Health Insurance in Our Early Retirement 2021 (FIRE Financial Independence, Retire Early)

[@GoWithLess]

We’ve been promising a video about our 2021 health insurance for months. Thanks for being patient. This past weekend, we FINALLY made a decision after so many hours of research. As early retired Americans who are also nomads, there are SO MANY FACTORS to consider. Unfortunately, there is not “an answer” for any of us. It’s truly insane. Please don’t shoot the messengers. Have you noticed we’re filming outdoors a lot more often lately? In addition to light and sound that are issues no matter where we film, WIND was a hurdle we couldn’t conquer this time in front of the Hollywood sign. See for yourself in the blooper at the end! In a few hours, we’re leaving our Burbank house sit and will spend a few nights in Palm Springs before heading to Scottsdale for a Christmastime sit. We’re digging this “winter weather”. Next Wednesday, you’ll see us in Arizona! Be well, Amy

[@Endowyeth]

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[@Paul-cj1wb]

How does the ASA Government Assistance work, do you pay out of pocket for the insurance per month or in in full, then at tax time you get the refund? Or do they give it to you per month? Specifically, how does it all work?

[@MH-vr4lx]

You have my full sympathy - I am a physician who originally came from Germany - after 20 y in health care in the US and being a US citizen - I will likely retire early - and ironically - before being eligible to Medicare- will reactivate my old German old health care plan ...,.I could write a book about it - I am a patriotic US citizen BUT it does NOT mean that I am a “socialist” to be in favor for a more inclusive health care coverage here in the USA - our society desperately needs COMMON sense

[@R1M1r1m1]

In other countries healthcare is a right not a privilege as opposed to the US which is "supposed" to be the greatest country.

[@stevenk195]

My wife retired earlier this year. I've been already somewhat retired, but will be fully in 2021. We are both in our early/mid 50's. 7 figure retirement split over taxable accounts, IRA roll-overs, and Roths. Also, we are completely debt-free and own our house outright. We are planning to go ACA with roth-conversions, "creating" enough income to satisfy ACA boundaries. The taxable account will take us 5+ years into the future, with the traditional IRA's then covering 59-69 age range. I will take Social Security at 70. It will be zero taxed because we will be drawing off of Roth's at that point (no income to report). Also, I'm holding off with my Social Security until 70, so that if I die, my wife will get the larger payout (my social security). She may, or may not, take her Social Security at age 62. Maybe just let her SS ride until full FRA (67). In the end, we will pay little for health insurance and little for taxes in our retirement. The ACA option wasn't our choice. It's just what we've been dealt, like most government programs. Our ACA options in Wisconsin are very good. We are not planning on being nomadic, but rather we enjoy just being at home together and left alone. We are not social. If replies to this post get too social, too crazy, we will just delete it. All the best to everyone taking the alternative view of life with early retirement. You can never replace lost time.

[@jeffhenry8586]

Did you get a copy of my retirement plan? It sounds like you are reading from my playbook. :)

[@nenefry8502]

right ACA subsidies. I thought Obamacare was for people who couldn't afford health insurance. If you have so much assets 7 figure why are you using Obamacare? oh that's right. it's a scam a feature not a bug. THat's why I hate Obamacare. Here I am my health insurance I pay in open market individual market went from 700 to 900 a month. I hate welfare cheats. If you want to retire early fine but why are you having me subsidize you? I pay 900.

[@emediongudoh9108]

It's getting social, delete it now pleaseee lol

[@minenow7150]

Thank you for sharing your insurance story. Glad to see others think the whole thing (insurance in the USA) is crazy. I could not agree more. Every fall our biggest question is "How much will our health care insurance picture change next year, and what should we buy?" Good hard working Americans that played by the rules their whole life should not face financial ruin trying to get health care.

[@marlanfagan7786]

My situation is very similar to you guys. I'm single and FIRE and retired 4 years ago at age 50. I've relied on the ACA for coverage every year so far. I manage my income (dividends, capital gains, interest and IRA conversions) to take advantage of subsidies. I do end up switching providers just about every year due to price increases and plan changes. I can still find decent plans with a pretty low deductible with very reasonable monthly premiums. No problems so far but we just never know how long the ACA is going to survive as it is today.

[@janekim7128]

Hi! This topic is scary. I will tell you insurance is a big reason why our plan is to live abroad until we qualify for medicare. Insurance is more affordable in other countries, and they have great medical services. It’s always nice to see you are doing well and happy. Happy Holidays.

[@chuckmurray1825]

This video perfectly illustrates why it's so hard to retire in the U.S. I'm looking to move to Portugal in approximately two years if things stay the same in the U.S. The cost of expat private health insurance in Portugal is about $1,600.00 per year (for a single person) even with pre-existing conditions and you have very little out of pocket expenses after that $1,600.00. Portugal ranks very high on the international healthcare surveys and Portuguese people enjoy a longer and more relaxed lifespan. The cost of living is also about 35% cheaper than the U.S. and it's a good launching point to explore the rest of Europe. Most people in the U.S. don't realize that even when you qualify for Medicare, you can still go bankrupt because Medicare does not have an annual out of pocket max. You have to find additional private supplemental insurance to cover the gap which can be VERY expensive if you have any pre-existing condition. Prescription drugs cost drive up out of pocket spending even further. Having our health insurance tied to our employment makes it very hard for people to retire early in this country which is one of the reasons our system has not changed. Employers don't want people to retire early because the loss of experienced employees. Our government does not want people to retire early because they are bought and paid for by big business. I was lucky to be offered an "early retirement package" this year and fortunate enough to be in a financial position that allowed me to take advantage of it. The package contained access to healthcare so I jumped on it. I am going back to work for 2 to 3 more years and then I'm done. I hope people will eventually realize that the U.S. needs a public option that allows us to pay premiums into a non-profit system with reasonable out of pocket expenses that won't rob us of our hard-earned retirement savings. In the U.S. right now the average retiree spends $275,000.00 out of pocket between retirement (age 65 to 67) and death. That's a huge chunk of anyone's retirement savings. The way the U.S. economy is currently set up, we all work our butts off and save as much as we can to retire, only to have private for-profit corporations do everything they can to take our hard-earned wealth and realize it as revenue and profits for themselves. That's really how our economy works. We will never get to a place of economic security in retirement as long as people continue to vote for the same Republicans in congress.

[@DaveM-FFB]

I agree completely

[@maryyoung7646]

Well said Chuck. I agree with you. As a nurse; this is a huge topic amongst my co-workers.

[@MaxPower-11]

‘With Medicare “you have to find additional private supplemental insurance to cover the gap which can be VERY expensive if you have any pre-existing condition”’ This statement is not exactly correct. If you sign up for supplemental coverage (traditional Medicare) within a 6-month window of starting Medicare then medical underwriting is waived and pre-existing conditions will not affect your premiums. Also, you should definitely shop around for supplemental plans as there could be vast premium differences on the same coverage between insurance companies (luckily all supplemental plans have standard coverage tiers and are therefore easy to compare between carriers).

[@chuckmurray1825]

@@MaxPower-11 I plan to select Medigap. I've read about all the problems with the private supplemental plans and of course with private insurance companies, they are all about taking as much as they can from you in premiums and paying out as little as possible. They set up all kinds of roadblocks and copays to take as much as they can from you to increase their bottom lines.

[@headlibrarian1996]

How does Portugal tax expat income? EU-zone taxes can be pretty darn stiff.

[@stevelach]

I took an ACA (Covered California) high deductible plan with an HSA starting in January. Like you, I'll use ROTH conversions and qualify for subsidies. I'll pay the first 6k/year out of pocket, then everything is 100% covered. Cost is about $67/month.

[@susanharkema2888]

Does your plan cover care outside of Cali? Thanks for info!

[@stevelach]

I’m not sure if my coverage is valid outside of California. Luckily for me, I traveled for work and part of my FIRE plan is to stop traveling!

[@missadda8890]

The health care industry has done an incredible job in convincing Americans that national health care is communism but once they reach 65 its absolutely fantastic and they cannot wait to enroll,kudos to the PR teams of these companies and the lobbying firms they hire they are doing a fantastic job.

[@nenefry8502]

have you actually been on Medicare? you get denied constantly. any doctor that comes by charges you $300 you get charges like you never believe and no one is looking. It's a frigging disaster. Medicare really is terrible. I'd rather have private insurance. Or give me $300,000 and I will take it from there.

[@genefields8097]

Great video! My wife and I are retiring a little early on January 1 and had the same insurance dilemma. Cobra way too expensive, both of us have pre- existing conditions so the only option is the ACA. We also took the BCBS HSA option in NC. Just have to keep our income below 68k to receive the subsides! Hopefully the Supreme Court keeps their nose out of the ACA.

[@billcummins9579]

I'm 64 and working for insurance... it's crazy.. I'm a college teacher and still paying $1,000 a month for my wife and I. State College.

[@FionaMacDonald]

Great video! Retiring in Feb and going to Cobra for 18 months. After that ACA because I have pre-existing conditions. Never been more grateful to be dual citizen of US/UK. I don’t understand why Americans settle for this situation (well I suppose cause most people get coverage through work), but still. Ridiculous situation for 1st world country!!

[@mrgopherguy]

Hi Fiona, I don't know if Americans settle for this situation as much as the insurance industry controls this horrible state of affairs. A lot of people in this country do believe healthcare is a basic right and are trying tiressly to encourage legislators to make it a reality. Unfortunately many feel sort of helpless and that may give the appearance Americans simply settle for the situation. I agree 1000%, it is ridiculous situation.

[@FionaMacDonald]

@@mrgopherguy yes I guess that’s true - the lobby industry certainly has a stranglehold on the legislative process!

[@barbiec4312]

Agree that it is completely ridiculous and I work for a large HMO! The reason people won’t go for it here is that the don’t want to pay for it through higher taxes like you have in the UK or other countries that have universal coverage. It smacks of “socialism” to the uneducated and that word is thrown around to create fear about losing freedom, increased taxes, more government etc. it is a serious trap that we are in and truly criminal. We are stuck to our darn employer coverage.

[@excatholicatheist]

@@barbiec4312 People say they don't want higher taxes but are ok with paying healthcare premiums and high deductibles. Plus when you consider the huge amount of money spent administering all of these "plans", we would be much better off with a single payer system. Healthwise and financially

[@susiestaton5544]

What about the large wait times to get treatment and situations like where the government in UK would not allow parents to send their baby to US for treatment. Maybe the baby would have died anyway but deserved the right to try. There are major downsides to universal Healthcare also. Also if there isn't a profit/incentive to be made for new health inventions then they will stall. I do believe there should be caps though.

[@cinderoftheland1496]

🙋🏻‍♀️ working for health insurance

[@julieg-b8910]

I semi retired at 58 (work only when I want to🥳) and was able to continue on company provided insurance for the first year and then went onto COBRA $507/mo for 18 months. July of 2020 I took a 1 year American General short term insurance $470 per mo w a 10k deductible and prexisting clause. I was able to lock in for the second year to get price guarantee for 510/mo. So far I am pleased with coverage. I just had to have an emergency procedure and am now in the process of providing 3 year medical history so they have investigate it’s not prexisting in order to cover it. I will be eligible for Medicare in just over 3 years. I agree Going with out insurance is not an option. Hope you stay in Scottsdale is a nice one. I am in Phoenix and love it here.

[@christypotter3315]

Health insurance is a nightmare in the U.S. My husband is retired, and I'm working for insurance while my daughter finishes high school. One more year, and we'll be looking for insurance. I suspect we'll do what you're doing. Have fun in Arizona!

[@amywallace2352]

Oh, if only this video wasn't necessary! It just underscores the sad state of health insurance in the US. Thanks for sharing, it is good content and nice to see what others have chosen in the comments.

[@Roxannelackey]

Went with Christian Health Shares ministry plus have the maximum hospital coverage on our car insurance. FYI...our son was in a major car accident, where he was driving and was at fault and also had two other passengers, a few years back. State Farm paid out way above what the policy cost was for all the medical bills that regular health insurance did not. The car insurance companies do not want the general public and even there employees to know about this practice. Hope this helps.

[@wsgriffi]

Luckily I retired from a company that I was with for over 38 years and was able to get retiree insurance until I turn 65 in 7 years. I chose the high deductible HSA plan. $6 K per person per year deductible but $0 monthly cost.

[@spicycopper2436]

Something to think about when you go get medical services (e.g. doctors visit, MRI, CAT scans, lab work, etc), ask how much it would be if you paid cash vs using your insurance. My friend does this and now I do. He needed a CAT scan. They told him if he paid cash it would be $400 vs $2,000 using his insurance. Based on his situation paying $400 was a better option for him. Just something to consider.

[@Bob-yh7ir]

This really hits close to home as we are looking at early retirement and the only big differential in the budget planning is health insurance. It could be as little as 200 to 300 a month with ACA and subsidies or as high as 1800 a month for private insurance. That's a big difference when trying to budget from year to year. We also plan in early retirement to spend months out of country at a time so navigating those insurance obstacles is like playing a hard game of tetris ! The more we investigate insurance in USA, the more disgusted we get with the crappy and sub par systems.

[@wcdanger6921]

Healthcare is a big issue, and an enormous cause of deferred retirement. My question about HSA plans is this ... Can a medical cost incurred out of country be paid for by HSA funds?

[@julietravels6400]

I chose the same option you guys did for 2021, an ACA BCBS HMO plan with HSA. 2021 will be my first full year of early retirement, and I plan to do some Roth conversions but keep my income (MAGI) under the amount to qualify for a subsidy. I have not contributed to an HSA post-tax previously, but I understand the contribution is tax-deductible and lowers MAGI. I only wish I understood HSAs better last year and had chosen a HDHP with HSA in 2020. Background: I am on a similar ACA BCBS bronze plan but without HSA this year, and it has been OK so far. One of the big negatives to me with HMOs is the limited coverage outside your home area, but I am not a nomad, so it has not been a problem for me yet. PPOs, which I previously used with my former employer's plan, are more than double the premium for the same metal level of coverage with ACA (in MD), and I could not justify the cost difference.

[@jagsterr1]

I too would like to retire due to extreme stress and culture at work, but looking at all options for health care (with no pre-existing conditions), find the cheapest at $690 on Los Angeles with $2000 deductible. My social security will be $1300 which is not much. If I wait to 67 I will get $1700 so I am not sure what to do at any age, so I TRULY appreciate you talking about some options and your experience!

[@gregguiltner8764]

I have Aetna through my former employer. It has great coverage, but costs $641/month. That is family Medical and Dental coverage and includes my wife and our grown "kids" up to age 26. We have four kids in that age range. This plan will convert to a Medicare Advantage plan at age 65 if we wish. I'm not a fan of Medicare Advantage, but we have a few years to research and decide. Thanks for your great informative videos!

[@azwileetoyote]

Sounds so odd... being so financially successful that you're able to retire early but have to 'modulate' your annual income to qualify for Gov't subsidies (free coverage as if you were poor)... i'm not hating, I plan to retire next year at 55 and will be in same boat so thanks for sharing and helping folks to navigate through it... my initial comment just goes to show how broken the US healthcare system is. Cheers.

[@oldfartsadventure]

I have to agree with you on the healthcare front but also wonder how successful some might be given that you really have to watch your pennies and how unforeseen things (like the pandemic) can wreak havoc on your plans. I am not a stay to the script kind of guy and am already retired, but the wife and I were talking about her retiring now at the age of 56 and we become queasy when seeing stuff like this. Not hating either.

[@gerdpapenburg7050]

I am glad to live in a country which you may call socialist but which has the oldest social security system which is based on solidarity. Healthcare is considered to be a service made available to all residents regardless of their personal or financial situation.

[@bladestratford]

From my experience - everyone here says they don't want "Single Payer - Socialized Medicine" until they reach age 65. Then they can't wait to get on Medicare which many would argue is exactly that!

[@BruceFlachsbart]

Another brainwashed CNN watcher, come out of your basement and maybe see how healthcare is done in none socialized countries? Head down to Panama for $20 doctor visits. My Canadian friends can never afford to WAIT to get any of their socialized crappy healthcare - he goes to Columbia. Another Canadian friend goes to Mexico for healthcare because it is faster for him to drive there than see a doctor or get treatment in Canada. The more medicine is socialized the scarcer it is and the less effective. Ask Army vets how well they like their completely socialized and free healthcare.

[@BruceFlachsbart]

@@bladestratford Your experience is crap. You probably don't know anything about what you talk about. Is it hard going through life so clueless?

[@heidibriones]

FYI: All ACA plans have emergency coverage anywhere in the country. HMO, EPO, or PPO. As a broker, I get this question daily but it's not true that some ACA plans aren't required to cover you out of network in case of emergency. It's part of the law.

[@mogain9258]

Heidi, I have wondered what types of medical care I might need while away from home that insurance would not cover. For example, if I am hiking the Appalachian trail and I suspect I have been bitten by a tick carrying Lyme disease, I am assuming testing and treatment wouldn’t be considered emergency care, even though I would consider it urgent. Still, it is good to know the ACA plans would cover the bigger life threatening emergency. Thanks for bringing it up!

[@heidilee6382]

Hi, I was just informed that the my aca plan, that I was trying to get, did not cover out of newt works. Not even emergencies. ??

[@oyamsbabe4028]

I hear Portugal has a great healthcare sys that’s super affordable. Plus, the country is so beautiful. Good luck with your journey and stay safe,

[@schoolofmediocrity2801]

If you're looking at Mexico for 6 or more months a year, might I suggest you go just a little further South to Costa Rica? The weather is great, residency is easy to qualify for, and their health care is fantastic AND incredibly affordable. Panama is another great option, though slightly more expensive. Just food for thought and a desire to be helpful if possible.

[@mrgopherguy]

Hi Tim and Amy, great to see you both. Tim I'm loving those 1970's sideburns. Ok.. on to insurance. I will FIRE end of next April so this is a subject I've been researching for a while now. And if anyone has to research health insurance for 'a while' then you know you live in a country that has sh*tty health insurance - as you both are well aware. Recently MMM published an article detailing DPC (Direct Primary Care, apologies in advance if someone else has already touched on this). Since my family doesn't plan on traveling or being NOMAD anytime soon this might be an option for us, as it's necessary to find A DPC physician near you. Again, I'm STILL researching all this and ACA of course is our only other real viable option. I follow a couple other families who live abroad and it is so tantalizing to think about picking up and leaving the USA after I FIRE, as it seems the folks abroad pay like $1500 for a whole year and have amazing health care. Love this topic, and all the content you provided in this episode. Super interesting!! Have a wonderful time in Scottsdale.

[@keithfrasier]

My wife and I retired at 55 and used ACA for insurance. Without it we would not have been able to retire so soon.

[@DaveM-FFB]

This is a great early retirement topic, and probably the biggest hurdle to FIRE enthusiasts. I'm nearly 63, and self employed. We have an expensive grandfathered HSA plan (non ACA), with coverage similar to ACA, but only slightly less expensive than ACA (no subsidy). We'll probably keep it for 2 more years, until eligible for Medicare. I wish there was an affordable (early Medicare) option for semi retirees.

[@LanceEkum]

Thanks for sharing your health insurance planning process - always useful information! My wife and I are on an ACA plan (we just this year took our youngest child off since he is now out on his own). We have been on an ACA plan for the last three years. This year our premiums did go up quite a bit - but we are also still getting a substantial subsidy yet, too. We've been happy with our plan - and have specifically chosen to get an HSA plan so we can put money away for medical expenses (and/or retirement).

[@annamyers121]

My employer offers retirement health insurance but it’s going to cost us $28k in annual premiums. So we are looking for other options.

[@collad1000]

We have had Liberty Health for the last few years. Fortunately my husband will be 65 in January and we will have Medicare and a supplement. I will probably continue on Liberty Health. I have no preexisting conditions. I may look around though once I get a price from them.

[@scottagbuis5321]

I will retire next year at 55. Wife also not working. I Will get a pension of 24k/yr. I have enough assets (cash, mutual funds) to carry us through until I am 62. We need about 46k/yr to live comfortably. With my annual income only 24k, I will owe $0 in income tax and I will be able to get enough credit to pay for ACA health insurance. (0$ my cost). At 62 I will assess if I will take SSI or wait until 65 when Medicare can take over for me and have to buy insurance( 0$ my cost. Her income may only be SSI. Approx. $10k) just for my wife(63). My "plan A".

[@ryanc7886]

This video has some good food for thought. The quagmire of US healthcare & federal/state tax codes isn't something I would wish on my worst enemy. I'm currently employed full-time, so health insurance is covered via that route. Once I reach FI, the tentative plan is to stay out of the US for the most part - using travelers insurance if there's a major incident and self pay for routine or urgent visits. Planning on living in countries that provide quite a high level of care for a fraction of the cost of the US. If I were staying in the US, I'd work on figuring out how to get the highest subsidy with the ACA. Otherwise, I would look into direct primary care/concierge medicine for primary care and high deductible health plan (not a fan of that, but I guess it's a possible option). Short term medical plans might be an option too if only living in the US for a relatively short amount of time, though the deductibles tend to be high for those too.

[@angelabarker8611]

Thank you! My greatest fear not having health insurance.

[@pettipaw]

Still working, but wanting to retire now at age 52. If I continue to work until age 55 (assuming my company keeps me that long, which is questionable), I will receive health insurance at slightly more than employee cost until I reach Medicare age. I keep looking at my numbers. If I use the 4% rule, I'm fine with un-subsidized insurance. If I use the 3.5% rule, then I'd need subsidized insurance. Then trying to estimate my income by pulling funds from my brokerage account.... I had no idea about ACA plans having "areas" where coverage applies. That is pretty shocking to me, as a person who likes to travel a lot (both in the US and outside of the US). That I'm going to need to research more on.

[@marierika2012]

I am a nurse, in America lots of nurse work in Perd diem bases where hospitals are not offering any coverage but instead a higher pay. I took the pay since I was young and healthy, but Covid came and I had to take insurance this year...I also plan to retire out of the country.

[@maryalex092761]

Like you said, so complicated and state dependent. I can live off of savings but wanted to get the subsidy. Like you, income will be IRA/401K withdraw. doing IRA to ROTH conversion and some consulting- it's rolling dice to have to guess at MAGI. Trick is to keep you eyes closely on the MAGI because you could end up having to pay back the subsidy if one makes too much. I know folks who had to do that which was brutal. thx for this video!

[@jimclark5037]

Wife is 62 and retired, I'm 59 and looking to retire ... sometime on or before 1.1.24 ,healthcare is the big issue. Starting to look at ACA, keeping AGI low enough for subsidies (so delaying one of our soc security most likely)

[@GoWithLess]

We know how that goes!! You’ll be retired soon!

[@artmania2239]

Here in Trinidad and Tobago thank God we don't pay for most health .example hiv medication is totally free and if they give you a referral for other health issues you still don't have to pay in almost all cases

[@scottprice4813]

This is definitely a mess but just imagine things without the aca! I have friends in Thailand and I've thought about being there 6 or so months a year. Found a very good reasonably priced expat plan - has 30% bump for claims in the US. It's underwritten as you mention so I would have the preexisting catch but could deal with it. Another thing I've thought about is a high deductible plan with very good broad coverage after the deductible. I am 60 and could live with that as a bridge until Medicare. That's the question though - does that exist? Primarily you hear about the high deductible plans being like swiss cheese. Any thoughts about a good high deductible individual plan?

[@thinktransnational]

When I retire, until the US gets onboard with every other developed nation and provides its citizens with universal healthcare, I plan to take advantage or geoarbitrage for my medical needs, while of course, fighting for universal healthcare in the US, as best I can from abroad.

[@feartheturtle9618]

My wife and I used Anthem Healthkeepers HSA plan for 2020 and will do same for 2021. She will go on Medicare in August 2021. I will be on Medicare April 2022 and will seriously look at Medi-Share for those 3 months. At the present we are pulling enough from IRA to have a $0 premium. Will pull from Roth if needed which is not included in MAGI.

[@travelrefocused]

Excellent info. Thank you for sharing your experience on this very important topic. I have been researching what you refer to as expat insurance pretty extensively. Things can get pretty complicated even within that realm. I do feel there are several good choices that are affordable if you plan to spend most of your time outside of the U.S., are OK with a high deductible, and are OK with taking advantage of the lower health care costs outside of the U.S. and paying out of pocket for some things. But, as you have pointed out, being outside of the U.S. right now is a challenge. As a result, we plan to keep working part time to maintain our employer provided insurance until our plans become more clear and we start our travels. Then, "expat" insurance it is. I must admit, we are now getting a bit antsy, considering we were planning to get going this past October. However, we also count our blessings and are thankful we have coverage. Safe travels!

[@beckytibbits5548]

Hello Tim and Amy- greetings from sunny warm chapala where it is in the low seventies at noon on December 17th! We are one of those incredibly fortunate people who were able to retire and continue with Tim's health coverage that covers us anywhere in the world in network! Still interesting to hear about your situation. I also really like the outdoor filmings to showcase other parts of the world, even though it makes bloopers! Merry Christmas, Feliz Navidad.

[@markbajek2541]

In Michigan the my healthy Michigan plan is essentially medicaid that you pick your provider, Blue Cross , Anthem etc . IF you make under 16K per year and fall between 54-64 it's essentially full coverage, no real co pays , and not asset tested. Just income tested. You could have a billion dollars in IRA's and because you don't legally have to distribute those assets as income until 72 or so, they don't consider it as potential income unless you happen to make a with drawl that pops you over 16K a year. I'm not sure why this of all the state's welfare type programs is not asset tested.

[@matsulli2086]

What was your experience with ACA in Colorado? Did the plan cover you throughout the US? I want to retire at 63 but need minimal coverage for two years.

[@deboramorrissey7442]

Hi, I will be eligible to retire in 3.5 years. I am fortunate that I work for the federal government and will have health insurance available to buy after I retire. There are requirements that take place years in advance (of retiring) for me to have the health insurance after retiring. So I have been making sure that I have met all of those requirements and documenting it too - very important. I do try to keep current on what others who do not have this option (post retirement) are doing for health insurance. Thanks for the informative video.

[@mainsale1]

We are on the same page as ya’ll. Asa with high ded 7,000 with 0 premium so we can do HSA

[@hundo9314]

Neat to know you have 3 kid's. Would be proud they all have insurance. My 55 year old sister just died without insurance. Liver failure took her out fast. Never got any disability or Medicaid. So sad all the hospitals are out all that money. Met a lot of people going on this journey. But very sad my sister could have had better care. If she had insurance. Lucky to be on Bob Hope drive. Sure weather is great.

[@ZariNation]

A key component of my decision to do FIRE this year was health insurance. I’m on my corporate plan as a retiree, qualified at the minimum age. I pay 2x an employee, but 1/2 the actual cost of the insurance. It’s a pretty good plan US PPO with global coverage, but I need to use providers in-network in the US.

[@kenny8351]

Texas is not a good state to acquire an ACA plan, though better than many others. Many states have much more affordable deductibles within plans, as well as a larger selection of companies. Nice video!

[@socrs]

Got the cigna expat plan with a 6mos. us option with a very high deductible. They were understanding about no covid travel and atleast they say they are not really tracking the 6mos. part (although i'm sure if you were sick for > 6mos. it would be an issue). One thing to watch out for is outpatient care is extra. Assume inpatient would be only major events/surgery etc

[@garycheng901]

Taiwan has one of the best healthcare systems in the world. It’s very affordable! I moved back to Taiwan after living and working in Michigan for over 20 years. The doctor visit only costs me 5 USD. The kidney stone shock wave lithotripsy only cost me less than 50 usd total. I can really retire in Taiwan without worryingly about healthcare expenses.

[@utubeddong]

Do you need a Taiwan citizenship? Can you get health care as foreigners?

[@garycheng901]

@@utubeddong You don’t need to be a Taiwanese citizen to get covered. As long as you have an ARC (resident certificate), then you can apply for the national Healthcare Insurance. You can find a teaching job in Taiwan. It’s the easiest way because there are many English teaching positions in Taiwan.

[@utubeddong]

Thanks

[@MOstix13]

What is the best way to find the right ACA plan for my situation?

[@FakePersonna]

I am 51 and FI with no debt. My wife quit her job 6 years ago. The ONLY thing keep me stuck my current job is the health insurance. If I can figure that out, I would quit literally tomorrow. ACA sounds like an option, but what happens if it goes away? I will need health insurance until FRA when I can get MediCaid.

[@northwindswi]

Retired at almost 60. We will do COBRA for 18 months and then look at our options each year. Residency overseas is one of the options we will look at. The allegedly best health care system in the world is forcing more and more people to be underinsured or to move from the U.S.

[@TeeAnn]

Lol, yes the whole topic stinks! It doesn’t need to be this complicated. Hope this gets worked out for all of us. My hubby turns 65 next January, but I have a few years to go. Crazy we all have to be excited for Medicare 🤪 He would like to retire in a couple years (so not early) so I am keeping my fingers crossed that the American insurance system gets fixed! 🤞🏼I really enjoyed this video.

[@badman5314]

We retired but our employer offered our same insurance plan to us but at a higher cost sharing. They subsidize 50% of the premium. Our premium share for a blue cross/blue shield PPO is $900 a month with a $750 deductible per person and then we pay 20% of eligible charges. Overall, we are out of pocket about $13,000 per year after prescriptions and no major events. It could be much higher so thankful to have good insurance.

[@cathypressey7876]

I was able to retire at 60 with my company insurance which cost me$517 a month. This insurance includes vision and dental.

[@me-lg1yw]

You may get a better deal under the ACA with a subsidy. Doesn't hurt to look into it.

[@Schultzman]

I don't understand why a company would subsidize someone's health insurance for 5 years if they are no longer an employee. I must be in the wrong company!

[@SM-jk9vs]

How did you sign up for your blue cross policy? I retired early and make too much for a decent ACA priced policy. They all come out to over 1200-1500 a month. Would be for my son and I

[@azmom0014]

Figuring out Health insurance is a tough subject. Awesome you guys are coming to Scottsdale. Weather will be really nice. Is there a FIRE group that meets around here ? Or a Forum ? I understand it’s difficult with our current situation of course. At least this time of year we can be outside comfortably and social distance. I’d like to give you guys some options that I know about in PHX and Colorado for health care if you are interested. These models may exist in other places , too. Would really like to see what you think.

[@scottprice4813]

By the way - the expat plan was Pacific Cross.

[@griffinreitz7041]

In FL it is exactly opposite. We have to have a PPO because we travel a lot. Or at least we used to LOL. Here an HMO will not cover us out of state, I'm told. We have had great luck with the ACA. My only problem with it is I am capped on how much money I can make till I'm 65. I semi retired at 40. Was a part time options and futures trader for about 10 years, and have goofed off since 08. I'll be 64 in March, so I don't have far to go. Part of me hates not trading in these great market conditions, but part of me thinks making to much passive income is a great problem to have ! I would love to be able to add to an IRA, but I haven't have earned income in over 20 years...LOL And I'm darned sure not getting a job. Haven't had one of them my whole life. I highly recommend retirement, and we are really enjoying Florida.

[@daveerickson5313]

Retired at 53 over 3 years ago. I went on a health sharing plan (CHM) and couldn’t be happier. I’ve never spent less on our healthcare (premiums + out of pocket). I wonder if I should have made this move before I retired?

[@lennysheldon7685]

do mind saying what your best case scenario and worst case scenarios are in terms of medical/health care costs are for 2021? Best case meaning no doctor visits (costs only include health insurance premiums) vs worst case meaning you have to pay full deductible plus the yearly premiums

[@doughunter8396]

We’re paying $2,500 a month for health insurance, for myself, my wife and our niece. Looking forward to changing states at some point for better rates.

[@doughunter8396]

@K Maxx we have custody of our niece

[@amandasartor2278]

Hey Tim and Amy! My husband and I are working for the next 5-8 years but are trying to figure out what to do about health insurance. For now. We both have HSA's and paying health expenses out of pocket so the money will grow over these years and be ready for us to use in retirement. Hopefully we will figure out the rest before we get to retirement.

[@cr6323]

Thank you for sharing health care plans during early retirement. ACA with HSA seems good way to get you through until you get medicare and I was considering myself. Question is: Does ACA cover outside the state you get ACA ? I appreciate any comments or info you have.

[@headlibrarian1996]

If your state has HSA-qualified ACA plans. Many don’t these days.

[@RetiredLovingIt]

Great information! Was wondering what you do for healthcare if you retire early.

[@stevenmessina3077]

Insurance planning in the USA is so fraught with risk. Because you do not ever know - what you have bought until, you have to use it. More importantly, the state ACA plans are generally limited to the state or as you said the county. This is not real insurance. Since in America knowing where to go for life saving treatment = less mortality - Regional Cancer centers etc., means that you usually are out of network - no coverage . period. Unless, you have a nationwide PPO/HMO plan. Because with a brain tumor you are not going to go to the county hospital in your ACA plan. You are going to Mayo or Dana-Farber etc. These gems costs a fortune. Medicare - makes a difference since it is accepted in all states but not abroad ex-emergencies.

[@365vacay]

If you eventually go with expat insurance, I would love to hear your thoughts. I have looked over IMG, but it would be great to hear first-hand experience. I will resume my nomadic life later this year... living outside of the US more than six months of the year.

[@AlexSmith-mi1rm]

Amy and Tim, First off thanks for this informative video (and for all your videos for that matter!). I'm getting ready to fire with my wife in the near future, but I'm a bit confused on one thing in terms of how one qualifies for the subsidy from the Gov. and what, in their view constitutes income? In other words if you are both retired, wouldn't your salary be $0.00 and thereby qualify you for the highest subsidy possible? At one point do the withdrawals you make count as 'income'? My guess was that money I withdrew from my 401k would be taxed, BUT not count as income. Could you help clarify? Thanks again for all the great information, my wife and I really enjoy watching these and I also agree with other commenters that seeing where you are in the world 'outside' is fun! There are some cheap options for a windscreen which will help (but not cure) the noise the wind makes. Keep posting and keep us posted! :)

[@stevenk195]

No. If your income is below a certain threshold, then you don't qualify for ACA and have to get forced on Medicaid, which is something you don't want to do. You need to show a certain amount of income. In my State, this would be around like $18000 for a couple. Generate too much income, say over $63000, and the subsidy ends completely and you pay $20000/year for insurance. One way to show income is to do Roth conversions. Seriously, you will need to do MUCH MORE research on what is considered income. Highly recommend searching youtube for more info, and visit healthcare.gov as well. We've spend two years researching this, and the topic is vast. Having your retirement structured correctly (taxable, IRA, roths, debt free, etc...) is very important as well.

[@stevenwilner7696]

Thank you great video and this is a very difficult subject. I guess I ask WHY? But after years I can certainly believe and understand and I guess just have to accept it?? But I want it to change... you asked about foreign insurance and I have those types of issues too.... And getting information is EXTREMELY difficult. So thanks again and wishing you a great life and great travels.

[@bridgetlove1884]

Maybe I missed it on the video, but what insurance will you use if God forbid you need outside of Texas but in the US?

[@GoWithLess]

Great question. There are 3 kinds of medical issues we could face traveling in the US but outside of TX. 1. Stuff that won’t break the bank. Considering our huge deductible, we’d pay out of pocket. I visited 3 Urgent Care facilities in February (did I have Covid?) and never even submitted the claims because we’re nowhere near the threshold. 2. Major stuff like cancer. We’d hightail it back to TX for treatment and rent a furnished place or stay in a hotel. 3. Major urgent stuff like an aneurysm. We need immediate treatment on-the-spot. We’d hope that we’re covered but understand that we might not be. Some of this would be included as “life or death” but unclear exactly what is covered. We’ve tried to get information about this piece and it’s next-to-impossible. The answer really amount to “it depends”. A terrible answer, but it’s all we’ve got.

[@bridgetlove1884]

@@GoWithLess I hope it's a non issue.

[@bridgetlove1884]

Just avoid an ER visit if at all possible as the cost of a visit is skyrocketing due to hospital mergers. I have a HDP and my son's ER visit bill for dehydration was in the neighborhood of $9,000. My OOP was around $3,500. For a 30 minute visit and bag of fluids.

[@me-lg1yw]

@@GoWithLess #3 gets a big UGH!

[@GoWithLess]

@@me-lg1yw Yep. 🥲

[@jasonedwards2571]

I have to wait until I am 52 to get access to early retirement healthcare. My university offers healthcare for retirees after 20 years of service (5 years to go). However, in order to get it I have to maintain and take income from my retirement accounts (e.g. annuitize one of them). Not sure I want to do that.

[@maa11235]

Did they say how much they have to pay monthly? I didn't catch it.

[@janefromthecountry1820]

Good morning Tim and Amy! Excited to watch this video with my husband later this morning. Best wishes! 💐🥰

[@greyhk2]

I retired in my mid forties. I live in both NJ and the Dominican Republic in the Caribbean and have insurance in both. Health insurance/care is dirt cheap in DR, and pharmacy meds r otc there too. And I chose to scrape the bottom of the barrel with Medicaid in NJ as well.

[@gibbs2799]

I have catastrophic health insurance through my former employer with $3000 deductible with maximum of $6350 per year. It works because I travel a lot and healthy with no monthly premium I have pay.

[@henryrivas8999]

Great information, this is one of those topics, that as much as you gave..., it didn't relieve any of my anxeity on heath care outside of my now subsidized work health insurance. , lol. One of the reasons, we want to retire out of the country. Thanks guys!

[@PicklesFiona]

How is an HSA different from just putting money into a separate savings account?

[@GoWithLess]

All growth/earnings on an HSA account aren't taxed as long as the funds are used for qualifying expenses.

[@PicklesFiona]

Thanks for the info.

[@conker206]

I'm a huge Trump supporter and could be considered "on the right", but I'm almost to the point of saying have the government pay for healthcare. We pay around $440/month for ok'ish insurance for 3 people. $440 a month is technically "cheap" but it's still a huge hit in our bank account every month. It's not super great but it'll do. However if you want GOOD health insurance, youre looking to pay well over $1,000 a month EASILY. That's the cost of a home. Prices have become insane and insurance is not affordable.

[@erinaustin9968]

Great info! The bottom line is to know the rules.

[@juliegoodwin6850]

Early retirement this year in TX and pay a small fortune for an HMO ! Included in our retirement is lots of exercise to keep us healthy!!!!!

[@andrea2015]

I apologize if you've covered this before (this is the first video I've watched of yours) but how do you get your mail being nomads?

[@GoWithLess]

Welcome to out channel! We talk all about it here...kzbin.info/www/bejne/hH26lmqdpc51e6M

[@Yazzie101]

I’m looking now and it’s a bloody nightmare ., these plans are covering nothing! I’m in Florida! The subsidy almost looks fake as the plans the cover nothing include my subsidy of $1100 month.. you don’t pay that amount for a nothing burger 🤷🏻‍♀️ very sad!!

[@ashleyhofmann6588]

I'm FIREing in the next 3 years and have looked into ACA. Similar to you, I can "modulate" my income to receive subsidies that make insurance affordable. Something I've noticed on the ACA estimator and question for everyone - If income is low enough you qualify for state Medicaid. Would you consider going on Medicaid instead of the plans offered by BCBS or other insurance companies? (Also, here's hoping the health insurance situation improves in the next 4 years.)

[@Mexicobeanpole]

That’s one of my biggest hopes for this new administration. Health care.

[@me-lg1yw]

@@mcrv7a There is no asset test for NY or CT. I haven't looked into other states but I'm sure it's similar. Seems odd, though. It's an unintended consequence of trying to ensure that everyone has access to medical coverage. The bureaucrats don't want to do the hard work required to make the system make sense. Plus, they don't want to lose political donations or votes.

[@CP59FIT]

The US is one of the highest costs of healthcare in the world. Most countries you would consider as an expat you can get a year of insurance in that country for around $400 per year. Also many expats just pay out of pocket it is so cheap. A lot of Americans' are currently doing medical travel. Where they go to a cheaper country medically to have surgery or dental work done and what they save more than pays for the trip.

[@GoWithLess]

Yes!! We have heard lots of stories about medical tourism. I had a basic cleaning in Mérida, Mexico just to see what the quality of care was. It was an excellent cleaning and about 20% of the cost of a US cleaning.

[@nesadcruz7840]

It is insane how expensive your healthcare is in the US, you definitely need insurance. It is expensive in Singapore too , not as bad as the US though. However across the border in Malaysia it is much cheaper and pretty good.

[@pmmahone1]

Interesting topic. Wish you would have left the expat info for another video.

[@tracywinters9502]

Thank you so much for the mention, Tim and Amy. It is a real pleasure working with you, and working with those that you have sent Good Neighbor's way! For those traveling internationally that needs medical coverage, whether comprehensive or catastrophic, keep in mind that going through a broker like Good Neighbor Insurance does not cost you any additional premium. You get an advocate for free! We are never too busy to answer your questions and work for what you need.

[@santanu2207]

Eligibility for ACA discount, does it only depends on earned income or your overall assets as well. Pls let us know.

[@GoWithLess]

In CO and TX where we’ve used the ACA, our assets have not been considered. Just earned income (which is affected by financial transactions…capital gains, Roth IRA conversions, etc).

[@santanu2207]

@@GoWithLess Thanks a ton! Anybody in CA, can you please share your experience. We are in the path of FIRE but this thought of health insurance cost is the biggest concern that spoiling the plan.

[@GoWithLess]

@@santanu2207 Since this video is 5 months old, you won't get much in the way of a response. Are you in our new Facebook group? That's a great place to ask this question! It's just 2 weeks old and we shared about it in this week's video - kzbin.info/www/bejne/fZuqqYiHoL-Ejs0 (GoWithLess group if you just want to go right to it...please answer the questions to join!)

[@marinoadr1]

Great video. Thank you for sharing such important information.

[@MW-mx6lu]

Very helpful! Thanks so much

[@boricua_in_wa]

Spouse may get us state insurance if works until age 55.

[@da7heaven]

I think we'll do COBRA for the first 18 months and then who knows.... we still have dependent young adults.