Will I ever feel completely comfortable with early retirement?

[Poopycat]

If this needs to be posted in the Health forum, please move it and my apologies. I think it’s less about health care and more about adjusting to retirement without fear.

I am just about to hit the 6-month mark of not working. I just sold my condo, not sure how I managed to get an offer above asking price in this market but I did. It sold so quickly that I hadn’t scoped out a place I want to live in the western states so I’m doing a short-term furnished rental for 3-4 months in my current location so I can wrap up some outstanding medical and dental stuff, and visit a few places in the Southwest and west coast I want to test out before I rent elsewhere.

The problem: every time I think about my COBRA coverage ending, I feel nervous because I don’t trust that there will be decent health insurance options available to me for the next 9 years until I hit 65. Insurers are pulling out of markets, and I expect that withdrawal to continue as fewer people apply for coverage due to affordability challenges. I also worry about not being able to find a doctor in my new state, whatever that is, who will accept the insurance I will eventually get after COBRA. That worry causes me to apply for jobs, so I can have employer-based insurance again. I have a video interview with a hiring manager next week. The job doesn’t interest me, but even if I pass on this opportunity, I’ll eventually get an interview for something better suited for me. I don’t need the money, it’s just the insurance considerations. And maybe a little about being employed again so I feel “normal.” And the longer I’m out of the workforce, the harder it will be to land a job.

I haven’t really experienced true retirement yet since much of my time had been focused on getting my place ready for sale. But I am starting to enjoy having less daily stress, and playing tennis in the mornings so frequently has been nice. Plus, I’m starting to research study abroad programs that look fun. Still, I keep applying every once in a while for jobs.

Is there anyone else out there with 8+ years to go til age 65 who is retired and worried about having health insurance options available to them until Medicare age? If so, how did you get past that fear? Are you thinking of going back to work? I hate that fear is keeping me from fully enjoying not working. At times I think I’m too risk averse for my own good.

 

[QG67PK00]

You can look into medical coverage under ACA. I retired at 55 and have been using ACA coverage for the past 3+ years.

 

[rk911]

And there are a few MedShare organizations, usually religious based. Uncle Google can tell you more.

 

[RetiredHappy]

I retired at 53, moved out of state and bought an ACA plan (BCBS PPO) at 54, and found out the hard way that the good specialists in my area didn't take it. I switched to paying full price off-exchange private individual health insurance the following year and have stayed with this insurer since. I reach Medicare age next year. If you can afford to buy the best health insurance plan, there is not a need to rely on employer provided plan, and many employer provided plans are not necessarily that good anyway.

 

[JBTX]

The problem is you are looking for certainty in an area that doesn’t exist, at least in this country. But realistically you have to assess probabilities.

So what is the probability that ACA will go away?

What is the probability that you, and other upper middle class individuals, will be unable to find any suitable insurance? From a political perspective it doesn’t seem like a tenable situation?

What is the probability that even though you get insurance, no suitable doctors are available? If you can’t get doctors, how are other people getting doctors?

Assuming the above are true, what is probability that you can’t find a job, any job that has insurance, at least for a few months that would allow another 18 months of cobra?

If unable to clear any of those hurdles, what’s the probability you can’t move to a geographic area where you can get insurance?

Finally if all of the above were true, you could potentially move to another country for at least some number of years. If you are looking for health care insurance absolute certainty that may be something to consider

Don’t let the tail wag the dog. The more important thing is to focus on your health now (including mental health) such that you have less of a need for health care.

 

[Koolau]

For enough money, you can get adequate cover "someplace." 1). You may have to move states. 2). You may have to pay WAY more than you planned on. 3). Of course, the "back-up" is to rejoin the w*rk force just to get coverage.

My thinking is that what you need is out there and it may take some real effort to find it - but it's out there. I'd suggest checking brokers in areas you might wish to settle.

All the best to you. Please keep us posted.

 

[audreyh1]

We had no difficulty using an ACA plan during the years to Medicare. Even though BCBS switched everyone to an HMO model after a few years, we still had the same broad provider network. So just meant getting referrals from a PCP for some things.

 

[Diogenes]

OP, if your qualms are about health insurance in particular, then there are various actionable recommendations, and even some already noted in this thread. But if your concern is more holistic and more psychological ("Am I truly ready to retire", "What will I do with my time", "What if I get the itch to return to work",...) then indeed the main thing to be offered is more about commiseration than anything genuinely actionable.

By way of personal example, I was (and still am) a small handful of years younger than you, and initially considered layoff to be segue into early retirement. It was not. I was antsy and unable to "enjoy" really anything about life, material or otherwise. So I when an opportunity to resume full-time employment presented itself, I took it. The good news about "retiring" really early, is that even a decade later, if one then chooses to really-and-truly retire... well, that's still technically early, given that the canonical retirement age in America is around 65-67.

 

[EastWest Gal]

Many primary care and specialty practices have been absorbed into large health systems. All of these health systems accept at least some of the ACA plans. In researching ACA plans, I found that our local health systems took one of two BCBS bronze plans, but not the other, so I chose the plan that they took. Most of the ACA plans are identical to non-ACA plans from the same companies.

So research the health systems in the area, check out their specialists, then look at the insurance plans they take. You can see most of it online, but they also have phone numbers you can call to double check. Doctors don't get paid less from plans through the ACA or not through the ACA. It's the same plan.

If you are considering the west coast, consider ACA plans through Kaiser Permanente as well. They have a whole network of specialists. My parents and in-laws had Kaiser throughout their adult lives and it suited them well.

Beware of non-ACA compatible insurance. Your pre-existing conditions will not be covered, and they can drop you if you become significantly ill.

As a pediatrician, I found that many specialists did not take Medicaid patients and that was a real problem. But the tertiary care center with all the pediatric specialists took all patients.

 

[CO-guy]

Although we navigated through them, I can relate to your concerns. I'm 55 and quit the full-time three years ago. However, my better-half plans to remain full-time employed for another four years and so I'm on her health insurance plan for now.

After she quits, our plan is to relocate to another country with a lower cost of living including better, cheaper health insurance. While we're still full steam ahead with those plans, our budget includes $180K for health insurance and other medical expenses ($15k/yr per person) for those six years. Hopefully we'll only need a fraction of that amount, but having that set aside is part of why we're comfortable with our FIRE plan.

 

[COcheesehead]

I retired 8 years out from Medicare. I used Cobra in year 1, wouldn’t recommend doing that, but have done ACA every year since without any issues.

 

[engineernerd]

If you are still undecided which (West Coast) state you want to live in, and your COBRA coverage is truly nationwide (routine care is covered in all states of interest), it seems to me the next year is a great opportunity to trial places to live. The main weakness of ACA insurance is how state-based these plans typically are.

But, as someone who was on ACA before ACA even existed (WA had an individual marketplace), I can tell you that just paying for routine care on a self-pay basis is not the end of the world. Whether visits are covered or not is a moot point if you don't reach your deductible, and even if you do, routine care does not normally add up to that much money so losing that gamble (that you won't hit your deductible) is not a big deal. I actually saved money most years because my HMO charged more per visit than the providers I chose.

And spending time outside your coverage area is not the end of the world either. Mainly because of the No Surprises Act, but also partly because routine care (a) can usually be scheduled for when you are in the coverage area and (b) won't break the bank even if you get it as a self-pay patient, especially if you take steps to avoid predatory providers who are cagey about prices and have online reviews complaining about their pricing.

Both of my main points apply to those of us who do not already have health conditions causing us to blow through our high deductibles and out-of-pocket maximums every year. Hopefully you are still in that category!

 

[TripleLindy]

I retired almost 9 years ago and still have 2 years to Medicare eligibility. I used COBRA for the 1st 18 months, but only because I wasn’t aware how the ACA plans worked/cost back then. I probably could have saved a little had I gone straight to ACA. We’ve been on ACA plans ever since. We’re in a large metro area and I haven’t had any trouble finding a plan that has our providers in-network.

But yes, health insurance is a significant variable when trying to bridge to Medicare. The end of the enhanced subsidies this year combined with massive increases in premiums introduces more risk, but thankfully, we’re in a pretty secure financial situation where it’s more of an annoyance than a crisis.

If you can keep your income below the 400% FPL threshold, the ACA plans remain relatively affordable. Without a subsidy, plan on spending around $15k per person for coverage under a high deductible Bronze plan. Those plans usually don’t provide coverage until you’ve hit a sizable OOP max - around $10k.

Personally, I’d stay away from any non-ACA plan. I’ve researched quite a few and they’re full of loopholes and exclusions.

Unfortunately, there’s nothing stable when it comes to healthcare policy in the U.S. It will probably remain that way for the foreseeable future. Understand your income so that you can structure it the most advantageous way in take advantage of any available assistance. And make sure your budget has room for the unexpected.

 

[engineernerd]

Is there anyone else out there with 8+ years to go til age 65 who is retired and worried about having health insurance options available to them until Medicare age? If so, how did you get past that fear? Are you thinking of going back to work? I hate that fear is keeping me from fully enjoying not working. At times I think I’m too risk averse for my own good.

This may be just me, but what helps me most with fear of the unknown is learning more so the topic is less unknown. So go here - The Marketplace in your state - pick your top-choice retirement state and enter your top-choice zipcode once you are on the state's ACA website. Shop the plans. See what the unsubsidized premiums are. See what each plan covers and what the deductibles and out-of-pocket limits are. Look for online reviews of each company.

Yes, that information only applies to 2026. But it can be reassuring if the premiums plus one or two thousand dollars fit into your retirement budget, and even more reassuring if the premiums plus the OOPM does.

Hope that helps! Another thought: are any of your West Coast family members on ACA plans? Maybe ask them what their experience has been like?