Health insurance for FIRE crowd - only major events

pjigar

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I am sure I am not the first one to have this question. We are planning to do Roth conversion up to 22%/24% tax bracket in FIRE which means our on paper income will be significant and no ACA subsidies for us. We are in good health without any chronic diseases. Are there any off-ACA plans which only covers major events like outpatient surgery and hospitalizations? We can afford to pay for office visits and regular drugs out of pocket. We just don't want to pay exuberant premium for ACA plan which we may not use enough services from.

I searched for "catastrophic health insurance" but that term is now used by ACA plans for people with hardship. A quick google search showed that there are hospitalization plans available but I also need coverage for any outpatient surgery in case a need arise. How do I find a health insurance for true catastrophic events like heart attack, stroke, cancer, major surgery, etc.? Are there any alternatives available for truly affordable health insurance plans for catastrophes?
 
My experience with ACA is that most have a pretty steep deductible- mine was $6,000 before I became eligible for Medicare. To me, that really was catastrophic coverage.
 
I think OP is looking for non ACA coverage. I don’t really know (probably shouldn’t comment) but I thought that’s how HDHP and HSA were being used.
 
I am ok with ACA or non-ACA plans. I started thinking about this because before ACA, there were affordable plans for people without pre-existing conditions which provided coverage with high out-of-pocket maximum and/or high deductible. I remember some old members talked about these plans in the past. Or maybe I am chasing a unicorn and we just have to pay for an ACA plan that works for us.
 
OP, I buy my own health insurance. I've searched everywhere and am in the ACA with a high deductible plan ($13,000 annual out of pocket) and a HSA.

You want to be in a provider network, they negotiate medical costs for you with your provider, that alone is huge if you're paying your own way.
 
I don't get ACA subsidies since I was 55 (retired at 53). I buy off-exchange private individual insurance and started with their Silver Plan. It is a fully ACA compliant plan. For next year, I am dropping to Bronze plan (still not in the ACA exchange) and it saves quite a bit of money. My health insurance premium would have been $17K but by dropping to a Bronze plan, it goes down to about $11K a year, with higher out of pocket for co-pays and drugs. You can play around with the ACA site and you should be able to find the cheapest Bronze plan to buy.
 
FYI, Affordable Care Act's enhanced premium tax credits may expire. A nonpartisan government analysis warned this week that letting the ACA subsidies expire next year would cause millions of Americans to lose health coverage in the years ahead.
 
What is available to YOU will be different depending on where you live. Here in Pennsylvania, our state regulates insurance pricing quite strongly. Insurance companies can sell on the ACA exchange, off the exchange, or both. But the pricing is reviewed and approved by the state for all of them. In my county, almost all the plans available on the ACA exchange are also available outside of the exchange. And guess what... the prices are almost identical (excluding subsidies) on or off. Where you live may be different. Our state insurance department's website makes it quite easy to find all companies that sell health insurance in my location. But the plans vary across the various counties. What is sold to me in western PA isn't the same same set of plans sold to someone in eastern PA because the insurance companies have different sales territories.

Perhaps your state has a similar website to help you find your alternatives to the ACA plans.
 
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