ownyourfuture
Thinks s/he gets paid by the post
- Joined
- Jun 18, 2013
- Messages
- 1,561
AAA+++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+++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.
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?
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.
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 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.
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
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...
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.
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.
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
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.
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).That's a great benefit. Do you have a Plan B if Mega cuts off your HI?
It's not useless, but not worth a lot.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.