Author Topic: Health insurance in your 40's  (Read 1148 times)

Pomegranate12

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Health insurance in your 40's
« on: June 09, 2024, 04:34:20 PM »
I'm interested in FIRE, I feel like we were put on this planet for more than this rat Race.

My fear and question is what do I do for health insurance, is anyone here using ACA, how much are you paying ?




seattlecyclone

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Re: Health insurance in your 40's
« Reply #1 on: June 09, 2024, 04:49:50 PM »
Every county has a different set of plans available, for different prices. Then there are subsidies based on income. The answer to your question is very much "it depends."

For example in my county nine companies sell insurance on the ACA marketplace, with 54 total plans available. A single, childless 40-year-old with $30k income would pay anywhere from $0-524/month on premiums depending on which plan they choose, while if they had a $300k income the premium would range from $286-919/month.

deborah

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Re: Health insurance in your 40's
« Reply #2 on: June 09, 2024, 05:20:44 PM »
Note that seattlecyclone said COUNTY not COUNTRY, and lives in the USA too.

Pomegranate12

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Re: Health insurance in your 40's
« Reply #3 on: June 09, 2024, 05:23:46 PM »
Note that seattlecyclone said COUNTY not COUNTRY, and lives in the USA too.

Sorry just saw that

swashbucklinstache

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Re: Health insurance in your 40's
« Reply #4 on: June 09, 2024, 07:39:29 PM »
The good news is you can go to healthcare.gov and find out what people pay today by age and income. Some states don't change the price by age, so check a few in case you move. Anyone's guess if these costs will inflate in line with general inflation or not.

Just like any insurance, you should be prepared to find that some medicines aren't covered. Some states have plans that don't cover all that much. Keep in mind that insurance doesn't cover things you may find you newly need, like grocery delivery or repairs you'd formerly DIY. If you travel a lot within the US for long periods you may desire travel insurance if you don't have a nationwide plan. Be mindful of MAGI and Medicaid and if you're flirting with that line check if you're in a Medicaid expansion state.

sonofsven

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Re: Health insurance in your 40's
« Reply #5 on: June 10, 2024, 06:04:40 AM »
If you have generally low spend on your health care costs, your 40's is a great time to utilize a high deductible health plan HSA (health savings account) qualified ACA plan and contribute the maximum every year into an HSA, and invest the HSA into an index fund.
https://youtu.be/xn6FtTZYeWE?si=DqYM5C2FdkyHx4xs

Glenstache

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Re: Health insurance in your 40's
« Reply #6 on: June 10, 2024, 01:13:39 PM »
I'm on an ACA plan and pay about $400/mo for just me at 48.

Wintergreen78

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Re: Health insurance in your 40's
« Reply #7 on: June 10, 2024, 01:46:56 PM »
I didnít work for three years in my early 40ís. Iím in California. I went through the county health office, which determined I should be on Medi-Cal, because I did not have ďregularĒ income. So, I did not pay any premiums.

It was strange, and I explained I had assets and would have dividends and capital gains as income. I found the county health department to do good job of walking me through the sign-up process though.

NotJen

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Re: Health insurance in your 40's
« Reply #8 on: June 10, 2024, 06:10:22 PM »
My fear and question is what do I do for health insurance, is anyone here using ACA, how much are you paying ?

Iím using ACA.  44yo, MAGI~$20k, $0/mo (Silver plan completely covered by subsidy).

As stated, you can play with the ACA website (or your stateís equivalent), and see what it will be for your age, income, and location.

spartana

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Re: Health insurance in your 40's
« Reply #9 on: June 10, 2024, 10:55:56 PM »
OP are you a military veteran? If so you can see if you can qualify to use the VA medical services. I use the VA myself and found it to be pretty good.

Otherwise the ACA is likely your best bet if you are within it MAGI income range to receive subsidies. Or Medicaid if in an expanded state and your MAGI income is low. Those states don't count assets just taxable income. Check your states ACA site and input your planned numbers and see what options you have. If you have family - kids and/or spouse - I believe they have family plans that are less expensive and offer more subsidies then for I individual medical insurance.

There's also expensive COBRA coverage that allows you to stay on your former employers plan for at least 18 months (sometimes longer).
« Last Edit: June 10, 2024, 11:00:16 PM by spartana »

jim555

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Re: Health insurance in your 40's
« Reply #10 on: June 11, 2024, 05:13:40 AM »
Retired 10 years now, between Medicaid and NY Essential Plan haven't paid anything so far.

Mr. Green

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Re: Health insurance in your 40's
« Reply #11 on: June 11, 2024, 12:04:14 PM »
In general, the formula for calculating health insurance premiums through the ACA amounts to something between 0% and 8.5% of your Modified Adjusted Gross Income for the year as long as your income is 400% or less of the Federal Poverty Level for your family size. It's a sliding scale that starts at 0% and increases as your income gets larger. The subsidy amount is calculated for the second lowest cost Silver plan available to you. If you choose less expensive insurance, like a Bronze plan, you pay even less because the subsidy remains the same. The income cap for subsidies at 400% of the Federal Poverty Level has been temporarily suspended through 2025 but without action from Congress it will return in 2026.

dandarc

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Re: Health insurance in your 40's
« Reply #12 on: June 11, 2024, 12:11:58 PM »
We pay full price on the exchange. Current plan is a gold HMO at $1,042 / month for 41/43 year old adults and no kids. This is probably the best insurance I've ever had in my life - very little cost for anything outside of the premiums.

But we're moving - somewhat comparable health insurance with acceptable network in the new place is a gold EPO at $1363 / month. We may dial this in as we have more experience there, but still acceptable for us. If only they had a well established HMO there to provide real competition to Blue Cross like we do in the current city, but it just is what it is - pick from the available options that you can use at your usual (or likely) doctors and hope for the best.

If I ever decide to cut work back to where we get subsidies, we could do a whole lot better on price than this.

Much Fishing to Do

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Re: Health insurance in your 40's
« Reply #13 on: June 12, 2024, 06:33:59 AM »
We pay full price on the exchange. Current plan is a gold HMO at $1,042 / month for 41/43 year old adults and no kids. This is probably the best insurance I've ever had in my life - very little cost for anything outside of the premiums.

But we're moving - somewhat comparable health insurance with acceptable network in the new place is a gold EPO at $1363 / month. We may dial this in as we have more experience there, but still acceptable for us. If only they had a well established HMO there to provide real competition to Blue Cross like we do in the current city, but it just is what it is - pick from the available options that you can use at your usual (or likely) doctors and hope for the best.

If I ever decide to cut work back to where we get subsidies, we could do a whole lot better on price than this.
I was paying full price when self-employed and very high income which had gotten to $2300/mth for family of 5 with me @ 50.  But just playing around with the ACA calculators it became clear I'd pay very little in FIRE, and given FIRE income is somewhat pliable, even close to zero if I forced it.  The numbers move around a lot but I basically knew I could assume $2k/mth less in health ins costs when I FIREd, which of course knocks out our largest single expense.  I've taken a half-time job that offered me insurance but I always have that lower ACA costs in the back of my head when figuring FIRE expenses.  But of course the program could always change.

rantk81

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Re: Health insurance in your 40's
« Reply #14 on: June 12, 2024, 09:11:03 AM »
Venting:

Looking for what the unsubsidized cost would be for the cheapest premium ACA plan for my spouse and I (both mid 40s) would be in my zip code:

$1053/month premium, and $18,800 deductible ($18,900 out of pocket max... The extra $100 difference for lulz I guess?)  ... for an HMO plan that requires referrals for everything and has a hyper-local doctor network (and only a small number of providers in network.)

That would put us to spending over $31,400 /yr of spending, before the insurance would pay for anything... and that's assuming we would somehow not "accidentally" or "unintentionally" get an out-of-network bill (say, the doctor sends an X-Ray to someone to write the report about it, who isn't in the network, and who I never had the choice of.  Or any random number of reasons why claims get processed out of network or denied.)


God help us if the law changes ever to take the subsidies away, I guess....  This whole garbage system needs to be imploded.

reeshau

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Re: Health insurance in your 40's
« Reply #15 on: June 12, 2024, 09:14:48 AM »
That would put us to spending over $31,400 /yr of spending, before the insurance would pay for anything... and that's assuming we would somehow not "accidentally" or "unintentionally" get an out-of-network bill (say, the doctor sends an X-Ray to someone to write the report about it, who isn't in the network, and who I never had the choice of.  Or any random number of reasons why claims get processed out of network or denied.)

Surprise billing is now illegal nationally.  That isn't to say they won't try and bill you.   But, you can complain to your insurance carrier, and they should correct it.