61 y/o trying to decide when to retire

[RetMD21]

I am 61, a physician, the wife is 59 and we are trying to decide when to retire. We have done the lbym thing for years. The portfolio would support our lifestyle with a very low withdrawal rate but health insurance uncertainty has me worried. At the earliest it would be a year from now but I don't want to start my exit strategy if the individual health insurance market is going to collapse. Leaving the county would be hard due to family obligations- children and parents. Anyway I thought I would say hello.

 

[FrugalLady]

Hello and welcome. I understand your concern over healthcare. I would be fully retired if I knew I could obtain affordable healthcare for the next 15 years. However, instead of full retirement I settled for semi-retirement working 30 hours per week to maintain health coverage. Semi-retirement may be an option for you to consider. It at least buys you more free time, and can be a good transition to full retirement.

 

[FlaGator]

Welcome.

I'm on a different side of the health insurance market than you, but am not worried about it collapsing. Getting even more expensive? I think that's a given.

My view is there is too much political and social concern for it to collapse, same with Social Security. I expect there will be more changes ahead, and my annual costs will continue to increase. I'm budgeting accordingly.

 

[FireFool]

The uncertainty of healthcare certainly is a common concern, one I share being already retired and also being younger than you. The thing that got me to get over that was the fear of collapsing before I ever got to enjoy retirement.

 

[robnplunder]

Don't waste your life. Retire now. If you are afraid of something like a potential health insurance industry collapse, you will never be able to retire. There are other worse things that can collapse that can dampen everyone's retirement but people find ways to retire and thrive. Many of the retirees here survived 2008-2009 market collapse and recession.

 

[urn2bfree]

Fellow physician here. Retired 4 years ago and love it. My wife - a physician -is paralyzed by the same health care coverage concerns you have - we could afford a few years of absurd insurance premiums but her fear is a return to non protection of pre- existing conditions (with age being the condition that used to make it virtually impossible to purchase health insurance if you were over 55). Eventually she will come around.

 

[joeea]

The portfolio would support our lifestyle with a very low withdrawal rate but health insurance uncertainty has me worried. At the earliest it would be a year from now but I don't want to start my exit strategy if the individual health insurance market is going to collapse.

That's understandable.

But you won't have many years before reaching Medicare age. I suppose that could collapse as well, but it seems less likely. I expect healthcare to get more expensive, but hopefully not prohibitively so for most of us.

How bad would the market have to get before you couldn't afford it? How close to the edge are you with your portfolio?

 

[RetMD21]

FrugalLady although I like the idea of part time work there isn't precedent in the group I work for. I may propose it but the nature of the work doesn't lend itself to this very well.

Flagator I am interested in Arizona and there is only one marketplace insurer for the county I am favoring. So maybe the system hasn't collapsed but it doesn't look like there is competition.

FireFool and RobnPlunder: It's impossible to predict what will happen so for quality of life reasons I am looking at retiring but as urn2befree points out the potential loss of ability to buy insurance at any price due to preexisting conditons used to be an issue and could happen again.

joeea, I am not close to the edge at all so if insurance based only on age is available I'll be able to afford in when few others can. Sticking around to 65 is doable so I am keeping my mouth shut at work.

 

[OldShooter]

... I like the idea of part time work there isn't precedent in the group I work for. I may propose it but the nature of the work doesn't lend itself to this very well. ...

I ER'd at 56, my wife at 58. The megabank she worked for had a retiree health plan that we could stay on until we hit Medicare. Megabank actually contributed a fixed $400/month and we paid the balance of the (increasing) premiums. The only hitch was that the risk pool was all the retirees in the program, not all the employees in the bank. So it was more expensive than it could have been. But overall we liked it a lot.

Sort of a longer-term COBRA.

Maybe your practice group benefits person could figure out something like this and you could propose it to your partners. You are not the only one who will be facing this issue in the future, so others might readily support it.

 

[MBAustin]

Welcome RetMD21! If you haven't found them already, we have a helpful list of things to think about as you're considering when to retire:

Some Important Questions to Answer

Keys are to have a good handle on your spending, be willing adjust it down on the discretionary side if healthcare expenses are high, and successful modeling in FIREcalc and/or other reputable retirement calculators.

Personally, given what happened regarding healthcare over the past 12 months, I don't think it's likely that pre-existing conditions coverage will completely go away in the next 6 years (or ever for that matter). But I definitely understand the concern.

 

[ivinsfan]

FrugalLady although I like the idea of part time work there isn't precedent in the group I work for. I may propose it but the nature of the work doesn't lend itself to this very well.

Flagator I am interested in Arizona and there is only one marketplace insurer for the county I am favoring. So maybe the system hasn't collapsed but it doesn't look like there is competition.

FireFool and RobnPlunder: It's impossible to predict what will happen so for quality of life reasons I am looking at retiring but as urn2befree points out the potential loss of ability to buy insurance at any price due to preexisting conditons used to be an issue and could happen again.

joeea, I am not close to the edge at all so if insurance based only on age is available I'll be able to afford in when few others can. Sticking around to 65 is doable so I am keeping my mouth shut at work.

It's very worrying when even the providers of Healthcare are worried about the system imploding ...one would think the providers have a birdseye view and know more then an ordinary citizen..

Perhaps you would need to put fulltime Arizona on the back burner for awhile until you both get closed to 65. I wouldn't willingly settle in an area with only one provider..... if you want to snowbird in AZ and have a good PPO network that would be a good option..

 

[PartIrish]

Since you mentioned Arizona, I will chime in and report that the single remaining ACA marketplace insurance option here in AZ has a very poor reputation for not paying claims, delayed payment, etc. I am retired from one position that was covered by AZ state retirement (teaching) and now work in the private sector. The health insurance I get through the state retirement system, while better than the ACA option, is quite expensive. There are not many good options here until Medicare, and I have 4.5 years to go until then. But for the failing health insurance markets with its steep price inflation, I would be retired by now.

 

[DrRoy]

Don't waste your life. Retire now. If you are afraid of something like a potential health insurance industry collapse, you will never be able to retire. There are other worse things that can collapse that can dampen everyone's retirement but people find ways to retire and thrive. Many of the retirees here survived 2008-2009 market collapse and recession.

+1

 

[robnplunder]

FrugalLady although I like the idea of part time work there isn't precedent in the group I work for. I may propose it but the nature of the work doesn't lend itself to this very well.

Flagator I am interested in Arizona and there is only one marketplace insurer for the county I am favoring. So maybe the system hasn't collapsed but it doesn't look like there is competition.

FireFool and RobnPlunder: It's impossible to predict what will happen so for quality of life reasons I am looking at retiring but as urn2befree points out the potential loss of ability to buy insurance at any price due to preexisting conditons used to be an issue and could happen again.

joeea, I am not close to the edge at all so if insurance based only on age is available I'll be able to afford in when few others can. Sticking around to 65 is doable so I am keeping my mouth shut at work.

Good decision. Mentally, I don't think you are ready to retire. Rather, IMO, you posted the OT to convince yourself NOT to RE. I understand that and probably did the same before things got so bad at work and pulled my own trigger. Good luck and best wishes! And if you want to reconsider, don't get into the mindset that some potential event (market crash, bank run, nuclear disaster, ...) can ruin your nest egg. If you are one such worrier, you will never be ready to RE.

 

[swakyaby]

It's very worrying when even the providers of Healthcare are worried about the system imploding ...

It's actually a very common concern among physicians who are considering retiring before medicare age, that paying for individual insurance for themselves and their spouse might consume a higher percentage of their annual expense budget than anticipated, and that the possible collapse of the ACA might bring pre-existing conditions back. I don't personally know any physicians in group practice that have retiree health benefits. I fretted about the unpredictable cost of health care for 3 years before early retiring.

 

[brucethebroker]

Personally, given what happened regarding healthcare over the past 12 months, I don't think it's likely that pre-existing conditions coverage will completely go away in the next 6 years (or ever for that matter). But I definitely understand the concern.

The pre-existing condition horse has fled the barn. IMHO, it may be modified (if you don't currently have insurance, perhaps a waiting period when you finally buy it. But those with insurance will be able to switch plans without proof of insurability).

Similar worries are common on this forum regarding "maybe" changes in SS retirement benefits (reductions, means testing), stock market crashes, etc. "What if's...." are a terrible way to live your life. Plan as best you can and adapt if things change. As mentioned earlier, you have a short time frame until Medicare rides to the rescue.

 

[Scout]

Fellow doc here.
I agree with other's sentiment of getting out now. I'm not sure what type of doc you are, but if the system brought back a pre-existing condition clause or collapsed in another way could you not re-enter your practice in some capacity? Would you even need to? What do you honestly think the chances are of a pre-existing clause making its way back? I can't imagine either party going for it at this juncture (certainly not trying to be political). Don't waste half of a perfectly good decade worrying about an extremely unlikely event. You know as well as I that the odds are probably greater that you could have a personal life changing event late 60's and you'd want those years back. You've worked hard for many years in a stressful job. Enjoy yourself!!

 

[jollystomper]

Don't waste your life. Retire now. If you are afraid of something like a potential health insurance industry collapse, you will never be able to retire. There are other worse things that can collapse that can dampen everyone's retirement but people find ways to retire and thrive. Many of the retirees here survived 2008-2009 market collapse and recession.

+1

Our insurance premiums will go up 5x-6x annually when I retire, before Medicare eligibility in 5 years. I have gone through calculations and have the projected premiums amount set aside. I can think of a lot better things I would rather spend the money on, but with the tradeoff of more time and much lower taxes it will be worth it. I might be way off or overly conservative, but I will never know at this point. I just plan for what I know now, and am prepared to adjust. The tradeoffs will make it worth while.

 

[Dreaming of Freedom]

You can get on Cobra from age 63.5 until Medicare/65, right? I am only 41 and my husband is 59, and I would like to ER in the next year or two, but I am terrified of the state of health insurance in this country. I don't know if the legislators care about the will of the people anymore, so I believe that pre-existing condition limitations could return. Also, the networks of the individual plans where I live have gotten so tiny and there is no out of network coverage at all; it is like not having insurance at all. Better hope the one hospital you can go to does not have an ER that goes on bypass all the time. Anyway, if anyone one here does know of a state that has good PPO insurance plans with some out of network coverage, please let me know. We are willing to move for decent health insurance! In fact, I am so frustrated with health insurance/ healthcare in the US, I am seriously considering retiring to Mexico in a year or two. I would love to learn about other options to research though. I worry death could come even faster if I become underinsured and can't obtain treatment for something super costly like treating breast cancer.

 

[target2019]

I am 61, a physician, the wife is 59 and we are trying to decide when to retire. We have done the lbym thing for years. The portfolio would support our lifestyle with a very low withdrawal rate but health insurance uncertainty has me worried. At the earliest it would be a year from now but I don't want to start my exit strategy if the individual health insurance market is going to collapse. Leaving the county would be hard due to family obligations- children and parents. Anyway I thought I would say hello.

Hello!
Everyone has health insurance concerns. I am waiting until 65, at a minimum, for this reason. Spouse is 3 years younger, and for now we feel she will stay in the job after I retire, for her health insurance.

Rather than a complete exit, is it feasible to stay involved, but with lesser scale, meaning pay and duties?

 

[brucethebroker]

You can get on Cobra from age 63.5 until Medicare/65, right? I am only 41 and my husband is 59, and I would like to ER in the next year or two, but I am terrified of the state of health insurance in this country. I don't know if the legislators care about the will of the people anymore, so I believe that pre-existing condition limitations could return. Also, the networks of the individual plans where I live have gotten so tiny and there is no out of network coverage at all; it is like not having insurance at all. Better hope the one hospital you can go to does not have an ER that goes on bypass all the time. Anyway, if anyone one here does know of a state that has good PPO insurance plans with some out of network coverage, please let me know. We are willing to move for decent health insurance! In fact, I am so frustrated with health insurance/ healthcare in the US, I am seriously considering retiring to Mexico in a year or two. I would love to learn about other options to research though. I worry death could come even faster if I become underinsured and can't obtain treatment for something super costly like treating breast cancer.

You are buying into much of the "crisis" reporting of health insurance by the media. Out of network does not mean no coverage (emergency care must be provided by law at any hospital). My DW has restricted network coverage, but we still travel the USA. If you are considering moving, go to the ACA marketplace online, and plug in zip codes in other states. And talk to a local health insurance agent in your area about your options. Do your research, it may not be as bad "out there" as you have been led to believe. Don't let health insurance keep you from chasing your dream of ER.

 

[EastWest Gal]

OP, look into locum tenens work. Years ago I worked with Weatherby, and our group uses them. Work as much or as little as you want. They don't offer health insurance directly, but as a self-employed physician, you get serious tax breaks on health insurance premiums (they are taken off 100%) on the first page of your 1040. The National Association of Self Employed (NASE) has access to insurance.

In theory, you could work a few days per month or take a full time assignment somewhere you want to live. The company pays housing, transportation, and meals. They cover malpractice insurance as well.

While I was writing this, I peeked at job openings in the west. There was a position in Hawaii that was M-F with no call. Something like that would be a no brainer.

You have more flexibility than you realize.

After 3 years, two years working part time as an independent contractor and one year off, I decided to go back. I'm working 11 hospital shifts/month and I get full benefits. I did it for health insurance stability.