My Healthcare Costs in Early Retirement (Year 3)

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  • เผยแพร่เมื่อ 6 ต.ค. 2024

ความคิดเห็น • 58

  • @TwoSidesOfFI
    @TwoSidesOfFI  8 หลายเดือนก่อน +16

    Important Correction: Medicare eligibility in the US starts at age 65. We mentioned 67 but that's our FRA for social security.

  • @RJones-Indy
    @RJones-Indy 7 หลายเดือนก่อน +3

    Hey guys, keep up the great work. I just retired (age 59), not exactly RE but still happy to be here. I am only three weeks in so far, and still trying to get my head around the fact that I don't have to schlep off to work or carry around the problems of my job 24/7. I am going on a cruise soon, and it will be the first time in decades that I have taken a vacation without worrying about the job. Thanks again for the great content and inspiration.

  • @ThomasGreuling
    @ThomasGreuling 8 หลายเดือนก่อน +2

    I very much appreciate the dialogue. I have been on COBRA from where I retired but you have inspired me to look at the ACA options for 2025. Kudos for the great value of this information you have provided!

  • @stevemlejnek7073
    @stevemlejnek7073 8 หลายเดือนก่อน +3

    I am doing similar as an early retiree aged 58. On Bronze ACA plan currently for 2024, and maxing HSA until age 65 medicare is the plan. Each year I will review things and adjust if needed based on health and insurance use.
    I often hear others says prescription drugs can be very expensive. For me, they have been really cheap. Perhaps I'm lucky, but the scripts I take are all available in generics through Cost Plus pharmacy (Mark Cuban's). 90 day supplies of each are under $10 each. So affordable, I don't bother running it through insurance. Everyone should look into this! Many generics are available here.

  • @hudooguru2
    @hudooguru2 4 หลายเดือนก่อน

    Great work gents. At 52 I'm very interested in joining the club. These conversations help untangle the options.

  • @mhoepfin
    @mhoepfin 8 หลายเดือนก่อน +2

    The math has always favored a bronze plan with low premiums for us and basically think of coverage as something catastrophic. Prescriptions are generally cheaper using GoodRX anyway. Typically for every one year of high cost procedures we have 3-4 of status quo expenses so why dump money into high premiums every year. Also we can time high cost elective procedures such as a knee scope or colonoscopy and take a higher tier plan for the year we do those.

  • @dumoon99
    @dumoon99 8 หลายเดือนก่อน +2

    Another great show. I’m also looking into ACA coverage costs for when I RE. Pondering managing MAGI to keep healthcare costs low vs doing more Roth conversions for future tax savings. Wonder if that is something Jason has run the numbers on? Pay more for healthcare and do more Roth conversions, vs less in conversions but immediate healthcare savings…

    • @bradk7653
      @bradk7653 7 หลายเดือนก่อน

      I am currently doing the former, where I remained on my former employer’s retiree health insurance so that I can perform some aggressive Roth conversions. My retiree health insurance is about $1,100 per month, higher than the $450 per month I was paying when working, but not excessively higher. After a few years I expect to switch to the ACA and manage my MAGI to get the maximum ACA subsidies.

  • @radioactivemike1
    @radioactivemike1 8 หลายเดือนก่อน +1

    I think one more thing to consider when evaluating plans is the geographical area of coverage is “in network”. If you end up out of network often the coverage is very very minimal and will cost you much more.
    We RE at 46yo a couple years ago. Up to that point we had always been covered with HSA plans and never had many visits or bills. We ended up buying up coverage to Gold because the HSA plans were to minimal and provided poor geographic coverage for our travel plans. I also knew we’d be far more active and have far more risk of injury. We’re about at that age when things start to go wrong. In our first year on the $18,000 gold plan we had nearly $60,000 of claims between the 3 of us. Undiagnosed issues became diagnosed and treated, a kidney stone and a bike crash causing me to break my leg. Nothing we could predict but glad we had the coverage. Walk carefully when deciding what coverage you need in RE.

  • @goldstandardaviation1667
    @goldstandardaviation1667 8 หลายเดือนก่อน +1

    What a relief it was to hit 65 and get Medicare. I no longer worry about copays, deductibles, and the fear of medical bankruptcy.

  • @FionaMacDonald
    @FionaMacDonald 8 หลายเดือนก่อน +1

    I ended up using a health insurance agent and it worked out great. Told him my docs and meds and he found a plan for me that included them. And all at no cost to me! Otherwise it was a bit overwhelming to look at all the plan options available in MA

  • @alanyoung159
    @alanyoung159 8 หลายเดือนก่อน

    Glad you are keeping healthy Jason, and it's not some recurring health issue!

  • @bradk7653
    @bradk7653 7 หลายเดือนก่อน

    Retired @60 and am currently on COBRA/company retiree insurance primarily to allow me to perform some aggressive Roth conversions over the next couple of years, but then I expect switch to the ACA.
    At about 18:00 Jason mentioned that there are ACA cost sharing benefits that can be available on the Silver Plan. This is something to explore if you can manage your MAGI to a fairly low number. There is a very tight sweet spot that you will want to explore, it appears there is about a $1,000 window above the minimum qualifying income for ACA that allows you to acquire an ACA plan at almost no monthly cost, no/low cost prescriptions, and very low deductible/max out of pocket (less than $2k). This is what I am going to strive toward when we make the jump to ACA.

  • @nata3467
    @nata3467 8 หลายเดือนก่อน +1

    Healthcare costs by fire my biggest push point for stress when it comes to retirement. Trying to really get into the subject now so that I feel prepared for 2.5 years to my date

  • @garygomulinski9797
    @garygomulinski9797 8 หลายเดือนก่อน

    We utilize an HSA account which has both a high yield money market account as well as an investment acct. We decided to peg the balance in the high yield money market acct to match our max out of pocket for our insurance policy. So, the funds are already available if needed. In years where our out of pocket is lower, it feels good to be under budget and only need to replace the smaller amount but, in a maximum out of pocket year (this year for us), it feels good to know the funds are ready and can be refilled.

    • @TwoSidesOfFI
      @TwoSidesOfFI  8 หลายเดือนก่อน

      Nice, thanks for sharing!

  • @JohnMcLaughlinPlus
    @JohnMcLaughlinPlus 8 หลายเดือนก่อน +1

    On the income -- it's a speculative thing. If you get it wrong then you have to 'true up' at tax time

  • @dancurran8977
    @dancurran8977 8 หลายเดือนก่อน

    We were on Northern California Kaiser through Covered California starting in June 2023 when I retired. I was pretty confident with my income estimate until I realized that our T-bills and money market funds were doing better than I anticipated. As was mentioned in the video this is not a big deal. We will pay the difference for the lowered subsidy when we file our taxes. This year we are looking forward to getting on Kaiser Medicare Advantage. These is no monthly premium but we will have to budget for up to $12K out of pocket.

  • @briansmith2313
    @briansmith2313 8 หลายเดือนก่อน

    If all goes to plan, as a 59yr old I will use cobra in 2025 and then ACA with subsidies until medicare age 65.
    Also have a 300K mortgage at 2.5% which I will payoff in 2025 to reduce income need for future ACA. It's all about free headspace versus investing in high yield savings account. No stress equates to better healthcare. In 2022, I was going between states and had an issue which I needed three crowns for 2400. Crowns are covered for 5 years yet only from original dentist, says insurance person. In 2024, salt water taffy took an old crown out. Not a kid again said my wife. I like that Jason says budget for worst case (premium, deductible and max out of pocket). Lumpy expenses are then covered. Keep up the great episodes.

  • @dougscrubjay3939
    @dougscrubjay3939 8 หลายเดือนก่อน

    Similar strategy as Jason. Bronze High Deductible with HSA, keep MAGI at 399% of FPL. Try to be Healthy and Lucky. Turns out sh*t happens. For 2023 - $444/month for 2 (58 & 56), spent $7050 deductible for one of us, more on dental, vision, small things. For 2024, had an issue right after the new year, hit $6800 so far, definitely going to blow the deductible of $7500 for one of us. Premium went down to $400/mo, deductible went up $500/each. I need to run the Silver Regret calculation to see what to do next year. Health care is so damn lumpy/unpredictable/expensive. Insurance is so damn tricky - the actuaries always win in the long run!

  • @qilu6313
    @qilu6313 8 หลายเดือนก่อน

    Never thought about this topic much due to me being young and naive. 400% of FPL for family of 3 is about 100k in 2024. That’s very comfortable income for a lot of mid COL area in the US. TIL moment.

  • @Lmessimer1567
    @Lmessimer1567 8 หลายเดือนก่อน +1

    Excellent content. I’d be interested to hear if you plan to purchase any kind of health waiver when you travel.

    • @TwoSidesOfFI
      @TwoSidesOfFI  8 หลายเดือนก่อน

      Thanks! Not yet but it is always worthwhile looking at what coverage, if any you get from your existing plan. But many travel plans are indeed available.

    • @patriciagolding7092
      @patriciagolding7092 7 หลายเดือนก่อน

      Depending on your travel frequency and financial situation, you might research annual travel insurance and recently we got a ridiculously expensive credit card that includes travel health, evacuation and repatriation insurance. Now, if we just lived in a state with the health coverage you enjoy. Buying on the exchange here in Texas is what financial nightmares are made of.

    • @bradk7653
      @bradk7653 7 หลายเดือนก่อน

      I have a brother that retired early (55) and he loves to travel, normally out of the states for 2-3 months each year, he has circled the world 3 of the last 4 years. He always purchases travel insurance, and for good cause. Last year he was Kenya in for a portion of his travels, he had some heart problems and ended up in a hospital for 3 days. Travel insurance reimbursed all of the hospital, doctor, prescription costs, as well as the flight cost for catching up with his tour. One oddity was his total medical bill in Kenya was less than $2,000 USD, whereas just visiting an emergency room in the US easily exceeds $1,000 and 3 days in a US hospital will normally cost well over $10k.

  • @paulturner4419
    @paulturner4419 8 หลายเดือนก่อน

    I’d just think in terms of risk and if max deductible is easily managed. If you accept a potential 50% drawdown on stocks then max deductible is so much smaller I wouldn’t worry about it.

    • @TwoSidesOfFI
      @TwoSidesOfFI  8 หลายเดือนก่อน

      Interesting approach, thanks!

  • @Hawking1969
    @Hawking1969 8 หลายเดือนก่อน

    Thanks for this deep dive. Healthcare is likely the #1 risk in forecasting retirement. Housing costs (rent and mortgage) are far more publicly accessible. In my model I assume $1500/month for me, wife and 2 kids (10 and 5). We are healthy. Is that a reasonable estimate? I'm in NY state.

  • @sstewart8503
    @sstewart8503 8 หลายเดือนก่อน

    The kiddo will drop in the 19th birthday (California is close to Washington). If anyone in the household is on a Medicaid plan or Medicare you can’t get the HSA. (Check rules for your state)
    ACA is limited to the state your in except for emergency care. If the kiddo goes out of state for school, it will add another level of complexity.
    Buying in to the aca biggest benefit is the lack of pre-existing.
    Medicare is 65. There is a penalty if you mess this up.
    Social security is 67.
    Oh, if you are over 50 and use Medicaid there may be asset reallocation (the state takes your money/assets) clause.

    • @spikinkev17
      @spikinkev17 8 หลายเดือนก่อน

      Kids can stay on a family plan til they are 26. www.hhs.gov/healthcare/about-the-aca/young-adult-coverage/index.html

  • @christinab9133
    @christinab9133 8 หลายเดือนก่อน +1

    ❤❤❤

  • @susanharkema2888
    @susanharkema2888 8 หลายเดือนก่อน

    Question for Jason: If you were over your budget ceiling and sinking funds, would you have dipped into your cash reserves for a down market?

    • @TwoSidesOfFI
      @TwoSidesOfFI  7 หลายเดือนก่อน

      To clarify - my cash reserves aren't like an emergency fund. They're just another part of my asset allocation from which I pay my expenses. We maintain about 5% of portfolio in money market funds, CDs, and cash. So we pay ourselves (i.e. fund the budget) from there. So if we are over budget it's still coming from there. We refill the cash allocation during twice-annual rebalancing. I hope that helps, Susan! -Jason

  • @SimonEllwood
    @SimonEllwood 8 หลายเดือนก่อน

    I love your channel, but as someone from outside the US this stuff is super complex. Regardless of finances I am pleased to still have good health. I do not want to trigger people but I rely on the NHS here in the UK and I have paid a lot if tax over the years into the system.

    • @TwoSidesOfFI
      @TwoSidesOfFI  7 หลายเดือนก่อน

      You're 100% right and not a day goes by that I don't wish we had a simpler system that covers all. Fingers crossed... -Jason

  • @pbjoness9056
    @pbjoness9056 8 หลายเดือนก่อน

    Hey guys. I am in a very similar situation to Jason and have really enjoyed your channel. I have been leveraging the California ACA for the last three years and have managed to hit my estimated MAGI to date. I have a question that I haven't gotten a clear answer to from my tax accountant or Covered California. I have been submitting my estimate as the exact amount of MAGI that gives my family of 4 the most amount of subsidies while not putting anyone on Medical. This was around 72k last year. I have hit this target using a combination of realizing capital gains, interest and dividends, fun job income and ROTH conversions. My question to the ACA is what happens when I come in under the MAGI threshold that would have qualified my kids for Medical for the previous year? Is there a chart and thresholds where coming in 10% less or 20% less or 50% less would cause an issue? Since I am already getting the maximum subsidies without being on Medical, I would not expect more subsidies, but my concern is that if the kids should have been on Medical, that maybe the subsidies that I did receive would need to be returned.

  • @stevekristoff4365
    @stevekristoff4365 8 หลายเดือนก่อน

    Interesting take on health care/insurance. Personally I have run my own numbers and more of the mindset that insurance is a loosing game at least for my situation. Find that it would be much more efficient to have the funds spend on insurance and instead put them into the market and pay for any operations or procedures out of of pocket. But *NOT* saying having insurance is 'bad' it's very individualized to each person's own genetics; how they take care of themselves; and the 'luck' factor (how accident prone you are). But I have noticed that the idea of 'self insurance' seems to be a social stigmata for some reason over the last 20-30 years don't know where that pernicious idea is coming from but it's just statistical modeling. (insurance companies exist to make a profit, i.e. more people pay in than what they pay out) that same math can work if you are on the side of the more pay in group.

    • @dumoon99
      @dumoon99 8 หลายเดือนก่อน +2

      Just remember that one of the goals of health insurance is to avoid major bankruptcy level costs. You always have the risk of a major event that could cost hundreds of thousands or a million out of pocket without the out of pocket max most health insurance plans have. If you are comfortable with the risk or wealth enough, then less of an issue.

    • @bradk7653
      @bradk7653 7 หลายเดือนก่อน

      I agree, what would be best is if we switched to a health care scenario where you paid out of pocket for the small stuff, such as regular doctors visits, prescriptions and then health insurance only covered the major things like cancer, heart attacks, and life threatening illnesses. We would find that the everyday healthcare would decrease in cost because people would only be willing to pay for what is actually needed, the healthcare industry would be forced to lower their costs to the level that people are willing to pay. With our current healthcare insuance the healthcare industry can raise prices as high as they wish because people don’t care what it cost because either their insurance or the government is paying the bill.

  • @pareshjoshi5113
    @pareshjoshi5113 7 หลายเดือนก่อน

    Jason - what happens if ACA is completely gone? What options have you explored for yourself? Can you please share?

    • @TwoSidesOfFI
      @TwoSidesOfFI  7 หลายเดือนก่อน

      If it’s prior to Medicare eligibility, private insurance is the option I’d seek.

  • @Ladybug8899
    @Ladybug8899 8 หลายเดือนก่อน +1

    Hi is it easy to find PCP who accepts ACA? I’ve heard a lot from doctors refused to take patients with ACA insurance. How true is this?

    • @TwoSidesOfFI
      @TwoSidesOfFI  8 หลายเดือนก่อน +1

      Likely just scare tactics. It's just like any other insurance plan and ACA coverage includes some of the same insurers you'd see on workplace-sponsored plans. In my case, I can choose between Aetna (a huge nationwide network) or CA Blue Shield (big in CA). Both have large networks and I've yet to have any questions about coverage. -Jason

  • @dutchy25ttm
    @dutchy25ttm 8 หลายเดือนก่อน

    So does it look at MAGI of 2023 for 2024 healthcare credit/premium determination?

    • @cathyg1465
      @cathyg1465 8 หลายเดือนก่อน +1

      MAGI will be based on the actual year partipating in ACH. You must estimate your MAGI & any over or under is reconciled when filing Fed taxes

  • @TrishaRico
    @TrishaRico 8 หลายเดือนก่อน

    Thanks for the info. Do you know if the answer to this? If ACA is much lower cost than my husbands insurance option at work for a 3 member family can we choose ACA instead? Thanks

    • @dougscrubjay3939
      @dougscrubjay3939 8 หลายเดือนก่อน +1

      Pretty sure that if you are eligible for insurance at work you are not eligible for ACA. I had to wait for my former employer to confirm that I was not eligible anymore (went part-time for a few months) in early 2023 before I could be on ACA.

  • @jeremynansen5541
    @jeremynansen5541 8 หลายเดือนก่อน

    Kinda weird that you’re “financially independent” but still dependent on the state for your health insurance. It feels a little slimy.

    • @TwoSidesOfFI
      @TwoSidesOfFI  8 หลายเดือนก่อน +5

      How so? Every system has rules, abiding by the rules is “slimy”…?

    • @agusus
      @agusus 8 หลายเดือนก่อน

      I initially thought that way (briefly) but realized you can say that about any tax credit (ex, child tax credit, mortgage interest deduction - these are govt incentives for child rearing and home ownership) or social program (Medicare). Healthcare could use many fixes on a national/ societal level, but we shouldn't fault ourselves for not having the power to singlehandedly fix it.

    • @bradk7653
      @bradk7653 7 หลายเดือนก่อน

      Sorry, but all Jason is doing is following the laws that were passed, just as any other wise person would do. You are personally free to pay extra taxes to the government or donate money to them, but it is not your choice to make someone else pay more than they are required to.

    • @jeremynansen5541
      @jeremynansen5541 7 หลายเดือนก่อน +1

      ⁠@@bradk7653you missed the point. Yes, you can take advantage of tax loopholes, but are you really financially independent if you have to socially loaf to get by? To extricate oneself from the workforce and then use the social welfare system because you don’t want to work is immoral… not illegal, but definitely immoral.

    • @bradk7653
      @bradk7653 7 หลายเดือนก่อน

      @@jeremynansen5541 The ACA is just another tax law, same as any any other tax code, this was how it was deemed legal by the Supreme Court. Jason is following that tax law, he is not gaming the system. Those in power passed a tax law that looks a your taxable income to determine what amount of tax credit you will receive. If you don’t have much taxable income then you get a larger ACA tax credit, that is not gaming the system. If they didn’t want the “wealthy” to be able to use the ACA then they would have restricted its use based on net worth rather than income. I don’t fault Jason or anyone else from paying the lowest taxes possible (including getting the maximum tax credits). In summary, someone is financially secure when you have sufficient funds to support yourself under the known or expected tax structure and economy, but if things drastically change, such as: civil war, full on socialism, asteroid hit, or some other major upheaval then almost no one is financially secure.