How Do Early Retirees Pay for Medical

[Tool-Time]

62 and ready to retire due to minor health reasons. Wife (61)will still work for a year. $2M in 401k, stocks and IRA. Wife has $300,000 pension. No kids. How do early retirees pay for their medical?

[HomerJ]

ACA.

https://www.healthcare.gov/

[celia]

Spouse’s employer plan or contact an insurance company directly.

[PaunchyPirate]

I pay for medical insurance out of my savings. I obtain it via the Affordable Care Act (ACA) exchange website (healthcare.gov). In my rural location, there are only 2 insurance companies to choose from (on or off the ACA exchange). Their plans are pretty much the same on the ACA website as they are directly from the company.

[Normchad]

The ACA, aka Obamacare, is a very popular choice. And if you keep your income down, generous subsidies are available. This is the route I hope/plan to use.

Other options include:
1. Provided by employer via COBRA for 18 months to get you to 65.
2. Provided by employer as part of pension
3. Be married to somebody who can put you on their plan
4. Take some sort of easy job that offers health care coverage. I’ve heard Starbucks has this.
5. Enroll in a university as a student, and get the super cheap student health plan.

[Tool-Time]

Looks like about $1000/month. Wow!

[Dottie57]

Looks like about $1000/month. Wow!

Cheap compared to what I pay.... not Cobra and not ACA.

P.s. with Medicare I expect to pay about 500-600 a month all in.

I pay out of savings/investments.

[jebmke]

Looks like about $1000/month. Wow!

Sounds about right order of magnitude. My rough budget before I retired was $1,000 per month per person - but that was for all medical. I had retiree insurance so my insurance was pretty reasonable. The uninsured costs can add up though. I'm on medicare now. Never really went back and tried to total up actual medical over the 10- years pre-Medicare but I think we came in under the budget number - in part because of the subsidized insurance from my employer.

[retired@50]

Looks like about $1000/month. Wow!

Premium Subsidy eligibility is related to your income. If it's low enough, you'll get help.

Regards,

[Lalamimi]

Maybe look into getting Medicare early, maybe thru SSI due to health? No idea how, but a friend did.

[Rudedog]

I pay $ 1,050 per month to BCBS, $ 6,750 out of pocket limit for deductible and co-insurance. My wife pays $ 750 per month to BCBS, $ 4,700 out of pocket limit. It is by far our highest expense. I pay it myself, but we CAN itemize deductions so we get a bit of a write-off on our Federal taxes.

[Tool-Time]

Thanks for the great replies.

[LilyFleur]

The Supreme Court is slated to hear a case that will determine the future of Obamacare, in October 2020.

[delamer]

How are you getting health insurance now?

[Slowtraveler]

Moving abroad is one option. Taiwan, Thailand, Mexico, Costa Rica. There's many places where a resident permit via investment is available for an indefinite stay and cheap, quality medical care is available if you look for it.

[visualguy]

The Supreme is slated to hear a case that will determine the future of Obamacare, in October 2020.

The risk that it will be eliminated then or some other time in the future makes planning for early retirement very problematic, unfortunately.

[Dave55]

delete

[Dave55]

62 and ready to retire due to minor health reasons. Wife (61)will still work for a year. $2M in 401k, stocks and IRA. Wife has $300,000 pension. No kids. How do early retirees pay for their medical?

For the past 35 years I paid for health insurance out of my own pocket. I was self employed. Currently, it is $1,025 per month and it goes up every year. Fortunately, DW turns 65 this year. A few more years before I hit 65.

Dave

[whodidntante]

If I were to retire now, I would go to a low cost country and look for the healthcare blue light special on aisle 5.

[printer86]

I'm early retiring this fall. Our plan is to use my COBRA policy thru 2021 and then sign up for the ACA in 2022. I also plan to manage our MAGI starting in 2022 to obtain the ACA discounts. Things may change in the future, but that's my plan for now.

[DesertMan]

The Supreme is slated to hear a case that will determine the future of Obamacare, in October 2020.

If the ACA is still a thing I am planning to control my income so as to qualify for discounted Silver plans. I will use a combo of 457 and taxable assets (along with contract work income)

[gwe67]

Paid for by the state retirement system, up to age 65.

[McGilicutty]

If you are planning to use the ACA, make sure you keep your income above the minimum amount required to get subsidies. There is a minimum amount and a maximum amount you need to be in between to get the subsidies.

[retire2022]

Op

My state retirement system allows for my 1500 hours of sick time to fund healthcare premiums until Medicare at 65, or I could use the sick time until death (edit)

As long as I'm vested as tier 4, 30 years at 55 full pension, and rolling off of payroll into retirement.

People who have less than 30 and as low as 5 years vested could pay for healthcare at reduced premiums.

[SevenBridgesRoad]

Only slightly "early" at age 61. ACA, and we have a good insurance plan here unlike some states.

Planned ahead so that we are (mostly) living off cash from taxable account until age 65 (enough dividends in taxable to avoid the lower threshold, which would mean Medicaid). We manage our Modified Adjusted Gross Income (MAGI) to achieve maximum Advance Premium Tax Credit. Brings a $2,100 a month premium (married couple) down to $2/month last year and slightly more this year at $3/month. Subsidy is based on taxable income (MAGI). Working well for us.

[informal guide]

I retired at 63.5 and used COBRA from my large but benefit friendly former employer for my spouse and me until I hit the Medicare threshold at 65. My spouse is younger so is using a retiree plan from my former employer for about $800 per month until turning 65 - -I checked the ACA offerings but this is a better deal and also allows my spouse to continue to contribute to an HSA plan. Fortunately the kids are financially independent.

[AerialWombat]

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[DameTime]

"Health Insurance in Early Retirement", via the White Coat Investor:

https://www.whitecoatinvestor.com/healt ... etirement/

I found it easy to read and helpful as a review of both options and considerations.

[printer86]

If you are planning to use the ACA, make sure you keep your income above the minimum amount required to get subsidies. There is a minimum amount and a maximum amount you need to be in between to get the subsidies.

Agreed. In addition to interest and dividends, I plan to do Roth conversions to meet the minimum income limits.

[Da5id]

I'm an early retiree, single and 53 years old. If your income (MAGI) is controllable, ACA is a pretty good deal. In particular, if you can keep your MAGI between 200 and 300% FPL you can (at least on the Massachusetts health connector) get a very nice plan. Mine costs $326/month for one person with subsidy. I could get a cheaper ACA plan, that is the most expensive one at my income level and gets me access to the doctors and hospitals I like.

(edit to fix stupid acronym typo)

[whodidntante]

Health sharing ministry.

Reckon they'll be OK with you sharing a quarter million in costs with them?

[InMyDreams]

Looks like about $1000/month. Wow!

Cheap compared to what I pay.... not Cobra and not ACA.

P.s. with Medicare I expect to pay about 500-600 a month all in.

I pay out of savings/investments.

ditto. Retiree health insurance premium is not cheap, but I don't have nightmares that it will disappear before I go on Medicare.

[Watty]

How do early retirees pay for their medical?

I used 18 months of COBRA, my wife then went straight to Medicare and I switched to an ACA policy.

I retired in July so that 18 months would get me through the rest of the year and all of the next year. If you switch to an ACA plan in the middle of the year you will need to restart your deductible for that year.

A few states have extended COBRA to 36 months but they may call it something else.

I carefully manage my taxable income to keep it low enough to get a ACA subsidy so even though it costs almost $1,000 a month for one person I only pay a bit over $400. The income limit varies with your family size but for a couple it is roughly $64K. If you go one dollar over that amount you lose the entire subsidy and will need to pay it back.

If you do not qualify for an ACA subsidy then it is important also price the same plan when you buy it outside the healthcare exchange since there may be much less expensive plans available in some states. The reason gets into politics but if you Google "silver switcheroo" you can get the details about how some poorly thought out changes meant to weaken the ACA backfired and made it stronger in states that choose to take advantage of it.

There are also "cost sharing plans" that are usually associated with a religion that have problems and may leave you in trouble since they have very major gaps. Do not mistake them for being insurance, they are not, which is why they are so much less expensive.

My COBRA policy has a high deductible so I qualify for an HSA account which I use.

My COBRA was using a Blue Cross plan and when I switched to an ACA plan there was also an ACA Blue Cross plan but when I looked into it none of my doctors were in the ACA Blue Cross plan and the network was limited and many of the primary care doctors were not taking new patients. I ended up getting a Kaiser HMO ACA plan so that I could be sure that I would have access to any doctors I need and I would not need to worry about any surprise out of network billing.

I had not used an HMO plan so when I was researching it one concern is that the top doctors in their field but that is true for a restricted network too. One thing that Kaiser is apparently pretty good at is not having bad doctors and that in many ways can be more important in most situations.

[pennywise]

I am 62 and retired a year ago. My previous employer, a university, allows retirees with enough seniority/age combined (ours is rule of 70) to retain our health insurance coverage although retirees pay the full monthly premium which is $831/month this year. The university includes a robust medical school so we have access to a very good level of care.

We baked in the cost of my health insurance coverage as one of our fixed expenses post retirement. Husband turned 66 a week after I turned 62 so he has Medicare and a Medigap coverage plan.

Only concern for me is whether the university will continue to allow retirees access to coverage and if so how expensive it will be. The premium went up 5% in the first enrollment period after I retired and I've got 2 more annual cycles to go.

I will be very glad to reach 65 YO and Medicare age!

[AerialWombat]

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[tibbitts]

My guess is that at least outside of Bogleheads, a high percentage of early reitrees have had employer/government/military pensions that included partially or fully funded healthcare.

[desiderium]

I retired at 63.5 and used COBRA from my large but benefit friendly former employer for my spouse and me until I hit the Medicare threshold at 65. My spouse is younger so is using a retiree plan from my former employer for about $800 per month until turning 65 - -I checked the ACA offerings but this is a better deal and also allows my spouse to continue to contribute to an HSA plan. Fortunately the kids are financially independent.

This was plan in 3 years. I am very fortunate in that my job is COVID-proof, but I am expecting major austerity that will make work problematic. I am personally committed to a project for the next year or so; after that, and depending on the status of the ACA, I may bail early.

[WhyNotUs]

Only slightly "early" at age 61. ACA, and we have a good insurance plan here unlike some states.

Planned ahead so that we are (mostly) living off cash from taxable account until age 65 (enough dividends in taxable to avoid the lower threshold, which would mean Medicaid). We manage our Modified Adjusted Gross Income (MAGI) to achieve maximum Advance Premium Tax Credit. Brings a $2,100 a month premium (married couple) down to $2/month last year and slightly more this year at $3/month. Subsidy is based on taxable income (MAGI). Working well for us.

Glad it is, since I am paying for it through my taxes I want to make sure that you are satisfied.

[SevenBridgesRoad]

Only slightly "early" at age 61. ACA, and we have a good insurance plan here unlike some states.

Planned ahead so that we are (mostly) living off cash from taxable account until age 65 (enough dividends in taxable to avoid the lower threshold, which would mean Medicaid). We manage our Modified Adjusted Gross Income (MAGI) to achieve maximum Advance Premium Tax Credit. Brings a $2,100 a month premium (married couple) down to $2/month last year and slightly more this year at $3/month. Subsidy is based on taxable income (MAGI). Working well for us.

Glad it is, since I am paying for it through my taxes I want to make sure that you are satisfied.

Totally satisfied. I understand your criticism, but if you are trying to make me feel guilty, it won't work. All tax deductions and credits are paid for by others. A large percentage of the threads and conversations on Bogleheads are about legally avoiding taxes by taking full advantage of the laws as they are written. You may have never taken a tax break for mortgage interest, or never have funded a tax-advantaged IRA or 401K or HSA, or any other legal tax strategy. If so, you may cast the first stone.

[willthrill81]

Health sharing ministry.

That's the route we would very likely take. It's extremely important for those considering this option to be aware of the limitations and exclusions, but it can be far more cost effective.

[StealthRabbit]

62 and ready to retire due to minor health reasons. Wife (61)will still work for a year. $2M in 401k, stocks and IRA. Wife has $300,000 pension. No kids. How do early retirees pay for their medical?

$2m invested...+ $300k pension and No Kids ought to adequately cover HC

I left wage income at age 49 no HC, No Pension... ( about 1/10th your $300k annual income)

I have used:
1) COBRA
2) TAA (Trade Act) / college student HC plan (Until they realized I was age 50... !!! and they quickly changed their insurance protocal to ONLY allow under age 40)
3) Health Sharing ministry (uncapped) $300 / month for (2) + ~$45 / yr for 'uncapped' option
4) PT 'gig' employment with HC benefits (Costco night shift is a good option, but I prefer international gigs (paid to travel)) Some people drive airport buses just to get HC. working (?) Night shift does not interrupt your day or your retirement! I did that for 30+ yrs.
5) International Living (I did Thailand) Greece is really cheap for living and medicine / care (Self pay)
6) Travel 'health' insurance (was gone for a year RTW)
7) Medi-vacations https://www.patientsbeyondborders.com/
8) ACA (subsidized) $3.34 monthly premiums for (2), very 'State dependent'; https://www.kff.org/interactive/subsidy-calculator/
9) Self pay
10) Gone without HC (a lot)

Hope to live to 65. (or not)

[sandramjet]

Company provided early retirees with ability to stay on company plan till 65. Could not have afforded it otherwise. Downside is when I move to Medicare my insurance costs will go up dramatically

[geerhardusvos]

Health sharing ministry.

How much does it cost per month for a family of five?

[Dottie57]

Health sharing ministry.

That's the route we would very likely take. It's extremely important for those considering this option to be aware of the limitations and exclusions, but it can be far more cost effective.

I think this Wikipedia article is fairly accurate.

https://en.m.wikipedia.org/wiki/Health_ ... g_ministry

[Rob54keep]

If you a military veteran (honorable discharge), you may qualify for veterans benefits (VA Care). There may be some costs depending on your income. However, your spouse would not be covered.

https://www.va.gov/health-care/eligibility/

[MikeG62]

I pay $ 1,050 per month to BCBS, $ 6,750 out of pocket limit for deductible and co-insurance. My wife pays $ 750 per month to BCBS, $ 4,700 out of pocket limit. It is by far our highest expense. I pay it myself, but we CAN itemize deductions so we get a bit of a write-off on our Federal taxes.

DW and I also in similar BCBS plans. We both have elected bronze plans and our combined premium is ~$1,375 per month. On top of this we budget $500 in health care out-of-pocket expenses. Total annual spend budgeted at ~$22,500. We don't qualify for any subsidies.

In answer to OP's question, "how do we pay for it"? Just like any other expense.

[Sandtrap]

Beware the ACA Subsidy limit penalties which can be brutal.
Search forum threads for “ACA Subsidy Cliff”

j🏝

[AerialWombat]

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[Robert20]

I pay $ 1,050 per month to BCBS, $ 6,750 out of pocket limit for deductible and co-insurance. My wife pays $ 750 per month to BCBS, $ 4,700 out of pocket limit. It is by far our highest expense. I pay it myself, but we CAN itemize deductions so we get a bit of a write-off on our Federal taxes.

OMG. its so costly to retire in USA!.. For Husband and wife, it costs $2500 just for insurance in retire life?

[AerialWombat]

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