Author Topic: Health Insurance?? Need advice  (Read 4918 times)

firing-guy

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Health Insurance?? Need advice
« on: March 17, 2019, 08:33:14 AM »
Hi all.. Been lurking a while and finally registered as I was looking for some advice.

Ideally I am looking to 'retire' in the the next 1-2 years prior to turning 50. Financially my biggest concern is health insurance, I have had a couple of medical issues in the past, nothing crazy but because of that I need insurance. I haven't decided if I will stay in NY where I have a home that's paid off or sell that and move so my question(s) are two fold but related.

What are people doing for health insurance in general? More specific, if anyone else is in NY I can't really find 'reasonable' insurance so if I were to stay in NY this could be an even larger issue.

Appreciate any assistance/advice and I will do some more searching here as well

smoghat

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Re: Health Insurance?? Need advice
« Reply #1 on: March 17, 2019, 08:39:44 AM »
Try healthcare.gov. It's going to suck, but …

Miss Piggy

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Re: Health Insurance?? Need advice
« Reply #2 on: March 17, 2019, 09:20:51 AM »
This keeps me up at night. I priced coverage on healthcare.gov a few weeks ago for me and my husband, and we're looking at $35,000/year for healthcare premiums and expenses.

frugaldrummer

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Re: Health Insurance?? Need advice
« Reply #3 on: March 17, 2019, 09:39:34 AM »
First of all, you do understand there's an income-based subsidy to those plans, so if you are retiring on a relatively low income you might get a decent subsidy.

Second, if you don't have a lot of ongoing medical expenses and have adequate savings you might buy a bronze plan with an HSA. I'm self employed and that's what I have. I fund the HSA every year and have more than enough to meet the annual deductible if I hit a bad year - meanwhile that money grows tax free in my HSA account.

The biggest concern is that Republicans have been undermining the ACA at every turn and smaller states with poor participation have poor coverage and high prices. You also have to be worried about losing the pre-existing condition exemption so you want to buy a good plan before they wreck that too because you may be stuck in that plan - and for cripes sake don't let yourself have a lapse in coverage.

And don't buy any of the "short term coverage" bullshit products they let back on the market; you don't need some giant medical bill if you get hospitalized. Trust me they're crap. That's why one of the important aspects of the ACA was limiting your total out of pocket per year to about $7,000.

Also consider that if Republicans do succeed in gutting the ACA your best bet is to be living in a large state that will implement their own version of Romneycare. California will definitely do that if the ACA falls.

In California, I'm in my early 60's and pay 675 a month for my bronze plan and (lousy) dental insurance. If you can't afford that you can't afford to be retired, in which case you might need to take a low stress job that offers insurance.
« Last Edit: March 17, 2019, 09:41:10 AM by frugaldrummer »

Paul der Krake

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Re: Health Insurance?? Need advice
« Reply #4 on: March 17, 2019, 09:54:46 AM »
Are you sure you're not overestimating your income when playing with healthcare.gov?

It's easy to intuitively think you need to spend 50k to maintain your living standard, therefore my income will be 50k. Except that's not what happens for a early retiree. You're likely going to be withdrawing money from a taxable account with both gains and principal. If you pull 50k for the year and 20k are capital gains, your income isn't 50k, it's 30k.

Saving in Austin

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Re: Health Insurance?? Need advice
« Reply #5 on: March 17, 2019, 02:39:31 PM »
We got off of the ACA exchange and switched to Liberty Health Share.

https://www.libertyhealthshare.org/how-it-works

It costs $350 a month for a couple. We are 54 and 57 years old. So far, we have had good luck and they have been reducing/repricing the costs of our doctors visits and reimbursing us. They have been much more responsive on the phone than Blue Cross ever was.

If anybody wants a referral please send a DM with your e-mail and phone. I'd be happy to split the $100 Visa Gift Card referral bonus. Once I submit your info they will call and e-mail you.


jim555

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Re: Health Insurance?? Need advice
« Reply #6 on: March 17, 2019, 03:35:24 PM »
https://nystateofhealth.ny.gov/

New York has very good options.  0-150 FPL is free.  150-200 FPL is $20 a month.  No age ratings so it helps those near 65 the most.

jim555

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Re: Health Insurance?? Need advice
« Reply #7 on: March 17, 2019, 03:41:27 PM »
https://nystateofhealth.ny.gov/

New York has very good options.  0-150 FPL is free.  150-200 FPL is $20 a month.  No age ratings so it helps those near 65 the most.

Thx.. I am not even 50 but will check it, as I said just looking for ideas as i'd like to be done with work in the next year at least for 1-2 yrs before finding some kind of side income. Maybe I should put a separate post with my numbers/situation
A completely unsubsidized Silver plan runs around $450.  If you keep you income under 400 FPL it will be cheaper.

Holyoak

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Re: Health Insurance?? Need advice
« Reply #8 on: March 17, 2019, 03:42:19 PM »
Hi all.. Been lurking a while and finally registered as I was looking for some advice.

Ideally I am looking to 'retire' in the the next 1-2 years prior to turning 50. Financially my biggest concern is health insurance, I have had a couple of medical issues in the past, nothing crazy but because of that I need insurance. I haven't decided if I will stay in NY where I have a home that's paid off or sell that and move so my question(s) are two fold but related.

What are people doing for health insurance in general? More specific, if anyone else is in NY I can't really find 'reasonable' insurance so if I were to stay in NY this could be an even larger issue.

Appreciate any assistance/advice and I will do some more searching here as well

Howdy NY, I know exactly what you mean and this crazy health insurance issue is on the top of the list for many.  It's the very first thing I look at and calculate considering a move, and prices are all over the place.  Some 0 cost policies in WY for my typical income, to mega expensive in AZ.

I retired at 46 and with Obama care when it was just coming out, and it was fine...  Then costs just kept going up, deductibles and out of pocket up, and with getting older it just keeps going UP, UP, UP...  What REALLY sucks is if you break through the subsidy ceiling.  For a single fella and don't go over $47,520/yr for income, the most you will have to pay back is $1250...  Well this year I was paid a small inherited IRA lump sum, and it pushed me over the $47,520 by about $3k...  This ends up having me pay back $5700 to the ACA... I lost the entire subsidy!!!  Going to have to review my situation and adjust, and what a PITA...  Going to look seriously into these alternate, non ACA plans. 

It always sucks with your investments too, as you are always afraid of what taking the profits will do to your ACA subsidy, and you miss out on wanting to sell...  I'm still kicking myself for some stock trades I missed because of this shit.  I love NY state but even with a paid off home, my God the taxes are just INSANE as you mention (like they are in some places of PA), and the firearm laws make it a deal-breaker for me to live there.  No wonder there is such a mass exodus from so many high tax states.  Can you imagine what states like NY and PA with very old populations will be like in 15-20 years as they die off???  Good luck, and I really empathize with your situation.

jim555

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Re: Health Insurance?? Need advice
« Reply #9 on: March 17, 2019, 03:48:05 PM »
Hi all.. Been lurking a while and finally registered as I was looking for some advice.

Ideally I am looking to 'retire' in the the next 1-2 years prior to turning 50. Financially my biggest concern is health insurance, I have had a couple of medical issues in the past, nothing crazy but because of that I need insurance. I haven't decided if I will stay in NY where I have a home that's paid off or sell that and move so my question(s) are two fold but related.

What are people doing for health insurance in general? More specific, if anyone else is in NY I can't really find 'reasonable' insurance so if I were to stay in NY this could be an even larger issue.

Appreciate any assistance/advice and I will do some more searching here as well

Howdy NY, I know exactly what you mean and this crazy health insurance issue is on the top of the list for many.  It's the very first thing I look at and calculate considering a move, and prices are all over the place.  Some 0 cost policies in WY for my typical income, to mega expensive in AZ.

I retired at 46 and with Obama care when it was just coming out, and it was fine...  Then costs just kept going up, deductibles and out of pocket up, and with getting older it just keeps going UP, UP, UP...  What REALLY sucks is if you break through the subsidy ceiling.  For a single fella and don't go over $47,520/yr for income, the most you will have to pay back is $1250...  Well this year I was paid a small inherited IRA lump sum, and it pushed me over the $47,520 by about $3k...  This ends up having me pay back $5700 to the ACA... I lost the entire subsidy!!!  Going to have to review my situation and adjust, and what a PITA...  Going to look seriously into these alternate, non ACA plans. 

It always sucks with your investments too, as you are always afraid of what taking the profits will do to your ACA subsidy, and you miss out on wanting to sell...  I'm still kicking myself for some stock trades I missed because of this shit.  I love NY state but even with a paid off home, my God the taxes are just INSANE as you mention (like they are in some places of PA), and the firearm laws make it a deal-breaker for me to live there.  No wonder there is such a mass exodus from so many high tax states.  Can you imagine what states like NY and PA with very old populations will be like in 15-20 years as they die off???  Good luck, and I really empathize with your situation.
NY has high tax, but when it comes to health insurance options it is much better options than most states.  I hear people paying outrageous sums for insurance in sparsely populated states.

Paul der Krake

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Re: Health Insurance?? Need advice
« Reply #10 on: March 17, 2019, 04:09:50 PM »
What REALLY sucks is if you break through the subsidy ceiling.  For a single fella and don't go over $47,520/yr for income, the most you will have to pay back is $1250...  Well this year I was paid a small inherited IRA lump sum, and it pushed me over the $47,520 by about $3k...  This ends up having me pay back $5700 to the ACA... I lost the entire subsidy!!!  Going to have to review my situation and adjust, and what a PITA...  Going to look seriously into these alternate, non ACA plans. 
Wouldn't it have made sense to just refuse part of your inheritance? Or were you caught by surprise when doing your taxes?

radram

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Re: Health Insurance?? Need advice
« Reply #11 on: March 17, 2019, 04:47:12 PM »
What REALLY sucks is if you break through the subsidy ceiling.  For a single fella and don't go over $47,520/yr for income, the most you will have to pay back is $1250...  Well this year I was paid a small inherited IRA lump sum, and it pushed me over the $47,520 by about $3k...  This ends up having me pay back $5700 to the ACA... I lost the entire subsidy!!!  Going to have to review my situation and adjust, and what a PITA...  Going to look seriously into these alternate, non ACA plans. 
Wouldn't it have made sense to just refuse part of your inheritance? Or were you caught by surprise when doing your taxes?

Understanding the rules is critical for successful maneuvering of the ACA, unfortunately. There are 2 "cliffs" to watch out for. Too LOW of income, you qualify for NO subsidy. Too much income, same thing, however there is a gradual reduction until you hit the ceiling.

ACA subsidies are based on current year income, not prior year. That is the first maneuver. It might benefit you to FIRE on January 1st.

That inheritance check was a killer. Knowing rules on inherited IRA's could have befitted you as well. Would you have been able to create an inherited IRA in that amount? You would have required minimum distributions and you would have been better able to control when it becomes income.  If that company would have said no, I would have investigated transferring it to another firm or like another said, not taken the check or a portion of it.




Holyoak

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Re: Health Insurance?? Need advice
« Reply #12 on: March 17, 2019, 04:51:42 PM »
Quote
NY has high tax, but when it comes to health insurance options it is much better options than most states.  I hear people paying outrageous sums for insurance in sparsely populated states.

Very true, and I was thinking the same after I posted, esp after I saw the no age rating comment for NY...  If you could score cheap rent, with modest income it would be sooooo much better than my effin state.  I still can't/won't give up my certain firearms that would be class B felonies in NY state, that are legal here.  It's truly staggering how fast the ACA went lousy after implementation in many ways, and not just by virtue of cost.

Quote
Wouldn't it have made sense to just refuse part of your inheritance? Or were you caught by surprise when doing your taxes?

In retrospect, yes to all of your points.  I should have stuck with my desire to have my brother and sister take a much larger share of the RMD (no harm to their tax situation) from one inherited IRA to satisfy the requirement, but didn't.  Then on top of this a much smaller state pension payout divided 33% ea, really killed my subsidy even with fed taxes taken out before distribution.  And lastly, I let my high yield savings account amounts for "buy my next home with cash", build up crazy interest that really put on the whammy.

No excuses...  But losing your last living parent, then experiencing very profound illness with just me to handle it, then throw in all of the shit with settling an estate, and I'm glad I guess that all I lost was a few thousand $$$.  New year, new ability to not make the same mistakes twice. 

Holyoak

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Re: Health Insurance?? Need advice
« Reply #13 on: March 17, 2019, 05:00:43 PM »
What REALLY sucks is if you break through the subsidy ceiling.  For a single fella and don't go over $47,520/yr for income, the most you will have to pay back is $1250...  Well this year I was paid a small inherited IRA lump sum, and it pushed me over the $47,520 by about $3k...  This ends up having me pay back $5700 to the ACA... I lost the entire subsidy!!!  Going to have to review my situation and adjust, and what a PITA...  Going to look seriously into these alternate, non ACA plans. 
Wouldn't it have made sense to just refuse part of your inheritance? Or were you caught by surprise when doing your taxes?

Understanding the rules is critical for successful maneuvering of the ACA, unfortunately. There are 2 "cliffs" to watch out for. Too LOW of income, you qualify for NO subsidy. Too much income, same thing, however there is a gradual reduction until you hit the ceiling.

ACA subsidies are based on current year income, not prior year. That is the first maneuver. It might benefit you to FIRE on January 1st.

That inheritance check was a killer. Knowing rules on inherited IRA's could have befitted you as well. Would you have been able to create an inherited IRA in that amount? You would have required minimum distributions and you would have been better able to control when it becomes income.  If that company would have said no, I would have investigated transferring it to another firm or like another said, not taken the check or a portion of it.

Exactly right.  Too low and it's welfare, too high and you get what I got.  I chuckle, because every year I was so close to being almost spot on, it was scary...  Same for estimated PA tax payments - Nearly spot on.  It's ironic, as I just nearly completed my taxes prior to seeing this posting, and I guess I have been holding off because I did not want to actually see it in black and white. 

Fer Christ sake, I used to be an Army units tax assistance officer, and slayed some pretty good tax problems in the past (my own audit being my magnum opus).  Let this one slip by I guess.

jim555

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Re: Health Insurance?? Need advice
« Reply #14 on: March 17, 2019, 06:11:00 PM »

NY has high tax, but when it comes to health insurance options it is much better options than most states.  I hear people paying outrageous sums for insurance in sparsely populated states.

Ridiculous.. I plan on staying in NY for a few years but my property tax alone is 14K and car/home insurance is high too
The reason it works for me is I am in a Condo, if I had to pay house taxes the plan would be almost impossible to keep income low enough to get the deal of low income health insurance.

frugaldrummer

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Re: Health Insurance?? Need advice
« Reply #15 on: March 17, 2019, 08:09:16 PM »
Please folks, stay away from Liberty Health Shares. Most people don't understand health insurance well enough to understand what they're NOT getting.
There is no free lunch and you get a LOT less coverage for catastrophic illnesses. Coverage is capped ( one of the good things about the ACA is coverage for catastrophic illnesses is not capped),  stuff happens to people - cancer, heart transplants - and you'd blow through their limits easily with care for something life-threatening and then there goes your retirement funds out the window.

My boyfriend's cancer drug would probably be 100-200k per year. My friend's successful heart transplant last year surely has cost well over a million dollars. I know 8 friends currently with cancer. Don't put yourself in a position where a catastrophic illness also means losing all your money. Don't fool yourself into thinking it can't happen to you. Boyfriend has stage 3 lung cancer in his 50's - never smoked, no second hand smoke, no chemical exposure, fit and has eaten a super healthy Mediterranean diet for 20 years, in his 60's.

frugaldrummer

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Re: Health Insurance?? Need advice
« Reply #16 on: March 17, 2019, 09:01:27 PM »
In his 50's

Saving in Austin

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Re: Health Insurance?? Need advice
« Reply #17 on: March 18, 2019, 09:18:00 AM »
Please folks, stay away from Liberty Health Shares. Most people don't understand health insurance well enough to understand what they're NOT getting.
There is no free lunch and you get a LOT less coverage for catastrophic illnesses. Coverage is capped ( one of the good things about the ACA is coverage for catastrophic illnesses is not capped),  stuff happens to people - cancer, heart transplants - and you'd blow through their limits easily with care for something life-threatening and then there goes your retirement funds out the window.

My boyfriend's cancer drug would probably be 100-200k per year. My friend's successful heart transplant last year surely has cost well over a million dollars. I know 8 friends currently with cancer. Don't put yourself in a position where a catastrophic illness also means losing all your money. Don't fool yourself into thinking it can't happen to you. Boyfriend has stage 3 lung cancer in his 50's - never smoked, no second hand smoke, no chemical exposure, fit and has eaten a super healthy Mediterranean diet for 20 years, in his 60's.

Liberty Complete covers up to $1 million per incident. To each his own, I suppose.

radram

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Re: Health Insurance?? Need advice
« Reply #18 on: March 18, 2019, 01:17:45 PM »
Liberty Complete covers up to $1 million per incident. To each his own, I suppose.

I really hope you have the coverage you want, and at a price you think is fair.

I know next to nothing about health shares. My limited reading on the subject caused me to pass on them being an option I was interested in learning more about them.

I read an article(famous beginning to useless advice) that mentioned at the time that the particular health share I was looking at was not an obligation to pay, but a mere contract to "try" to meet the obligations described. At the time, the share met all of its obligations, but past results was no indication of future results, blah blah. That scared me away. Who knows, maybe my insurance coverage says exactly the same thing. Maybe my insurance is "insured". I really do not know.

Don't remember the share, the article, or even when, but I do remember the bad taste in my mouth after reading a litttle about them. I hope things are different now.

Does anyone know about health shares or insurance carriers that can not meet their obligations? Who pays in that case, or is it just "written off"?

Viking Thor

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Re: Health Insurance?? Need advice
« Reply #19 on: March 18, 2019, 08:54:31 PM »
I have not researched Health Shares thoroughly but I saw once it said they don't cover ongoing monthly prescriptions.

That's a huge red flag/ risk if true. There are various medical conditions that can be successfully managed but only with very expensive prescription drugs that need to be taken continuously.
« Last Edit: March 18, 2019, 08:56:28 PM by Viking Thor »

Paul der Krake

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Re: Health Insurance?? Need advice
« Reply #20 on: March 18, 2019, 10:15:33 PM »
Health shares are a terrible idea. You are literally buying from people who believe in virgin birth, or pretend to, for the purpose of the common bond of that group. They have incredibly weak guarantees, whereas the point of health insurance for Mustachians is to insure against existential threats. I can't believe they are regularly touted on this forum as a real alternative.

By enrolling into one you're also contributing to the freerider problem because let's get real, the second something really wrong happens, you'll find a way to trigger a special enrollment period and get on a real insurance product. Everyone would.

frugaldrummer

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Re: Health Insurance?? Need advice
« Reply #21 on: March 19, 2019, 07:56:41 AM »
As mentioned before, a million dollar cap does not go as far as you think. My friend's heart transplant cost more than that for sure. New cancer drugs can cost $200k per year just for the drug alone.

One of the biggest benefits of the ACA, besides protecting those with pre existing conditions, was the elimination of caps like this.

Don't risk your hard earned retirement money by buying cheap ass insurance that doesn't protect you against the very things that cause people to go bankrupt due to medical problems. I don't care how healthy you think you are, shit happens to people all the time.

radram

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Re: Health Insurance?? Need advice
« Reply #22 on: March 19, 2019, 10:45:06 AM »
As mentioned before, a million dollar cap does not go as far as you think. My friend's heart transplant cost more than that for sure. New cancer drugs can cost $200k per year just for the drug alone.

One of the biggest benefits of the ACA, besides protecting those with pre existing conditions, was the elimination of caps like this.

Don't risk your hard earned retirement money by buying cheap ass insurance that doesn't protect you against the very things that cause people to go bankrupt due to medical problems. I don't care how healthy you think you are, shit happens to people all the time.

I think this topic is one of many without 1 true answer. Life itself is about risk vs reward. I am not going to preach to @austin that he is not adequitly covered. If there were a million people like him, how many would not be adequetly protected? 1, 1,000, all of them? How much more money is required to put that number to a level acceptable to you, or to me? What if the costs were triple? Or 10 times? Or 1 extra dollar?

It is all about acceptable risk. That is why the ACA is so problematic. There are people that think ACA carries too much risk , and others that believe it does not carry enough. When something like that is mandated, you will have conflict.

My main concern with health shares is that customers may not understand the risks they are taking. Maybe there is no risk at all. I just do not know. Healthcare is NOT a simple idea that can be understood by the most unintelligent of the community. I argue it SHOULD be, but it just is not. That bothers me not only for me, but the other 80% of the population that thinks they are of above average intelligence.

If everyone drove a tank that maxed out at 10 MPH, I would argue there would never again be a road death(yes some idiot would still manage to die, but still). Why don't we? Cost and time lost by driving slower. Are we all "wrong"? I say no.

I drive small cars. I like the mileage, and I believe I am taking an acceptable risk of getting run over by a semi. MMM even did an article about this very topic. Others may think I am crazy to take that risk, and only feel safe in SUV monstrosities(in MY opinion). That makes me right and others wrong, right? Right?.... Of course not.

Regarding losing your "hard earned retirement money:"
It varies by state, but for most, 401k money is protected against bankruptcy, so based on your situation, you really might not be risking ANY of your retirement by being under-insured. Would it be crappy to ditch on a hospital bill? Yup. Is it a tool in my toolbox I would consider. ABSOLUTELY. If it is good enough for my president's companies to do SIX times, it is good enough for me. Sorry to get political here. It was inappropriate, and I was wrong.

This really is yet another example of acceptable risk vs. reward. I would NEVER start a company if there was a reasonable possibility I would need to default on my creditors. Others would not bat an eye. Who is right? The law says we both are. I can live with that. But 6 times? Seriously (ok, last time).

What if ALL credit was like student debt? Never discharged. Carried with you for life. No more bankruptcy, no more "payment reductions". No more restructuring. If you have a debt they can just take all you have to pay it back and put your body into indentured servitude. Would that change peoples minds about healthcare and acceptable risks? It would for me.