How to plan for health expenses with pre-existing conditions

[dantownehall]

Has anyone got any advice on planning for large health expenses in retirement/early retirement?

I lost the genetic lottery and will most likely hit the out-of-pocket maximum on whatever insurance plan I'm on every year until I die.  I know what that cost is for my current employer-sponsored health plan, and so I budget for it, but post-employment I have no idea how much I would need to save to cover those expenses, and I can really have no guarantee that they will stay anywhere near the same from one year to the next.

I know that the Affordable Care Act provides some help, but a) I would feel guilty accepting subsidies if I've left work voluntarily and thereby lowered my income significantly and b) what the OOP maxes and premiums will be 10, 20 or 30 years from now is totally unknown and unknowable.

Thoughts?

[forummm]

If the ACA continues to exist in its current form, your OOP max will go up approximately with inflation. Premiums are harder to predict. But the increase in health care costs is totally unsustainable, so it will have to mirror inflation eventually, but who knows what exactly that ends up looking like.

[Exflyboy]

Fortunately you cannot be excluded for pre-existing conditions these days. I.e if you go on the ACA you are just asked what your age is and if you smoke... then get your premium.

You will need to balance OOP max with monthly premiums to get the best deal for you.. i.e Platinum, gold, silver or bronze plans (probably not Bronze plans in your case).

As to how the OOP max fairs over time, or even if the ACA remains at all are open to question at this point (although I personally this it will survive in some form).

If you retire and the ACA dies or costs become prohibitve you basically have 3 options (none of them good)

1) Go back to a job with medical bennies
2) Leave the country and live somewhere with low cost HC
3) Pay a lot more money
4) wait till 65 to retire and go on Medicare.

[MayDay]

We are in the same position.

We are about 10 years out, so I'm not thinking about it much yet, since legally and economically, the healthcare market could change a lot.

Buy yah, we hit out OOP max of around 10k every year.  Wouldn't it make sense for whatever the OOP max on high deductible plans to match the HSA max? That's my current dream.

[dantownehall]

If the ACA continues to exist in its current form, your OOP max will go up approximately with inflation. Premiums are harder to predict. But the increase in health care costs is totally unsustainable, so it will have to mirror inflation eventually, but who knows what exactly that ends up looking like.

Is there any particular reason you believe increases will mirror inflation?  This has obviously not been the case historically, and just because something isn't sustainable doesn't mean it won't continue to happen.

[Thegoblinchief]

Are there cheaper HC options for your condition abroad? American medical care is grossly overpriced, and many folks have had good luck with geographic arbitrage.

[ShoulderThingThatGoesUp]

If the ACA continues to exist in its current form, your OOP max will go up approximately with inflation. Premiums are harder to predict. But the increase in health care costs is totally unsustainable, so it will have to mirror inflation eventually, but who knows what exactly that ends up looking like.

Is there any particular reason you believe increases will mirror inflation?  This has obviously not been the case historically, and just because something isn't sustainable doesn't mean it won't continue to happen.

Same reason college eventually will. It's not possible to spend 100% of GDP on health care for senior citizens.

[matchewed]

Has anyone got any advice on planning for large health expenses in retirement/early retirement?

I lost the genetic lottery and will most likely hit the out-of-pocket maximum on whatever insurance plan I'm on every year until I die.  I know what that cost is for my current employer-sponsored health plan, and so I budget for it, but post-employment I have no idea how much I would need to save to cover those expenses, and I can really have no guarantee that they will stay anywhere near the same from one year to the next.

I know that the Affordable Care Act provides some help, but a) I would feel guilty accepting subsidies if I've left work voluntarily and thereby lowered my income significantly and b) what the OOP maxes and premiums will be 10, 20 or 30 years from now is totally unknown and unknowable.

Thoughts?

You're still going to be paying your share of taxes throughout your life. Get rid of your guilt.

That being said you probably just need to save up a larger buffer than others. You'll need to put some estimation numbers at some time. Make sure they're reasonable and slightly larger than you anticipate. That's about all you can do IMO.

[This_Is_My_Username]

Has anyone got any advice on planning for large health expenses in retirement/early retirement?

I lost the genetic lottery and will most likely hit the out-of-pocket maximum on whatever insurance plan I'm on every year until I die.  I know what that cost is for my current employer-sponsored health plan, and so I budget for it, but post-employment I have no idea how much I would need to save to cover those expenses, and I can really have no guarantee that they will stay anywhere near the same from one year to the next.

I know that the Affordable Care Act provides some help, but a) I would feel guilty accepting subsidies if I've left work voluntarily and thereby lowered my income significantly and b) what the OOP maxes and premiums will be 10, 20 or 30 years from now is totally unknown and unknowable.

Thoughts?

move to a foreign country with free medical services

[dantownehall]

If the ACA continues to exist in its current form, your OOP max will go up approximately with inflation. Premiums are harder to predict. But the increase in health care costs is totally unsustainable, so it will have to mirror inflation eventually, but who knows what exactly that ends up looking like.

Is there any particular reason you believe increases will mirror inflation?  This has obviously not been the case historically, and just because something isn't sustainable doesn't mean it won't continue to happen.

Same reason college eventually will. It's not possible to spend 100% of GDP on health care for senior citizens.

That makes a cetain kind of sense, but the word eventually in there is what's hard for me - could be a long time before eventually comes.