Sub $1M no pension retirement? Any out there?

[xdafly]

It's definitely all about healthcare. If we had coverage in retirement I'd be gone now..

Why is it all about healthcare?

Our entire family (all born in US) take medical trips overseas. For example, recently, business class round trip to Narita/Tokyo for MRI. Total cash price including an overnight stay, including ticket, including labs/MRI results, under $1000. No insurance needed and everything was handled in english at high tech facilities. Have done the same for dental work in Colombia, Costa Rica, other family members used a surgery center in India with US trained surgeons and ultra-high tech hospital with private rooms and 5 star food service. Typical cost is less than 10% of US prices.

There is also surgerycenterok.com where bypass cost inclusive of ALL possible complications is 10,700 cash. No insurance wanted or needed.

Again, why is it all about healthcare?

 

[MichaelB]

Why is it all about healthcare?

Our entire family (all born in US) take medical trips overseas. For example, recently, business class round trip to Narita/Tokyo for MRI. Total cash price including an overnight stay, including ticket, including labs/MRI results, under $1000. No insurance needed and everything was handled in english at high tech facilities. Have done the same for dental work in Colombia, Costa Rica, other family members used a surgery center in India with US trained surgeons and ultra-high tech hospital with private rooms and 5 star food service. Typical cost is less than 10% of US prices.

There is also surgerycenterok.com where bypass cost inclusive of ALL possible complications is 10,700 cash. No insurance wanted or needed.

Again, why is it all about healthcare?

It's all about healthcare because the average cost for a large group policy is 31% of the median household income before payroll taxes, and overseas travel is may be an option for a few people for some selective procedures but is in no way a viable system for primary care for the majority. We all can't get on a plane to Japan, India or Costa Rica every time we need to see a doctor.

 

[Lagniappe]

Why is it all about healthcare?

Our entire family (all born in US) take medical trips overseas. For example, recently, business class round trip to Narita/Tokyo for MRI. Total cash price including an overnight stay, including ticket, including labs/MRI results, under $1000. No insurance needed and everything was handled in english at high tech facilities. Have done the same for dental work in Colombia, Costa Rica, other family members used a surgery center in India with US trained surgeons and ultra-high tech hospital with private rooms and 5 star food service. Typical cost is less than 10% of US prices.

There is also surgerycenterok.com where bypass cost inclusive of ALL possible complications is 10,700 cash. No insurance wanted or needed.

Again, why is it all about healthcare?

I am curious about this. How do you identify reputable physicians and facilities from the US?

Also, I can see it for one time issues requiring intervention, but for chronic conditions, is there some kind of virtual support?

Btw, please tell me what site you used to get a business class ticket to Tokyo for under $1000.

 

[MrLoco]

Not for nothing and no offense but I do not see the appeal in my retirement years of having to travel to other side of the globe to have an MRI or travel to a third world country for surgery. Especially multiple times over the course of a 30 year retirement.

YEs. I get it. You save a ton of money. But I have been to medical facilities in a 3rd world country (Philippines) and full payment is expected up front. Also the patient is expected to provided linens for the bed, food not included, etc. This is provided by family members.

And even though some physicians may have been trained in the US....no way the technology is up to par with most US Hospitals. Not cutting edge. And when it is my body....I want the absolute best. Which is why when the very rich from 3rd world countries ( the few that there are) need complicated surgery....they travel to the US or Europe/ Australia/Japan. And if the surgery is botched what do you do? Try suing a physician / hospital in a 3rd world country.

 

[xdafly]

It's all about healthcare because the average cost for a large group policy is 31% of the median household income before payroll taxes...

Multiple married couples, in different CONUS locations, pay on the average $175 for 2 persons per month for concierge medical service. When and if something is needed, a little domestic travel is required, all lab work is done via multiple online (no Rx needed from MD) pre-paid labs, we arrive to facility with PDF docs in hand, discuss diagnostics, plan ahead and book travel in case surgical or expensive additional diagnostics needed. Very simple and very cost effective.

No such 31% cost is incurred. Multiple people below poverty, at poverty, above poverty incomes or no incomes. Works for all of us.

 

[MichaelB]

No such 31% cost is incurred. Multiple people below poverty, at poverty, above poverty incomes or no incomes. Works for all of us.

I'm glad it works for you.

 

[xdafly]

And when it is my body....I want the absolute best. ... need complicated surgery..

So, you are familiar with Oklahoma Surgical Center?

All prices posted at the door, all inclusive. No surprise drive-by doctor billings. All cash. No insurance needed.

 

[simple girl]

Why is it all about healthcare?

Our entire family (all born in US) take medical trips overseas. For example, recently, business class round trip to Narita/Tokyo for MRI. Total cash price including an overnight stay, including ticket, including labs/MRI results, under $1000. No insurance needed and everything was handled in english at high tech facilities. Have done the same for dental work in Colombia, Costa Rica, other family members used a surgery center in India with US trained surgeons and ultra-high tech hospital with private rooms and 5 star food service. Typical cost is less than 10% of US prices.

There is also surgerycenterok.com where bypass cost inclusive of ALL possible complications is 10,700 cash. No insurance wanted or needed.

Again, why is it all about healthcare?

What is your plan if you get cancer that requires extensive treatment including surgery, chemo, and radiation?

Or what if you have a heart attack in the US and need to be rushed to the nearest hospital, and need emergency intervention?

 

[razztazz]

What is your plan if you get cancer that requires extensive treatment including surgery, chemo, and radiation?

Or what if you have a heart attack in the US and need to be rushed to the nearest hospital, and need emergency intervention?

That's called "freedom"

 

[brewer12345]

Not for nothing and no offense but I do not see the appeal in my retirement years of having to travel to other side of the globe to have an MRI or travel to a third world country for surgery. Especially multiple times over the course of a 30 year retirement.

YEs. I get it. You save a ton of money. But I have been to medical facilities in a 3rd world country (Philippines) and full payment is expected up front. Also the patient is expected to provided linens for the bed, food not included, etc. This is provided by family members.

And even though some physicians may have been trained in the US....no way the technology is up to par with most US Hospitals. Not cutting edge. And when it is my body....I want the absolute best. Which is why when the very rich from 3rd world countries ( the few that there are) need complicated surgery....they travel to the US or Europe/ Australia/Japan. And if the surgery is botched what do you do? Try suing a physician / hospital in a 3rd world country.

I would not sell overseas facilities short too quickly. 6 or 7 years ago Dad had a bad concussion when vacationing in Mexico. He ended up at a hospital in Cancun that was maybe 5 years old, built to the latest and greatest specs, had all the latest equipment, and all of the doctors spoke English. He was in intensive care for a while and then in a regular ward for a week or so. Mom stayed on site at what amounted to a very nice/high end hotel meant for family members. When they finally cleared him to travel home, his doctor stateside was mightily impressed with the care Dad had received. This place was clearly set up for medical tourism, but I imagine that it is far from unique.

All that said, it is hard to live in the US without at least catastrophic medical insurance. Stupid way to run a country, but there it is.

 

[razztazz]

I would not sell overseas facilities short too quickly. 6 or 7 years ago Dad had a bad concussion when vacationing in Mexico. He ended up at a hospital in Cancun that was maybe 5 years old, built to the latest and greatest specs, had all the latest equipment, and all of the doctors spoke English. He was in intensive care for a while and then in a regular ward for a week or so. Mom stayed on site at what amounted to a very nice/high end hotel meant for family members. When they finally cleared him to travel home, his doctor stateside was mightily impressed with the care Dad had received. This place was clearly set up for medical tourism, but I imagine that it is far from unique.

All that said, it is hard to live in the US without at least catastrophic medical insurance. Stupid way to run a country, but there it is.

He ended up at a hospital in Cancun

Cancun is a Potemkin Village of sorts for rich touristos. Let's all go to Cancun for our medical needs!! Are we there yet?!!

 

[exnavynuke]

What is your plan if you get cancer that requires extensive treatment including surgery, chemo, and radiation?

Or what if you have a heart attack in the US and need to be rushed to the nearest hospital, and need emergency intervention?

This is kinda what I was thinking. Infrequent, planned visits or a non-emergent nature is all fine and dandy. but the $400k bill for that emergency that needed an ambulance ride, two separate operations, and all associated tests etc isn't something you can hop on over to Tokyo for.

 

[Carpediem]

No mortgage , but will need a new car soon. We would like to move south.

I'm sure you probably already did but check out the ACA rates for the southern states you're considering. Mine only has one insurer offering a plan through the market place and it's very expensive - $1500-$1700 per month for a silver plan with no subsidies. Of course we don't qualify for any either so hi ho, hi ho it's off to w*rk I go.

 

[brewer12345]

Cancun is a Potemkin Village of sorts for rich touristos. Let's all go to Cancun for our medical needs!! Are we there yet?!!

Did you notice I also said that you still need insurance to live in the US? I was just making the point that the US does not have a monopoly on high quality medical services.

 

[MichaelB]

Totally agree with Brewer on the quality of healthcare abroad. We lived overseas for many years, DW and the young'uns have received far more care there than here in the US, me about the same amount in each. I think there are many places around the world where care is just as good as the local care one receives here in the US.

Traveling anywhere for health care, domestically or abroad, is an option for services than can be scheduled, delivered in a relatively short period of time, with a lower risk for complications, and not needing require significant follow-up. Our health insurance covers this type of care, but that is not why we have insurance. It is for sudden, unscheduled, unpredictable, longer term, emergency, or chronic care need. The cost of care is high in the US, so insurance is also costly, but the impact of no insurance can be catastrophic, so we bite the bullet.

As a curious anecdote, twice I had to travel for emergency medical care, once with DS and once with DD#2. They were real medical urgent situations. For DS it took around 10 days to make the arrangements, and with DD#2 around 3 1/2 weeks. The individuals involved in the arrangements responded to my pleas for urgency with practiced indifference. I particularly recall pleading with airline employees as they left us stranded in Miami because of their delay getting there.

 

[jim584672]

I think people should consider moving to another state if they have FIREd and are paying huge health insurance bills. One advantage to FIREing is location independence.

 

[Lstansbury]

Multiple married couples, in different CONUS locations, pay on the average $175 for 2 persons per month for concierge medical service. When and if something is needed, a little domestic travel is required, all lab work is done via multiple online (no Rx needed from MD) pre-paid labs, we arrive to facility with PDF docs in hand, discuss diagnostics, plan ahead and book travel in case surgical or expensive additional diagnostics needed. Very simple and very cost effective.

No such 31% cost is incurred. Multiple people below poverty, at poverty, above poverty incomes or no incomes. Works for all of us.

What is CONUS

 

[Lstansbury]

Love the info here, and by the way...I work in health care quality. The US is middle of the pack of industrialized countries when it comes to medical "outcomes". Just average.

 

[MichaelB]

What is CONUS

Continental Unites States

 

[Lstansbury]

Thank you!

 

[SheitlQueen]

I would definitely check out the ACA for your insurance until you turn 65, this is what I am doing. Retired at 61 and have insurance through ACA which pays for the bulk of my premium. Although I have a nice retirement nest egg, I live off of Social Security and rental income. So far (2 years into retirement) I haven't had to dig into any of my savings.

 

[street]

You have done a great job saving 800K plus! You know how to save and live below your means. You will be fine to retire with that kind of savings.

I know many people that never ever had that kind of money and had great retirements. Make a plan and watch what you spend and I bet at sometime you will have more then what you retired on.

 

[brucethebroker]

You have done a great job saving 800K plus! You know how to save and live below your means. You will be fine to retire with that kind of savings.

I know many people that never ever had that kind of money and had great retirements. Make a plan and watch what you spend and I bet at sometime you will have more then what you retired on.

1+

Also, it depends on how you invest your money. Planning on low interest CD's will take more money than stocks/bonds. Real estate, owned outright and self managed, will take less. If your expenses include a mortgage free home and no car payments you can get by on less income. Add a lower cost of income location, perhaps much less.

A friend has a small union pension, free health care and a modest paid off home. Hasn't had a car payment in 30 years. Has very cheap hobbies. He has been able to get by on much less than you have ($15k income or so). But if he wants to go crazy and buy something big, (newer used car, expensive vacation) he takes a PT job for a few months. Many here would not want that lifestyle, but he has been "retired" since age 49 (13 years) and would not change anything for the world. He is very happy, and does not worry about "market returns".

In short, it's all about the income (plus your expenses), not the net worth or amount of invest able assets.

 

[garyt]

Why is it all about healthcare?

Our entire family (all born in US) take medical trips overseas. For example, recently, business class round trip to Narita/Tokyo for MRI. Total cash price including an overnight stay, including ticket, including labs/MRI results, under $1000. No insurance needed and everything was handled in english at high tech facilities. Have done the same for dental work in Colombia, Costa Rica, other family members used a surgery center in India with US trained surgeons and ultra-high tech hospital with private rooms and 5 star food service. Typical cost is less than 10% of US prices.

There is also surgerycenterok.com where bypass cost inclusive of ALL possible complications is 10,700 cash. No insurance wanted or needed.

Again, why is it all about healthcare?

You have to admit that's an extreme way to manage healthcare and most people won't go that way. I'll give it consideration, though. So you have no HI and just pay the ACA penalty? What happens when it goes way up?

 

[garyt]

I would definitely check out the ACA for your insurance until you turn 65, this is what I am doing. Retired at 61 and have insurance through ACA which pays for the bulk of my premium. Although I have a nice retirement nest egg, I live off of Social Security and rental income. So far (2 years into retirement) I haven't had to dig into any of my savings.

Problem right now is, will the ACA be there in the next couple years? We could manipulate our income to qualify for the biggest subsidy. I'll wait till the air clears on the ACA or what's coming next.