "save up for whatever plan to cover any prexisting condition". That's not how it worked. The way it worked was the insurance company would look for any reason to deny coverage and if they found something, you couldn't get insurance at any price. And if you omitted something in the application that was later found, they would deny coverage, so you'd have been paying for nothing.
Now, one of the most popular aspects of ACA is requiring insurance companies to cover regardless of pre-existing conditions, so I do think it will be hard to remove this. But what I can see happening is because the individual mandate is gone, there is no longer as much incentive for healthy people to get insurance, so the pool in general becomes older and sicker. That drives up prices, which causes lower participation, again mostly the healthy people leaving the exchanges. At some point it is so expensive nobody will buy except for the subsidized folks and the insurers pull out of the exchange. A lot of locales are already down to one insurer. They leave and the only options are 1) live on an income low enough to qualify for Medicaid 2) Move 3) Get a job.
Obviously, #2 & 3 are options for a lot of the early retirees on these boards, but can also be tough.
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In early 2016 I'd planned to be FIRE class of 2018. The election nullified that. I'm currently hoping to go class of 2019 or no later than 2020. The next elections could extent that till 2023 when I'll qualify for employer retirement benefits. Even those employer benefits aren't great but with the potential loss of the ACA they are at least some hedge. I don't expect sympathy for our situation, yes we're millionaires and we can roll the dice in FIRE. It would be much nicer however if our government would get off their ass and come up with a decent health care system. We cannot plan our retirement because we are in Limbo on a major cost. The only thing that can possibly bankrupt us at this point is a medical emergency. We've saved nearly 30 years and it's the potential to get sick that prevents our retirement. This is a fucked up situation and one party is to blame. I voted Republican like a fool for decades and now I'm paying the price.
So you voted Republican when you were in the earning phase of life, and now that you are going to be in the consuming phase of life, you want to vote against the Republicans. How convenient!
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In early 2016 I'd planned to be FIRE class of 2018. The election nullified that. I'm currently hoping to go class of 2019 or no later than 2020. The next elections could extent that till 2023 when I'll qualify for employer retirement benefits. Even those employer benefits aren't great but with the potential loss of the ACA they are at least some hedge. I don't expect sympathy for our situation, yes we're millionaires and we can roll the dice in FIRE. It would be much nicer however if our government would get off their ass and come up with a decent health care system. We cannot plan our retirement because we are in Limbo on a major cost. The only thing that can possibly bankrupt us at this point is a medical emergency. We've saved nearly 30 years and it's the potential to get sick that prevents our retirement. This is a fucked up situation and one party is to blame. I voted Republican like a fool for decades and now I'm paying the price.
Well said. My million+ sta$h won't cut it without ACA subsidies. I'm not sure how long I would have to delay FIRE without the ACA. Without ACA, premiums would continue to go up with time and age, if you can get it at all (if no guaranteed issue). As long as I keep working, I have great healthcare benefits.
So you both can get high deductible plans, high the catestrophic stuff in case it gets bad. Done. Why the complainy pants; the government is no longer giving you free, high quality, health care as you live in bliss?
https://www.healthinsurance.org/faqs/i-have-an-individual-hdhp-and-an-hsa-will-i-still-be-able-to-have-them-under-the-aca/
No, I can't. I was unable to get ANY health insurance, included high deductible plans prior to ACA, for ANY price.
My comment was directed at people who were thinking they needed to work for years to come in order to pay high premiums (since they are no longer artificially low).
No, premiums are still subsidized and artificially low due to the PTC as mentioned in this thread as long as you keep your MAGI low enough. The concern of the people you responded to, me being one, isn't that I can't control my MAGI to receive a PTC under ACA if I were to retire today, it is our concern that the ACA and/or its subsidies could go away altogether.
My point being, if they want to retire early, while receiving a subsidy they should lower their income to a reasonable amount. This isn't boggleheads, get on board.
If that's the case, you're misundestanding the posts you replied to. We know all about controlling MAGI to qualify for PCT and CSR. Controlling income under ACA to get the subsidies was not the concern being posted about but rather the ACA going away completely or otherwise being dismantled vs. what is available now. Bateaux and I were both referring to losing ACA subsidies due to that, not because of any income planning.
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In early 2016 I'd planned to be FIRE class of 2018. The election nullified that. I'm currently hoping to go class of 2019 or no later than 2020. The next elections could extent that till 2023 when I'll qualify for employer retirement benefits. Even those employer benefits aren't great but with the potential loss of the ACA they are at least some hedge. I don't expect sympathy for our situation, yes we're millionaires and we can roll the dice in FIRE. It would be much nicer however if our government would get off their ass and come up with a decent health care system. We cannot plan our retirement because we are in Limbo on a major cost. The only thing that can possibly bankrupt us at this point is a medical emergency. We've saved nearly 30 years and it's the potential to get sick that prevents our retirement. This is a fucked up situation and one party is to blame. I voted Republican like a fool for decades and now I'm paying the price.
Well said. My million+ sta$h won't cut it without ACA subsidies. I'm not sure how long I would have to delay FIRE without the ACA. Without ACA, premiums would continue to go up with time and age, if you can get it at all (if no guaranteed issue). As long as I keep working, I have great healthcare benefits.
So you both can get high deductible plans, high the catestrophic stuff in case it gets bad. Done. Why the complainy pants; the government is no longer giving you free, high quality, health care as you live in bliss?
https://www.healthinsurance.org/faqs/i-have-an-individual-hdhp-and-an-hsa-will-i-still-be-able-to-have-them-under-the-aca/
No, I can't. I was unable to get ANY health insurance, included high deductible plans prior to ACA, for ANY price.
My comment was directed at people who were thinking they needed to work for years to come in order to pay high premiums (since they are no longer artificially low). Essentially, not early retiring. My point being, if they want to retire early, while receiving a subsidy they should lower their income to a reasonable amount. This isn't boggleheads, get on board.
Why can't you, do you have Type 1 diabetes? You are still young, presuming you were born in '84 and have plenty of time to save up for whatever plan you need to cover any preexisting condition.
I'm confused by this comment. I think you are saying we should plan on low MAGI as a hedge against price fluctuations in ACA plans? Is that right?
The ACA is such a boon to the MMM community. I can't believe we didn't take the chance to solidify it for decades with our votes. I'm also rethinking our ability to FIRE in the next 5-10 years. We'd be fine without the subsidy, but we can't afford a return to the pre-ACA insurance environment.
https://www.washingtonpost.com/news/wonk/wp/2018/06/08/aca-lawsuit-could-jeopardize-52-million-americans-access-to-health-care/?utm_term=.255f9a49efd9
This administration is hell-bent on dismantling the most popular provision of the ACA: preexisting condition coverage. Look at the map in that article! The states with the most preexisting conditions under age 65 are like a Hall of Fame for Trump Voters. They aren't likely to save the ACA, so we'll have to save it ourselves. Vote like your FIRE depends on it.
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In early 2016 I'd planned to be FIRE class of 2018. The election nullified that. I'm currently hoping to go class of 2019 or no later than 2020. The next elections could extent that till 2023 when I'll qualify for employer retirement benefits. Even those employer benefits aren't great but with the potential loss of the ACA they are at least some hedge. I don't expect sympathy for our situation, yes we're millionaires and we can roll the dice in FIRE. It would be much nicer however if our government would get off their ass and come up with a decent health care system. We cannot plan our retirement because we are in Limbo on a major cost. The only thing that can possibly bankrupt us at this point is a medical emergency. We've saved nearly 30 years and it's the potential to get sick that prevents our retirement. This is a fucked up situation and one party is to blame. I voted Republican like a fool for decades and now I'm paying the price.
So you voted Republican when you were in the earning phase of life, and now that you are going to be in the consuming phase of life, you want to vote against the Republicans. How convenient!
This high earner is voting against them in all phases of life, so I cancelled him out. Plus, most of our senior citizens in the consuming phases of their lives are eagerly voting Republican to replace his lost vote. Socialized medicine is only patriotic after age 65?
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Been working with this guy from South America. he had to go to the doctor.
When he got back I showed him how the US ranks in terms of medicine with other countries. He just shook his head.
Then there's the ambulance story in Massachusetts.
http://thehill.com/homenews/media/395409-story-of-injured-woman-begging-people-not-to-call-ambulance-due-to-costs-gains (http://thehill.com/homenews/media/395409-story-of-injured-woman-begging-people-not-to-call-ambulance-due-to-costs-gains)
Makes me want to get alone in a dark room with some of those right wing politicians and give them the opportunity to avail themselves of THEIR excellent health care.
This health care thing can be can be fixed.
The US had some of the best cutting edge healthcare in the world if you have good insurance or the cash to afford it. Not so much for the poor or lower middle class which is what makes us rank so poorly. People from all over world come to the US to get treated.
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After reading several of these health care threads, I am amazed at how much risk younger Mustachian are willing to assume, either knowingly or naively. As a current 60year old who would have FIRE'd in 2017 if not for the last election, I have experienced unexpected health costs that have escalated since age 52. I currently have recurring annual expenses that exceed $47,000. Luckily I have excellent employer insurance that costs approx $3,300 for employee premiums, deductibles and copays. These conditions make me uninsurable if not for guaranteed issue under ACA. My wife has separate insurance which is more expensive and poorer coverage and her family history and conditions make her uninsurable as well, even though she has few actual claims.
A risk I don’t see discussed is the plan many Republicans want to enact that allows association plans to be offered at lower cost. What many don’t realize is that even if guaranteed issue is preserved, any people who become high cost patients will need to retain their current coverage if community rating is allowed in these association plans. The reason is that anyone with health concerns won’t meet underwriting requirements. As a result as premiums rise, healthy people will leave and join a new lower cost plan with a 'healthy' association. Those unable to do so will be forced to stay with ever increasing premiums until they are broke, reach Medicare age (65) or die. My family experienced this in Minnesota when I was young and my Dad had a heart attack. Over time the affordable group coverage premiums rose exponentially and yet he was unable as a farmer to join a reasonable cost group due to underwriting concerns. Luckily he was successful enough to be able to afford the coverage.
FYI, 2 years ago when I looked at coverage on the exchange, the premium was approx $14,000 for my wife and I, and we would have had to pay $15,000 out of pocket for my treatments on top of that. If I could be sure of that continuing to be available, we would still retire this year. However, we plan for one of us to work to age 63.5 at Chico time we will be able to buy Cobra coverage to span 18 months till Medicare eligibility.
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Plus, most of our senior citizens in the consuming phases of their lives are eagerly voting Republican to replace his lost vote. Socialized medicine is only patriotic after age 65?
Seniors seem to have a short memory (duh), and they only seem to race back to the Democrats when the Republicans think that everyone is voting for them to gut Social Security & Medicare (e.g., 2006).
Socialized medicine is not aspect of patriotism; it's as aspect of common-sense cost-control that everyone else in the world has figured out.
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I currently have recurring annual expenses that exceed $47,000. Luckily I have excellent employer insurance that costs approx $3,300 for employee premiums, deductibles and copays.
Don't worry, I'm sure the beady-eyed accountants at your employer (if you're in the government, disregard this) have noticed, and your net cost has been duly noted in your file so that appropriate targets of the next layoff can be identified.
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I currently have recurring annual expenses that exceed $47,000. Luckily I have excellent employer insurance that costs approx $3,300 for employee premiums, deductibles and copays.
Don't worry, I'm sure the beady-eyed accountants at your employer (if you're in the government, disregard this) have noticed, and your net cost has been duly noted in your file so that appropriate targets of the next layoff can be identified.
Nice theory, but unlikely to be true. Employers only get anonymized claim data.
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In early 2016 I'd planned to be FIRE class of 2018. The election nullified that. I'm currently hoping to go class of 2019 or no later than 2020. The next elections could extent that till 2023 when I'll qualify for employer retirement benefits. Even those employer benefits aren't great but with the potential loss of the ACA they are at least some hedge. I don't expect sympathy for our situation, yes we're millionaires and we can roll the dice in FIRE. It would be much nicer however if our government would get off their ass and come up with a decent health care system. We cannot plan our retirement because we are in Limbo on a major cost. The only thing that can possibly bankrupt us at this point is a medical emergency. We've saved nearly 30 years and it's the potential to get sick that prevents our retirement. This is a fucked up situation and one party is to blame. I voted Republican like a fool for decades and now I'm paying the price.
Well said. My million+ sta$h won't cut it without ACA subsidies. I'm not sure how long I would have to delay FIRE without the ACA. Without ACA, premiums would continue to go up with time and age, if you can get it at all (if no guaranteed issue). As long as I keep working, I have great healthcare benefits.
So you both can get high deductible plans, high the catestrophic stuff in case it gets bad. Done. Why the complainy pants; the government is no longer giving you free, high quality, health care as you live in bliss?
https://www.healthinsurance.org/faqs/i-have-an-individual-hdhp-and-an-hsa-will-i-still-be-able-to-have-them-under-the-aca/
No, I can't. I was unable to get ANY health insurance, included high deductible plans prior to ACA, for ANY price.
My comment was directed at people who were thinking they needed to work for years to come in order to pay high premiums (since they are no longer artificially low). Essentially, not early retiring. My point being, if they want to retire early, while receiving a subsidy they should lower their income to a reasonable amount. This isn't boggleheads, get on board.
Why can't you, do you have Type 1 diabetes? You are still young, presuming you were born in '84 and have plenty of time to save up for whatever plan you need to cover any preexisting condition.
I'm confused by this comment. I think you are saying we should plan on low MAGI as a hedge against price fluctuations in ACA plans? Is that right?
The ACA is such a boon to the MMM community. I can't believe we didn't take the chance to solidify it for decades with our votes. I'm also rethinking our ability to FIRE in the next 5-10 years. We'd be fine without the subsidy, but we can't afford a return to the pre-ACA insurance environment.
https://www.washingtonpost.com/news/wonk/wp/2018/06/08/aca-lawsuit-could-jeopardize-52-million-americans-access-to-health-care/?utm_term=.255f9a49efd9
This administration is hell-bent on dismantling the most popular provision of the ACA: preexisting condition coverage. Look at the map in that article! The states with the most preexisting conditions under age 65 are like a Hall of Fame for Trump Voters. They aren't likely to save the ACA, so we'll have to save it ourselves. Vote like your FIRE depends on it.
Then your real concern should not be one, either. Republicans may have an agenda but they aren't stupid. Even if that lawsuit went that way Republicans, probably along with some Democrats(some Repubs would never vote for it), would pass a patch. Not trying to be partisan, but the only way I don't see that happening is if Democrats think they have a moment to gain something additionally and overreach.
edit to clarify; even then the president and repub leadership would continue to press and say they want to approve a clean patch and the dems, not being stupid either, would eventually give in.
Mandate=unpopular, gone. Pre-existing conditions=popular, staying.
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Wexler:
Plus, most of our senior citizens in the consuming phases of their lives are eagerly voting Republican to replace his lost vote. Socialized medicine is only patriotic after age 65?
https://www.theguardian.com/news/datablog/2016/sep/23/older-americans-vote-republican-fact-check-election-2016 (https://www.theguardian.com/news/datablog/2016/sep/23/older-americans-vote-republican-fact-check-election-2016)
It certainly isn't a pure thing. This talks about the presidential election with Romney and says 56 percent of those over 65 voted GOP.
I'm fast heading to be in that age group. A pox on both the parties. Corporations own them both.
I'm surprised people aren't more angry about this health care thing than they are. I'm surprised people aren't more organized than they are.
I'm surprised people aren't saying,"Sure, I'll pay a bit more tax if it is allowed to be used as FU money against the insurance companies." I mean these guys are like lawyers. People do not like insurance companies. They are cold blooded actuaries making their money from the chance of the misfortune of others. Correct me when I say they do not have the morals of the Society at large.
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My wife's mother is a Canadian citizen which may give us the option to seek citizenship for my wife. I hope we don't have to do that, but our country certainly is trending in the wrong direction for us in these two important areas.
If your wife's mother was born in Canada or naturalized in Canada before she gave birth, then your wife is almost definitely already a Canadian citizen.
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Mandate=unpopular, gone. Pre-existing conditions=popular, staying.
Sadly, the insurance companies and reality does not work this way. Pre-existing conditions are too expensive for insurance pool = gone.
I'm surprised people aren't more angry about this health care thing than they are. I'm surprised people aren't more organized than they are.
"People" are angry about the bills they get in the mail, but then it's too late. And government right now is doing a really good job of keeping them distracted. The government are definitely not in your corner looking to hammer out the complexities.
Bottom line, I'm keeping my job and health insurance until I figure out what I really want. If I want ER bad enough, then having to go overseas where healthcare is a basic human right is a distinct possibility. It's ironic though, that America was founded on "inalienable rights", and we are currently becoming a 3rd world shit-hole because of treatment of immigration (separating families) and inability to provide reasonable health care!
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In early 2016 I'd planned to be FIRE class of 2018. The election nullified that. I'm currently hoping to go class of 2019 or no later than 2020. The next elections could extent that till 2023 when I'll qualify for employer retirement benefits. Even those employer benefits aren't great but with the potential loss of the ACA they are at least some hedge. I don't expect sympathy for our situation, yes we're millionaires and we can roll the dice in FIRE. It would be much nicer however if our government would get off their ass and come up with a decent health care system. We cannot plan our retirement because we are in Limbo on a major cost. The only thing that can possibly bankrupt us at this point is a medical emergency. We've saved nearly 30 years and it's the potential to get sick that prevents our retirement. This is a fucked up situation and one party is to blame. I voted Republican like a fool for decades and now I'm paying the price.
Well said. My million+ sta$h won't cut it without ACA subsidies. I'm not sure how long I would have to delay FIRE without the ACA. Without ACA, premiums would continue to go up with time and age, if you can get it at all (if no guaranteed issue). As long as I keep working, I have great healthcare benefits.
So you both can get high deductible plans, high the catestrophic stuff in case it gets bad. Done. Why the complainy pants; the government is no longer giving you free, high quality, health care as you live in bliss?
https://www.healthinsurance.org/faqs/i-have-an-individual-hdhp-and-an-hsa-will-i-still-be-able-to-have-them-under-the-aca/
No, I can't. I was unable to get ANY health insurance, included high deductible plans prior to ACA, for ANY price.
My comment was directed at people who were thinking they needed to work for years to come in order to pay high premiums (since they are no longer artificially low). Essentially, not early retiring. My point being, if they want to retire early, while receiving a subsidy they should lower their income to a reasonable amount. This isn't boggleheads, get on board.
Why can't you, do you have Type 1 diabetes? You are still young, presuming you were born in '84 and have plenty of time to save up for whatever plan you need to cover any preexisting condition.
Why can't I what? Why could I not get insurance? No, not type 1 diabetes, not at all. Something much, much smaller. I locked up a muscle in my back that required muscle relaxants to fix. That's it. No insurance at all for me based on that. I was a college kid and hurt my back and then when I aged out of my mom's plan, I tried to get insurance. I was ineligible for anything, at any price. I applied to every single insurance company in California, so this was not a rural area with one insurance company nor a major medical issue and I still could get absolutely nothing. I ended up COBRAing my mom's insurance for over $500/month back in 2010. So I have never expected cheap insurance, I just wanted something. And without ACA, that was not possible for me.
I think you need to learn more about what happened to people with minor medical issues prior to ACA.
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My wife's mother is a Canadian citizen which may give us the option to seek citizenship for my wife. I hope we don't have to do that, but our country certainly is trending in the wrong direction for us in these two important areas.
If your wife's mother was born in Canada or naturalized in Canada before she gave birth, then your wife is almost definitely already a Canadian citizen.
Yes, I believe so as well. We just don't have the paperwork to show that. MIL is currently working on getting her paperwork in order as she has lived in the USA for over 40 years. I imagine we will need to have a quick chat with an immigration lawyer to figure out the steps.
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Why can't you, do you have Type 1 diabetes? You are still young, presuming you were born in '84 and have plenty of time to save up for whatever plan you need to cover any preexisting condition.
Why can't I what? Why could I not get insurance? No, not type 1 diabetes, not at all. Something much, much smaller. I locked up a muscle in my back that required muscle relaxants to fix. That's it. No insurance at all for me based on that. I was a college kid and hurt my back and then when I aged out of my mom's plan, I tried to get insurance. I was ineligible for anything, at any price. I applied to every single insurance company in California, so this was not a rural area with one insurance company nor a major medical issue and I still could get absolutely nothing. I ended up COBRAing my mom's insurance for over $500/month back in 2010. So I have never expected cheap insurance, I just wanted something. And without ACA, that was not possible for me.
I think you need to learn more about what happened to people with minor medical issues prior to ACA.
Should have used 'couldn't', maybe that would have made my questioning a little more clear. Anywho, a catastrophic plan for someone of your age would be the best economical choice (given what you have revealed about yourself) which is/was no longer an option with the mandate.
Bolded; I was simply asking a question, no need to get defense and believe you need to lecture anyone.
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Why can't you, do you have Type 1 diabetes? You are still young, presuming you were born in '84 and have plenty of time to save up for whatever plan you need to cover any preexisting condition.
Why can't I what? Why could I not get insurance? No, not type 1 diabetes, not at all. Something much, much smaller. I locked up a muscle in my back that required muscle relaxants to fix. That's it. No insurance at all for me based on that. I was a college kid and hurt my back and then when I aged out of my mom's plan, I tried to get insurance. I was ineligible for anything, at any price. I applied to every single insurance company in California, so this was not a rural area with one insurance company nor a major medical issue and I still could get absolutely nothing. I ended up COBRAing my mom's insurance for over $500/month back in 2010. So I have never expected cheap insurance, I just wanted something. And without ACA, that was not possible for me.
I think you need to learn more about what happened to people with minor medical issues prior to ACA.
Should have used 'couldn't', maybe that would have made my questioning a little more clear. Anywho, a catastrophic plan for someone of your age would be the best economical choice (given what you have revealed about yourself) which is/was no longer an option with the mandate.
Bolded; I was simply asking a question, no need to get defense and believe you need to lecture anyone.
That is completely not true because as I stated before, no insurance company would cover me with any plan, including a catastrophic plan.
You were not asking questions, you (still) seem to believe you have all the answers on how things are done, and your conclusions are based on faulty information. I'm correcting that faulty info.
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It's not a matter of "save up for whatever plan to cover any prexisting condition". That's not how it worked. The way it worked was the insurance company would look for any reason to deny coverage and if they found something, you couldn't get insurance at any price. And if you omitted something in the application that was later found, they would deny coverage, so you'd have been paying for nothing.
Ah, the good ol' days before the ACA.
They'd rescind your policy if you were treated for acne. For a cancer claim.
https://www.reuters.com/article/us-wellpoint-breastcancer1/corrected-wellpoint-routinely-targets-breast-cancer-patients-idUSTRE63M5D420100423
The women all paid their premiums on time. Before they fell ill, none had any problems with their insurance. Initially, they believed their policies had been canceled by mistake.
They had no idea that WellPoint was using a computer algorithm that automatically targeted them and every other policyholder recently diagnosed with breast cancer. The software triggered an immediate fraud investigation, as the company searched for some pretext to drop their policies, according to government regulators and investigators.
It's a sobering article about how insurance companies treated people to increase their profit margins. We don't want to go back to that era.
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Corporations are focused on keeping employee benefit costs down, subsidized & Medicaid people don't really care, so there is not much of a lobby representing people who make $100k+ outside of normal employment.
"I retired early with a couple million in the bank, but can't afford healthcare" isn't going to generate much sympathy from the general population.
I agree. It's a similar situation to the "welfare Rothers" like Yours Truly who have their income as tax-free Roth distributions. As long as we don't get noticed, we'll continue to get our free stuff.
I love this term... "welfare Rothers"
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I currently have recurring annual expenses that exceed $47,000. Luckily I have excellent employer insurance that costs approx $3,300 for employee premiums, deductibles and copays.
Don't worry, I'm sure the beady-eyed accountants at your employer (if you're in the government, disregard this) have noticed, and your net cost has been duly noted in your file so that appropriate targets of the next layoff can be identified.
Nice theory, but unlikely to be true. Employers only get anonymized claim data.
https://money.cnn.com/2014/02/12/news/economy/employer-health/index.html
http://articles.chicagotribune.com/2009-01-05/news/0901040237_1_medical-bills-firing-nurse
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Gin1984:
I was a college kid and hurt my back and then when I aged out of my mom's plan, I tried to get insurance. I was ineligible for anything, at any price.
Jeepers - That just sounds like back strain. I've had that about 3 times, but it probably never registered with my insurance due to the high deductible.
Despite their complaints about not making money, I think these insurance companies must make a dandy investment. I guess folks without souls have no compunctions about stealing.
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Gin1984:
I was a college kid and hurt my back and then when I aged out of my mom's plan, I tried to get insurance. I was ineligible for anything, at any price.
Jeepers - That just sounds like back strain. I've had that about 3 times, but it probably never registered with my insurance due to the high deductible.
Despite their complaints about not making money, I think these insurance companies must make a dandy investment. I guess folks without souls have no compunctions about stealing.
Look at the stocks for health insurance companies...they are more profitable today as compared to pre ACA days.
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Gin1984:
I was a college kid and hurt my back and then when I aged out of my mom's plan, I tried to get insurance. I was ineligible for anything, at any price.
Jeepers - That just sounds like back strain. I've had that about 3 times, but it probably never registered with my insurance due to the high deductible.
Despite their complaints about not making money, I think these insurance companies must make a dandy investment. I guess folks without souls have no compunctions about stealing.
Look at the stocks for health insurance companies...they are more profitable today as compared to pre ACA days.
Well, with government subsidizing millions of people's insurance, that will happen.
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I currently have recurring annual expenses that exceed $47,000. Luckily I have excellent employer insurance that costs approx $3,300 for employee premiums, deductibles and copays.
Don't worry, I'm sure the beady-eyed accountants at your employer (if you're in the government, disregard this) have noticed, and your net cost has been duly noted in your file so that appropriate targets of the next layoff can be identified.
Nice theory, but unlikely to be true. Employers only get anonymized claim data.
https://money.cnn.com/2014/02/12/news/economy/employer-health/index.html
http://articles.chicagotribune.com/2009-01-05/news/0901040237_1_medical-bills-firing-nurse
I think these articles are saying the same thing as me. AOL didn't get told that this particular employee was the recipient of expensive care. They just get a report of costs, see that there were two very expensive births, and that's it. Could they potentially figure out/trick employees into revealing who that is? Sure, but that's playing with fire.
I'd love to know what happened in the case of the nurse. The article made it sound like a blatantly illegal firing too.
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I am not freaking out about it because my FIRE estimated date is in 6 to 8 years.
However, I am very concerned, if my FIRE goal is $1mil and I get 40k a year following the 4% rule, having an annual health insurance cost of 24k will leave me with little money to live my life.
And don't get me started on medicare, that is the largest scam, the mainstream makes you belive that medicare is free health insurance when it is actually more expensive than some ACA plans.
The fact is that if I have reached my $1mil today, I would not be able to retire due to the health care situation and I would be freaking out. Ridiculous thought that you have enough money to cover your needs for life but health insurance, which in many cases you won't need, keeps you from retiring and instead have you in the rat race OMY.
The current political climate is so negative and against the people, but nothing lasts forever. I want to be optimistic, I want to believe that someone out there wants to help the people and bring us closer to what health insurance is supposed to be in a developed country.
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I am not freaking out about it because my FIRE estimated date is in 6 to 8 years.
However, I am very concerned, if my FIRE goal is $1mil and I get 40k a year following the 4% rule, having an annual health insurance cost of 24k will leave me with little money to live my life.
And don't get me started on medicare, that is the largest scam, the mainstream makes you belive that medicare is free health insurance when it is actually more expensive than some ACA plans.
The fact is that if I have reached my $1mil today, I would not be able to retire due to the health care situation and I would be freaking out. Ridiculous thought that you have enough money to cover your needs for life but health insurance, which in many cases you won't need, keeps you from retiring and instead have you in the rat race OMY.
The current political climate is so negative and against the people, but nothing lasts forever. I want to be optimistic, I want to believe that someone out there wants to help the people and bring us closer to what health insurance is supposed to be in a developed country.
I couldn't agree more. I think it behoves each and every one of us to look for ways to make just little bit more income to cover potential healthcare needs. The reality is that we have a 100% chance of getting sick and needing healthcare one day. This doesn't necessarily mean working many many more years. It could be as simple as working part time to allow your stash to grow for a few more years.
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Health Share Ministry?
Since these are so much cheaper than insurance, I am pretty sure they either do not cover certain things or they have greatly underestimated their possible costs. My fear is that when you present them with a huge medical cost, they will either go bankrupt or tell you"the needs of the many outweigh the needs of the few,' and leave you bankrupt or untreated.
Thoughts and prayers are not healthcare.
I know of several people who have had significant on going health issues while on Health Share Ministry and not had any problems getting reimbursed.
A couple reasons why they are significantly cheaper:
1. They don't cover tobacco, alcohol, and other drug related expenses.
2. Don't cover most STD's, out of wedlock type expenses.
3. Some have caps, i.e. $1M per incident
4. Regular health insurance premiums for healthy people are partly subsidizing the sickly or poor (not sure about this)
I'm not religious, but when I retire I can accept those conditions. And while the person who was blocked suggested the point a little more crudely, I think there is a point to be made that as medical expenses get more costly you have to start playing the odds and saying I can either have 100% chance of paying astronomical premiums which would significantly hinder my enjoyment of life or except a small chance of a catastrophic injury/disease that won't be covered and I can't afford.
I think. but am not sure, that the health share ministries are not necessarily as profit driven as insurance companies. If this is true, not paying so many middlemen may make their plans cheaper with hopefully a similar amount of care.
For the record, I have been on Liberty health share since I FIREd late last year. I had one "female wellness" yearly visit that was totally covered as preventive care ($200 for the visit, got reimbursed), and several chiropractor visits that have fallen under the $500 deductible.
Liberty doesn't pay for prescriptions, but on the plan you get a separate pharmacy discount on drugs. I only take one drug regularly, birth control pill. This was covered at a discounted rate. Before ACA, I paid for my own birth control. I can't remember how much it cost, but it wasn't that much. After ACA, birth control was "free" (yeah right, it's added to your premiums). With Liberty, I got a 3 month prescription filled for $50. Not bad, I think.
Someone above mentioned health share ministries wouldn't cover them because they were gay. I know someone on this forum that is gay and was accepted by Liberty healthshare and were honest about their sexual orientation. I'm not sure how the other health share ministries deal with this, but don't automatically think you won't be covered. The best option is to call and see if you qualify.
BTW, on Liberty you get $100 for a referral, so if interested you can use me as a referral. PM me if interested.
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I’m not freaked out at all.
It’s just money.
Take a reasonable silver ACA plan healthcare for your family, and then double it’s yearly cost. Add that to your expected yearly budget, and save for it.
MMM preaches FLEXIBILITY. If your state runs the ACA plans into the ground, move. Consider Medicaid if you have to. Work a low effort 15 hr/week job just to pay for healthcare, etc...
Make a plan. Adjust as necessary. No big deal.
Also, STAY fit and eat right. That always helps too.
This is my mindset, too. Plus, Healthcare laws in this country are outside of my control. Therefore it's not something I worry about. What can I control? How I vote. What I buy (voting with dollars). How I exercise. How I eat. How I commute (bikes!).
I do agree though that it is very unfortunate. I wish the US would take a stab at the free healthcare thing, trust me...
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I’m not freaked out at all.
It’s just money.
Take a reasonable silver ACA plan healthcare for your family, and then double it’s yearly cost. Add that to your expected yearly budget, and save for it.
MMM preaches FLEXIBILITY. If your state runs the ACA plans into the ground, move. Consider Medicaid if you have to. Work a low effort 15 hr/week job just to pay for healthcare, etc...
Make a plan. Adjust as necessary. No big deal.
Also, STAY fit and eat right. That always helps too.
This is my mindset, too. Plus, Healthcare laws in this country are outside of my control. Therefore it's not something I worry about. What can I control? How I vote. What I buy (voting with dollars). How I exercise. How I eat. How I commute (bikes!).
I do agree though that it is very unfortunate. I wish the US would take a stab at the free healthcare thing, trust me...
There is no such thing as free healthcare. Someone always has to pay. I think you prefer that someone not to be you when in retirement.
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I’m not freaked out at all.
It’s just money.
Take a reasonable silver ACA plan healthcare for your family, and then double it’s yearly cost. Add that to your expected yearly budget, and save for it.
MMM preaches FLEXIBILITY. If your state runs the ACA plans into the ground, move. Consider Medicaid if you have to. Work a low effort 15 hr/week job just to pay for healthcare, etc...
Make a plan. Adjust as necessary. No big deal.
Also, STAY fit and eat right. That always helps too.
This is my mindset, too. Plus, Healthcare laws in this country are outside of my control. Therefore it's not something I worry about. What can I control? How I vote. What I buy (voting with dollars). How I exercise. How I eat. How I commute (bikes!).
I do agree though that it is very unfortunate. I wish the US would take a stab at the free healthcare thing, trust me...
There is no such thing as free healthcare. Someone always has to pay. I think you prefer that someone not to be you when in retirement.
I'd write a check today for $300k for guaranteed coverage for DW and I for the rest of our lives and I've already paid many thousands into Medicare. I don't want free, I want predictable and no chance of getting denied because of a pre existing condition or going to the wrong hospital or filling out a form wrong.
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I’m not freaked out at all.
It’s just money.
Take a reasonable silver ACA plan healthcare for your family, and then double it’s yearly cost. Add that to your expected yearly budget, and save for it.
MMM preaches FLEXIBILITY. If your state runs the ACA plans into the ground, move. Consider Medicaid if you have to. Work a low effort 15 hr/week job just to pay for healthcare, etc...
Make a plan. Adjust as necessary. No big deal.
Also, STAY fit and eat right. That always helps too.
This is my mindset, too. Plus, Healthcare laws in this country are outside of my control. Therefore it's not something I worry about. What can I control? How I vote. What I buy (voting with dollars). How I exercise. How I eat. How I commute (bikes!).
I do agree though that it is very unfortunate. I wish the US would take a stab at the free healthcare thing, trust me...
There is no such thing as free healthcare. Someone always has to pay. I think you prefer that someone not to be you when in retirement.
I assumed you knew what I meant. Obviously it's not actually free. But still, the point stands... US healthcare could go the direction of other Western places and probably be better off for it. At least in the FI community.
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I’m not freaked out at all.
It’s just money.
Take a reasonable silver ACA plan healthcare for your family, and then double it’s yearly cost. Add that to your expected yearly budget, and save for it.
MMM preaches FLEXIBILITY. If your state runs the ACA plans into the ground, move. Consider Medicaid if you have to. Work a low effort 15 hr/week job just to pay for healthcare, etc...
Make a plan. Adjust as necessary. No big deal.
Also, STAY fit and eat right. That always helps too.
This is my mindset, too. Plus, Healthcare laws in this country are outside of my control. Therefore it's not something I worry about. What can I control? How I vote. What I buy (voting with dollars). How I exercise. How I eat. How I commute (bikes!).
I do agree though that it is very unfortunate. I wish the US would take a stab at the free healthcare thing, trust me...
There is no such thing as free healthcare. Someone always has to pay. I think you prefer that someone not to be you when in retirement.
I'd write a check today for $300k for guaranteed coverage for DW and I for the rest of our lives and I've already paid many thousands into Medicare. I don't want free, I want predictable and no chance of getting denied because of a pre existing condition or going to the wrong hospital or filling out a form wrong.
Just curious, but have you looked at SSA.gov to see how much you have contributed to medicare? Lets just do a simple example of a person who makes $100k/yr salary for 40 years. Excluding any salary deduction this person would pay 2.9% on $100k for 40 years. That is a total of $116k. I find that kind of interesting how little we actually pay into medicare over the course of most people's working career.
I agree with predictable. I would also like to add the following adjectives: Understandable, transparent, accurate, efficient, hassle free.
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I’m not freaked out at all.
It’s just money.
Take a reasonable silver ACA plan healthcare for your family, and then double it’s yearly cost. Add that to your expected yearly budget, and save for it.
MMM preaches FLEXIBILITY. If your state runs the ACA plans into the ground, move. Consider Medicaid if you have to. Work a low effort 15 hr/week job just to pay for healthcare, etc...
Make a plan. Adjust as necessary. No big deal.
Also, STAY fit and eat right. That always helps too.
This is my mindset, too. Plus, Healthcare laws in this country are outside of my control. Therefore it's not something I worry about. What can I control? How I vote. What I buy (voting with dollars). How I exercise. How I eat. How I commute (bikes!).
I do agree though that it is very unfortunate. I wish the US would take a stab at the free healthcare thing, trust me...
There is no such thing as free healthcare. Someone always has to pay. I think you prefer that someone not to be you when in retirement.
I'd write a check today for $300k for guaranteed coverage for DW and I for the rest of our lives and I've already paid many thousands into Medicare. I don't want free, I want predictable and no chance of getting denied because of a pre existing condition or going to the wrong hospital or filling out a form wrong.
Just curious, but have you looked at SSA.gov to see how much you have contributed to medicare? Lets just do a simple example of a person who makes $100k/yr salary for 40 years. Excluding any salary deduction this person would pay 2.9% on $100k for 40 years. That is a total of $116k. I find that kind of interesting how little we actually pay into medicare over the course of most people's working career.
I agree with predictable. I would also like to add the following adjectives: Understandable, transparent, accurate, efficient, hassle free.
Yeah, between my employers and myself, we've put in just under $150k. Yes, Medicare taxes probably need to be a bit higher and hit non payroll income. Over the years as I've started to target FIRE, it has amazed me how much things are tilted in favor of the rich and Medicare is an easy example where living off capital instead of labor is much favored by our laws. Capital Gains & Dividends being taxed lower is another one. ACA subsidies are another. The fact that I will quite likely be able to manipulate things to be subsidy eligible despite having a lot of money in investments doesn't seem quite right.
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I’m not freaked out at all.
It’s just money.
Take a reasonable silver ACA plan healthcare for your family, and then double it’s yearly cost. Add that to your expected yearly budget, and save for it.
MMM preaches FLEXIBILITY. If your state runs the ACA plans into the ground, move. Consider Medicaid if you have to. Work a low effort 15 hr/week job just to pay for healthcare, etc...
Make a plan. Adjust as necessary. No big deal.
Also, STAY fit and eat right. That always helps too.
This is my mindset, too. Plus, Healthcare laws in this country are outside of my control. Therefore it's not something I worry about. What can I control? How I vote. What I buy (voting with dollars). How I exercise. How I eat. How I commute (bikes!).
I do agree though that it is very unfortunate. I wish the US would take a stab at the free healthcare thing, trust me...
I live in a neighborhood where the local mob comes and takes half my income every year, but what are you going to do about it? It's not like it's in my control, so I just budget accordingly and things are fine.
And for those who think that there will be positive change, the fact is that NOBODY knows that. It could get worse, or it could get better. But judging from history, they've been talking about reforming healthcare since before I was born, and finally we got the crappy ACA after a fluke once in a lifetime landslide election. I'm not trying to be political, but if you look at it objectively, you have to admit that things are unlikely to get better for the coming decades.
For those who are close to 65 hoping to rely on medicare/medicaid, it's probably a non-issue unless the ACA disappears or drastic change happens. For those of us who are young though, 30+ years of uncertainty is an exponentially longer gap to bridge then 5-10 years.
Just because MMM did it doesn't mean he didn't take a gamble - and things have gotten considerably more expensive since he retired, so it's not the same situation anyways.
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genesismachine:
For those who are close to 65 hoping to rely on medicare/medicaid, it's probably a non-issue unless the ACA disappears or drastic change happens.
Not for some of us. If the ACA isn't wholly corrupted for some years, I could cruise to medicare. However, that does not preclude me from wanting to see this problem licked. I see the entire country being ripped off by having a somewhat dis-functional system. It's a health issue. It's a moral issue. It's something that just ain't right and should be fixed. There's the bad guys that overcharge highly for drugs people need to stay alive and there's the good guys. The good guys are the people that want to fix this and make it better. They want to help poor sick kids. It's not a remote issue like an immoral war. It affects people we see every day and ultimately affects us all.
Sol wrote the following on another topic. I thought it was a great description of this issue. I
Healthcare is never a free market. Buyers can't comparison shop, prices are not transparent or consistent, competition is basically non-existent, and supply and demand are essentially uncoupled from the amount of care provided. If there was ever an ironclad case for government intervention in an industry, I think this is it. Every other western nation seems to agree.
What can be done? Hard mail. Bombard those politicians with letter after letter until the intern hauling in the mail to the congressman complains about the heavy mailbags. Blogs & e-mail can be deleted, but it's hard to ignore another letter. Make the elected officials be the ones who are "freaked out about health care right now."
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For those who are close to 65 hoping to rely on medicare/medicaid, it's probably a non-issue unless the ACA disappears or drastic change happens.
The ACA disappearing won't affect Medicare as much as Medicaid, because expanded Medicaid is part of the ACA.
However, Medicare gets very expensive when you add the different parts and supplemental to fully protect yourself against excessive costs. Someone mentioned in the ACA thread it was costing about $10,000/yr just for the Medicare/supplemental premiums. Those will likely skyrocket in the years ahead. Relevant thread:
https://forum.mrmoneymustache.com/welcome-to-the-forum/are-you-worried-that-medicare-will-run-out-of-money/
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I’m not freaked out at all.
It’s just money.
Take a reasonable silver ACA plan healthcare for your family, and then double it’s yearly cost. Add that to your expected yearly budget, and save for it.
MMM preaches FLEXIBILITY. If your state runs the ACA plans into the ground, move. Consider Medicaid if you have to. Work a low effort 15 hr/week job just to pay for healthcare, etc...
Make a plan. Adjust as necessary. No big deal.
Also, STAY fit and eat right. That always helps too.
This is my mindset, too. Plus, Healthcare laws in this country are outside of my control. Therefore it's not something I worry about. What can I control? How I vote. What I buy (voting with dollars). How I exercise. How I eat. How I commute (bikes!).
I do agree though that it is very unfortunate. I wish the US would take a stab at the free healthcare thing, trust me...
I live in a neighborhood where the local mob comes and takes half my income every year, but what are you going to do about it? It's not like it's in my control, so I just budget accordingly and things are fine.
Wtf? This deserves some more explanation.
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Wtf? This deserves some more explanation.
I suspect this is just parroting that usual fox news sound byte about how "taxes are theft" with a little bit of metaphorical embellishment. It's certainly not unusual to pay half of your gross income in total, if you add up federal/state/local taxes plus property and gas and sales taxes and stuff like car tabs, utility bills, and health insurance premiums.
Some people want all of the benefits of living in a prosperous civilized nation, without paying for any of it.
Or maybe he lives in Somalia.
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Wtf? This deserves some more explanation.
I suspect this is just parroting that usual fox news sound byte about how "taxes are theft" with a little bit of metaphorical embellishment. It's certainly not unusual to pay half of your gross income in total, if you add up federal/state/local taxes plus property and gas and sales taxes and stuff like car tabs, utility bills, and health insurance premiums.
Some people want all of the benefits of living in a prosperous civilized nation, without paying for any of it.
Or maybe he lives in Somalia.
This is what I figured. Can't wait to see the reply!
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Its an expense I add into my future needs column at 25k per year for the spouse and I until we are eligible for medicare.
My wish is not "free" healthcare, but healthcare that has clear pricing that is the same for all patients at each facility, and insurance plans that are actually insurance against high costs rather than all inclusive health maintenance plans. Deal with healthcare funding directly rather than through a 5,000 page bill chock full of special interests. ACA was/is horrible. The only problem is that so is everything else. I'm resigned to the fact that it will just suck no matter who controls the politics.
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Its an expense I add into my future needs column at 25k per year for the spouse and I until we are eligible for medicare.
My wish is not "free" healthcare, but healthcare that has clear pricing that is the same for all patients at each facility, and insurance plans that are actually insurance against high costs rather than all inclusive health maintenance plans. Deal with healthcare funding directly rather than through a 5,000 page bill chock full of special interests. ACA was/is horrible. The only problem is that so is everything else. I'm resigned to the fact that it will just suck no matter who controls the politics.
This thread resonated with me.
We're getting close to our retirement savings numbers, and currently the health care insurance through my work is excellent. The insurance through my wife's employer (she wants to keep working!!) is not as good, but I was prepared to budget in the additional premiums and figured coverage can't be terrible.
Then my wife had a weekend bicycle accident a little while ago. Nothing life-threatening, but by the time we got home it was clear that she couldn't walk because something was broken. Called BlueCross. No response because it's a weekend. I took her to the nearest emergency room (one of 10 within 10 miles) and asked if they take our insurance. They told me that they are required to take everyone, but can't guarantee that everyone that sees her will be included in our insurance. Turns out she did have a few broken bones, and the doctor then recommend hospitalization for a couple days to make sure she's okay. Probably okay, but want to be sure.
Is hospitalization covered? Can't tell you. Does BlueCross have someone I can call? No. What if we leave? That would be against medical advice. Okay fine, she stays for 2 days.
Good news is that it all ended up being covered by insurance. The actual bill though just for the hospital was $41,000.
This has me concerned. The fact that even minor accidents could potentially trigger huge expenses that are unpredictable both in terms of cost and whether we'll have insurance to cover it makes this a real source of uncertainty. I'm now a little hesitant to walk away from a job with excellent health care insurance, but I'm also not inclined to work another 25 years just for health insurance, so now I'm struggling with how to properly evaluate this issue.
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Its an expense I add into my future needs column at 25k per year for the spouse and I until we are eligible for medicare.
You probably should leave a lot of that in the budget for when you hit Medicare. Even today, you could be talking $10K/yr with the various Medicare parts/supplementals. Expect those costs to rise.
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Its an expense I add into my future needs column at 25k per year for the spouse and I until we are eligible for medicare.
My wish is not "free" healthcare, but healthcare that has clear pricing that is the same for all patients at each facility, and insurance plans that are actually insurance against high costs rather than all inclusive health maintenance plans. Deal with healthcare funding directly rather than through a 5,000 page bill chock full of special interests. ACA was/is horrible. The only problem is that so is everything else. I'm resigned to the fact that it will just suck no matter who controls the politics.
This thread resonated with me.
We're getting close to our retirement savings numbers, and currently the health care insurance through my work is excellent. The insurance through my wife's employer (she wants to keep working!!) is not as good, but I was prepared to budget in the additional premiums and figured coverage can't be terrible.
Then my wife had a weekend bicycle accident a little while ago. Nothing life-threatening, but by the time we got home it was clear that she couldn't walk because something was broken. Called BlueCross. No response because it's a weekend. I took her to the nearest emergency room (one of 10 within 10 miles) and asked if they take our insurance. They told me that they are required to take everyone, but can't guarantee that everyone that sees her will be included in our insurance. Turns out she did have a few broken bones, and the doctor then recommend hospitalization for a couple days to make sure she's okay. Probably okay, but want to be sure.
Is hospitalization covered? Can't tell you. Does BlueCross have someone I can call? No. What if we leave? That would be against medical advice. Okay fine, she stays for 2 days.
Good news is that it all ended up being covered by insurance. The actual bill though just for the hospital was $41,000.
This has me concerned. The fact that even minor accidents could potentially trigger huge expenses that are unpredictable both in terms of cost and whether we'll have insurance to cover it makes this a real source of uncertainty. I'm now a little hesitant to walk away from a job with excellent health care insurance, but I'm also not inclined to work another 25 years just for health insurance, so now I'm struggling with how to properly evaluate this issue.
You described just one of the many reasons why healthcare is busted in the US. Another fancy new thing that came around at the same time as the ACA is that even though you have insurance, certain items like imaging or procedures cost more if you use insurance but cost less without insurance. Although when not using your insurance the cost does not add up into your deductible. What kind of bullshit is that? Basically I get hosed if I don't have insurance, and if I do I get charged more.
I see no reason why I shouldn't be able to contact the Hospital, call the ER and ask how much some routine items may be without getting some BS run around.
Initial eval = $x
each X-ray = $y
CT = $z
Basic labs ranging $a-$b
As for us. We pay for health care now and it is a line item on our budget. We expect that line item to increase as we get older and are accounting for it in our total number.
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Wtf? This deserves some more explanation.
I suspect this is just parroting that usual fox news sound byte about how "taxes are theft" with a little bit of metaphorical embellishment. It's certainly not unusual to pay half of your gross income in total, if you add up federal/state/local taxes plus property and gas and sales taxes and stuff like car tabs, utility bills, and health insurance premiums.
Some people want all of the benefits of living in a prosperous civilized nation, without paying for any of it.
Or maybe he lives in Somalia.
It was intended as a parody of people insisting that there's 'nothing they can do' or 'budget for it accordingly' because those are the only options to healthcare taking half their income. Literally nowhere else has this problem. I find this attitude especially ironic on this forum since people regularly bash people who spend half their income on expensive houses and cars.
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I've set up a health care FIRE budget set aside from other living expenses. I made the decision six months ago and posted my plans in one of the threads. I decided upon 20k a year as a health care budget expense. Using the 4% rule that's 500k of stash for health care. I've reached my FIRE stash amount of 2MM recently. Now it's OMY till the health care stash is filled. The good thing is that saving 500k more after running up to 2MM should be a lot easier. I think it's a bit immature to plan FIRE without a plan for health care.
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Bateaux:
The good thing is that saving 500k more after running up to 2MM should be a lot easier.
Two and a half million sounds about right. Now,......where have I seen that before?
https://www.youtube.com/watch?v=eikbQPldhPY (https://www.youtube.com/watch?v=eikbQPldhPY)
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Bateaux:
The good thing is that saving 500k more after running up to 2MM should be a lot easier.
Two and a half million sounds about right. Now,......where have I seen that before?
https://www.youtube.com/watch?v=eikbQPldhPY (https://www.youtube.com/watch?v=eikbQPldhPY)
The position of F-U. 😆
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I wonder what the state of affairs will be in 15 yrs (around when I retire) Seems like maybe I shouldn't worry about it yet.
Glad we have an option with our British Passports though.
I can't believe people got refused insurance.. how does that even work?
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Its an expense I add into my future needs column at 25k per year for the spouse and I until we are eligible for medicare.
My wish is not "free" healthcare, but healthcare that has clear pricing that is the same for all patients at each facility, and insurance plans that are actually insurance against high costs rather than all inclusive health maintenance plans. Deal with healthcare funding directly rather than through a 5,000 page bill chock full of special interests. ACA was/is horrible. The only problem is that so is everything else. I'm resigned to the fact that it will just suck no matter who controls the politics.
This thread resonated with me.
We're getting close to our retirement savings numbers, and currently the health care insurance through my work is excellent. The insurance through my wife's employer (she wants to keep working!!) is not as good, but I was prepared to budget in the additional premiums and figured coverage can't be terrible.
Then my wife had a weekend bicycle accident a little while ago. Nothing life-threatening, but by the time we got home it was clear that she couldn't walk because something was broken. Called BlueCross. No response because it's a weekend. I took her to the nearest emergency room (one of 10 within 10 miles) and asked if they take our insurance. They told me that they are required to take everyone, but can't guarantee that everyone that sees her will be included in our insurance. Turns out she did have a few broken bones, and the doctor then recommend hospitalization for a couple days to make sure she's okay. Probably okay, but want to be sure.
Is hospitalization covered? Can't tell you. Does BlueCross have someone I can call? No. What if we leave? That would be against medical advice. Okay fine, she stays for 2 days.
Good news is that it all ended up being covered by insurance. The actual bill though just for the hospital was $41,000.
This has me concerned. The fact that even minor accidents could potentially trigger huge expenses that are unpredictable both in terms of cost and whether we'll have insurance to cover it makes this a real source of uncertainty. I'm now a little hesitant to walk away from a job with excellent health care insurance, but I'm also not inclined to work another 25 years just for health insurance, so now I'm struggling with how to properly evaluate this issue.
My attitude to avoid getting ripped off like this is to always be in a bankruptable financial condition (i.e., have ALL liquid assets in an IRA/401K, etc.) Our health care system is MADNESS!
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My FIRE number should arrive around 2023. If I keep my side gig of $18k and withdraw about $42k from tax deferred investments, that gives us a MAGI of about $60, which would qualify for the subsidy. A silver plan would run $416 per month, or about $5 grand per year. Take another $5 grand for taxes, and that leaves us $50 grand to live on, or about $4,100 per month. Sweet.
If there is no Obamacare in 2023 we are stuck on the open market. My side gig offers insurance if I am willing to work 19 hours per week (right now I probably do about 5 hours a week at the gig). (N.B., that's not really retirement, it's just downsizing to part time.) The premium for a couple our age would be $1,900 per month, or $22.8k per year. That would require a substantially bigger draw from the investments, meaning wife and I would have to work full time at our real jobs at least two more years.
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I think the medical tourism industry is underdeveloped. One can get major surgeries like joint replacements, cancer treatments, or heart jobs done by quality healthcare providers in a lot of countries for six figure discounts, even at their retail prices. That option isn't much help in the ER when you don't have time to preplan, but having such an option certainly reduces the need for insurance. E.g. one might accept a policy with a $750k cap and then be able to drop $50k on medical tourism if needed while still having sufficient savings to stay retired afterwards. This would cover all contingencies except an emergency with costs exceeding the max - which probably doesn't occur as often as we might think due to the saliency bias.
Besides, these massive bills are usually incurred during a person's last six months of life anyway. Are we working an extra 5 years of our physical prime to ensure we get the treatment to suffer through those 6 months? That's not a hypothetical. My grandfather-in-law opted to go through bypass surgery in his 80s. This was followed by six months of a terribly painful institutional existence followed by death. Good thing he had coverage for the half-million dollar surgery, we might say, but in hindsight that coverage allowed him to make a choice that turned his last 6 months into a living hell while churning up a huge bill. He would have been much better off dying at home from the coming heart attack a few sweet months after declining the surgery. Perhaps being truly FI means having the courage to accept death when it is time, instead of burning away our healthy years working to earn end of life care.
My third thought will be controversial, and stands independently from the first two, so feel free to disagree. Perhaps at some point of cancer, dementia, organ failure, pain, etc. suicide or assisted suicide is more rational than the way things currently work. As a family member of multiple people who suffered through end of life care, I can attest that I gained nothing from their heroic suffering, and instead experienced my own pain and worry watching them suffer. Perhaps a better life would involve a goodbye party, a time capsule, some songs, some cake, a review of old photos, a few interviews for posterity, and then you take the injection. This seems far more dignified than a couple of years of nursing homes or losing one's self to Alzheimers. As a side bonus, some inheritance might remain intact, potentially allowing the next generation to live more fully instead of running on their own work/healthcare treadmill. Life would end in an event of love, giving, sharing, and hopefulness for the future, instead of months of bedsores, pain, and mental deterioration. This will seem sick and twisted to some people, but it's the culture I'd rather live in.
Remember, the definition of risk is: the probability of not achieving one's goals. That excludes a lot of what we worry about.
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My third thought will be controversial, and stands independently from the first two, so feel free to disagree. Perhaps at some point of cancer, dementia, organ failure, pain, etc. suicide or assisted suicide is more rational than the way things currently work. As a family member of multiple people who suffered through end of life care, I can attest that I gained nothing from their heroic suffering, and instead experienced my own pain and worry watching them suffer. Perhaps a better life would involve a goodbye party, a time capsule, some songs, some cake, a review of old photos, a few interviews for posterity, and then you take the injection. This seems far more dignified than a couple of years of nursing homes or losing one's self to Alzheimers. As a side bonus, some inheritance might remain intact, potentially allowing the next generation to live more fully instead of running on their own work/healthcare treadmill. Life would end in an event of love, giving, sharing, and hopefulness for the future, instead of months of bedsores, pain, and mental deterioration. This will seem sick and twisted to some people, but it's the culture I'd rather live in.
Remember, the definition of risk is: the probability of not achieving one's goals. That excludes a lot of what we worry about.
The numbers vary based on the study but give or take about 20% of healthcare costs are incurred via end of life care for those with no quality of life. I agree with you that there is no reason for an 85 year old to undergo bypass surgery. The statistics show that this is a very expensive and painful death sentence. For us, my grandfather went for a partial colectomy for colon cancer at 92 after which he had a poor recovery and developed severe dementia, a fall with a bad head injury followed by death. It involved lots of pain and suffering for him and the family. He would have had a much better life dealing with the cancer for another year, and if when the pain became unbearable to take copious amount of pain medicine and end it there. His last year of life would have been much more productive and much better.
As a physician I wish I was not forced to provide care to some of those people. But the law is the law and I abide by it.