Between FIRE and 65 paid healthcare options.

[sturbridge]

My husband is on Medicare (so minimal there for his Part B and a medicare advantage plan). Mine is $126/month for premium. Much better coverage and cheaper than when I was employed. I am in MA, and intentionally quit in May to keep my income under the 4x poverty level to get a subsidy.

 

[Go-NoGo]

Thank you everyone. I looked at ACA and will range from ~17K to ~21K from bronze to gold. Are there other options out there now? Anyone else want to chime in?

Have you tried Health Sherpa ?
https://www.healthsherpa.com/

"HealthSherpa is a website that provides you with recommendations for healthcare marketplace plans based on your income, family size and the frequency with which you visit the doctor.

What makes the site unique is that they’re one of the few sites that allow you to do all of your enrollment through their website without ever having to go to healthcare.gov, the site where you’d normally sign up for an “on-exchange plan” which refers to health plans you buy through helathcare.gov."

 

[38Chevy454]

I am fortunate to have retiree medical available, although it costs me about $650/mo. That is for good Blue Cross with reasonable copay and deductibles, not the very high ACA deductibles. When DW was on the insurance it was a little less than double the single cost, but she's on medicare now and actually gets a health reimbursement account balance from my retiree medical to help pay up to $1500/yr in medical costs.

 

[joeea]

Dublin, Virginia...not Ireland.

I wasn't assuming Ireland.
Dublin NH, OH, CA, VA - all different. All with different insurance rates. That was the point.

 

[joeea]

Thank you everyone. I looked at ACA and will range from ~17K to ~21K from bronze to gold. Are there other options out there now? Anyone else want to chime in?

Remember, you have a long way to go until Medicare. And things change over time.

In 10 years, who knows if the ACA will exist? And if not, who knows what alternatives will be available and affordable?

 

[COcheesehead]

Remember, you have a long way to go until Medicare. And things change over time.

In 10 years, who knows if the ACA will exist? And if not, who knows what alternatives will be available and affordable?

Being in this same situation I plan to have at least a grand or two a month variance. If you think you can sneak by, don’t FIRE.

 

[samcat]

We are 59 and 53. Still working our home based business. In California. A couple years ago, we were going to pay over $36k plus $12k deductible for a bronze plan for a family of four per year. We considered it major medical.

We could not afford that so went with Christian Healthcare Ministries. For four of us, we paid $450 a month plus $75 a quarter for unlimited coverage plus $40 a year administrative fee. There are similar organizations for non Christians. I've had one expense I submitted and received reimbursement within four months just like they said.

 

[fh2000]

We are 63 and 57, in Los Angeles, California. This is our first year with ACA. Our estimated MAGI will be around $55K. We have got a Bronze HDHP PPO plan from Blue Shield California and pay a premium of $2 monthly.

The deductible is $12,000, and OOP is $13,300. So, we budget for $20K this year. So far, we only spent around $530 in 6 months.

 

[Teacher Terry]

We spend 12k which is a fourth of our income. Can’t wait for husband to be 65.

 

[N02L84ER]

Over the last 5 years, we have paid from $100/yr to $4000/yr on the ACA exchange. We have kept our O-MAGI between 58K and 61K for those years. We had a $10K to $14K max OOP potential each year. Luckily, we only hit a max of $7K one year. The other 4 years, our OOP costs were less than $2500. We have another 7 years to Medicare.

 

[Audie Murphy]

Thanks for all the posts. Some very interesting information coming here. I was thinking there might be some healthcare sharing going on (like Christian Healthcare Ministries). That option sounds very budget friendly. Has anyone actually has to use that type of insurance for coverage? My hope is to find the least expensive option that works and to stay healthy. If things change and improve that will be good but I am excited to know real amounts so I can run those FIRE numbers.

 

[joeea]

My hope is to find the least expensive option that works and to stay healthy.

Hoping to stay healthy is nice. But it's not much of a plan.

I was hoping to stay healthy too - right up until my cancer diagnosis. I'm happy that I was sufficiently insured, because paying $28,000 for each of my infusion sessions would have been unpleasant.

 

[Audie Murphy]

Hoping to stay healthy is nice. But it's not much of a plan.

I was hoping to stay healthy too - right up until my cancer diagnosis. I'm happy that I was sufficiently insured, because paying $28,000 for each of my infusion sessions would have been unpleasant.

Joe,
Sorry to hear about your cancer. I wish you the best and hope you fight it off and live a long and happy life.

I actually used the word hope instead of “plan” since our health is not completely in our control. There is a dark side to healthcare discussion and I don’t intend any negativity toward anyone that is fighting the good fight. I really just want to learn what people are paying and what the low cost alternatives to ACA that actually work.

 

[Audie Murphy]

Have you tried Health Sherpa ?
https://www.healthsherpa.com/

"HealthSherpa is a website that provides you with recommendations for healthcare marketplace plans based on your income, family size and the frequency with which you visit the doctor.

What makes the site unique is that they’re one of the few sites that allow you to do all of your enrollment through their website without ever having to go to healthcare.gov, the site where you’d normally sign up for an “on-exchange plan” which refers to health plans you buy through helathcare.gov."

I finally got the link to work today. Thank you. I was able to shop with different income levels and got premiums pretty low like $5,900/year. I am not to worried about the high deductibles just want protection against something major coming along. I guess that future retirement “boat” just looks a little closer to the retirement “dock.”

 

[scrabbler1]

I was diagnosed with Type 2 Diabetes 4 years ago, so I need a good (silver) plan which covers my expensive drug. That and the lab costs are my biggest expenses, both are covered well by my plan. The plan's premiums here in NY have been rising quickly and are up to $647 per month. I have been on the edge of qualifying for an ACA premium subsidy - from 2014-2016 I barely qualified, from 2017-2018 I did not. Going over that "cliff" has been more costly the last few years, so if my MAGI can stay under the max (single person, just under $50k), it will save me around $2k for the year.


Copays for doctors, labs, drugs, and labs are pretty small, in the $700-$1,200 range per year and are likely to stay under $1,000 due to shopping around more.

 

[Go-NoGo]

I finally got the link to work today. Thank you. I was able to shop with different income levels and got premiums pretty low like $5,900/year. I am not to worried about the high deductibles just want protection against something major coming along. I guess that future retirement “boat” just looks a little closer to the retirement “dock.”

Glad it worked..

If you and your family are in good health and your utilization is low, get a plan that has high deductible/out of pocket cost with low premiums - you are still protected on the backend if something bad were to happen, while still coming out ahead by paying out of pocket for routine care - The savings in premiums should more than compensate for this expense.

And if you were to be diagnosed with something awful (God forbid) change the plan next year during open enrollment.

 

[footenote]

If you're reluctant to use the healthcare.gov site, try the Kaiser Family Foundation ACA calculator: https://www.kff.org/interactive/subsidy-calculator/

As joeea and others have mentioned, an "average" or "norm" is meaningless. Your rate will be very sensitive to your age and projected household income once you've retired. If you can project both of those stats, you'll get a ballpark premium from the Kaiser calculator.

 

[ncbill]

Wish we could use the ACA for coverage.

Based on our location, income, and family size we could pay as little as $100/month, $2600 max out of pocket for a silver-level plan (using the KFF calculator)

But we get health insurance through spouse's plan...~$900/month employee share, $13,500 max out of pocket...for a HDHP.

 

[kimcdougc]

We pay $1826 a month for two (61 and 59) in WA state for a gold plan with a $1,000 deductible. Hard to find doctors in our Coordinated Care insurance. Can't wait till 65. Not wishing my life away but it will be nice to have much lower health care costs with more choices of doctors/hospitals etc.

 

[Willers]

In the last three years, I've spent $2200, $4600 and $40 (YTD). We've (by luck) played the ACA income game perfectly. Injuries when on cost sharing silver plans, none when on HSA HD plans.

YMMV. Good luck!

 

[MRG]

I will double down on it's so locale specific it not going to help much. That said, DW has Medicare, I'm on an ACA plan. I know another forum member says I'm lying but the unsubsidized cost of my ACA plan is just short of 2k monthly, I only pay 380, cheap copays and deductible too. That doesn't tell the whole story, I need surgery for BPH and the only person in network I won't go to. So, I can complain loudly and my insurance company will let me go hours away multiple times, or I can go 90 miles to a surgeon in another state and pay out of pocket. That's probaby what I'm going to do.

 

[joeea]

Joe,
Sorry to hear about your cancer. I wish you the best and hope you fight it off and live a long and happy life.

Thank you. My treatments went well. No signs of cancer since January. I go back for a recheck 2 times per year.

I actually used the word hope instead of “plan” since our health is not completely in our control.

I understand. My point is to hope for the best, but plan for the worst.

There is a dark side to healthcare discussion and I don’t intend any negativity toward anyone that is fighting the good fight. I really just want to learn what people are paying and what the low cost alternatives to ACA that actually work.

I understand. My point is that it's extremely hard to plan for many years of pre-Medicare healthcare costs. Far too many variables.

The ACA is under attack today. It may or may not be around soon. Low cost alternatives that can provide adequate protection may or may not exist. And whatever you do find today could be gone tomorrow.

My suggestions: don't try to save a few bucks by underinsuring yourself and hoping to stay healthy. And plan on spending a lot for healthcare.

If that means you have to work a few more years and/or save more, then that's simply what it means. Not everyone can afford to retire as early as they might prefer. So it goes...

 

[Audie Murphy]

Thank you. My treatments went well. No signs of cancer since January. I go back for a recheck 2 times per year.


I understand. My point is to hope for the best, but plan for the worst.


I understand. My point is that it's extremely hard to plan for many years of pre-Medicare healthcare costs. Far too many variables.

The ACA is under attack today. It may or may not be around soon. Low cost alternatives that can provide adequate protection may or may not exist. And whatever you do find today could be gone tomorrow.

My suggestions: don't try to save a few bucks by underinsuring yourself and hoping to stay healthy. And plan on spending a lot for healthcare.

If that means you have to work a few more years and/or save more, then that's simply what it means. Not everyone can afford to retire as early as they might prefer. So it goes...

Points taken. Thank you!

I can say that the information shared in this thread has given me a better understanding of what others are doing now. It is all I have to go on at this point in time. It helps me put future FIRE in better perspective knowing these real costs. There will be other variables for certain. I don’t wish to be underinsured. I would rather pay out of pocket for regular health maintenance and have insurance for some large, high dollar, health crisis. It seems like paying 17-21k annually is a bit steep for what I am after. Saving enough liquid cash on hand before retirement is going to be important. That pile will allow us stay around a certain level of income to keep HC costs lower and use it to buffer any short falls. It all seems like a game. I guess I am thankful that there is no means testing. We will be choosing whatever income level will optimize income to cost (HC,tax,etc) ratio, between FIRE and 65.

Thanks to everyone for sharing!

 

[joeea]

I would rather pay out of pocket for regular health maintenance and have insurance for some large, high dollar, health crisis.

So high deductible makes sense for you.

It seems like paying 17-21k annually is a bit steep for what I am after.

It may be steep. But it may be the best you can do.

Saving enough liquid cash on hand before retirement is going to be important. That pile will allow us stay around a certain level of income to keep HC costs lower and use it to buffer any short falls.

Yes. I assume you mean for an ACA plan.

I guess I am thankful that there is no means testing.

None today at least.

I wish you the best of luck.

 

[RunningBum]

Saving enough liquid cash on hand before retirement is going to be important. That pile will allow us stay around a certain level of income to keep HC costs lower and use it to buffer any short falls. It all seems like a game.

Yes, this is what I wound up doing. Not initially, because I retired before ACA and subsidies existed. But a few years ago I gave up the subsidy for one year and went more liquid in my taxable (shifting some non-equities out of my IRA, so I really didn't throw my AA off at all), and also went all index funds in taxable as they generally don't throw unpredictable distributions. I think of it as a puzzle to solve. There are many solutions, but some are much better than others.