Your Health Care Costs -

[starry night]

DH and I both attained age 65 this year, so left ACA to Medicare. Here is the reality of annual costs under Medicare for two:

Part B monthly premium $135.50 x 2 x 12 = $3,252
Part B Ann deductible $185 x 2 = $370
Med Supp Plan G for two $385 x 12 = $4,620
Part D RX plan $18 x 2 x 12 = $432
Dental plan x 2 = $220
——————————————————-
Annual total fixed expenses = $8,894

[bigreader]

Quote:

Originally Posted by ivinsfan I'm surprised at the cost of your insurance. One tends to think that HC in Europe it cheaper and in some cases almost free. The insurance company comment is interesting. My DH had a 200K plus surgery and hospital stay and we never had to make one phone call with a billing problem. We never paid one penny more then his deductible. It was hassle free.

Others can speak to this better than me, but the Swiss do it a bit differently than, say France or Italy. Those countries fund care from taxes and employ providers. The Swiss system is based on mandatory private insurance. Private doctors and hospital provide the services, which the insurance companies pay. The insurance is expensive but the care is fantastic.
I think of the Swiss system as a really high functioning example of what the ACA could have been.
BR

[jj]

Quote:

Originally Posted by starry night DH and I both attained age 65 this year, so left ACA to Medicare. Here is the reality of annual costs under Medicare for two: Part B monthly premium $135.50 x 2 x 12 = $3,252 Part B Ann deductible $185 x 2 = $370 Med Supp Plan G for two $385 x 12 = $4,620 Part D RX plan $18 x 2 x 12 = $432 Dental plan x 2 = $220 ——————————————————- Annual total fixed expenses = $8,894

Thank you - What dental plan is that?

[starry night]

Delta Dental basic plan. I will change at end of term to Costco Delta and save a few bucks.

[mistermike40]

Our premium ($17K/year) is paid by Megacorp, even in retirement. Our plan has a family max out-of-pocket of $7000 (less than $600/month)... this includes copays, prescriptions, ER/hospital stays, specialists, everything (as long as it's in-network). My wife is quite ill and we hit the Max OOP fairly early last year (and closing in on it for 2019) but we're very fortunate to have such an inexpensive plan.

[ivinsfan]

Quote:

Originally Posted by mistermike40 Our premium ($17K/year) is paid by Megacorp, even in retirement. Our plan has a family max out-of-pocket of $7000 (less than $600/month)... this includes copays, prescriptions, ER/hospital stays, specialists, everything (as long as it's in-network). My wife is quite ill and we hit the Max OOP fairly early last year (and closing in on it for 2019) but we're very fortunate to have such an inexpensive plan.

That's a great benefit. Do you have a Plan B if Mega cuts off your HI?

[mistermike40]

Quote:

Originally Posted by ivinsfan That's a great benefit. Do you have a Plan B if Mega cuts off your HI?

Agreed, especially given her situation it's a huge benefit. If Megacorp cuts back or stops funding our medical we'll take it out of our 401k (otherwise we haven't been touching it... with DW ill we really aren't traveling, etc and our pension covers all of our living expenses plus some extras).

DW turns 65 in a few years... at that point Megacorp is scheduled to give us a stipend for Medicare. I'm not sure how much, or how much we'll owe, but we'll be taking SS by then so we should be fine.

The cost of medical insurance still amazes me... it's probably the #1 thing in our country that's broken.

[bingybear]

Quote:

Originally Posted by ivinsfan That's unless you can control income to hit cost share on the OOP and deductible..

It's not useless, but not worth a lot.

I can't get deep in the cost sharing without restructuring my taxable assets. That in turn would incur significant cost.

There are bigger issues to plan around in my mind.

[ivinsfan]

Quote:

Originally Posted by bingybear It's not useless, but not worth a lot. I can't get deep in the cost sharing without restructuring my taxable assets. That in turn would incur significant cost. There are bigger issues to plan around in my mind.

Yes if you were younger it might be worth it but for short term not so much.

[Midpack]

Right at $11K in premiums for medical, Rx, dental-hearing-vision, no idea yet what our out-of-pocket costs will be other than highly variable year to year. I just started Medicare, DW will be COBRA/ACA for a couple years.

The state of health care in the USA is a disgrace, WAY overpriced (much more than any other country and on average twice the cost of all developed nations) without outcomes to support it, but we've had plenty of threads/discussions about that, and it's not going to change anytime soon...special interests have it all sewn up with campaign contributions.

[ivinsfan]

Quote:

Originally Posted by starry night DH and I both attained age 65 this year, so left ACA to Medicare. Here is the reality of annual costs under Medicare for two: Part B monthly premium $135.50 x 2 x 12 = $3,252 Part B Ann deductible $185 x 2 = $370 Med Supp Plan G for two $385 x 12 = $4,620 Part D RX plan $18 x 2 x 12 = $432 Dental plan x 2 = $220 ——————————————————- Annual total fixed expenses = $8,894

Not much different then the numbers for DH and I. This doesn't cover any drug costs either, which can add up quickly. My DH can use the VA for his meds which can help tremendously since they have a yearly cap on OOP drug expenses. Due to our location, the fact we like to travel and the great cardio team that saved his life, we only use the VA for his annual checkup. If we wanted to tweak our spend we could drop his supplement and simply pay the Medicare rate for his twice yearly cardio checkups.

This 9K number can be a big shock to someone on Medicare who has employed provided health care before turning 65. I think that's why people are flocking to the Advantage plan on paper they look a lot cheaper. But when the SHTF the bills can be tremendous.

[Bryan Barnfellow]

Quote:

Originally Posted by bigreader Others can speak to this better than me, but the Swiss do it a bit differently than, say France or Italy. Those countries fund care from taxes and employ providers. The Swiss system is based on mandatory private insurance. Private doctors and hospital provide the services, which the insurance companies pay. The insurance is expensive but the care is fantastic. I think of the Swiss system as a really high functioning example of what the ACA could have been. BR

You beat me to it, bigreader; but with the correct response to ivansfan's observation. But I'll add that my wife and I use one of the most expensive health insurance providers...there are cheaper ones and you don't need to get the supplemental, as we did; but we like ours and are very satisfied with the care, customer service and ease of use. I agree the Swiss system is like the ACA on steroids. I'm happy to pay a lower overall tax rate and then choose my HI. The Swiss tend to be very independent, so this system is unlikely to change.

There is no Medicare equivalent here; you just keep paying and using your private health insurance and if things go south financially, the canton will step in and help. Longer term, if you need old age services, there also is help for that. The key thing is that everyone must sign up for HI; no exceptions, so it really operates as a cross-demographic pooled risk venture.

With respect to ivansfan's experience with health insurer's, I can only say that our own experience in the US was filled with hassles and constant conflict with the HI. I'm glad to be rid of it.

-BB

[jj]

Quote:

Originally Posted by ivinsfan This 9K number can be a big shock to someone on Medicare who has employed provided health care before turning 65. I think that's why people are flocking to the Advantage plan on paper they look a lot cheaper. But when the SHTF the bills can be tremendous.

It's all relative, if you're used to paying $25,000/year, with a 5 digit max oop on top, then $9,000 looks like a bargain. When you're used to highly subsidized employer HI, $9,000 seems like daylight robbery, maybe more with IRMAA.

[jollystomper]

Quote:

Originally Posted by Carpediem I would have 4 years to cover with COBRA and ACA. This thread is making me nervous. I had planned to use some of the cash bucket for 2 of the years in order to get subsidies. Maybe I should plan on 18 mos of COBRA (approx $1100/mth), 2 years of ACA subsidies ($0/mth), and 1 year full cost ACA (approx $1500/mth. (The reason for no subsidies the last year is not to drain the entire cash bucket.)

I delayed my retirement for 2 years primarily to set aside money for health premium costs. We are not eligible for subsidy and my estimate was $24K a year for premiums and potential deductibles.

The delay of 2 years left me with current family coverage of $400/month on COBRA, which goes through the end of this year. from 2020-2022, based on the terms of my retirement, it will be around $18K/year for just my wife and I. Then it is Medicare time As far as I am concerned, Medicare under $10K a year I will consider a bargain.

[Markola]

Quote:

Originally Posted by starry night DH and I both attained age 65 this year, so left ACA to Medicare. Here is the reality of annual costs under Medicare for two: Part B monthly premium $135.50 x 2 x 12 = $3,252 Part B Ann deductible $185 x 2 = $370 Med Supp Plan G for two $385 x 12 = $4,620 Part D RX plan $18 x 2 x 12 = $432 Dental plan x 2 = $220 ——————————————————- Annual total fixed expenses = $8,894

Super helpful. Thank you.

[Markola]

Quote:

Originally Posted by Midpack The state of health care in the USA is a disgrace, WAY overpriced (much more than any other country and on average twice the cost of all developed nations) without outcomes to support it, but we've had plenty of threads/discussions about that, and it's not going to change anytime soon...special interests have it all sewn up with campaign contributions.

Yeah, and it’s not like it’s a fair disagreement between those who want government to pay vs. the free market, because this industry won’t even post their prices.

[jimandthom]

These numbers are for both of us.

Part B $3252
Aetna Direct thro FEHB $3660 includes RX
Dental/Optical $540

Total $7452

Aetna Direct supposedly is no deductible, copay, coinsurance assuming the provider accepts Medicare assignment. RX excluded for no deductible etc.

There is also an $1800 reimbursement account for use on any medical costs. We intend to use the account for reimbursement of Part B premiums.

We have a potential bargain price of about $5650 for premiums per year. Really fortunate to have this.

[Teacher Terry]

I have a few friends on advantage plans and when they had a serious illness they paid really well. Probably varies by location.

[ziggy29]

Quote:

Originally Posted by Teacher Terry I have a few friends on advantage plans and when they had a serious illness they paid really well. Probably varies by location.

I'm sure it varies a lot by location. A lot of advantage plans don't cover people outside of metro areas. My wife is in a plan where they offer a good Medicare supplement plan for retirees for a pretty good price, but it is mostly only available in urban and metro suburban counties. We are not exactly in the total boonies but we are not in a covered county.

[ivinsfan]

Quote:

Originally Posted by Teacher Terry I have a few friends on advantage plans and when they had a serious illness they paid really well. Probably varies by location.

Not that they don't pay. the OOP can be really high, limitations on doctors and areas that you can use may be very strict. The Advantage plans do not bill at the official Medicare approved rate. They can set their own rates and co-pays...