WyomingLife
Recycles dryer sheets
Jaw-dropping, worst-case health care cost estimates
This is a great thread; thank you all again.
I continue to fret about health care costs for those FIRE'd, not on a company plan, and not yet 65. And also with a significant disease. Stuff does indeed happen, and indeed, I think health stuff happens fairly commonly, certainly as one moves into their 50's and heads towards their 60's. I know exceedingly fit people who have died of heart attacks or cancer in their 50's.
I tend to plan based on worst cases. So today using the ACA exchange, I calculated the following ACA premiums for two people (non-smokers) from ages 61 to 64, applying an escalating inflation factor. I did not consider subsidies (again, being conservative). And I also added in the maximum cost of deductibles and co-pays on top of the premiums, which is what the exchange advises you to do to come up with total costs. I assumed, in other words, that a person completely maxed out coverage every year.
(Note: I also fiddled with HealthSherpa; and I'm aware of the religious-based exemptions/approaches to the ACA). Anyway, I came up with the following total annual costs for the four hypothetical years for a couple (two people) passing through ages 61 to 64:
$52,700
$54,900
$57,100
$59,300
Another wrinkle. None of the plans available to me on the exchange covered the top hospitals, and similarly, some of the top hospitals, so I've come to learn, tend not to accept ACA plans.
So let's say one of the couple has major cancer, too. Despite paying the outrageous premiums above, you can neither continue, nor initiate, cancer treatment at the best hospitals unless you self fund. The numbers are all over the place for self funding, but I read somewhere that for a generic cancer treatment that included surgery and some post-surgery care, the total bill could approach $170,000 at a top hospital.
I realize the future is unknown. A meteor could strike my house tomorrow. The odds of anybody maxing out insurance for four straight years is also outrageously remote. One could go crazy pondering the billion of disasters that could strike tomorrow. Cancer could be cured tomorrow. Still, I find it hard to ignore the numbers above, particularly if you are in the funnel and the fact pattern doesn't seem to be all that hypothetical after all. Stuff happens, and commonly so.
So I've come to believe that the biggest wild card --- or gamble perhaps? -- of exiting the workforce early is pre-Medicare health care costs as one toddles into their late 50's and early 60's. You also are gambling that you don't get a fairly common disease such as cancer that could benefit from treatment at a top hospital.
This is a great thread; thank you all again.
I continue to fret about health care costs for those FIRE'd, not on a company plan, and not yet 65. And also with a significant disease. Stuff does indeed happen, and indeed, I think health stuff happens fairly commonly, certainly as one moves into their 50's and heads towards their 60's. I know exceedingly fit people who have died of heart attacks or cancer in their 50's.
I tend to plan based on worst cases. So today using the ACA exchange, I calculated the following ACA premiums for two people (non-smokers) from ages 61 to 64, applying an escalating inflation factor. I did not consider subsidies (again, being conservative). And I also added in the maximum cost of deductibles and co-pays on top of the premiums, which is what the exchange advises you to do to come up with total costs. I assumed, in other words, that a person completely maxed out coverage every year.
(Note: I also fiddled with HealthSherpa; and I'm aware of the religious-based exemptions/approaches to the ACA). Anyway, I came up with the following total annual costs for the four hypothetical years for a couple (two people) passing through ages 61 to 64:
$52,700
$54,900
$57,100
$59,300
Another wrinkle. None of the plans available to me on the exchange covered the top hospitals, and similarly, some of the top hospitals, so I've come to learn, tend not to accept ACA plans.
So let's say one of the couple has major cancer, too. Despite paying the outrageous premiums above, you can neither continue, nor initiate, cancer treatment at the best hospitals unless you self fund. The numbers are all over the place for self funding, but I read somewhere that for a generic cancer treatment that included surgery and some post-surgery care, the total bill could approach $170,000 at a top hospital.
I realize the future is unknown. A meteor could strike my house tomorrow. The odds of anybody maxing out insurance for four straight years is also outrageously remote. One could go crazy pondering the billion of disasters that could strike tomorrow. Cancer could be cured tomorrow. Still, I find it hard to ignore the numbers above, particularly if you are in the funnel and the fact pattern doesn't seem to be all that hypothetical after all. Stuff happens, and commonly so.
So I've come to believe that the biggest wild card --- or gamble perhaps? -- of exiting the workforce early is pre-Medicare health care costs as one toddles into their late 50's and early 60's. You also are gambling that you don't get a fairly common disease such as cancer that could benefit from treatment at a top hospital.
