Your Health Care Costs -

[ownyourfuture]

This is one depressing thread. How the United States ended up with such a warped health care non-system is one of our nation’s greatest failures.

AAA+++

 

[Markola]

Unsubsidized private HDHP costs just under $20,000 per year for two adults, 59, 64 and one dependent. I hope to contain healthcare (medical, dental, vision) costs to <$30,000/year. In 2018, with minor surgery and some substantial dental work we reached $38,500. The excess came out of the vacation budget.



Do not underestimate how much insurance premiums increase from your 40s to your 50s and beyond.



Going on Medicare will reduce these costs somewhat.

It sounds like you’ve estimated Medicare benefits. Curious if you’d define “somewhat”? I was under the impression Medicare was a very substantial savings. Maybe your one dependent continues to drive up costs even after Medicare?

 

[mamadogmamacat]

to get back to OP's original question
as a single female in late fifties and 3 yrs into ER with a non ACA expensive mega corp plan my total health care expenses for each yr were 8600, 9000, and 9800 consisting of mostly premiums it would have been twice that amount if i had gotten sick enough to hit the OOP max but fortunately I've been so far relatively healthy

so my personal heath care inflation rate in retirement has been between 5% and 9% per yr so far. So inflation in health care has been far greater than for other expenses. yet another consideration for you. Sorry to be such a downer

 

[SumDay]

It sounds like you’ve estimated Medicare benefits. Curious if you’d define “somewhat”? I was under the impression Medicare was a very substantial savings. Maybe your one dependent continues to drive up costs even after Medicare?

DH has been on Medicare for 11 months, so I'll give our take. Monthly, Part B is $135.50, Supplement G (which puts the Medicare $185 deductible on you) is $146 and his Part D Silver Scripts is $30. We have some co-pays with most prescriptions which haven't been ridiculous so far, and other than that, everything is pretty much paid 100%. I'm 62 and counting the days until I'm on it. My HDHCP Retiree Medical is $6k a year, so my costs plus his minimal Medicare premiums make MEDICAL our biggest expense.

 

[Bryan Barnfellow]

Health Care Costs in Switzerland for me and my spouse:

Health Insurance: 17,040 Swiss Francs annually (about same in $USD right now). This is the mandatory standard insurance that everyone has plus an optional supplemental plan, which pays for some addtional services, alternative treatments, etc. About 30% of Swiss residents get the supplemental. The basic plan is equivalent to the old gold standard Blue Cross/Blue Shield, 20 years ago or so.

There are dozens of nonprofit companies which do the insuring, under strict overview by the Swiss government. It's very rare for an employer to pay your insurance bill; virtually everyone pays for it themselves and its portable from job to job, and then to retirement. You have the option to switch health insurers every November without any hassle. The government (cantonal) will help people whose income is low to pay for their health insurance via subsidies, so that nobody ever goes without proper health care. There is no political jerrymandering with health insurance, which is a breath of fresh air. However, people have complained about rising premium costs. Last three years our went up 1%, 3%, and 3.5%. So, I'm not complaining. After our rental costs and taxes (Swiss plus US), health care is our largest expenditure. I retired at 59 with no worries about health care in the equation.


Prescription Drugs: Included in health insurance.
Hospitalization: Included in health insurance (but with annual deductibles).
Co-Pays: 10% up to max of 700 francs annually each.
We budget for the max co-pays and hospital deductibles each year.

US Medicare deduction from Social Security: $135.50 each, monthly, to avoid the premium increase penalty if we ever decide to return to the US.

There are no limits on lifetime payout, no issues with pre-existing illnesses, no pre-approval of what your doctor determines is best treatment. And the health insurer, in our case, has always just paid the bills (we use their mobile phone app to scan and submit the medical invoices we receive, in cases where the medical provider doesn't just bill the insurer directly). This is so different from our days in the US, when my wife spent upwards of 5 hours a week dealing with miscoded treatments, balking insurers, pre-approvals, incorrect bills, promised callbacks that never came, and so on. Premiums can increase (by law) only due to higher costs overall and the experience of your age cohort (e.g., after 65, there is a bump up...about 7% for us). And hte cantonal government negotiates rate increases to protect its citizens. There are no increases due to our own use of medical care. Acupuncture, holistic therapies, and spa treatments are also covered by the supplemental insurance.

Hope this comparison is useful in some way.

-BB

 

[scrabbler1]

I pay about $650 per month, unsubsidized, for a Silver ACA plan. I pay another $100 a month for OOP costs such as copays and dental. One person.

 

[MarieIG]

Yea, Our niece was covered by the U.K. National Health System when she came down with uterine cancer. Instead of quick surgery, they had a conservative protocol of a couple rounds of chemo and radiation over a period of a year.

We buried her in Memphis 4 years ago this month--after a 18 month fight.

The worst part is that there are plenty of healthcare professionals in this world that know how to solve our healthcare problems. Let me just say politics just get in the way.

https://www.formosapost.com/pros-and-cons-of-universal-health-care-in-the-united-kingdom/

That is tragic.

I found this pro and con article about the health system. Interesting, Mick Jagger had his heart surgery here, not there.

 

[Another Reader]

Since going on Medicare last December, my costs have been $0.00. Part B, the Part D plan, co-pays and the supplement are paid by the retirement system. The supplement, the Part D plan, and the co-pays are paid through an HRA. Part B is reimbursed through a fund that is set up to do this but could run out of money at some point. Not guaranteed for life.

At some point I will have to pick up IRMAA. Looks like 2020. I expect to pick up more of the costs as premiums increase faster than the HRA. Right now, I'm making up for 12 years of the overpriced HMO.

 

[jj]

It sounds like you’ve estimated Medicare benefits. Curious if you’d define “somewhat”? I was under the impression Medicare was a very substantial savings. Maybe your one dependent continues to drive up costs even after Medicare?

I estimate that once my spouse is on Medicare our annual premiums will drop from about $20k/year to maybe $15k. The oop max per year will be lower with a medigap plan. This will at least stop our healthcare going up at such a fast rate as the past few years. My private HI premium will get higher and higher and our dependent's premium will stay around $270/month. Dental and vision carry on as normal.

Healthcare will continue to be our largest single expense until I am on Medicare. Even after that, I see it being a major expense for us at around $15k/year, including co-pays, dental etc.

 

[Markola]

Thanks for sharing your numbers.

 

[bingybear]

Quote:
Originally Posted by MichealKnight View Post

*$1500 per month, health insurance

(Bronze Level ACA plan where I pay 40%.)

I think anyone considering early retirement should be aware of the unsubsidized price of health insurance and have a “Plan B” in case the subsidy goes away.

The use of subsidy is not relevant to the topic. The cost of health care to the OP is post subsidy.

I have not taken the subsidy option yet ( this is also off topic) Our health expenses have varied quite a bit in ER with the most being the cost of insurance (bronze HDHP) plus about 4k. most of this was dental crowns between both of us.

I expect in a couple years we will break the bank when I get my pacemaker changed out.

 

[ivinsfan]

Health Care Costs in Switzerland for me and my spouse:

Health Insurance: 17,040 Swiss Francs annually (about same in $USD right now). This is the mandatory standard insurance that everyone has plus an optional supplemental plan, which pays for some addtional services, alternative treatments, etc. About 30% of Swiss residents get the supplemental. The basic plan is equivalent to the old gold standard Blue Cross/Blue Shield, 20 years ago or so.

There are dozens of nonprofit companies which do the insuring, under strict overview by the Swiss government. It's very rare for an employer to pay your insurance bill; virtually everyone pays for it themselves and its portable from job to job, and then to retirement. You have the option to switch health insurers every November without any hassle. The government (cantonal) will help people whose income is low to pay for their health insurance via subsidies, so that nobody ever goes without proper health care. There is no political jerrymandering with health insurance, which is a breath of fresh air. However, people have complained about rising premium costs. Last three years our went up 1%, 3%, and 3.5%. So, I'm not complaining. After our rental costs and taxes (Swiss plus US), health care is our largest expenditure. I retired at 59 with no worries about health care in the equation.


Prescription Drugs: Included in health insurance.
Hospitalization: Included in health insurance (but with annual deductibles).
Co-Pays: 10% up to max of 700 francs annually each.
We budget for the max co-pays and hospital deductibles each year.

US Medicare deduction from Social Security: $135.50 each, monthly, to avoid the premium increase penalty if we ever decide to return to the US.

There are no limits on lifetime payout, no issues with pre-existing illnesses, no pre-approval of what your doctor determines is best treatment. And the health insurer, in our case, has always just paid the bills (we use their mobile phone app to scan and submit the medical invoices we receive, in cases where the medical provider doesn't just bill the insurer directly). This is so different from our days in the US, when my wife spent upwards of 5 hours a week dealing with miscoded treatments, balking insurers, pre-approvals, incorrect bills, promised callbacks that never came, and so on. Premiums can increase (by law) only due to higher costs overall and the experience of your age cohort (e.g., after 65, there is a bump up...about 7% for us). And hte cantonal government negotiates rate increases to protect its citizens. There are no increases due to our own use of medical care. Acupuncture, holistic therapies, and spa treatments are also covered by the supplemental insurance.

Hope this comparison is useful in some way.

-BB

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.

 

[ivinsfan]

Quote:
Originally Posted by MichealKnight View Post

*$1500 per month, health insurance

(Bronze Level ACA plan where I pay 40%.)



The use of subsidy is not relevant to the topic. The cost of health care to the OP is post subsidy.

I have not taken the subsidy option yet ( this is also off topic) Our health expenses have varied quite a bit in ER with the most being the cost of insurance (bronze HDHP) plus about 4k. most of this was dental crowns between both of us.

I expect in a couple years we will break the bank when I get my pacemaker changed out.

You can always upgrade your plan as your switch out get closer...

 

[bingybear]

You can always upgrade your plan as your switch out get closer...

That is the plan if I can determine the correct year. But the gains are not that much. To lower the deductible you pay a good % more. IIRC I'd pay $1500 to drop the deductible $3k.Worth doing if I pick the right year. A wash if not. There are multiple levels to drop deductible.

 

[ivinsfan]

That is the plan if I can determine the correct year. But the gains are not that much. To lower the deductible you pay a good % more. IIRC I'd pay $1500 to drop the deductible $3k.Worth doing if I pick the right year. A wash if not. There are multiple levels to drop deductible.

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

 

[starry night]

HC costs on Medicare

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]

Insurance Costs in Switzerland

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]

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]

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]

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]

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]

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.