Author Topic: Does your stash cover potential chronic health condistions?  (Read 5187 times)

backandforth

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I am wondering if anybody (self or a family member such as spouse or child) with chronic health condition(physical or mental) that still plan to or already FIERed? Of courese if you are covered by disability or vested in a health plan through work that's great. But if you don't, how do you plan to cover the ongoing and sometimes high medical cost? A much bigger stash? one spouse works longer? Wait till condition greatly improved and stabilized? Move to a country with lower health care cost and just do annual check up back in US and have meds mailed oversea? If ACA unravels and some provisions go away it could be really bad news..
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Thanks for replying everybody. It looks like FIER is more of a previlige of the healthy crwod, at least in the US. So I changed the title to refelct the questions more directly

Do you actually prepare for it in the stash even if you are healthy today? If someone is lucky enough to retire in late 30 or early 40s, chances are that it's on the early side for anything scary to show up; if retire in early 50ish and still in very good health, they may do OK and have enough to last until Medicare kicks in.

To me the tricky age is 40-50. This is when, for most people, kids are young and still depend on us, and anything scary could just begin lurking around. AND it is too far away (read: expensive) to Medicare.

We have been pretty healthy and plan on ER in a few years, until recently. We are now going through a rough patch and I am hoping it's not super chronic (maybe  a few years), which lead me to wonder how people would handle this in early retirement. What if something bad, but not bad enough for medicade, hit you a few years into reitrement? For me the answer is that I will have to add more to the stash, and work few more years until the condition goes away or greatly dimished. Even then I would think twice before both of us call it quits. I have also researched options to living in other countries that offer lower cost high quality healthcare to expat, but that measn moving the kids to a different continent for school, etc, not sure I am ready for that.

This also leads me to take a serious look at my family history. I am not coming from a sickly faimly, but neither do I have the super genes that live healthly till 90s. It's more like things start to break down, or need replacement/surgery, in the 55-65 range, which I guess is pretty normal overall. The dilemma has now become: retire earlier with a decent stash, but run the risk of getting sick 5-10 years out without inexpensive coverage options, or retire later, have a bigger stash, but have to suffer more years at work and leave less years to enjoy before the body needs some major repair work.

So what's your plan?
« Last Edit: June 06, 2017, 08:13:08 AM by backandforth »

snacky

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Re: Anybody plan or already FIERed wtih chronic health condition?
« Reply #1 on: June 05, 2017, 02:58:48 PM »
Hi.
I had to stop working just over a year ago due to what looks like might be a permanent illness. I'm single with kids. Canadian, so the healthcare costs issue is different.

So far I have been getting long term disability payments from my work insurance, but they are trying hard to dump me and sooner or later will succeed. That insecurity has led me to renting out my house and moving to a bigger one where I can house international students. These non-work income streams aren't enough to live on, but hopefully I can buy another rental property before disability stops paying. If that happens I will be fine. If not, I'll figure something out.

birdiegirl

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Re: Anybody plan or already FIERed wtih chronic health condition?
« Reply #2 on: June 05, 2017, 03:38:25 PM »
This is my biggest concern with FIRE.  I have a couple chronic conditions that could mean individual insurance would be very expensive or that perhaps I could not get it at all.  We have a way to go before FIRE but right now the plan is that either DH or I will have to keep working in a job that offers insurance.  Hopefully we might be able to find something less than FT that offers it....or maybe we'll have to take turns working FT to keep coverage. 

We had a late start and are still building our stache.  Trying to build an even bigger stache to cover health insurance would probably take us until normal retirement age anyway.   Hoping the next few years while we are getting ready to FIRE there may be some new policies put in place (like ACA or similar).

Dusty Dog Ranch

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Re: Anybody plan or already FIERed wtih chronic health condition?
« Reply #3 on: June 05, 2017, 08:20:22 PM »
This is the main reason we decided to do the downshifting route instead of FIRE sooner. We will be going to 4 day weeks which will give us more freedom while keeping our health benefits the same. Until the US gets medicare for all or something like it, retiring early is going to be a tough one for us because we are not super high earners like some people here.

spicykissa

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Re: Anybody plan or already FIERed wtih chronic health condition?
« Reply #4 on: June 05, 2017, 08:32:13 PM »
I have a few coworkers who have "downshifted", but not fully retired essentially for this reason. One in particular I know had cancer in the past, so is very leery of not maintaining continuous health coverage and will probably continue to work part-time (1-2 days/week) until she is eligible for Medicare.   

zinethstache

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Re: Anybody plan or already FIERed wtih chronic health condition?
« Reply #5 on: June 05, 2017, 08:57:00 PM »
I am a chronically unhealthy person (too much to list, but its all in my blog-you have been warned, it's gnarly), but not bad enough for disability by any means. I am FIREd and the number one reason for it was health and sanity as I worked in a very intense IT field as a "leader" for 20 years at the same company.

Then, as I was working through a major injury that happened in 2013, my husband was diagnosed with Sarcoidosis in his lungs. I don't believe he could ever go back to blue collar work. He had been FIREd since 2011 as we built up our rental properties for both of us to FIRE.

Right now we are on a healthcare plan with subsidies. If the new healthcare law does not support pre-existing conditions, DH and I are likely screwed for insurance, but for now we are enjoying our FIREd time while not stressing too much about it.

I will never go back to IT software development management again, but could easily supplement our income teaching in my hobby area. I also do some web work (reluctantly) and could get serious with it if pushed.

I am on a variety of scripts, including some spendy ones (insulin) that are currently well covered. I would not be able to afford them without coverage, it would not be possible with just side gig work. DH is on equally expensive breathing medication that has no generic however right now with our current travelling his breathing is much improved so he needs it very little. I worry when I hear him struggling to breathe because oxygen is a pretty critical necessity. I do have a sizable 401k that is not currently necessary, so in the back of my mind if our health care costs got really bad, I could 72t and that would likely(hopefully) cover us.

Our current living expenses are VERY low, but it only works out this way because we are healthy enough to live on the road (even with our conditions - we are "forcing" ourselves to push through our chronic issues with this lifestyle). One of us becoming very ill, or physically challenged would be difficult and if we are forced to settle in one location, our living expenses would jump up dramatically.

It's all very scary but were living the dream anyways! So far so good (as I sit with my ankle up icing it, I've sprained another ankle - one of the joys I get to live with.)

NOTE: when/if we do ever settle down we "can" increase our income by taking back over the maintenance of our rentals - this of course will require at least one of us is healthy enough to do the work.


Gin1984

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Re: Does your stash cover potential chronic health condistions?
« Reply #6 on: June 06, 2017, 09:46:52 AM »
I have medical issues which is one of the reasons I am trying to become financial independent.  I do expect to need a lot more than many people here to account for medical.  If my husband loses his job, we may end up in Massachusetts or abroad which both will cost extra.  But being FI gives me choices we would not otherwise have.  My goal is my living expenses plus COBRA plus daycare/private school.  I plan to quit work later than many people here but may not have that luxury if my medical conditions worsen.  That means private school may end up off the table. 

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Shrike

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Re: Does your stash cover potential chronic health condistions?
« Reply #7 on: June 07, 2017, 12:33:20 AM »
The uncertainty about what I will do for health insurance before reaching Medicare eligibility is the only issue preventing me from quitting my job tomorrow.  My plan for addressing health insurance in retirement is basically to allocate a big 'ol pile o' money for it and try to stay active and healthy in the meantime.  Am I allocating too little? Too much?  Who knows?  I sure don't. 

Here's the details:

I'm currently assuming the ACHA is worst case scenario for any new healthcare law and am saving an extra $150,000 to cover medical insurance costs of up to $10,000 per year (6.7% of 150k).  I'm using a >4% withdrawal rate since this fund only needs to last the 15 years until I reach Medicare eligibility, not forever.   I was previously planning on saving an extra 250k to get a 4% SWR but no longer think this is necessary.

There's some hope still, however, that much of this extra saving will be unnecessary because some states are taking action independently of Congress.

I'm particularly keeping an eye on Nevada which has passed a "Medicaid-for-all" bill which is sitting on its GOP governors desk right now, awaiting his signature (or veto).  If it passes, Medicaid would become a Public Option that anyone can buy into.  If that bill gets signed, I might be looking at real estate in Nevada real soon.

Barring that, another consideration when the time comes will be moving to a state (like Florida) that has outlawed the practice of "balance billing".  This is where you go in for a procedure at an in-network hospital but they employ out-of-network specialists who work on you  and you get billed thousands of dollars or more for the balance your insurance won't cover.
« Last Edit: June 07, 2017, 12:58:33 AM by Shrike »

Bateaux

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Re: Does your stash cover potential chronic health condistions?
« Reply #8 on: June 07, 2017, 12:56:34 AM »
With the almost certain end of the ACA, I'm saving an additional 500k to cover future health care.   

AnnaGrowsAMustache

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Re: Does your stash cover potential chronic health condistions?
« Reply #9 on: June 07, 2017, 01:05:46 AM »
I don't know how you could possibly cover all potential chronic conditions. You're talking covering the cost of anything from asthma to having a seriously, congenitally ill child that costs hundreds of thousands of dollars a year. My plan is to keep my ability to earn (even if I was retired, perhaps by increasing a hobby into an income) AND have very comprehensive health insurance. As I get older, I'll probably need the additional income just to pay for bloody insurance!

Mezzie

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Re: Does your stash cover potential chronic health condistions?
« Reply #10 on: June 07, 2017, 02:15:42 AM »
There's no way I could save enough to cover my health conditions without insurance. I'm not (yet?) disabled enough for disability benefits. If I have to stop working without those benefits, I'll be relying on the help of family and friends, unfortunately.

The good news is, so far I feel best at work, which I love. I hope that continues until I'm old enough to keep my health insurance when I retire (55).

There are more details in my journal.

wenchsenior

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Re: Does your stash cover potential chronic health condistions?
« Reply #11 on: June 07, 2017, 07:51:28 AM »
With the almost certain end of the ACA, I'm saving an additional 500k to cover future health care.

Same.  I have chronic conditions, both diagnosed and frustratingly undiagnosed (likely autoimmune) that have worsened notably in my 40s. If I could quit work and focus on my health for a few years, I suspect I could improve things.  But I too am driven to save an additional 500K over our base FI limit because of my health likely worsening further in later years.

It is very frustrating.

backandforth

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Re: Does your stash cover potential chronic health condistions?
« Reply #12 on: June 07, 2017, 09:08:08 AM »
Yeah I am with you guys on at least 500K extra stash just to cover higher insurances/medical bills, even if it means work a few more years. Now that we have kids, my own happiness can take backseat to their security somewhat.

It has recently dawn on me that, overall we are quite an optimistic bunch here on the forum. My DH and I were, and still are, pursuing FI with enthusiasm, despite the recent setback on health.

Maybe it's me being naive, I somewhat mistakingly thought as long as we live and eat healthy, we will stay healthy. Heck no, when sh*t happens, it hits you like a truck. There are real uncertaintis in life, somehow amid all that enthusiasm( which is a very positive force overall), I grow a false sense of confidence, which is contagious, that all will go well as long as we play by the mustache book.

Today I am actually grateful that this life event hit us before we hit FI. Had I reached FI and ERed in our early-mid 30th we'd be screwed.

Don't get me wrong, I am eternally grateful that I found MMM and followed the good advices by him and others on the forum. I do think, however, if you were like me before this, going for a <4% rule stash based on day to day spending plus a few lux spends and plan to retire young, you might want to take a serious look at your family health history and others around you, an extra stash might be in order. Personally, it will be really hard to re-enter the workforth to get the same pay after a number of years off, and mentally it's probably easier to ride the momentum now. I'd rather work now and spend the money/time later to nurse my loved ones or myself back to health instead of back to work during a stressful event.

Sorry if it all sound a bit gloomy, the life lessons be can sobering at times.

BFGirl

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Re: Does your stash cover potential chronic health condistions?
« Reply #13 on: June 07, 2017, 10:16:05 AM »
This is my number one concern about retirement.  I plan to retire between 3.5 and 5.5 years from now.  Currently, my employer offers health insurance to retirees and depending on length of service will pay a portion of the premiums, but who knows if that will still be available when I get to retire.  At the latest, I am looking at retiring at 55, so I have to bridge 10 years until Medicare.  However, I am not at all confident that they won't raise the age limit for Medicare, so it could be longer.  I might have to work a part time job to cover health insurance costs.  I will see what it looks like as I approach my planned retirement and make a judgment then about whether or not I need to keep working or maybe take part time work to cover insurance premiums.

MrMoogle

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Re: Does your stash cover potential chronic health condistions?
« Reply #14 on: June 07, 2017, 11:03:55 AM »
5 years ago I discovered I have a permanent illness that will require treatment for the rest of my life.  I was already planning on having a 3% withdrawal rate to account for things like that and other life changes, but I might drop it down to 2%.  Since it's mostly market driven at that point, it shouldn't take that much more time. 

I'm trying different treatments now, since the last one stopped working, so I'm not sure my illness will allow me to work that long.  Moving to another country is an option, many other countries allow for higher doses and have lower medical costs.  It's definitely something I should consider.

Hexbolt

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Re: Does your stash cover potential chronic health condistions?
« Reply #15 on: June 07, 2017, 02:42:34 PM »
I have a chronic condition (ME/CFS) that is not treatable, which ironically makes it quite cheap to manage. So most of my concern is centered around the health insurance situation in the US. Having a significant preexisting condition could be no big deal on the ACA, or could price me out of the market on AHCA. By the time I'm ready to retire, I should know which is the case.

Geographical flexibility is my fallback plan. If I need to, I can relocate to Massachusetts or a similar state until Medicare kicks in. We're lucky to have options. Too many people don't.

jim555

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Re: Does your stash cover potential chronic health condistions?
« Reply #16 on: June 07, 2017, 03:04:13 PM »
My plan would be go to the UK and come back at 65.  If I didn't have this option I don't know how I would deal with the uncertainty around the ACA, it is the only thing keeping me sane.

cadillacmike

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Re: Does your stash cover potential chronic health condistions?
« Reply #17 on: June 07, 2017, 09:04:36 PM »
No but the VA will (for me).

Bateaux

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Re: Does your stash cover potential chronic health condistions?
« Reply #18 on: June 07, 2017, 09:57:52 PM »
I just sent in my application for VA benefits.   Never thought I'd need them but, best to see what I'm eligible for.

Nudelkopf

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Re: Does your stash cover potential chronic health condistions?
« Reply #19 on: June 08, 2017, 12:18:08 AM »
My parents are retired (retired mid50s, so not early.. but earlier than the pension age)

Dad has Parkinson's disease. (Early onset. Fairly advanced). They've got a stash of $3m including their PPOR, but are worried about funding a care home for dad in the next year or so. Not eligible for any government or insurance help.

I think Mum's very glad they didn't ER when they hit FI, and kept working til their mid-50s to build up enough of a buffer.

mancityfan

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Re: Does your stash cover potential chronic health condistions?
« Reply #20 on: June 08, 2017, 02:08:13 AM »
53 years old with a NW of 1.5M. I am a cancer survivor, but just got another cancer diagnosis and have started chemo in the last few weeks. I am assured that my condition is "treatable" and should not kill me. However, fair chance of relapse in future years. Some very expensive therapies at present. I estimate my current treatment regimen would cost $300k on open market. I have great insurance with my job. FIRE is on the back burner as future treatment options if I relapsed could push 500k. I am in the classic golden handcuffs. My stash has helped to reassure me, but only if I maintain health coverage, which means maintaining my employment for the foreseeable future.

From this thread - specific to the US members - one aspect that I find particularly sad, is that I should be looking at imminent (next few years) retirement. The health care mess has wrecked that. The ones that will be hurt IMHO are the younger generations, who will have opportunities restricted by older workers having to cling to jobs.

Bateaux

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Re: Does your stash cover potential chronic health condistions?
« Reply #21 on: June 08, 2017, 06:03:44 AM »
/\ /\ /\  Good luck with the fight.  My son is 24 and a cancer survivor.   I'll have him on my insurance till he's 26.  With about 2M total NW we could probably FIRE in a country with better health insurance.  I'm 48 and a diabetic.    If preexisting conditions are used against me I may be forced to work a lot longer.  An illness can easily wipe out even a multi million dollar stash. 

Laura33

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Re: Does your stash cover potential chronic health condistions?
« Reply #22 on: June 08, 2017, 07:01:35 AM »
Maybe it's me being naive, I somewhat mistakingly thought as long as we live and eat healthy, we will stay healthy. Heck no, when sh*t happens, it hits you like a truck. There are real uncertaintis in life, somehow amid all that enthusiasm( which is a very positive force overall), I grow a false sense of confidence, which is contagious, that all will go well as long as we play by the mustache book.

This.  I think most people think this way, and especially the optimists who are attracted to the MMM lifestyle.  I was "lucky" to be disabused of this notion in my early 30s (infertility out of the blue, followed by some autoimmune diagnosis -- nothing with any symptoms or advance warning whatsoever).

So, yeah, I'm 51 and still working.  And the medical insurance "what ifs" do weigh significantly into what kind of 'stache I think I need.

backandforth

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Re: Does your stash cover potential chronic health condistions?
« Reply #23 on: June 08, 2017, 09:47:19 AM »

 The ones that will be hurt IMHO are the younger generations, who will have opportunities restricted by older workers having to cling to jobs.
An illness can easily wipe out even a multi million dollar stash.

This and this. It gets disheartening to realize that a regular working salary(even with 2 white collar professional job) is just not enough to get you to the saving level to be sick proof in this country, if you have 20+ years to bridge till 65. With older and sicker people hanging onto their jobs, younger generation as a whole will be stuck in lower paying relatively entry level position, and they have to work till pretty late too because they have to squeeze harder to get to the same stash...

I do think there is a huge market opportunity out there in healthcare. There are so much fat and inefficiency in the current system. If someone smart can start something that take out those fat and inefficiency they can kick traditional healthcare system's ass, make some serious money, and do all of us a huge favor! Based on what I heard from friends working in hospitals and doctor's office, there is not much of business sense going on... yeah I get it saving life is top priority, but they could definitely do better for cheaper

Livingthedream55

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Re: Does your stash cover potential chronic health condistions?
« Reply #24 on: June 09, 2017, 07:08:03 AM »
53 years old with a NW of 1.5M. I am a cancer survivor, but just got another cancer diagnosis and have started chemo in the last few weeks. I am assured that my condition is "treatable" and should not kill me. However, fair chance of relapse in future years. Some very expensive therapies at present. I estimate my current treatment regimen would cost $300k on open market. I have great insurance with my job. FIRE is on the back burner as future treatment options if I relapsed could push 500k. I am in the classic golden handcuffs. My stash has helped to reassure me, but only if I maintain health coverage, which means maintaining my employment for the foreseeable future.

From this thread - specific to the US members - one aspect that I find particularly sad, is that I should be looking at imminent (next few years) retirement. The health care mess has wrecked that. The ones that will be hurt IMHO are the younger generations, who will have opportunities restricted by older workers having to cling to jobs.

Another cancer survivor here Mancityfan - Just wanted to say sorry you have to deal with this and  sending you best wishes for as you face this latest chapter.

retired?

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Re: Does your stash cover potential chronic health condistions?
« Reply #25 on: June 09, 2017, 10:39:50 AM »
With the almost certain end of the ACA, I'm saving an additional 500k to cover future health care.

healthcare in general, and the possibility of developing a chronic/expensive condition, is the main uncertainty in my financial planning.  It's the big unknown.

Given many, many people cannot choose to save another 500k to cover this uncertainty, I have to wonder how it will evolve for society as a whole.  Who covers those who cannot afford it?  They just get shitty or no care?  Big Bro?  Govt teat?

Gin1984

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Re: Does your stash cover potential chronic health condistions?
« Reply #26 on: June 09, 2017, 11:04:25 AM »
With the almost certain end of the ACA, I'm saving an additional 500k to cover future health care.

healthcare in general, and the possibility of developing a chronic/expensive condition, is the main uncertainty in my financial planning.  It's the big unknown.

Given many, many people cannot choose to save another 500k to cover this uncertainty, I have to wonder how it will evolve for society as a whole.  Who covers those who cannot afford it?  They just get shitty or no care?  Big Bro?  Govt teat?
Well we can look at what happened prior to ACA.  People died, people went to the ER and passed the expense on to the rest of us when preventive medicine would have been cheaper.  The question remains, is that what we want.

Abe

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Re: Does your stash cover potential chronic health condistions?
« Reply #27 on: June 11, 2017, 09:58:49 AM »
Please note when deciding on your healthcare insurance plans for FIRE that many many studies have demonstrated significantly worse care for patients relying on Medicaid or other safety-net programs compared to private insurance and to a lesser extent, Medicare. A lot of that is explained by socioeconomic factors that wouldn't apply to financially independent people, but a substantial part of that is Medicaid doesn't reimburse the cost of treatment in many situations.

Our plan is to have enough to cover the $10k per year or so in insurance premiums & co-pays our employers are currently providing. This comes out to ~$250k extra in savings. If one of us develops a significant illness like metastatic cancer or heart failure then that'll burn into the $250k pretty rapidly, but the decreased survival will probably mean less money needed in the long term anyway.

DMoney

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Re: Does your stash cover potential chronic health condistions?
« Reply #28 on: June 11, 2017, 11:38:08 AM »
This is one of the major reasons my spouse insists I stay in the military until I'm eligible for "retirement" which includes pension and health care, forever.  We're going to get to a point where the pension isn't really necessary with our growing 'stache but the cost of healthcare over the next few decades until medicare eligible is such a big unknown.

Bateaux

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Re: Does your stash cover potential chronic health condistions?
« Reply #29 on: June 11, 2017, 11:48:20 AM »
This is one of the major reasons my spouse insists I stay in the military until I'm eligible for "retirement" which includes pension and health care, forever.  We're going to get to a point where the pension isn't really necessary with our growing 'stache but the cost of healthcare over the next few decades until medicare eligible is such a big unknown.

Health care is the most attractive thing about military service.   I'm not sure I'd would have stayed in even if I had a do over.  But, if I did it would be for health care.   I forsaw this healh care brick wall coming decades ago.  The rate of costs increases guaranteed this day would come.

gaja

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Re: Does your stash cover potential chronic health condistions?
« Reply #30 on: June 11, 2017, 11:50:09 AM »
(...) how do you plan to cover the ongoing and sometimes high medical cost?
Continue living in Norway.