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Old 11-15-2015, 09:33 PM   #161
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What people, including me, are saying is that Medicare plus a supplement is going to cost upwards of $300/mo each or upwards of $600/mo for a couple. And you have to pay 2.5% of your income for life to qualify to pay that. Still, likely the best HI deal going for most geezers.
Yes. It is just that compared to what I pay, the cost of Medicare is peanuts and without all the out of network angst that you always have with non-Medicare insurance.

Yes, I now that say $7200 a year is not literally peanuts. But, last year our family medical expenses for insurance and healthcare costs were well over $20k (that includes 2 of our kids). Even taking the kids out of the pictures, the costs will go down a lot when I become eligible and I won't have to worry about the whole out of network thing.
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Old 11-15-2015, 10:17 PM   #162
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I don't hear people talking about Medicare as if it were free.
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Old 11-15-2015, 10:30 PM   #163
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On the 2.5% tax that pays for Part A (Hospital) unless you exceed about 250k in income the tax is not imposed on capital income, pension and Social Security.
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Old 11-15-2015, 10:46 PM   #164
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Couples just need to remember to pencil in $8k or so annually to pay for it. Somehow, the rumor that Medicare is free, or near-free, persists
Good reminder. We burn about 20% more than this now for lowish Bronze crappy ACA (full PPO network disappearing for 2016). Still, the big anticipated advantage of Medicare is, presumably, better network coverage and lower OOP.

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Old 11-16-2015, 07:27 AM   #165
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I think the 2018 Cadillac tax on employees healthcare benefits would produce a slightly better balance between employees and non-employees but I wouldn't be surprised if our politicos cave in under pressure and reduce/remove that 2018 tax. For budgetary reasons that means politicos would stick it to somebody else, new target(s) yet to be determined. Who has the least clout?

The good news (in one way) is that right now employers are exposing their employees to ever-increasing healthcare costs by increasing their premiums, deductibles and out-of-pocket costs. The more EVERYBODY sees the problem, the higher the chances of actually doing something to control costs at their source, as mentioned in NW-Bound's post.
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Old 11-16-2015, 07:42 AM   #166
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We relocate to the UK next year* and I have already done a detailed tax estimate for what we will pay for our circumstances.

We have a mixture of pensions, interest, qualified dividends and capital gains. Like the US, the UK taxes its residents on their worldwide income. Roth distributions are free of UK tax which is why I have been so aggressive in conversions this past 5 years.

We will pay ~$3k more in income taxes than in the US ($9k instead of $6k). (We live in Texas so no State income tax).
...

*We are moving back for emotional reasons (family and friends) , not financial or because 1 country is somehow better than the other.
Yet, you are retired and I assume that your current income is less than that when you were both working and the tax would have been much higher.
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Old 11-16-2015, 07:53 AM   #167
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Congrats MRG on taking control of your health. DW and I (actually more DW) improved our diet and we've both lost tons of weight. We avoided/stopped some of the same issues you listed just by diet and modest exercise.

DW and I constantly remind each other that under ACA we can no longer afford unhealthy lifestyles. The deductibles and OOP would kill us, not to mention the "lifestyle" illnesses themselves.

It's interesting that most folks here strongly advocate taking care of most/all of their own finances. Experts like lawyers, accountants, and FA should be used sparingly on an as needed basis. Well, DW and I feel the same way about our health. We want to maintain it as well as possible by diet and exercise, and also know enough to see when to call in an expert from the healthcare, I mean sick-care, money complex.

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I'm impressed that you know when to get medical help. I had a few light headed instances a few years back, less than 10 seconds at a time. After less than 5 I went to the ER or recommendation of my PCP. Note that when the light headed feeling was not happening, I was fine, could exert myself to very high levels for long periods of time.
I got admitted for testing. Cardiology did its testing and said I was good to go. Waiting on neurology tests, I had 3 more light headed instances. I asked the nurses after each one if the wireless EKG caught anything....nothing. After the 3rd time a nurse manually went through the data and found a class 3 heart block. The way they catch these is to capture the event which my not occur all that often.
While I was in the hospital I really questioned if I had over reacted. Normally I would have waited longer to search out help.
I don't always know when to search out help. I've gone to urgent care and got stitches when I should have treated it at home with ice and proper bandaging. I make some educated guesses, but I don't know since I'm not always right.

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There are some fair points here. But at the same time, not everyone is genetically blessed and even people who do everything right can get cancer, just as people who are generally financially responsible can hit hard times through circumstances not of their own making.

I'm not sure it's really a fair point, though, to suggest that people who are "responsible" financially are not responsible when it comes to their health.
ziggy, I didn't take Freebear's comments were implying fault for everyone who gets ill. But even when one had tendencies to have certain health problems does not mean they should not try to live in healthy manners: diet , exercise, etc. You seem aware of the cancer issues, I would assume you are watching for symptoms and checking with healthcare professionals when necessary..."know enough to see when to call in an expert from the healthcare"
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Old 11-16-2015, 08:02 AM   #168
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I sometimes hear people talking as if maintaining a healthy lifestyle will mean they don't get sick or need expensive medical attention. But there are many, many diseases, some expensive, and some chronic, that have nothing to do with lifestyle. Not to mention accidents causing major health expenses - sometimes with long term consequences. No matter how careful you are, you can still be involved in an accident.
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Old 11-16-2015, 08:15 AM   #169
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I sometimes hear people talking as if maintaining a healthy lifestyle will mean they don't get sick or need expensive medical attention. But there are many, many diseases, some expensive, and some chronic, that have nothing to do with lifestyle. Not to mention accidents causing major health expenses - sometimes with long term consequences. No matter how careful you are, you can still be involved in an accident.
+1.

Maintaining a healthy lifestyle helps stack the odds in your favor, at least until you are ready to meet your maker (a heart only has so many beats), but the healthy lifestyle is not guarantee.

Earlier in the year I was doing fine that I helped a brother move, but a few days after I was hobbling around for a day or two with a cane. Back to about 99% okay now, but a reminder one can be feeling great one moment then terrible in a flash.
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Old 11-16-2015, 08:16 AM   #170
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In contrast with auto insurance where a driver can really help with his driving habits, healthcare for each of us will go up as we age. And I have read that lung cancer patients cost less for healthcare than people we would consider healthier, for the morbid reason that they die off sooner.

I think the cost for healthcare is difficult to contain if we keep the idea that a human life must be prolonged at any cost. It is hard to put a price on a day of life for a terminal patient, but the truth is that we already do in other situations.

How much do surviving families of victims of wrongful death get in lawsuits? If you take the amount awarded and divided by the victim's days that he would have lived, it comes out a lot less than what we spend to keep dying patients alive.
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Old 11-16-2015, 08:17 AM   #171
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I sometimes hear people talking as if maintaining a healthy lifestyle will mean they don't get sick or need expensive medical attention.
Healthy lifestyle? We don't need no stinkin' healthy lifestyle.

As my dad was fond of saying in his latter 80's, "If I had known I was going to live for so long I would have taken better care of myself."
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Old 11-16-2015, 08:22 AM   #172
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Healthy lifestyle? We don't need no stinkin' healthy lifestyle.
Same with life as anything else, we have to ask ourselves, do we want quality or quantity?
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Old 11-16-2015, 08:51 AM   #173
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Same with life as anything else, we have to ask ourselves, do we want quality or quantity?
Not sure these are competing qualities. I like hiking, biking, sailing.... active life style. But this should be good for longevity. So I vote for both! It is not necessarily a continuum of states where you trade quality for quantity.
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Old 11-16-2015, 09:07 AM   #174
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In contrast with auto insurance where a driver can really help with his driving habits.....
No matter how good a driver is, other people can still cause bad accidents.

And you don't have to be driving, or even in a car, to be involved in an accident either!
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Old 11-16-2015, 09:09 AM   #175
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Not sure these are competing qualities. I like hiking, biking, sailing.... active life style. But this should be good for longevity. So I vote for both! It is not necessarily a continuum of states where you trade quality for quantity.
Probably does, but active life styles have their own risks.
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Old 11-16-2015, 09:23 AM   #176
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+1.

Maintaining a healthy lifestyle helps stack the odds in your favor, at least until you are ready to meet your maker (a heart only has so many beats), but the healthy lifestyle is not guarantee.

Earlier in the year I was doing fine that I helped a brother move, but a few days after I was hobbling around for a day or two with a cane. Back to about 99% okay now, but a reminder one can be feeling great one moment then terrible in a flash.
I agree with both- when I bought travel insurance for our trip to Iceland, it was partly due to DH's health issues, but I was well aware that my propensity to go on more physically demanding expeditions, scramble up nearby hills to get a better picture, put me more at risk for accidents. DH also had a friend with insanely healthy habits who developed oat cell carcinoma (pretty much incurable) in her 30s.

Still, I used to hang out on a board for people trying to get into shape/lose weight and the success stories were really heartening. Many were able to stop meds for diabetes and high cholesterol with the blessing of their doctor; for others, knee and back pain subsided when they were no longer carrying the extra weight. I also know from my work in insurance that obesity complicates many medical conditions, makes surgery more dangerous, etc. Look up "co-morbidity".

Stuff happens but there are many things we CAN control to keep medical costs down.
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Old 11-16-2015, 09:31 AM   #177
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Stuff happens but there are many things we CAN control to keep medical costs down.
Incorrect analysis. Group output data cannot be used to diagnose any individual's chances of anything. This is a prime failure of the medical/"fitness industry. Bsing people into thinking this. It's the veneer of control.
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Old 11-16-2015, 10:04 AM   #178
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We may improve our outcomes by being healthier, but that doesn't mean we have control over our health or our medical costs.

Cousin suffers a brain aneurism in his forties. Luckily the wife sees him collapse and is able to get him to the right hospital in time to save him. This is a lean, healthy, active person.

Super fit, active neighbor in her sixties. Being super fit may have helped her survive that stroke. Wait a minute - it wasn't a stroke after all. They finally found the cause - it was a tiny brain tumor - malignant, unfortunately.
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Old 11-16-2015, 10:08 AM   #179
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Is there a healthcare plan that provides national healthcare network? It seems everything is turning into non PPO local care. We travel a good bit and wondered if there are supplemental policies or better policies I am missing?
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Old 11-16-2015, 10:29 AM   #180
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I think some of the 16.5 million people now insured might be happier with health insurance than none at all:

"The number of American adults without health insurance fell 16.5 million from five years ago, when Obamacare was signed into law, the largest drop in four decades, a new report says."

Uninsured rates drop dramatically under Obamacare

Our premiums are much lower, even pre-subsidy amounts for a better policy than we had before with a much lower deductible.
To be clear, 7M+ of those 16.5M are covered by Medicaid expansion & CHIP & another 2M+ by the requirement for children up to age 26 be covered on parents policies. So that's like 7M covered by Obamacare policies while another 30M remain uncovered. Net, without turning the insurance industry upside down & making it into a utility, it could have accomplished over half of what it did while leaving way more out in the cold. Surely there's many better ways.
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