Your Health Care Costs -

[Teacher Terry]

These are people who live on SS only so they must not be paying much or they would be unhappy.

[Old Microbiologist]

I am shocked when I see figures like in this post. Apparently everyone has swallowed the koolaid and accepts this as a given.

We retired to Hungary and our health care is all on a cash basis. We never exceed $4000 a year even with major incidents. For example my wife spent a week in cardiac intensive care for right atrial fibrillation with all tests, intraarterial scan etc. which cost under $2000. She also broke her leg requiring major surgery and that cost $1200. My point is good medicine doesn't have to be expensive. But, you have to leave the United States to get it.

[Zona]

We each have a Grandfathered Blue Cross Plan (pre-ACA - we've had it since 2005). Paid entirely out of pocket since we are self-employed. Have kept it all these years because we are planning to retire early. Never was able to make the ACA exchange numbers work better, given our income, and our home state's options (AZ).

My premiums/year: $4020 (43 yo female).
DH premiums/year: $4320 (47 yo male).

Our OOP max for in-network is 10K. Each. Luckily we are young, and healthy-ish. No major prescriptions or chronic conditions. But that can change on a dime. Worst case scenario if we both get very sick and stay totally in-network we are looking at nearly $30,000 in a given year. The uncertainty of future healthcare costs makes it really difficult to say with certainty we are ready to FIRE, since we have a very long marathon until Medicare age.

We use Quicken, and I've tracked these costs over time. Based on 9 years of historical data I budget $12,650/yr including premiums and OOP spend. Then in Quicken lifetime planner, I project our individual medical expenses as a "Special Expense" that has an inflation rate of 10% per year, each year until we are Medicare age. I based the 10% on the fact that there have been some years where the premiums have increased 10%, as well as the expectation that we will actually use more healthcare services as we age, so our out-of-pocket portion will increase accordingly.

I feel like this is one area where you can't be too conservative in your planning.

[Shardo]

For just myself, $827/month with $2000 deductible for UHC thru previous employer.

My Sweetie is still working and has hers thru the state of SC.

Can't wait for medicare next May, should save a bundle.

[iloveyoga]

Quote:

Originally Posted by Markola 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.

+1 Our HC costs are easily our largest expense.

[Dtail]

Quote:

Originally Posted by iloveyoga +1 Our HC costs are easily our largest expense.

Our 4th highest cost so far, but will probably move up the list in the coming years.

[copperdogs]

DH 64; Moi 59. FIRE’d x 4 years.
Generally good health so far—staying active and try to manage stress.
No meds yet for me; DH on 4 generics.

(With market subsidy)
Medical Premiums $4872/yr. (no dental, no vision)
Office Copays $380/yr ($70 specialists, $35 primary care)
Rx copays (incl vitamins, OTC’s) $300/yr (Mexico Pharma reduces this cost if we make the drive during winter stay in AZ)
Vision: some years $3-5/yr dollar store readers; others $1800/yr DH cataract lens
Dental: $350-500/yr (2 cleanings each, xrays if needed, one dentist exam each)
The year we both needed implants? $9000

Our yearly combined medical insurance OOP max $14,500, a number we’ve not hit (yet). As a retired RN routine medical costs for us are somewhat lowered due to basic issues being managed at home without needing to introduce outside care.

Our Plan B if subsidy became unavailable was always to begin outsourcing all dental care and prescriptives to Mexico. When DH goes on Medicare in 6 months I don’t expect a significant change in costs overall for us.

Like most who have posted, health care costs consistently remain the number one expense in FIRE. I agree with other posters that adequate and realistic planning is absolutely necessary in this area. Having children still at home in addition to needing to cover a 20 year gap before MDC would have been an absolute financial FIRE deal breaker for us, as we had moderate incomes and likely could not have saved the enough to fund both.

[ivinsfan]

copperdog, you will see changes as the number you pay with a single subsidy will go up or at the least not go down...to that you add a Part B and Medicare supplement plus additional for drug coverage..

[Emerson11]

Quote:

Originally Posted by Markola 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.

I retired early over a decade ago and used an HSA high deductible policy early on, and it was very affordable. Then came ACA and premiums and deductibles soared. Living healthy gets you no price break. My vacation and "fun" budget now goes to health insurance premiums and out-of-pocket expenses. Too much income for subsidy, but not enough income to be comfortable with the high cost of insurance. If you eat right and exercise, you are forced to subsidize those who don't.
Additionally, government prohibits the sale of catastrophic illness/accident policies.
My husband's Medicare supplement and RX policy have risen similarly, and worse still, many doctors will not except the low reimbursements provided by medicare.
My point -- expect 20% or more annual increases in health insurance premiums, and be prepared to keep buying private insurance when you reach medicare age.

[Doribe]

My cost is about 12k/year. This was my estimate before RE and it is still close.

DH Medicare 135.2 x 12 =1,620
DH Advantage 110 x 12 = 1,320
DH deductible 350
DH meds 350
DH typical copay(15%) 200
DH Dental (no ins) 2,000
DH Glasses (no ins) 200
DH subtotal 6,040

DW BCBS premium 450 x 12 = 5,400
DW deductible 350
DW copay 0
DW RX 20
DW dental (no ins) 537
DW glasses (no ins) 100
DW subtotal 6,407

Total 12,447

[Emerson11]

"DW BCBS premium 450 x 12 = 5,400
DW deductible 350"

Gosh, I'm 58, and pay $741/mo for BCBS with $6500 deductible. I must be living in the wrong state!

[jj]

Quote:

Originally Posted by Emerson11 "DW BCBS premium 450 x 12 = 5,400 DW deductible 350" Gosh, I'm 58, and pay $741/mo for BCBS with $6500 deductible. I must be living in the wrong state!

I'm guessing there's a subsidy for that BCBS HI...? My Bronze HSA policy with no subsidy is similar to yours, age 59.

[Teacher Terry]

Emerson, eating healthy and exercising is no guarantee of having no health issues. It’s insulting.

[Emerson11]

Quote:

Originally Posted by Teacher Terry Emerson, eating healthy and exercising is no guarantee of having no health issues. It’s insulting.

You're correct, I should have simply stated that the healthy must pay at the same rate as the unhealthy. Some think that's fair. I do not.

[Winemaker]

Quote:

Originally Posted by Emerson11 You're correct, I should have simply stated that the healthy must pay at the same rate as the unhealthy. Some think that's fair. I do not.

Well, that's why it's called insurance pools. It's bad enough we are monitored by our we site choices, credit card usage, grocery discount purchases, type of car/mileage reporting, and facial recognition. I'd hate to have the food insurance police go through my pantry, give me a ticket for a hot dog at the game, or write up a citation because I sat on my arse one day to watch a couple of football games.

And the same thing could be said for paying taxes, why do the wealthy pay a higher rate? Life isn't fair.

[Teacher Terry]

People with cancer can barely survive if too sick to work even with insurance. As a civilized society we take care of each other.

[Emerson11]

Insurance pools could be based on folks of similar age, weight, smoking/non-smoking etc. It wouldn't require "food insurance police." That said, I respect your right to have a different view of economics, taxes, insurance and fairness than I. The bulk of our population agrees with you.

[Moemg]

Quote:

Originally Posted by Emerson11 Insurance pools could be based on folks of similar age, weight, smoking/non-smoking etc. It wouldn't require "food insurance police." That said, I respect your right to have a different view of economics, taxes, insurance and fairness than I. The bulk of our population agrees with you.

Even people who eat right and exercise get awful diseases .No one gets out of here alive .My uncle died in the Philadelphia marathon .

[kimcdougc]

We pay $1,827 per month for a gold plan on the ACA for me (age 59) and DH 61. $1,000 deductible. I have an ongoing monthly check on my INR checkup. Had open heart surgery in 2013 and had my aortic valve replaced with a mechanical valve. I am on a low dose warfarin for the rest of my life. I was born with a 2 flap valve verses a 3 flap valve.

I also pay $86 per month for us both dental insurance with Metlife take along dental. It covers up to $2,000 per year each.

Vision - out of pocket.

I also include in my budget $500 per month for deductibles and my 20% co pay.

Health care is by far the most expensive bill in our early retirement. Added together I budget around $30,000 for healthcare, dental and vision.

So far in the 4 years we have been on ACA our plan has went up $500 per month since its inception and there are fewer and fewer choices each year to choose from and I live in the progressive state of Washington. It is not affordable for most. Just my two cents.

[Teacher Terry]

Kim, that’s awful. We couldn’t afford that.