# How to Retire in Your 30s With $1 Million in the Bank



## RNCollins (Sep 8, 2018)

*How to Retire in Your 30s With $1 Million in the Bank*
https://www.nytimes.com/2018/09/01/style/fire-financial-independence-retire-early.html

By Steven Kurutz / The New York Times / September 1, 2018

“Carl Jensen experienced what he calls “the awakening” sometime around 2012. 

He was a software engineer in a suburb of Denver, writing code for a medical device. The job was high-pressure: He had to document every step for the Food and Drug Administration, and a coding error could lead to harm or death for patients. 

Mr. Jensen was making about $110,000 a year and had benefits, but the stress hardly seemed worth it. He couldn’t unwind with his family after work; he spent days huddled over the toilet. He lost 10 pounds.

After one especially brutal workday, Mr. Jensen Googled “How do I retire early?” and his eyes were opened. He talked to his wife and came up with a plan: They saved a sizable portion of their income over the next five years and drastically reduced expenses, until their net worth was around $1.2 million. 

On Tuesday, March 10, 2017, Mr. Jensen called his boss and gave notice after 15 years at the company. He wasn’t quitting, exactly. He had retired. He was 43.

*Hacking Your Way to Retirement *
Although Mr. Jensen’s story may seem exceptional, a more modest version of the stockbroker who makes a killing on Wall Street and sails off to the Caribbean, he is part of a growing movement of young professionals who are intently focused on quitting their jobs forever. 

Millennials especially have embraced this so-called FIRE movement — the acronym stands for financial independence, retire early — seeing it as a way out of soul-sucking, time-stealing work and an economy fueled by consumerism. 

Followers of FIRE tend to be male and work in the tech industry, left-brained engineer-types who geek out on calculating compound interest over 40 years, or the return on investment (R.O.I.) on low-fee index funds versus real estate rentals....”



 
Photo:  SecretEntourage.com


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## MOXJO7282 (Sep 8, 2018)

He better have a way to continue to make more money because $1.2M net worth doesn't mean $1.2M in cash, even that wouldn't last the rest of a 43 yrs life unless he goes off the grid to live in the forest and doesn't have a concern with healthcare. He has alot more living to do.

 I hope to retire in 5 years after what will be 30 years in Corp America and we've been very smart with our money and have more than the $1.2m which they say should be enough if you retire at 65 or so but I'm still very concerned about the future of healthcare and how much that will cost considering my wife has lupus and RA.


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## am1 (Sep 8, 2018)

That's great for them but 40k a year is not much.  Things can get expensive in a hurry.  Inflation can wipe out ones savings.  Advancement in technology as well. 

I hoped for the same but after retiring work harder then ever but I enjoy it.


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## Passepartout (Sep 8, 2018)

Someone 40 is looking at very likely 40 and should plan for 60 more years. That million dollars better be someplace besides a bank if it is to provide sufficient income for a couple for that many years. I'm afraid that a lack of 'qualified quarters' will leave their Social Security lacking in 25 years, Health insurance will take a very large bite for 25 years, and that 'life of leisurely retirement' ain't cheap unless one wants to do little more than tend the garden they will need to eat from and sit in a lawn chair doing crosswords.

Still, there is something to be said for saving aggressively while young, and living well below one's means in order to retire both earlier, and wealthier than those who wait until their 50's or later to get serious about saving for a better 'tomorrow'.

That leaves just the crap shoot of one's health as the great unknown about 'how long, and how enjoyable' one's retirement will be. 

Jim


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## bbodb1 (Sep 8, 2018)

As I am getting in the neighborhood of considering retirement, every consideration toward retirement has been bloodily beaten into remission by the costs and uncertainties associated with healthcare costs.  
Nothing else is even close. 
I feel like we have housing under control.
And (hopefully) our investments. 
But healthcare is the great unknown.


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## am1 (Sep 8, 2018)

bbodb1 said:


> As I am getting in the neighborhood of considering retirement, every consideration toward retirement has been bloodily beaten into remission by the costs and uncertainties associated with healthcare costs.
> Nothing else is even close.
> I feel like we have housing under control.
> And (hopefully) our investments.
> But healthcare is the great unknown.



You may be better off to move to a place where health care is reasonable.


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## Brett (Sep 8, 2018)

retiring in your 30s is nice but you would probably need more than a million and like others have mentioned health care costs could be a problem


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## PigsDad (Sep 8, 2018)

I guess if they want to basically live not much above the poverty line for the rest of their lives, they might be able to retire on such a small amount in their 30's or 40's, but who would want to live that way?  The big unknown of health care expenses as I get older, which rise much faster than general inflation, would cause me more stress than any job, IMO.  I guess by their standards I could have retired in my late 30's, but I want to have fun in my retirement, not worry about pinching pennies for the rest of my life.  I guess it takes all types...

Kurt


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## BJRSanDiego (Sep 8, 2018)

Interesting article stressing the importance of living below your means, and saving a lot while still working.  Those two things are really important.  The author should have teased his audience though with a follow-on article of "how much can I afford to spend in retirement without running out."

The "4% rule" is a good starting point.  No two financial advisors will give you the same answer of whether it should be 4% or something less or more based upon measurable or predictable factors and a good crystal ball.  But if you grossly overspend the 4%, especially early into retirement you are more likely to run out of $ early.  I've read that one mistake that new retirees sometimes make is to take an extravagant around-the-world vacation, do a major remodel of their house or buy an expensive motor home.  That $100K that you pull out of the retirement account will never be going back.  If you aren't familiar with the 4% rule, google it.

My best friend had a $1 million retirement nest egg and he wanted to buy a $250K diesel-pusher motor home for traveling a month or two a year.  I helped him understand that it was an awful lot to pull out of his retirement account and wasn't too good of an idea.  He came to his senses and didn't buy the motorhome.  Two months later he died of a brain aneurysm.  His widow was glad that they hadn't bought the motorhome.


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## bogey21 (Sep 8, 2018)

bbodb1 said:


> But healthcare is the great unknown.



Healthcare in retirement is a tough call.  Medicare Advantage Plans are the least costly.  Some actually have no monthly premiums depending where you live.  The problem with them is that you are locked into the issuer's networks and rules.  Traditional Medicare is no free lunch.  In addition to your Plan B premium you really should buy a Supplemental Policy and a Prescription Drug Plan.  The benefit of Traditional Medicare is that you can go to any Doctor or Hospital that takes Medicare anywhere in the country and don't have to fool with referrals.  For some this is a tough call and is generally based on how well off one is financially...

George


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## WinniWoman (Sep 8, 2018)

For us the worst seems to be health care insurance and property and school taxes, as well as other insurances- like car and homeowners.


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## DaveNV (Sep 8, 2018)

I have a friend who got a big settlement from Verizon a number of years ago. (He was a very long-term employee, sued them over some sort of labor discrimination issue, and he won.  I'm not sure how much he received, but I heard it was a lot.  They encouraged him to consider "early retirement."  He took the money and ran.)

He'd always been frugal, to the point of being the poster boy for squeezing every drop of blood out of every rock he ever found.  I've never seen anybody as cheap as he is.  (But it's his life, not mine.) He had invested in a vacation condo in Mexico a number of years before, and would take his vacations there.  At first he went there for a couple of weeks at a time,  Then for a month.  Then three months.  And finally, he said, "I'm not coming back."  His house here was put into a rental program through a real estate company.  He sold everything else, and moved to Mexico permanently.  

It's been more than ten years, and he's still there.  He married a Mexican National a few years ago, so I assume he now has some sort of dual citizenship, and from all signs, he is very, very happy.  He's still as tight-fisted as a man can be, but he lives comfortably on his investments.  His house and other investments here have since been liquidated, and he's having great fun on the beach down there.  He's just now about 50.  I'm very proud of him.

Dave


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## Panina (Sep 8, 2018)

mpumilia said:


> For us the worst seems to be health care insurance and property and school taxes, as well as other insurances- like car and homeowners.


I moved to a place with very low property taxes, unfortunately one is stuck with high insurance prices.


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## Panina (Sep 8, 2018)

BJRSanDiego said:


> My best friend had a $1 million retirement nest egg and he wanted to buy a $250K diesel-pusher motor home for traveling a month or two a year.  I helped him understand that it was an awful lot to pull out of his retirement account and wasn't too good of an idea.  He came to his senses and didn't buy the motorhome.  Two months later he died of a brain aneurysm.  His widow was glad that they hadn't bought the motorhome.


Saving is prudent but none of us know how long we will be here. Sometimes $1 is alot, sometimes $250,000 isn’t.  What if he had the time of his life before he left with the motor home? No right answer but something to think about.


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## DaveNV (Sep 8, 2018)

BJRSanDiego said:


> My best friend had a $1 million retirement nest egg and he wanted to buy a $250K diesel-pusher motor home for traveling a month or two a year.  I helped him understand that it was an awful lot to pull out of his retirement account and wasn't too good of an idea.  He came to his senses and didn't buy the motorhome.  Two months later he died of a brain aneurysm.  His widow was glad that they hadn't bought the motorhome.



Sometimes that isn't all that uncommon.  My Uncle had deferred pleasure all through his working life, preferring to be a workaholic who banked and/or invested every nickel.  He finally retired.  He and my Aunt sold their older house, bought a fancy new one, and a big motorhome to travel around the country.  A few months later, he was hospitalized out of state for what turned out to be a severely advanced strain of leukemia.  He died just a few weeks later.  My Aunt was stranded four states from home with a motorhome she couldn't drive, and was now a widow.  Her kids had to come rescue her.  She lived about 20 more years, but was never happy after that.  She felt she'd been robbed of her happiness, too.

As the saying goes, "Life is short.  Eat dessert first."

Dave


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## BJRSanDiego (Sep 8, 2018)

Panina said:


> Saving is prudent but none of us know how long we will be here. Sometimes $1 is alot, sometimes $250,000 isn’t.  What if he had the time of his life before he left with the motor home? No right answer but something to think about.


He was contemplating buying it in advance of traveling.  So, even if he bought it, it would have sat in his driveway....sadly....until he passed.  He was such a good friend.  I miss him a lot.


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## Panina (Sep 8, 2018)

BJRSanDiego said:


> He was contemplating buying it in advance of traveling.  So, even if he bought it, it would have sat in his driveway....sadly....until he passed.  He was such a good friend.  I miss him a lot.


So sorry for your loss.  I understand. I lost my first husband unexpectedly from a brain aneurysm.


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## VacationForever (Sep 8, 2018)

bogey21 said:


> Healthcare in retirement is a tough call.  Medicare Advantage Plans are the least costly.  Some actually have no monthly premiums depending where you live.  The problem with them is that you are locked into the issuer's networks and rules.  Traditional Medicare is no free lunch.  In addition to your Plan B premium you really should buy a Supplemental Policy and a Prescription Drug Plan.  The benefit of Traditional Medicare is that you can go to any Doctor or Hospital that takes Medicare anywhere in the country and don't have to fool with referrals.  For some this is a tough call and is generally based on how well off one is financially...
> 
> George


When people who want to retire early say healthcare costs is the unknown, they are mostly referring to years before they become eligible for Medicare.  Medicare premiums and even with a supplemental insurance + drug plan are small potatoes when compared to how much health insurance cost in the US before they become eligible for Medicare.


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## BJRSanDiego (Sep 8, 2018)

Panina said:


> So sorry for your loss.  I understand. I lost my first husband unexpectedly from a brain aneurysm.


Thank you for your kind thoughts.  After he was taken to the hospital they operated on him to address the aneurysm.  They stopped the bleeding but, sadly, it was too late.  He was gone.  His brain had no activity.  So his wife did the only thing that law allows - - sedate him with opiates and deprive him of food and water.  California has a new euthanasia law to avoid unnecessary and actually barbaric suffering.  But it requires that the person be cognizant and be able to go through a series of three interviews.  So, my poor friend did not have that humane option.  He existed until his system slowly shut down.


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## breezez (Sep 8, 2018)

I want to be able to retire at 56, my wife would be 62...   I want to be able to go and do stuff before I’m too old to be able to do much stuff.   I have done well saving and think from an expense standpoint I can survive ok.   But my one concern is health care,  It’s the one thing I have no idea how to budget for.   My guess is maybe $1200 per month, but I have no idea.

I would be interested in knowing for those of you that retired early and your pension/employer did not provide health care how are you going about your health care coverage / expenses, and just how expensive is it?


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## bluehende (Sep 8, 2018)

VacationForever said:


> When people who want to retire early say healthcare costs is the unknown, they are mostly referring to years before they become eligible for Medicare.  Medicare premiums and even with a supplemental insurance + drug plan are small potatoes when compared to how much health insurance costs in the US before they become eligible for Medicare.



I cannot wait until i am eligible for medicare.  It will be the biggest raise I have ever had.


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## VacationForever (Sep 8, 2018)

breezez said:


> I want to be able to retire at 56, my wife would be 62...   I want to be able to go and do stuff before I’m too old to be able to do much stuff.   I have done well saving and think from an expense standpoint I can survive ok.   But my one concern is health care,  It’s the one thing I have no idea how to budget for.   My guess is maybe $1200 per month, but I have no idea.
> 
> I would be interested in knowing for those of you that retired early and your pension/employer did not provide health care how are you going about your health care coverage / expenses, and just how expensive is it?


We retired 2.5 years ago - me at age 53.  As you may know as you get older, the premiums go up.  At 55, I pay $900 per month for a "Gold" plan from the private individual market, aka off-exchange plan.  The insurance plans offered by ACA are extremely crappy where we live and none of my doctors, PCP inclusive, would take any of them.  I have no choice but to find something that is off-exchange that costs more but provide better reimbursement rates.  When I get to 64, at net present value, I expect it to go to around $1.5K per month.  The main thing is to budget for it and add another $3K to $5K per year for deductible and co-pay.  Yes, I plan for 20K a year in medical expenses for me.  I cannot wait to get old and get on Medicare.

In the meantime, we are enjoying retirement.  We exercise and golf regularly, and travel a lot - cruise, timeshare, land tour etc.


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## bluehende (Sep 8, 2018)

breezez said:


> I want to be able to retire at 56, my wife would be 62...   I want to be able to go and do stuff before I’m too old to be able to do much stuff.   I have done well saving and think from an expense standpoint I can survive ok.   But my one concern is health care,  It’s the one thing I have no idea how to budget for.   My guess is maybe $1200 per month, but I have no idea.
> 
> I would be interested in knowing for those of you that retired early and your pension/employer did not provide health care how are you going about your health care coverage / expenses, and just how expensive is it?



I know the policy I have which is subsidized by my old company costs about 1500 a month and has a fairly high deductible 2800.  I also looked into Obama care and the unsubsidized rate was about 2200 a month with very good coverage.  That was for 2 at 62


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## breezez (Sep 8, 2018)

Thanks for the reply’s.    So plan on 20K to be safe till Medicare kicks in.   Is that for 2 people or 1?  Hopefully 2.

Not to be political, but I sure hope they can work together to come up with a health care solution most Americans can be happy with and could be reasonably affordable for the average person.


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## VacationForever (Sep 8, 2018)

breezez said:


> Thanks for the reply’s.    So plan on 20K to be safe till Medicare kicks in.   Is that for 2 people or 1?  Hopefully 2.
> 
> Not to be political, but I sure hope they can work together to come up with a health care solution most Americans can be happy with and could be reasonably affordable for the average person.


One person - just me.  My husband is on Medicare.

If you are relatively healthy, you can look into Health Sharing.  It is a much cheaper option but when I spoke with my doctors, they all told me to pay them directly and claim from Health Sharing directly. I am still chewing on it.


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## rapmarks (Sep 8, 2018)

We are on Medicare, and we spend just under twenty thousand a year for the two of us with deductibles, co pays, prescriptions, dental and insurance costs.
I retired at 55, and probably good as my husband has struggled the last few years and we won’t be doing much traveling


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## bogey21 (Sep 8, 2018)

breezez said:


> Not to be political, but I sure hope they can work together to come up with a health care solution most Americans can be happy with and could be reasonably affordable for the average person.



I couldn't agree with you more but am not optimistic...

George


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## am1 (Sep 8, 2018)

I pay cash.  Last month an unneeded x-ray was $7 but the cashier had no change so I gave the $5 bill I had. Anything major and I am getting on a plane where government health care is provided to everyone.  

  My wife and kids have private insurance that totals $160 a month.   Health care does not have to be expensive.

It is because it is allowed and even encouraged.


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## bizaro86 (Sep 8, 2018)

am1 said:


> I pay cash.  Last month an unneeded x-ray was $7 but the cashier had no change so I gave the $5 bill I had. Anything major and I am getting on a plane where government health care is provided to everyone.
> 
> My wife and kids have private insurance that totals $160 a month.   Health care does not have to be expensive.
> 
> It is because it is allowed and even encouraged.



I believe you're a Canadian living in central America? If so, are you sure you would qualify for Canadian health care if you hopped a plane back? My impression was you needed to be a resident (==taxpayer) of a specific province in order to qualify for healthcare.


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## Panina (Sep 8, 2018)

breezez said:


> Thanks for the reply’s.    So plan on 20K to be safe till Medicare kicks in.   Is that for 2 people or 1?  Hopefully 2.
> 
> Not to be political, but I sure hope they can work together to come up with a health care solution most Americans can be happy with and could be reasonably affordable for the average person.


It really depends on your taxable income if you are getting your insurance from the government market plan. If you have high taxable income between premiums, deductibles and co payments it can be for each 20k a year.  If you can keep your taxable income low it can be much much lower then 20K for the two of you.


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## am1 (Sep 9, 2018)

Manitoba and Alberta are two where healthcare starts as soon as one is a resident.  But both requires two planes though.  If it came down to it I would stil take my chances as no hospital would turn someone away regardless of residency.  If I had to pay cash I would.  




bizaro86 said:


> I believe you're a Canadian living in central America? If so, are you sure you would qualify for Canadian health care if you hopped a plane back? My impression was you needed to be a resident (==taxpayer) of a specific province in order to qualify for healthcare.


d


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## Brett (Sep 9, 2018)

breezez said:


> Not to be political, but I sure hope they can work together to come up with a health care solution most Americans can be happy with and could be reasonably affordable for the average person.




not likely to happen anytime soon ..... whoever "they" are working together for reasonably affordable health care costs


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## Patri (Sep 9, 2018)

breezez said:


> I want to be able to retire at 56, my wife would be 62...   I want to be able to go and do stuff before I’m too old to be able to do much stuff.   I have done well saving and think from an expense standpoint I can survive ok.


I am sure this is true for you, do stuff now. Don't wait until you are retired, as this thread has proven. DH and I packed in a lot of living before he was disabled. I am so grateful for our travels (through his work we went all over the country, as spouses were invited to many events, so we were fortunate). We made it work by lining up babysitters including family or friends from out of state, or people in town. We had many adventures with our kids too.
Otherwise, our plans for retirement have been derailed. And we hadn't decided if we wanted a winter home, or to just take extended trips. We both expected to work until at least 65, maybe beyond, because we loved our jobs.
Tuggers tend to get out there and do now, which is such a good thing.


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## pedro47 (Sep 9, 2018)

Great article, we have both been retired for over seventeen (17) years. You still need to save while you are in retirement. Please save for that rainy day.

Inflation, health issues  and medical costs are the three (3) big factors that you cannot predict from day to day in retirement. IMHO.

All I can say is please enjoy every day and every moment.  While you can open you eyes, your body and mind are stable & clear and you can walk, jog or run without a walking cane/stick or in a wheelchair.


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## PamMo (Sep 9, 2018)

If you have saved up to retire early, do not underestimate the cost of healthcare. DH and I retired before 65 and buy health insurance on the open market. We are healthy and don't utilize the health system, so we basically want catastrophic protection.

Two years ago, our insurance _premiums_ (Bronze plan equivalent with $6K/pp deductible) cost us just over $15K/yr.  At the end of 2017, one of the three area providers left our market, so we had to choose between staying with our plan for $28,000/yr in premiums, or switch to a new plan with different providers for $20K/yr.  We switched. We just received notice that our current provider is dropping out of the individual market at the end of 2018, so our only option for 2019 is to go back to our original insurance provider with projected premiums for the most basic plan at $36K/yr.  Actually, another option is to move, which we're looking at now.


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## Ralph Sir Edward (Sep 9, 2018)

This is a very complex issue. Personally, I am only working for healthcare. When I hit 63 1/2, I can retire. I can then COBRA into Medicare.

There are games that can be played with ACA and income, depending on how you retirement is structured. But they are very complex, and not usable for most people. (Hint, they don't work with pensions.)


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## Makai Guy (Sep 9, 2018)

> How to Retire in Your 30s With $1 Million in the Bank



Step 1: Deposit $1 Million in the Bank


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## Panina (Sep 9, 2018)

PamMo said:


> If you have saved up to retire early, do not underestimate the cost of healthcare. DH and I retired before 65 and buy health insurance on the open market. We are healthy and don't utilize the health system, so we basically want catastrophic protection.
> 
> Two years ago, our insurance _premiums_ (Bronze plan equivalent with $6K/pp deductible) cost us just over $15K/yr.  At the end of 2017, one of the three area providers left our market, so we had to choose between staying with our plan for $28,000/yr in premiums, or switch to a new plan with different providers for $20K/yr.  We switched. We just received notice that our current provider is dropping out of the individual market at the end of 2018, so our only option for 2019 is to go back to our original insurance provider with projected premiums for the most basic plan at $36K/yr!  Actually, another option is to move, which we're looking at now.


I feel your pain.  Our state has only one provider too.  My husband is on it and his premiums have skyrocketed like yours. On top of the cost, which doctor he can go to is minimal.  He lost his doctors.  

He is one of the lucky ones because next year he can go on tricare, a military retirement plan.  

I chose to stay on my deceased first husbands plan where I have to pay full cost, the price the company pays.  Initially it was four times the cost of the affordable care act plan and everyone thougt I was crazy to keep it but once I left it I could never go back.  Now my cost is significantly less then if I was on the affordable care act plan and I can go to any doctor I want. Just doesn’t make sense.


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## pedro47 (Sep 9, 2018)

Pania, wants your spouse becomes eligible for tricare, do not cancel it. I do not care what any insurance organization tell you. Please do not cancel Tricare . Is that clear. It is cheaper, better health care benefits and you will have the very best medical care in the United States IMHO.


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## bluehende (Sep 9, 2018)

Panina said:


> I feel your pain.  Our state has only one provider too.  My husband is on it and his premiums have skyrocketed like yours. On top of the cost, which doctor he can go to is minimal.  He lost his doctors.
> 
> He is one of the lucky ones because next year he can go on tricare, a military retirement plan.
> 
> I chose to stay on my deceased first husbands plan where I have to pay full cost, the price the company pays.  Initially it was four times the cost of the affordable care act plan and everyone thougt I was crazy to keep it but once I left it I could never go back.  Now my cost is significantly less then if I was on the affordable care act plan and I can go to any doctor I want. Just doesn’t make sense.



That was me.  If I stopped my old employers plan I could not get back on it.  I could have saved 10 grand a year on Obama care (small pension is only income) but did not want the risk that if Obama care went away I may not be able to get on any plan.


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## BJRSanDiego (Sep 9, 2018)

breezez said:


> I want to be able to retire at 56, my wife would be 62...   I want to be able to go and do stuff before I’m too old to be able to do much stuff.   I have done well saving and think from an expense standpoint I can survive ok.   But my one concern is health care,  It’s the one thing I have no idea how to budget for.   My guess is maybe $1200 per month, but I have no idea.
> 
> I would be interested in knowing for those of you that retired early and your pension/employer did not provide health care how are you going about your health care coverage / expenses, and just how expensive is it?


My wife has some health issues, so her premiums were quite high.  I am generally healthy as a horse and my own premiums were still pretty high.  I had a $6000 deductible.  I could have chosen a $1000 deductible but I would have had to pay about 5 or 6 k more PER YEAR.  So, it was really a wash.

We both had a PPO because we wanted to be able to choose our own doctors and hospitals.  An HMO would have been cheaper.

When we turned 65 we were able to get on to medicare.  Prior to that (4 or 5 years ago) we were paying more than $20K together.  Also, every year or premiums were going up at the rate of around 20% annually.  The insurance companies would explain it away saying that it was the result of a shift of financial responsibility from the public to the private sector.  I interpreted that as meaning that a rising portion of my payments were going to uninsured people.  I wouldn't be terribly surprised if we had to pay for our medical insurance TODAY that it may be between $25 and 30K a year for the two of us.

So, I would recommend that you call some of the healthcare providers or HMO's to get a better estimate.


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## breezez (Sep 9, 2018)

It’s pretty sad you need the earnings off the first $500K of your retirement money just to pay for insurance.    Makes me wish I would have stayed 8.5 years longer in Navy and got my pension.   Arg!


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## vacationhopeful (Sep 9, 2018)

>>> $1MM is not what it used to be. <<< my personal opinion.

18 months ago, my monthly single health insurance premuim was over $1600 monthly. Then at age 65, I move onto Medicare plus supplemental. Even at age 65+, health insurance is NOT free nor really reasonable.

Unless you have BIG HEALTH ISSUES .... work as long as you can and delay collecting your Social Security.

To everyone ... downsize your lifestyle. We have 5 more years til the LARGEST BABY-BOOMER class turns 65 (with access to Medicare). I could had collected full Social Security til age 66 ... but as I am still self-employed (working 40+ hours/weekly), I am letting Social Security 'grow'. My aunt is 93 and in good shape for her age .. living in her own apartment.


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## WinniWoman (Sep 10, 2018)

pedro47 said:


> Great article, we have both been retired for over seventeen (17) years. You still need to save while you are in retirement. Please save for that rainy day.
> 
> Inflation, health issues  and medical costs are the three (3) big factors that you cannot predict from day to day in retirement. IMHO.
> 
> All I can say is please enjoy every day and every moment.  While you can open you eyes, your body and mind are stable & clear and you can walk, jog or run without a walking cane/stick or in a wheelchair.



How can you save money while in retirement when your only income is SS? SS doesn’t cover all your expenses- especially if you just have one check- like when a spouse dies.


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## Talent312 (Sep 10, 2018)

I cannot not stash more $$ in savings with my current retirement income
But I do not need to draw anything from my investments (nest egg), either.

IMHO, it's best to strike a balance between being frugal and enjoying life.
.


.


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## am1 (Sep 10, 2018)

Social security was never meant to be ones only retirement savings/income.  



mpumilia said:


> How can you save money while in retirement when your only income is SS? SS doesn’t cover all your expenses- especially if you just have one check- like when a spouse dies.


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## Passepartout (Sep 10, 2018)

am1 said:


> Social security was never meant to be ones only retirement savings/income.


And furthermore, when SS was set up, life expectancy in the US was 65. Coincidence? I doubt it.


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## breezez (Sep 10, 2018)

I see those commercials on TV where an old couple no longer needs their life insurance plan so they sell it now to get money now.

I wonder how, many of them die from un naturally causes after selling their policy to one.   I would be scared to have a company that could make money off me dying sooner than later.


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## Steve Fatula (Sep 10, 2018)

breezez said:


> I want to be able to retire at 56, my wife would be 62...   I want to be able to go and do stuff before I’m too old to be able to do much stuff.   I have done well saving and think from an expense standpoint I can survive ok.   But my one concern is health care,  It’s the one thing I have no idea how to budget for.   My guess is maybe $1200 per month, but I have no idea.
> 
> I would be interested in knowing for those of you that retired early and your pension/employer did not provide health care how are you going about your health care coverage / expenses, and just how expensive is it?



Liberty Health Share, $231/month. Not very expensive is how we did it, wife is on Medicare, so, her part is about the same. Her total expenses are actually more than mine, and she is on an advantage plan. I never pay the doctor, for me works just like insurance, they bill Liberty (Medcost). Paid for shoulder surgery this spring.

I was able to retire early as we did somewhat penny pinch, some would call it that. I would more call it not waste. Didn't buy a new car every 3-5 years, didn't spend on cigarettes, liquor, expensive cable, no new cell phone every year, etc. It's not even a problem for us, didn't miss any one of those. We mostly eat at home too, imagine that. So, now we can travel most every month of the year as long as we can. Wanted to retire early to be able to enjoy things before it was too late. I should add, retired at 56, could have retired earlier but was helping someone out.


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## breezez (Sep 10, 2018)

Steve Fatula said:


> Liberty Health Share, $231/month. Not very expensive is how we did it, wife is on Medicare, so, her part is about the same. Her total expenses are actually more than mine, and she is on an advantage plan. I never pay the doctor, for me works just like insurance, they bill Liberty (Medcost). Paid for shoulder surgery this spring.
> 
> I was able to retire early as we did somewhat penny pinch, some would call it that. I would more call it not waste. Didn't buy a new car every 3-5 years, didn't spend on cigarettes, liquor, expensive cable, no new cell phone every year, etc. It's not even a problem for us, didn't miss any one of those. We mostly eat at home too, imagine that. So, now we can travel most every month of the year as long as we can. Wanted to retire early to be able to enjoy things before it was too late. I should add, retired at 56, could have retired earlier but was helping someone out.


Steve

I have heard the commercials for medishare and the looked at reviews on line.   Pretty scary.

I just looked at reviews on this one and it to looks kind of scary.

The Concerns with these is they operate outside the scrutiny of consumer protection laws.   

Some like it, many hate them.   And when they have a big claim it seems like it takes tremendous effort to get them to pay.

I like the concept.   I just wouldn’t want to go through life thinking I’m set have a major medical expense, they don’t pay and I’m wiped out financially.

The other concern I see is they don’t have negotiated rates with providers.  So that trip to ER where hospital bills 16,000 and Insurance pays 800 less copay/deductible and writes the other 15,200 off doesn’t seem to apply under these programs.   The seem to have to cover the full freight fee.   If they refuse to cover it could be a disaster for you.

I’m glad it’s working for you.   Anyone else have exoeriences good or bad with medical share systems?


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## Brett (Sep 10, 2018)

breezez said:


> Steve
> 
> I have heard the commercials for medishare and the looked at reviews on line.   Pretty scary.
> 
> ...




I have no personal experience with Liberty HealthShare but have heard of it   "Christian healthcare sharing ministry" that spreads the costs among members.  The complaints with the Better Business Bureau, Yelp, etc. and many other sites  should scare people.


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## Ken555 (Sep 10, 2018)

For years I’ve heard that one of the most typical issues facing (early) retirees is how to handle health insurance. It seems many used to simply gloss over this issue as it was assumed many who qualified to retire early had enough in the Bank to handle any contingency. As we all now know, that’s not the full story since we all desire to retire early (and congrats to those of you who did!). 

Unfortunately, health insurance is a political issue or else we could have a more interesting discussion. All I know is that I have the most expensive plan I can get (it’s the best option for me, as there is minimal to no savings between the plans once you include drug benefits), costs too much, and is still not all that great. 

I’ve had the same plan since 2014. I doubt I will be able to change, as it’s now the only PPO provider in my area. My costs increased as follows:

2015: 8.72%
2016: 28.2%
2017: 18.81%
2018: 25%

I’m expecting another 25% increase in January. How long can this go on before I, and others, are squeezed to the point where there’s nothing left to give?

While I could change to a HMO to lower my costs, the actual savings is actually rather minor (perhaps $250/mth) and when looking at the total it’s worth that extra to me to have choice of doctor, etc. However, I do look at those prices every year.

When I look at retirement options, I find it sad that of the recurring expenses health insurance is more than any other expense. Then I remind myself that I’m still having fun working and don’t ever intend to fully stop, unless forced to do so due to health concerns. 

A good friend and colleague, who is 20+ years older than I and often joins me and others on annual trips, just told me yesterday he was preliminarily diagnosed with Leukemia and is waiting results from other blood tests now. He will never have the opportunity to retire, even if he was able to afford it. 

I don’t understand how anyone could consider our healthcare system and its insurance industry good for the long term health of our country. Something needs to change.


Sent from my iPad using Tapatalk


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## Panina (Sep 10, 2018)

Ken555 said:


> For years I’ve heard that one of the most typical issues facing (early) retirees is how to handle health insurance. It seems many used to simply gloss over this issue as it was assumed many who qualified to retire early had enough in the Bank to handle any contingency. As we all now know, that’s not the full story since we all desire to retire early (and congrats to those of you who did!).
> 
> Unfortunately, health insurance is a political issue or else we could have a more interesting discussion. All I know is that I have the most expensive plan I can get (it’s the best option for me, as there is minimal to no savings between the plans once you include drug benefits), costs too much, and is still not all that great.
> 
> ...


Something does need to change. Many who have health insurance from work or free really don’t understand how many people are getting financially ruined from the escalating costs of health insurance when they have to self pay being they get no assistance being they make a little too much income.

My friends who are rich have no trouble paying.  My friends who are poorer get it for free.  My friends who are lazy work part time to get it for free. Lower middle class pay a somewhat reasonable amount and the middle class, what exists of it gets clobbered pushing them down in class, wiping out their savings.


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## Brett (Sep 10, 2018)

Panina said:


> Something does need to change. Many who have health insurance from work or free really don’t understand how many people are getting financially ruined from the escalating costs of health insurance when they have to self pay being they get no assistance being they make a little too much income.
> 
> My friends who are rich have no trouble paying.  My friends who are poorer get it for free.  My friends who are lazy work part time to get it for free. Lower middle class pay a somewhat reasonable amount and the middle class, what exists of it gets clobbered pushing them down in class, wiping out their savings.



so you think the best approach to getting good health care is to be poor and lazy  (or rich)


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## Panina (Sep 10, 2018)

Brett said:


> so you think the best approach to getting good health care is to be poor and lazy  (or rich)


Unfortunately “good healthcare “ even for the people getting it for free or low cost isn’t that good as choice is gone.

I outright pay for my health insurance and it takes a significant chunk from my assets that I saved working three jobs at times because I didn’t want to be poor like I was growing up.  

I also believe there are many that have disabilities or working at lower paying job that I feel we always have to help provide good healthcare for. 

My point was the people paying the most for healthcare  really can’t afford it and are having the burden to support the current system and then they lose everything they worked hard to attain. 

I personally know someone who is educated and intelligent in their 50’s, owns a beautiful home outright, that had a part time job and was getting their healthcare from the government program for almost free.  They got promoted into a full time position with pay that put them in the position of having to pay significantly for their healthcare. The person said I am making less then I was making part time because of my healthcare costs and working much harder. They quit the job and now working elsewhere part time.  The system allows this and it doesn’t make sense . Work should be encouraged and rewarded, not make you poorer.

I don’t care which side you are politically, this is not political.  Take away the medical benefits our senators and congress people have and give them what we have and we would see the system fixed. Even though many would have the money to pay they would not want the limitations of where they could go.


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## Brett (Sep 10, 2018)

Panina said:


> Unfortunately “good healthcare “ even for the people getting it for free or low cost isn’t that good as choice is gone.
> 
> I outright pay for my health insurance and it takes a significant chunk from my assets that I saved working three jobs at times because I didn’t want to be poor like I was growing up.
> 
> ...



so you think the "system" is making people quit their jobs and "government programs" are giving health care away for free (part time workers)
......
sure,  the politicians deserve the same health care as the rest of us


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## WinniWoman (Sep 10, 2018)

am1 said:


> Social security was never meant to be ones only retirement savings/income.




Yes- I know. And people were never meant to live past age 65 either. But now it's a whole 'nother ballgame.

I was never meant to be born outside of royalty either - but it happened. So- back to that SS check....


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## am1 (Sep 10, 2018)

People have options to make more, save more, spend less or work longer.  If benefits increased that would mean withholdings would increase even more giving people less money on each paycheck.


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## Ken555 (Sep 10, 2018)

am1 said:


> If benefits increased that would mean withholdings would increase even more giving people less money on each paycheck.



Sorry, no. Just no. And I can’t explain why you’re wrong without going political, so please refrain from making similar posts in future.


Sent from my iPad using Tapatalk


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## Brett (Sep 10, 2018)

Ken555 said:


> Sorry, no. Just no. And I can’t explain why you’re wrong without going political, so please refrain from making similar posts in future.



actually the poster could be correct,  "increasing benefits"  could mean extending medicare type benefits to younger people which would certainly increase payroll taxes for employees and employers


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## Ken555 (Sep 10, 2018)

Brett said:


> actually the poster could be correct,  "increasing benefits"  could mean extending medicare type benefits to younger people which would certainly increase payroll taxes for employees and employers



As i posted, i can’t explain without going political. Why try to even guess? Let’s not get the thread locked, as it’s been quite interesting so far.


Sent from my iPad using Tapatalk


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## VacationForever (Sep 10, 2018)

I am in total agreement with @Panina , I have seen it and experienced.  If you have employer provided/subsidized health insurance or retiree ex-employer provided/subsidized health insurance, you are fine.  If you are poor or very rich, you are fine.  Poor gets free or subsidized health insurance, very rich can afford to pay the high costs.  It is the group in the middle who don't have employer-provided insurance that need to pay a substantial chunk of money to receive healthcare, while subsidizing for the ones who receive free or subsidized healthcare.

There are certainly a few loopholes in the law that some of the early retirees here may be able to benefit from.

If you google early retirees can benefit from ACA.  If someone retires and have household taxable income below 400% of poverty level, the person can get premium and cost-sharing subsidies.  So if you have a large chunk of IRA or ROTH IRA sitting there and you are not yet 70.5 yo, and have taxable income and pension if there is one, which generate income of between 135% to 400% of poverty level, you can receive premium and cost-sharing subsidies.  Cost sharing subsidies only apply to Silver plan from the Health Exchange.  If your taxable investment income generates below 135%, then you get drop into Medicaid.  There is no means test on assets in ACA. 

I happened to make use of this loophole to get premium and cost-sharing subsidy last year (only) by buying a Silver ACA plan.  We won't be able to make use of this loophole starting from this year and forward as we will start drawing from IRA and my husband also started his SS income.

My 2017 health insurance premium was $161 per month, with maximum out of pocket (copays and deductibles) costs of $650 for the entire year.  This year my plan costs $900 per month plus $3K deductible.


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## bogey21 (Sep 10, 2018)

A cheaper alternative while waiting for Medicare to kick in, *if you are healthy and have no pre-existing conditions,* are Short Term Policies.  Obama limited them to 89 days but Trump is in the process of again allowing them to be written for up to one year.  The new rule is due to go into effect on October 1st.  Historically  these policies have not been renewable although Trump is addressing that too by allowing renewals for up to 3 years....

I have rolled these policies for my *healthy* 45 year old Son for 6 or 7 years now using both Standard Life Insurance Company and Golden Rule (a subsidiary of United Healthcare) and saved a ton of money...

Note that the risk in these policies is that any major health issue that comes up while you are covered by one of these policies is then considered a pre-existing condition at the expiration of your policy and they will not sell you another after your current policy matures...

George


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## Patri (Sep 10, 2018)

Brett said:


> I have no personal experience with Liberty HealthShare but have heard of it   "Christian healthcare sharing ministry" that spreads the costs among members.  The complaints with the Better Business Bureau, Yelp, etc. and many other sites  should scare people.


I just checked the reviews through BBB, and they are not scary. They reached resolutions. Liberty has 98,000 members, so there are always going to be complaints. Google your own insurance companies. I belong to a different group, and feel very comfortable with it. People need to understand the guidelines. As ministries, they do not cover routine maintenance drugs, so people need to take that into consideration before joining. They also expect members to be non-smokers, and not excessive drinkers. So right away you rule out a chunk of unhealthy people. Routine physicals etc. are not covered. There is also a one year waiting period on pre-existing conditions. But for new illness and injury, you are covered. My monthly newsletter is heartwarming, with beautiful stories of medical expenses paid. People are advised to ask for discounts as private pay patients, and it appears most medical facilities honor that. Then the ministry covers the rest. 
It is a very real alternative to traditional insurance with high deductibles, high out-of-pocket, and high co-pays.


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## am1 (Sep 10, 2018)

Brett said:


> actually the poster could be correct,  "increasing benefits"  could mean extending medicare type benefits to younger people which would certainly increase payroll taxes for employees and employers



My post was responding to the post above me be about social security payouts.  Maybe benefits was the wrong term but increasing payouts in that would require people paying in more.  I am all for a single payer health care system where private insurance could provide extras or allow people to jump the line.  But basic healthcare should be free for all.


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## PamMo (Sep 10, 2018)

I guess the general consensus is a million dollars in the bank doesn't guarantee an amazing 60+ year retirement!!!


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## Brett (Sep 10, 2018)

Patri said:


> I just checked the reviews through BBB, and they are not scary. They reached resolutions. Liberty has 98,000 members, so there are always going to be complaints. Google your own insurance companies. I belong to a different group, and feel very comfortable with it. People need to understand the guidelines. As ministries, they do not cover routine maintenance drugs, so people need to take that into consideration before joining. They also expect members to be non-smokers, and not excessive drinkers. So right away you rule out a chunk of unhealthy people. Routine physicals etc. are not covered. There is also a one year waiting period on pre-existing conditions. But for new illness and injury, you are covered. My monthly newsletter is heartwarming, with beautiful stories of medical expenses paid. People are advised to ask for discounts as private pay patients, and it appears most medical facilities honor that. Then the ministry covers the rest.
> It is a very real alternative to traditional insurance with high deductibles, high out-of-pocket, and high co-pays.




I don't know what you checked but simply *google* "Liberty HealthShare BBB"  and look at all the red warnings from the Better Business Bureau
*Alert!  Alert!  Alert !*
*Pattern of Complaints  *
I don't know your definition of scary but compared to say, Anthem it's about as scary warning for consumers -  as bad as it can get


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## Steve Fatula (Sep 11, 2018)

breezez said:


> Steve
> 
> I have heard the commercials for medishare and the looked at reviews on line.   Pretty scary.
> 
> ...



My opinion is it's just people who are fear mongering. My brother in law has been on them for over 10 years. Know a few others as well, my opinion is that they (the posters) don't understand the product. The government specified under what conditions and rules these things operate, for example, they cannot call themselves insurance. But they are insurance, however not using that word that scares some people. If it scares you, don't do it, doesn't scare me, so I do do it and had no problem at all paying for $80,000 surgery. My sister using it had cancer and many treatments. They paid my physical therapy, where some insurance for people at PT were only allowed 5 visits, mine paid for all of them. They have their money, of course!

"The other concern I see is they don’t have negotiated rates with providers." - Again, a total misunderstanding. Liberty pays 1.something * Medicare rates, it's documented. No provider is missing this info. In your example, 15,200 you would not owe, just like any insurance. Happened on my surgery, of course, since billed amount was vastly higher than paid amount. The same applied to an MRI, I did not owe the ridiculous billed amount. Right on the card, like all medical cards, it says something to the effect of acceptance of this card means you accept what we pay. So, they can decline the card, or, accept it. You are protected for this reason.

"I just wouldn’t want to go through life thinking I’m set have a major medical expense, they don’t pay and I’m wiped out financially."

The same applies to traditional insurance, sorry, but it does. But if you truly believe that only applies to health sharing based on reading someone elses fears, then don't do it.

Not understanding a product does not mean it's bad. As you know, you can find negatives about anything on the internet. Yes, you may have found a lot, but again, I suspect it's people who mostly have nothing to do with health sharing, twisted a story, etc and are just coming up with reasons to justify their fears. I can find thousands of cases about BCBS (or other carriers) not paying for things, maybe tens or hundreds of thousands. One can choose to pay $1,200 a month if they wish, there is nothing wrong with that if you feel it gives you that peace. But meanwhile ponder this..... Assuming this statement is true, and I believe it to be, that Liberty (just an example) has always paid claims (IF they pass the rules like any insurance), how can Liberty charge so little compared to traditional insurance, with mostly better coverage? You can say they only accept healthy customers. Nope, all traditional insurance (before the ACA) always turned me down, always, due to various pre existing conditions. Liberty accepted me, I had written them a nice letter about why my conditions should not scare them, *and they actually read it *(unlike traditional insurance). I found service to be much better than I ever had with BCBS and some others. You can reach an actual person, who actually can make a reasoned decision. I have yet to cost them 1 cent for a pre existing condition just as I told them, I just had an unfortunate shoulder issue that was not pre existing.

So, how is this possible they charge less? My belief is there is a heckava lot more profit in insurance than these companies let on. That, and, the biggest drawback is they don't pay for prescriptions (except for a short period of time if with some illness). I have found this to be an incredible racket. Pills that BCBS paid $200 for, I pay $12 for without prescription coverage, etc. I had one pill I could not source cheaply here in the US, so, went to Canadian pharmacy and imported them for 2% of the US cost. The amount they charge here for some things is simply outrageous. I know I know, that scares some people also, no idea why.

As medical insurance continues to go up, will you be paying $2,000/mo? $3,000/mo? $5,000/mo? It's coming, unless someone actually does something. And that's just premiums, remembering that most plans pay nothing until you pay some massive deductible. Note, not speaking of those with company insurance, speaking of those of us self employed with no access to company insurance, which sometimes is actually good.

My suggestion - read the documents about what is covered, or not covered, and the conditions. There is nothing better than facts, as opposed to opinions like the fear mongerers, or mine. Learn. Then make your decision.

Anyway, I am sure I could ramble on, but, having firsthand knowledge of these systems (several of them) and a lot of second hand knowledge from family and friends, and how they work, I have no concerns at all. Been around a long time (the oldest ones). But that I do not have any should never mean you should not.

PS - I'll add one more thing. People are always thinking that the cash rate people must pay for a service is higher than insurance. I was uninsured for several years (talk about scary!), and was dumbfounded to find I never ever paid more than the discounted BCBS rate, usually, I paid LESS. So, it's just another fear that is not reality. Generally, I would tell a doctor I am self pay, and they give me a much lower rate. I would always inquire before going to a specific doctor (if a new one), and all existing ones that knew me cut me the break.


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## Steve Fatula (Sep 11, 2018)

Brett said:


> I don't know what you checked but simply *google* "Liberty HealthShare BBB"  and look at all the red warnings from the Better Business Bureau
> *Alert!  Alert!  Alert !*
> *Pattern of Complaints  *
> I don't know your definition of scary but compared to say, Anthem it's about as scary warning for consumers -  as bad as it can get



Disagree. I can find those same reviews about many companies. Let's look at Libertys BBB page, what is the average *customer* rating? Looks like 3.5 stars, right? So, BBB (a useless org IMHO for many many reasons) has red warnings, but, actual customers (and remember that complainers are usually more vocal than lovers), rate it pretty good. Comments like this BBB comment are ridiculous: "Additionally consumers state confusion of medical services/procedures covered by the plan. ", well, read the insurance docs! People don't. Has there been some delays, that part is true lately. But the number of members has skyrocketed this year, not an excuse of course. But since I do not pay the doctor, this has pretty much zero effect on me, the doctor is waiting the extra month. That will eventually be solved, I hope, though, with more and more people unable to afford traditional insurance each year, maybe not easily.

Now, let's look at BCBS of Texas, as an example. What is the average *customer* rating? 1 star.

Sure, you can pick out any measurement you want to make your point. I suggest that firsthand facts trump. And the BBB as a reliable measure of anything is pretty worthless. Apple and Google have a 1 star rating, but their profits and popularity indicate otherwise right? Google actually has a C BBB rating even.

But thanks for pointing out the BBB page, I am adding my review now.

I realize I am possibly? over passionate about this issue since healthcare has become mostly unaffordable for many who are self employed or retired before Medicare. I just love health sharing and Goodrx. And i don't like it when non facts pick on them. There is simply no way I will ever pay BCBS or anyone else over $1,000/mo for minimal coverage with a $10k deductible. Not going to happen. That's over 20k per year just to get one cent back.


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## Brett (Sep 11, 2018)

Steve Fatula said:


> Disagree. I can find those same reviews about many companies. Let's look at Libertys BBB page, what is the average *customer* rating? Looks like 3.5 stars, right? So, BBB (a useless org IMHO for many many reasons) has red warnings, but, actual customers (and remember that complainers are usually more vocal than lovers), rate it pretty good. Comments like this BBB comment are ridiculous: "Additionally consumers state confusion of medical services/procedures covered by the plan. ", well, read the insurance docs! People don't. Has there been some delays, that part is true lately. But the number of members has skyrocketed this year, not an excuse of course. But since I do not pay the doctor, this has pretty much zero effect on me, the doctor is waiting the extra month. That will eventually be solved, I hope, though, with more and more people unable to afford traditional insurance each year, maybe not easily.
> Now, let's look at BCBS of Texas, as an example. What is the average *customer* rating? 1 star.
> Sure, you can pick out any measurement you want to make your point. I suggest that firsthand facts trump. And the BBB as a reliable measure of anything is pretty worthless. Apple and Google have a 1 star rating, but their profits and popularity indicate otherwise right? Google actually has a C BBB rating even.
> 
> ...



You are welcome - glad I could help
.
 I'll point out that Liberty Healthshare is actually not rated with the Better Business Bureau (like many organizations)   but unlike other organizations Liberty Healthshare has *repeated red warning signs *on it's BBB profile page  :
 "*There is a pattern of complaints involving this business *
The repeated warnings are there for a reason unlike other unrated organizations

For anyone contemplating faith based "health ministries" do all the research and read all the reviews.   "Consumers who face problems with a healthcare sharing ministry, such as when a claim is paid or a service is not covered, they aren’t protected by their state’s insurance department or any laws or regulations,  There is no requirement or obligation of the ministry to pay any of the member's health care costs."


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## Steve Fatula (Sep 11, 2018)

Semantics. There is no requirement that traditional insurance pays either. Wait, you say there is. Please read the testimony from the original ACA discussions. They simply call something it isn't, experimental, whatever, they find a reason to decline a claim within the rules (but stretching it). There are many ways around not paying. Reviews only go so far, typically you will always find negative reviews far more than positive, it's just the way humans are. So, while useful, that's only part of the story. Definitely find people in one, and definitely read, totally agree. I think we are on the same page really. I just totally disagree with the red warnings, other than the slower part this year. Doesn't mean it can't or doesn't happen. And insurance isn't always fast either, they come up with ways to delay payments, say something is mis-coded, didn't get pre auth, whatever. So many ways to cheat the customer. But the overall impression the BBB gives is very misguided I can assure you.

Note they are all faith based as that's all the ACA allows at this time. There shouldn't need to be this requirement. Those statements about the state insurance department are kind of silly, when has your states insurance department done anything for you? Probably never. Do they really hold down rates? Obviously not!

And what of those who cannot possibly pay thousands a month for traditional insurance. That's another set of customers, right? Should they just forgo all insurance? Maybe for them, having something is better than nothing? There are a *lot* of people in this boat these days, that cannot possible pay the premiums and copays. They do need options, and most states don't provide any or much help at all for their health pools or whatever your state might call them. Every year there will be more that cannot afford to pay, it's a terrible problem facing many. 

It is complicated for sure. All health insurance is. I will never claim that they are suitable for all people, no insurance or company is! Everyones situation is different. It is a tool that might help some, or many, who knows. But > 0. And they do work, with a long history of success. People often do not read the rulebook of what is covered or not, and, when a non covered event is not paid, they complain. But to even imply that covered events are not paid, is dishonest. Not saying anyone here is.

Brett, are you going to evacuate if you are in Newport News, supposed to?


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## Brett (Sep 11, 2018)

Steve Fatula said:


> Semantics. There is no requirement that traditional insurance pays either. Wait, you say there is. Please read the testimony from the original ACA discussions. They simply call something it isn't, experimental, whatever, they find a reason to decline a claim within the rules (but stretching it). There are many ways around not paying. Reviews only go so far, typically you will always find negative reviews far more than positive, it's just the way humans are. So, while useful, that's only part of the story. Definitely find people in one, and definitely read, totally agree. I think we are on the same page really. I just totally disagree with the red warnings, other than the slower part this year. Doesn't mean it can't or doesn't happen. And insurance isn't always fast either, they come up with ways to delay payments, say something is mis-coded, didn't get pre auth, whatever. So many ways to cheat the customer. But the overall impression the BBB gives is very misguided I can assure you.
> Note they are all faith based as that's all the ACA allows at this time. There shouldn't need to be this requirement. Those statements about the state insurance department are kind of silly, when has your states insurance department done anything for you? Probably never. Do they really hold down rates? Obviously not!
> 
> And what of those who cannot possibly pay thousands a month for traditional insurance. That's another set of customers, right? Should they just forgo all insurance? Maybe for them, having something is better than nothing? There are a *lot* of people in this boat these days, that cannot possible pay the premiums and copays. They do need options, and most states don't provide any or much help at all for their health pools or whatever your state might call them. Every year there will be more that cannot afford to pay, it's a terrible problem facing many.
> ...



sorry, it's not semantics and and we are definitely not on the 'same page'

Liberty Healthshare has excessive consumer warnings on many review sites.  You may not appreciate state governments but the insurance regulations exist for a reason. Religious faith based health care "charity" organizations that depend on "God's laws" instead of insurance regulations are not necessarily better and could be much much worse for consumers.  

quote from the state government  -  (about insurance companies, not faith based health ministries)

"State Insurance Department ensures that citizens are provided with access to reliable insurance protection, that the insurance companies selling policies are financially sound to support payment of claims; that the agents selling company policies are qualified and conduct their business according to statutory and regulatory requirements, as well as acceptable standards of conduct; and that the insurance policies are of high quality, are understandable and are fairly priced"


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## Steve Fatula (Sep 11, 2018)

Brett said:


> sorry, it's not semantics and and we are definitely not on the 'same page'
> 
> Liberty Healthshare has excessive consumer warnings on many review sites.  You may not appreciate state governments but the insurance regulations exist for a reason. Religious faith based health care "charity" organizations that depend on "God's laws" instead of insurance regulations are not necessarily better and could be much much worse for consumers.
> 
> ...



Ok, I agree to disagree. When I said same page, I was speaking of do your research, and we did agree with that. This thread segment was about what do people do for insurance, and I answered the question factually. Apparently, you do not believe it and that's fine. You, as an outsider, know more than someone who actually uses it because the internet says so.


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## Brett (Sep 11, 2018)

Steve Fatula said:


> Ok, I agree to disagree. When I said same page, I was speaking of do your research, and we did agree with that. This thread segment was about what do people do for insurance, and I answered the question factually. Apparently, you do not believe it and that's fine.



 yes  ... we do not agree (or believe) the facts about some types of "religious health care" organizations


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## Steve Fatula (Sep 12, 2018)

PamMo said:


> If you have saved up to retire early, do not underestimate the cost of healthcare. DH and I retired before 65 and buy health insurance on the open market. We are healthy and don't utilize the health system, so we basically want catastrophic protection.
> 
> Two years ago, our insurance _premiums_ (Bronze plan equivalent with $6K/pp deductible) cost us just over $15K/yr.  At the end of 2017, one of the three area providers left our market, so we had to choose between staying with our plan for $28,000/yr in premiums, or switch to a new plan with different providers for $20K/yr.  We switched. We just received notice that our current provider is dropping out of the individual market at the end of 2018, so our only option for 2019 is to go back to our original insurance provider with projected premiums for the most basic plan at $36K/yr.  Actually, another option is to move, which we're looking at now.



People discussing here should really hear what PamMo said. And plan accordingly. Your premiums in your area may not be as much as hers, but, you should check the prices in your area. I had rotator cuff surgery in February, still in recovery of course. I met a guy there in PT (physical torture) as we had the same PT schedule, we became very good friends. He had an ACA plan here, the one provider that offers one. You know, the "affordable" one. He is self employed and does not make a lot of money, and struggles to pay his premium which is close to 12k per year for one. When he had the surgery, sadly, he had no idea insurance those plans do not pay the cost. Like many, he didn't understand his insurance. He was out the deductible, plus 40%. So, after his premiums, this year, and with only surgery, pain pills, and recovery (PT), he has spent right around $18,000 (on TOP of his premiums) and he was insured! Needless to say since he struggles to just pay his premiums, it virtually bankrupted him. He is really struggling. It's so sad to see. Understand, as recently as 9 years ago, that same surgery with premiums and deductible and copays would have cost ~$7,000 with the same insurance company. *So, 9 years later, and it costs 4x ($30,000).* This is a moderate cost surgery, I'd hate to imagine a more expensive surgery, or needing ongoing care.

The point is you may indeed be healthy today, and maybe you have insurance at your business. If you retire early though, things may cost way more than you can imagine. You really do need to consider these costs. In my case, with my full rotator cuff tear, I was perfectly healthy for the most part. I had maybe one doctor visit a year, a few odd diseases but they didn't cost anything as there is no treatment so no visits. One day, I couldn't raise my right arm up any more, so, went and found out I had a full rotator cuff tear. I didn't do anything, not throwing anything, etc. Turns out I had some bone spurs and those detached it eventually. So, the point is, you can be super healthy, but, that does not mean things will not happen as you get older.

This planning is a critical step for most before retirement, unless you are super rich. Understand your potential costs, don't just retire early and hope.


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## rapmarks (Sep 12, 2018)

We have a Medicare advantage plan, we pay Medicare and then monthly premium through our retirement. We just got an email stating that if we went into hospice care, our advantage plan would be dropped and we would no longer have a supplement. Is this usual?


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## Passepartout (Sep 12, 2018)

rapmarks said:


> We have a Medicare advantage plan, we pay Medicare and then monthly premium through our retirement. We just got an email stating that if we went into hospice care, our advantage plan would be dropped and we would no longer have a supplement. Is this usual?


You would still have your Medicare, which does provide some Hospice care. By it's definition, under hospice, you get limited medical care, just palliative (or comfort) care. I'm curious why you would get such an email. Was it from your MA carrier? Had you inquired about Hospice?


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## VacationForever (Sep 12, 2018)

Center of Medicare and Medicaid pays for Hospice care directly and that is the law.  Don't panic.  It is how it works.  Cost to the patient is zero.


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## rapmarks (Sep 12, 2018)

Passepartout said:


> You would still have your Medicare, which does provide some Hospice care. By it's definition, under hospice, you get limited medical care, just palliative (or comfort) care. I'm curious why you would get such an email. Was it from your MA carrier? Had you inquired about Hospice?


No inquiries. Just got notice


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## geekette (Sep 13, 2018)

mpumilia said:


> How can you save money while in retirement when your only income is SS? SS doesn’t cover all your expenses- especially if you just have one check- like when a spouse dies.


Yikes, SS only?  That person will have a rough go of it.   

I planned like SS wouldn't exist so I should be able to put it off to age 70.


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## Steve Fatula (Sep 13, 2018)

geekette said:


> Yikes, SS only?  That person will have a rough go of it.
> 
> I planned like SS wouldn't exist so I should be able to put it off to age 70.



Well, they won't be saving money! But I am living on no SS and no income at all really, I am living on savings until 59.5. when I can start normal withdrawals from retirement plans.


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## WinniWoman (Sep 13, 2018)

geekette said:


> Yikes, SS only?  That person will have a rough go of it.
> 
> I planned like SS wouldn't exist so I should be able to put it off to age 70.




What I meant is financial people say to at least cover your steady ongoing monthly expenses with SS. Then use savings for everything else that pops up- medical, home and car repairs, etc. With the high school and property taxes where I live, no way could one do that.


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## Steve Fatula (Sep 13, 2018)

mpumilia said:


> What I meant is financial people say to at least cover your steady ongoing monthly expenses with SS. Then use savings for everything else that pops up- medical, home and car repairs, etc. With the high school and property taxes where I live, no way could one do that.



Yeah, depends where you live. DW and I could actually live totally on SS since those other issues you mentioned are handled. But we won't, that would mean little to no travel, etc. We had done the things you were "supposed" to do and were fortunate to be able to do. So, we have money in various 401k, and, I do get a pension at 62 as well. Of course, you can plan all you want, and then life may take you a different direction anyway. You can only do the best you can.


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## rapmarks (Sep 13, 2018)

My parents and two aunts lived on social security and did fine


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## Steve Fatula (Sep 13, 2018)

rapmarks said:


> My parents and two aunts lived on social security and did fine



Come to think of it, my Dad in Cleveland Ohio lived for several decades on SS only. It does depend where you live, how much you owe (hopefully 0), and how much you spend, sometimes the most important factor. Since my Dad grew up in the Great Depression, that impacted him for life and spending was just not his thing.


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## rapmarks (Sep 13, 2018)

Steve Fatula said:


> Come to think of it, my Dad in Cleveland Ohio lived for several decades on SS only. It does depend where you live, how much you owe (hopefully 0), and how much you spend, sometimes the most important factor. Since my Dad grew up in the Great Depression, that impacted him for life and spending was just not his thing.


That is it, not being addicted to spending.  My parents and one aunt had low cost supplemental insurance.  The other aunt spent a lot for her supplement.  My aunts bought nursing home insurance, and they moved to assisted living which meant I didn’t need to touch capital during those years, but did need all social security to cover everything.


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## geekette (Sep 14, 2018)

mpumilia said:


> What I meant is financial people say to at least cover your steady ongoing monthly expenses with SS. Then use savings for everything else that pops up- medical, home and car repairs, etc. With the high school and property taxes where I live, no way could one do that.


I guess this is why I don't consult "financial people".  It is far better for me to have ignored SS and be able to claim it than relying on it to defray fixed costs monthly.  Instead, I'll handle my costs from what I stashed away and whenever it is that I claim SS, it will be a bonus.  

I do understand why some want to make sure they "get what's theirs" and not use savings in order to leave it to next gen, but I consider to have saved for my own retirement so no heartburn on spending it for my own retirement, just as planned.  There was no inheritance for me and I will not be leaving one, either.  

My prop taxes are reasonable and many states offer decreases for seniors.  Sales tax isn't crazy, about 7%.  I drive older cars so registration, plates and insurance are cheap.   There are many months where I don't need heat nor AC so I can keep elec costs down as well.


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## Patri (Sep 14, 2018)

geekette said:


> I do understand why some want to make sure they "get what's theirs" and not use savings in order to leave it to next gen, but I consider to have saved for my own retirement so no heartburn on spending it for my own retirement, just as planned.  There was no inheritance for me and I will not be leaving one, either.


This sounds like sour grapes.
There will probably be something left in your estate. And you aren't going to die the minute your money runs out, if it should. In that case, you would have to rely on others.
We also didn't necessarily save money to leave to our kids, but for retirement. However, I honestly don't see how I can spend all that we have. So pretty sure our heirs will get something. My parents were wise with investments, and Dad's IRA named us kids as beneficiaries. That was a nice surprise. Mom is in assisted living at 90. If she doesn't have to go to a nursing home, her assets will likely outlast her as well.


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## WinniWoman (Sep 14, 2018)

geekette said:


> I guess this is why I don't consult "financial people".  It is far better for me to have ignored SS and be able to claim it than relying on it to defray fixed costs monthly.  Instead, I'll handle my costs from what I stashed away and whenever it is that I claim SS, it will be a bonus.
> 
> I do understand why some want to make sure they "get what's theirs" and not use savings in order to leave it to next gen, but I consider to have saved for my own retirement so no heartburn on spending it for my own retirement, just as planned.  There was no inheritance for me and I will not be leaving one, either.
> 
> My prop taxes are reasonable and many states offer decreases for seniors.  Sales tax isn't crazy, about 7%.  I drive older cars so registration, plates and insurance are cheap.   There are many months where I don't need heat nor AC so I can keep elec costs down as well.




The other thing is not everyone has a huge income to save from over their lifetime. My husband and I were never big 6 figure earners, but we always saved since we were kids in our 20's.  We are pretty frugal for the most part, also. I would have loved to not have to contribute to SS all these years and took that money and invested it myself. Same for most everything else taken out of payroll.

Then- there were market crashes. Some people- us included made some mistakes with investments. Ok- kill us now. But we do need those SS checks and when one of us dies it will be hard with just one- savings or not. If we had pensions, things would have been much easier and I guess we wouldn't need the SS checks, but that's not the case.

Now with me losing my job, forget it altogether. Have stop all savings at a time when we could have saved a big chunk of money until retirement. Except the HSA- but when hubby turns 65 in the spring and goes on Medicare he won't even be able to contribute to that any longer.


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## bogey21 (Sep 14, 2018)

geekette said:


> *There was no inheritance for me and I will not be leaving one, either.*



Exactly the way I look at things.  I told my kids that I am going to die as near broke as possible.  I use any extra money I have to help them along the way with things of my choice (they know not to ask).  My kids know they are better off the longer I live and have no reason to wish me an early exit from life...

George


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## Steve Fatula (Sep 14, 2018)

mpumilia said:


> The other thing is not everyone has a huge income to save from over their lifetime. My husband and I were never big 6 figure earners, but we always saved since we were kids in our 20's.  We are pretty frugal for the most part, also. I would have loved to not have to contribute to SS all these years and took that money and invested it myself. Same for most everything else taken out of payroll.
> 
> Then- there were market crashes. Some people- us included made some mistakes with investments. Ok- kill us now. But we do need those SS checks and when one of us dies it will be hard with just one- savings or not. If we had pensions, things would have been much easier and I guess we wouldn't need the SS checks, but that's not the case.
> 
> Now with me losing my job, forget it altogether. Have stop all savings at a time when we could have saved a big chunk of money until retirement. Except the HSA- but when hubby turns 65 in the spring and goes on Medicare he won't even be able to contribute to that any longer.



Basically normal, I doubt you are that unusual. DH shouldn't need the HSA for him once on Medicare. The Advantage plans can pay basically everything for not much premium. Your medical expenses may go down because of that. Depends on the insurance you have now. DW of mine is on an Advantage plan and our expenses went vastly down. The key thing is the lowest ongoing monthly expenses, anything above that becomes play money. The best laid plans do not always work out, but you are likely way ahead of the majority of Americans.


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## WinniWoman (Sep 14, 2018)

Steve Fatula said:


> Basically normal, I doubt you are that unusual. DH shouldn't need the HSA for him once on Medicare. The Advantage plans can pay basically everything for not much premium. Your medical expenses may go down because of that. Depends on the insurance you have now. DW of mine is on an Advantage plan and our expenses went vastly down. The key thing is the lowest ongoing monthly expenses, anything above that becomes play money. The best laid plans do not always work out, but you are likely way ahead of the majority of Americans.




Yes. I know. But we are hoping he will still be working since he is not full retirement age (for SS) and I am on his employer insurance plan- though pay a premium- and I am only 62. So it would have been nice to still be able to continue to contribute to it since his insurance is a high deductible plan and he has no premium for his insurance through the employer.  But I guess we can try to save in a regular savings account at that point instead of the HSA, though it will be less $ since it will be after taxes.


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## geekette (Sep 17, 2018)

Patri said:


> This sounds like sour grapes.
> There will probably be something left in your estate. And you aren't going to die the minute your money runs out, if it should. In that case, you would have to rely on others.
> We also didn't necessarily save money to leave to our kids, but for retirement. However, I honestly don't see how I can spend all that we have. So pretty sure our heirs will get something. My parents were wise with investments, and Dad's IRA named us kids as beneficiaries. That was a nice surprise. Mom is in assisted living at 90. If she doesn't have to go to a nursing home, her assets will likely outlast her as well.


Sour grapes???   What a strange accusation.  Are you saying that I resent my parents for not being wealthy and giving me piles of money throughout my life?  Not at all.  Everything I have is because I made it happen.  how could I possibly be sour over being self made??  What sourness is there in knowing I did everything my way and it worked??  Should I instead wish to have been raised as a princess believing it is the job of someone else to take care of me financially?  Should I instead wish to be beholden to someone else?  this makes no sense.  You have me all wrong.  I rely on no one and build my assets to guard against ravages of old age.  Because that is what people are supposed to do, not expect handouts from someone else.  

What do I care if people neglect their happy retirement to leave a boodle to their kids?   I stashed away money to look after myself in old age.  This is what people are supposed to do else the accounts would not be called INDIVIDUAL Retirement Accounts.  Yeah, there may be something left when I'm gone but I do not aim to conserve it for that purpose, I plan to live better than I did all the working years while I have sacrificed to save.  I am not in the "I don't see how I could spend it all" category and doubt that will ever be the case.  If you have piles to dole out, go for it.  Doesn't bother me a bit.  Not at all sure why expecting to spend my retirement money on my retirement makes you think I'm sour.  My money, my choice.  Where does resentment enter into it??


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## geekette (Sep 17, 2018)

mpumilia said:


> The other thing is not everyone has a huge income to save from over their lifetime. My husband and I were never big 6 figure earners, but we always saved since we were kids in our 20's.  We are pretty frugal for the most part, also. I would have loved to not have to contribute to SS all these years and took that money and invested it myself. Same for most everything else taken out of payroll.
> 
> Then- there were market crashes. Some people- us included made some mistakes with investments. Ok- kill us now. But we do need those SS checks and when one of us dies it will be hard with just one- savings or not. If we had pensions, things would have been much easier and I guess we wouldn't need the SS checks, but that's not the case.
> 
> Now with me losing my job, forget it altogether. Have stop all savings at a time when we could have saved a big chunk of money until retirement. Except the HSA- but when hubby turns 65 in the spring and goes on Medicare he won't even be able to contribute to that any longer.


No gifts, no 6 figure salary, just living lean and stashing away everything I can.  That is the single best thing people of any income can do, live beneath means. 

Indeed, crap happens throughout life, plans get tossed when these things happen.  I have no crystal ball, cannot guarantee that I won't "need" SS before age 70, I just have a plan.   Cancer wasn't in it, this is an expensive illness.  Nothing to do but march through it, take the financial lumps and get income started again when I can.  My job can terminate me at the one year leave mark.  I may be in your situation in a few months, canned.  There is no spouse, no roommate, I will get by on my own ingenuity.  

I understand stopping savings, boy, do I!  But, you did save, you did invest, you will come through this.  Don't stop believing that (doubt you will, you strike me as A "Can Do" Person).


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## am1 (Sep 17, 2018)

How many on here would keep working if they had 5-10 million in the bank?  I would.  It's what I am use to and a way to pass the time.  Ideally do less but more money more problems (stuff to manage).


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## geekette (Sep 17, 2018)

am1 said:


> How many on here would keep working if they had 5-10 million in the bank?  I would.  It's what I am use to and a way to pass the time.  Ideally do less but more money more problems (stuff to manage).


I would be out the exit very fast.  

If I don't need the money, then I can volunteer.  I would join Red Cross and be one of those people serving meals or settling people into shelters.  When I don't need the pay, "work" can be defined however I want.  

I don't consider "what to do with the money" as a problem.  I know how to invest and all along the numbers have become bigger.  Banks would hold only up to FDIC (probably 3 different banks).  And I would finally have time and the need to have a trust constructed.


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## Panina (Sep 17, 2018)

am1 said:


> How many on here would keep working if they had 5-10 million in the bank?  I would.  It's what I am use to and a way to pass the time.  Ideally do less but more money more problems (stuff to manage).


You don’t need nearly that much to stop working and be comfortable.  

I retired early and never looked back.  I now choose to do what I want to do as work.  I might not get paid but I still keep very busy from helping others to trying to write a book I have wanted to for years. 

My sister hints at me as being lazy as I don’t have a paying job.  She says she works and everyone should at our age even though she can afford not to work.

I say everyone should do what is best for them. Each of us have different needs and that is ok.


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## breezez (Sep 17, 2018)

Ok for those of you that retired early...

(1)How old were you retired?
(2)What unforeseen financial dilemmas did you experience once you quit?
(3)For your personal situation, what percentage of pre-retirement income do you need to maintain or live a slightly improved life style?
(4)Since this is a timeshare site: What % of your retirement income are you spending on MF’s and considering  timeshare MF’s can double every 15 years, at what % of income would you start reducing holdings to lower MF’s
(5)How many of you work part time as a means to have some form of employer subsidized health insurer.
(6)What’s your plan with timeshares you own if you lose your spouse.   If your single, what is timesharing like as a single person?


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## VacationForever (Sep 17, 2018)

breezez said:


> Ok for those of you that retired early...
> 
> (1)How old were you retired?
> *53*
> ...


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## WinniWoman (Sep 17, 2018)

geekette said:


> No gifts, no 6 figure salary, just living lean and stashing away everything I can.  That is the single best thing people of any income can do, live beneath means.
> 
> Indeed, crap happens throughout life, plans get tossed when these things happen.  I have no crystal ball, cannot guarantee that I won't "need" SS before age 70, I just have a plan.   Cancer wasn't in it, this is an expensive illness.  Nothing to do but march through it, take the financial lumps and get income started again when I can.  My job can terminate me at the one year leave mark.  I may be in your situation in a few months, canned.  There is no spouse, no roommate, I will get by on my own ingenuity.
> 
> I understand stopping savings, boy, do I!  But, you did save, you did invest, you will come through this.  Don't stop believing that (doubt you will, you strike me as A "Can Do" Person).




I love your spirit! You are an inspiration as a self reliant individual! I hope all goes well for you. Battling cancer requires tremendous bravery! You no doubt will overcome anything that is thrown at you! Keep us posted! I am routing for you! 

You are undoubtedly much more of an optimist than I am when it comes to money and security!! I need some of that! LOL!

Thanks!


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## Panina (Sep 17, 2018)

Ok for those of you that retired early...

(1)How old were you retired?

51

(2)What unforeseen financial dilemmas did you experience once you quit?

None

(3)For your personal situation, what percentage of pre-retirement income do you need to maintain or live a slightly improved life style?

Never figured it out, just asked myself do I have enough to pay for what I need and want. Always thought if I can’t manage I will go back to work.

(4)Since this is a timeshare site: What % of your retirement income are you spending on MF’s and considering  timeshare MF’s can double every 15 years, at what % of income would you start reducing holdings to lower MF’s

Retirement income is a moving number, pension is fixed but investment return isn’t. When My mfs come due and I say I can’t afford this I will reduce my holdings.

(5)How many of you work part time as a means to have some form of employer subsidized health insurer.

Not me, just pay private which is higher then my timeshare mfs and I own a lot of timeshares. 

(6)What’s your plan with timeshares you own if you lose your spouse.   If your single, what is timesharing like as a single person?

Been there , I had to get rid of the timeshares I went to because it hurt too much.  10 years later still can’t go to those resorts. I kept my trading ones and made girlfriends to travel with.  My current hubby wasn’t a timeshare person and looked down at it at first.  Now loves them.  I actually own more with him.


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## WinniWoman (Sep 17, 2018)

geekette said:


> I would be out the exit very fast.
> 
> If I don't need the money, then I can volunteer.  I would join Red Cross and be one of those people serving meals or settling people into shelters.  When I don't need the pay, "work" can be defined however I want.
> 
> I don't consider "what to do with the money" as a problem.  I know how to invest and all along the numbers have become bigger.  Banks would hold only up to FDIC (probably 3 different banks).  And I would finally have time and the need to have a trust constructed.



Heck- I would have been out with 2 million. LOL! But I am out now with less than that! Ha! ha!


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## Fredflintstone (Sep 17, 2018)

Frankly, I love the United States and Americans. Even though I am Canadian, I do have wonderful, god fearing American family many of whom are farmers in Nebraska.

I too have invested over the years. I focused on the Income and let bank professionals deal with the investments. As my net worth gradually built like a tortoise, the bank did better and better as they knew without performance my business goes elsewhere.

I know the issue of Health Care is a thorny issue with Americans as many of my relatives there say why should we pay someone else’s bills? However, health care affects everyone and the person saying why should I pay someone else’s bills may be the very same person worrying that if they get sick, they become broke and wiped out. To me, again understanding the Canadian lens being we help others, health care for everyone IS a fundamental right and should not break those to receive. 

Maybe one day Americans will explore Universal healthcare and accept a 10 percent increase in taxes so that they can help each other out so no one ever has to worry about going broke just to get better.

When one is a senior who has worked and saved hard all their life, the last thing on their minds should be how to pay health care if they become ill. This should frankly apply to anyone at any age. Caring for each other is the thrust of any kind, just, healthy society.

Don’t get me wrong. I firmly believe in competition and capitalism. Those that work hard and be smart deserve to be rich. However, health care is one thing rich or poor that should be universal.

Oh, I should add I will retire wealthy and will never need to worry about health care. That allows me to plan many vacations without thinking what I will do if my health fails.


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## WinniWoman (Sep 17, 2018)

Fredflintstone said:


> Frankly, I love the United States and Americans. Even though I am Canadian, I do have wonderful, god fearing American family many of whom are farmers in Nebraska.
> 
> I too have invested over the years. I focused on the Income and let bank professionals deal with the investments. As my net worth gradually built like a tortoise, the bank did better and better as they knew without performance my business goes elsewhere.
> 
> ...




I am assuming the system works for you and the other Canadians you know? We in the states hear so much conflicting information about the Canadian Healthcare system. Things like- Canadians come to the states for some surgeries; long waiting lists for various procedures, etc. The tax thing doesn't bother me because i assume it takes the place of the outrageous premiums we would pay instead.


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## Fredflintstone (Sep 17, 2018)

mpumilia said:


> I am assuming the system works for you and the other Canadians you know? We in the states hear so much conflicting information about the Canadian Healthcare system. Things like- Canadians come to the states for some surgeries; long waiting lists for various procedures, etc. The tax thing doesn't bother me because i assume it takes the place of the outrageous premiums we would pay instead.



Yes, the system works well.  There are waiting lists for elective items but life threatening items are dealt with right away. If you are sick, you are taken care of immediately. Medications are very affordable. The only thing I find expensive is dental.

If you need long term care, it is fully covered. If you want luxury though like gourmet meals etc., you need to pay for that.

Also, home care for seniors is included if needed.

No, Canadian Health care is excellent. When my dad had a heart attack he received wonderful care and it was all covered. 

I might add my Cousin in Nebraska also suffered a heart attack and was out of pocket 80 k. He did receive excellent care though. Dad was out of pocket zero.

Sent from my iPad using Tapatalk


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## Fredflintstone (Sep 17, 2018)

I should add my cousin here had a rare form of brain aneurism  that could not be dealt with here. So, the health care system here flew my cousin via air ambulance to Portland Oregon where she received surgery that same evening. 4 days later she was flown back home and was in hospital here for a week. Again, all covered. 


Sent from my iPad using Tapatalk


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## bluehende (Sep 17, 2018)

breezez said:


> Ok for those of you that retired early...
> 
> (1)How old were you retired?
> (2)What unforeseen financial dilemmas did you experience once you quit?
> ...




51 also

not a dilema but a surprise was my company moving me to a group insured as pre medicare retirees thus almost doubling my expected health care cost.  Also it was 2007 and we all know what happened in 2008.  There were a few moments when I was a bit worried l but it came back and sound financial planning allowed me to reap the rewards.

I have never figured what percentage of my income was needed, but that would be subjective and personal.

timeshare fees are pretty small as I have two that have low maintenance fees.  My rentals cost me much more.

I never considered working again, but in 2009 it looked like I may have had to.

I am lucky enough to have my spouse with me so the last does not apply.  I would hope that I could find a way to enjoy them if the worst happened.


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## VacationForever (Sep 17, 2018)

Fredflintstone said:


> I might add my Cousin in Nebraska also suffered a heart attack and was out of pocket 80 k. He did receive excellent care though. Dad was out of pocket zero.


Did your cousin in Nebraska not have health insurance?


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## Fredflintstone (Sep 17, 2018)

Sadly no
From what I understand, there are millions of Americans without health insurance. In Canada, health insurance is universal and included for all citizens. It is provincial based so benefits depend on which province you live in. 

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## DancingWaters (Sep 17, 2018)

1. 62

2. Deceased in laws house being on the market for a year and us footing the bill to maintain

3. I’m not much of a math person, but if we need to we can dip into saved funds

4. Too much

5. Health insurance covered by husbands former employee for a $400 a month

6. If I lose my spouse, I don’t know. Too many other things I would have to unload first  Depends how young


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## am1 (Sep 18, 2018)

Fredflintstone said:


> Sadly no
> From what I understand, there are millions of Americans without health insurance. In Canada, health insurance is universal and included for all citizens. It is provincial based so benefits depend on which province you live in.
> 
> Sent from my iPad using Tapatalk



Included for all residents and refugees.


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## am1 (Sep 18, 2018)

geekette said:


> I would be out the exit very fast.
> 
> If I don't need the money, then I can volunteer.  I would join Red Cross and be one of those people serving meals or settling people into shelters.  When I don't need the pay, "work" can be defined however I want.
> 
> I don't consider "what to do with the money" as a problem.  I know how to invest and all along the numbers have become bigger.  Banks would hold only up to FDIC (probably 3 different banks).  And I would finally have time and the need to have a trust constructed.



I like what I do (mostly).  I have bigger goals then just surviving.  I have young kids where I need to show them hard work and things can get expensive real fast.  I do not want to miss the boat like so many have before me and so many will continue to.  The cost of living is going up. 

I mostly invest in physical assets.  Stocks are just a place to hold money until the next purchase.  Stock prices are very easily manipulated and I would prefer not to have my life subjected to that.  I believe in economies of scale for my investments but also need to consider not being spread too thin.


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## baf99 (Sep 18, 2018)

breezez said:


> Ok for those of you that retired early...


(1)How old were you retired? 61

(2)What unforeseen financial dilemmas did you experience once you quit? _None, but I'm only one year in (the end of this month). I'm sure something will eventually occur...
_
(3)For your personal situation, what percentage of pre-retirement income do you need to maintain or live a slightly improved life style? _I was living on 75% of my income and putting the rest in retirement savings. I planned my finances so that using pension, social security, and savings I could start with 75% of my pre-retirement income in retirement and give myself a 3.5% raise to adjust for inflation every year. When my spreadsheet said I was OK until at least age 95 I retired.
_
(4)Since this is a timeshare site: What % of your retirement income are you spending on MF’s and considering  timeshare MF’s can double every 15 years, at what % of income would you start reducing holdings to lower MF’s _I only have one timeshare right now and its MF is at 1.5% of my income right now but I am thinking of adding more for additional retirement travel. I haven't really thought about the maximum that way, but I will probably reassess every year or two to see if my inflation adjustment plan mentioned above is working out and may eliminate some timeshares if it isn't...
_
(5)How many of you work part time as a means to have some form of employer subsidized health insurer. _I do not, nor do I expect to have to work for this reason (I may some day choose to have a fun or volunteer job). I am fortunate that my employer has a retiree plan that I am part of. I do have to pay for it but it is much less than the exchanges. They even have a post 65 plan that seems better than many of the Medicare supplement plans and includes prescriptions. Did I say LUCKY!
_
(6)What’s your plan with timeshares you own if you lose your spouse.   If your single, what is timesharing like as a single person? _I am single and for the next several years I plan to do a lot of traveling. I don't mind traveling alone. I will sometimes have family or friends join me when they are available, but I am OK with my own company. During my previous 1 week stays I haven't really spent much time at the resorts except to sleep but with my planned slower pace that may change. I chat with people I encounter on hikes or at the beach and I sometimes take tours. Hmm... I wonder if I could get a cheap wedding ring and say "I'm here without husband" to avoid sales presentations... _


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## WinniWoman (Sep 18, 2018)

Fredflintstone said:


> I should add my cousin here had a rare form of brain aneurism  that could not be dealt with here. So, the health care system here flew my cousin via air ambulance to Portland Oregon where she received surgery that same evening. 4 days later she was flown back home and was in hospital here for a week. Again, all covered.
> 
> 
> Sent from my iPad using Tapatalk




Wow. Forget retiring in New Hampshire. I need to convince my husband to move just over the border! But then again, the cost of housing in Canada I hear is outrageous. Maybe wrong about that?


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## joestein (Sep 18, 2018)

My wife and I are 48 years old.  Our twin daughters are sophomores in high school.  So they will start college when we are 51 and my daughter wants to go to dental school (If she ever gets the grades).  That means potentially 8 years of schools.  I hope to pay the vast majority of the costs.

So I guess at 58 years old we will have to decide if we have enough to retire.  I am worried about health care if we are not yet eligible for Medicare.  That concerns me more than income.


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## PigsDad (Sep 18, 2018)

joestein said:


> My wife and I are 48 years old.  Our twin daughters are sophomores in high school.  So they will start college when we are 51 and my daughter wants to go to dental school (If she ever gets the grades).  That means potentially 8 years of schools.  I hope to pay the vast majority of the costs.
> 
> So I guess at 58 years old we will have to decide if we have enough to retire.  I am worried about health care if we are not yet eligible for Medicare.  That concerns me more than income.


Yeah, we're waiting to retire until our daughter is out of school as well.  Since we were 35 when she was born, we will be about 57 when she will have her bachelor's degree.  We want to wait until we know for sure what school she will be attending before we make our plans on when we will retire.  Her front-running schools are UPenn and Carnegie Mellon, so the ~$70K/year price tag of those will definitely impact our plans! 

Kurt


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## rapmarks (Sep 18, 2018)

We retired at 55, my son was in grad school and my daughter was in college for quite awhile afterwards


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## VacationForever (Sep 18, 2018)

Regarding supporting children, my son who has autism spectrum disorder is back in university pursuing his second bachelor's degree.  I have been using 2 X gifting limit amount, using both my husband's and my limit, since he graduated with his first degree which was about 7 years ago. Now I am back to paying for his second degree + gifting and I hope that I can get out from under this financial obligation when he can get a job with his second degree in the next 18 months.  My life is complicated.


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## am1 (Sep 18, 2018)

VacationForever said:


> Regarding supporting children, my son who has autism spectrum disorder is back in university pursuing his second bachelor's degree.  I have been using 2 X gifting limit amount, using both my and my husband's limit, since he graduated with his first degree which was about 7 years ago. Now I am back to paying for his second degree + gifting and I hope that I can get out from under this financial obligation when he can get a job with his second degree in the next 18 months.  My life is complicated.



That is great of you.  Things can happen to anyone of our children or ourselves.  Even with regular health care covered, there could be new procedures or drugs that can only be had for cash.  50-60 years is a long time to try to time ones savings.


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## geekette (Sep 18, 2018)

Panina said:


> *You don’t need nearly that much to stop working and be comfortable. *
> 
> I retired early and never looked back.  I now choose to do what I want to do as work.  I might not get paid but I still keep very busy from helping others to trying to write a book I have wanted to for years.
> 
> ...



Outstanding, live your life your way!!   My sister is unlike me, also, yet believing her beliefs are universal truths that I go against.  What a treat to be an adult that can live as I wish.  People that think everyone should work as long as possible are free to do that themselves and keep their judgments to themselves.  

no, I don't even need a million saved to retire.   I am open to working low wage "fun jobs" to continue to feed the Roth, but mostly, to get discounts.  I am eyeing JoAnn Fabrics (I am getting "crafty") and Starbucks.   I have no desire to work the hard job that pays well any longer than I have to because it takes too much out of me.  And the clock.  

Indeed, all are free to arrange their lives as they wish.  Ok by me, I am in favor of happy people.


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## Fredflintstone (Sep 18, 2018)

mpumilia said:


> Wow. Forget retiring in New Hampshire. I need to convince my husband to move just over the border! But then again, the cost of housing in Canada I hear is outrageous. Maybe wrong about that?



House prices do vary. Yes, if you buy in Toronto or Vancouver you will pay dear. But many other places you can buy a house for 150 k.

One comment is refugees get health care and that is true. In my opinion I see that as a stupid government decision.  However saying that, every government in the world does stupid things at times. I would rather have universal health care with some stupid aspects than no health care at all or very expensive health care.

The fact is as we get older that’s when we need health care the most. And....that’s the time when worrying about the cost should not happen. No one should worry about going broke if they get sick. 

Just my 2 cents. 


Sent from my iPad using Tapatalk


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## geekette (Sep 18, 2018)

I expect to "retire early" at 59.5 on April 1, 2025.

Unforeseen $ issues will likely be stupid crap with the house.  I expect to have at least $20k in bank earmarked for house stuff, aside from normal emergency savings.

I won't bother identifying % of ending salary, I am instead going the income vs expense route with dividends.  In one portfolio, I am about to $1k/month, that should easily cover utilities + groceries + fuel.  I continue to let it ride, so in 7 years that could more than double.  The div raises have been substantial this year.  

Note that I will retire immediately at such time as my dividends across all portfolios exceed paycheck.  Don't need any major math for that.   I've proven the ability to get by just fine on 40% income while I have a mortgage, so I'm not too queasy about any of it.  Strange trial run I'm doing right now!!

If it so happens that I can suffer the 10% penalty in stride, I'll bail out before age 59.5.   There are other ways to tap retirement plans, like taking "substantially equal distributions" for at least 5 years.  If I catch wind of that rule ending, I might quickly elect it.  I otherwise don't like locking myself into anything.  My thinking on this has changed greatly since I got sick.  It turns out that I want out of the workforce more than I want money.  Living simply isn't hard for me and I have proven it again.


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## Steve Fatula (Sep 18, 2018)

Ok for those of you that retired early...

(1)How old were you retired?

58

(2)What unforeseen financial dilemmas did you experience once you quit?

None

(3)For your personal situation, what percentage of pre-retirement income do you need to maintain or live a slightly improved life style?

100%, but see below. I understand the intent of the question. It's kind of misleading though as I was sort of working volunteer. I.e., paid, but very very low to help someone. Because of this, I am answering as if the question was how much of my pre retirement living expenses will I need. I will have well over 100%. 

(4)Since this is a timeshare site: What % of your retirement income are you spending on MF’s and considering timeshare MF’s can double every 15years, at what % of income would you start reducing holdings to lower MF’s

Well, this is a toughie. Investment divideds pay my MFs. I have a special account for that, and I don't need that money for anything. So, it's treated by me as if I don't have any MFs. But if you count the typical way, I suppose you could say it was 9%. But really, not a concern. It is almost certain I can continue to do this indefinitely.

(5)How many of you work part time as a means to have some form of employer subsidized health insurer.

Why would I do that and pay more? No chance of me working. Not a concern at all. 

(6)What’s your plan with timeshares you own if you lose your spouse. If your single, what is timesharing like as a single person?

I believe I would still travel. Perhaps with friends or family, perhaps not. Hard to predict. If DW lost me, she would liquidate and not travel.


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## bizaro86 (Sep 18, 2018)

mpumilia said:


> Wow. Forget retiring in New Hampshire. I need to convince my husband to move just over the border! But then again, the cost of housing in Canada I hear is outrageous. Maybe wrong about that?



It varies dramatically by area. In the big expensive cities (Toronto, Vancouver) a pretty regular house would be well over a million dollars.

The average house price where I live, Calgary, is $430k Canadian, or about $330k USD. It's a decent sized city, a bit over a million people. We have a symphony, an NHL team, multiple direct flights to Europe/Asia, world class zoo, etc, so while the opportunities arent the same as a bigger place, it isn't a rural area either. 

If you were willing to go smaller centre's,  I would expect 150-200k CAD to be doable.

Healthcare is pretty good here. My son has had two trips to the emergency room (one for stitches close to his eye, and a small break in his arm for a fall). Never waited more than 10 minutes in either case. My mom had leukemia treatments completely covered a few decades ago.

Things that can have longer wait times are knee/hip replacement,  or non-acute imaging. If you have hard-to-diagnose back pain, you could wait months for an MRI. If you have a serious disease and need one you'll get it right away.

The things with longer waits tend to be what people pay privately for, ie, $800 privately for an MRI. Extremely wealthy people tend to go to the US for world class care at places like the Mayo Clinic. My general impression is that everyone in Canada gets good medical care, whereas in the US it ranges from great to not attainable, so there is more variance.

Dental, prescriptions, vision, massage therapy type services are not covered. We have an optional self-paid plan through my wife's job that cover that stuff, it's about $200 CAD per month for a family of 4. Drug costs are govt paid for >65.


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## Fredflintstone (Sep 18, 2018)

bizaro86 said:


> It varies dramatically by area. In the big expensive cities (Toronto, Vancouver) a pretty regular house would be well over a million dollars.
> 
> The average house price where I live, Calgary, is $430k Canadian, or about $330k USD. It's a decent sized city, a bit over a million people. We have a symphony, an NHL team, multiple direct flights to Europe/Asia, world class zoo, etc, so while the opportunities arent the same as a bigger place, it isn't a rural area either.
> 
> ...



One thing I like in Canada is if you get very sick like cancer your treatments are fully covered AND you still have health care for no cost.  My uncle in Nebraska got Cancer in Nebraska and was covered on his private plan that cost him at the time 1500 a month. He called it COBRA? Anyway, afterwards they jacked up his insurance to 8 K a month forcing him to cancel. So, if he needs any more treatment he will need to sell his farm and use money in the bank to pay. That is sad. 

As for an MRI you will get one immediately if it’s life threatening. If not, there is a waiting list. The fellow above is quite right.

I also have private blue cross which costs me 105 a month CDN. That covers my eye exam, glasses and most my dental. However, having type 2 diabetes, I do get more eye checkups free.

Sent from my iPad using Tapatalk


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## vacationhopeful (Sep 18, 2018)

"Cobra" is a continuation of the employer's medical insurance where the ex-employee gets to pay the cost at the employer's rate (which is NOT the employee's cost when employed). When the Cobra period ends (a time limit) .. they are dropped from the corporate group policy.  The former employee gets a BIG shock as to the insurance cost of WHAT they had verses the open market rate .. depending on age, weight, prior health issues, etc.

I paid $1500-1700+ for months after the ACA started .... before ACA, my individual health insurance policy was under $575/monthly ... and no problem getting an office visit for $20.

I spent 16 months COUNTING DOWN to "age" into Medicare. And Medicare is cheaper dollar-wise .. but the US medical providers and services HAVE CHANGED. Play the game of 'hunting' for 'the doctor' you have been seeing last year ... or WHERE are my medical records for my last physical? Or where is the office and the number to call?

Doctor's office NOW morfied into "Walkin-Clinics" which charge MORE than an private doctor's visit did 5 years ago. Listen to their hospital-like services ... generating costs to cover while selling you on Full Service without the visiting the (dreaded) Emergency Room.

I rather wait in a doctor's office and NOT PAY hospital-size bills.

But emergency rooms are NOW the free clinics of yester-year. No insurance, no cash, and bleeding ... get world class treatment and no money needed up front or at checkout. Arrive with sirens blaring ... no wait to see a doctor and no taxis bill plus no tipping permitted.


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## Fredflintstone (Sep 18, 2018)

But emergency rooms are NOW the free clinics of yester-year. No insurance, no cash, and bleeding ... get world class treatment and no money needed up front or at checkout. Arrive with sirens blaring ... no wait to see a doctor and no taxis bill plus no tipping permitted.[/QUOTE]

Thanks for that. I know very little on the US health system so it’s helpful.

Funny you mention that the emergency room is “free”. That explains the time in the 1990s my dad was snow birding in Yuma AZ and got bilateral pneumonia. Thank god he bought travel insurance. He was in the hospital on antibiotic IV drip for 5 days and the cost was 45 k USD all covered by his travel insurance. The care was excellent but he was charged for every tissue and toilet paper roll he used. They even charged him for needles. He never returned to the US as he can’t get travel health insurance at an affordable price anymore. Too Huge a risk and age I suppose. 

Anyway, at the time the Yuma AZ hospital was FULL of Mexican nationals getting treatment for dehydration and other ailments caused by trying to cross into the US illegally. There were also quite a few Mexican nationals who were giving birth there as well. The place was full of CBP officers. I was not sure who paid for that. So, do I assume, those very poor still can get medical care free? And those who are middle class are wiped out?  All I know is if dad didn’t have travel insurance he would have been in the hook 45 k. 



Sent from my iPad using Tapatalk


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## bluehende (Sep 18, 2018)

If you don't think you will not wait in the US try to get an appointment with virtually any surgeon.  I had to wait almost 3 months to get an appointment with a neurosurgeon for a neck problem.  At the start I was in pretty severe pain so thought that was pretty much an emergency.  Luckily it resolved itself without surgery needed.  Your mileage may vary, but any network type care insurance will have some specialties that are hard to get to.


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## vacationhopeful (Sep 18, 2018)

ERs are NOT free .. but emergency services CAN NOT be denied by a hospital. 

A person might not pay a PENNY towards the cost of ANY service, but a malpractice suit will yield BIG money to the dead, maimed or the 'acting' dying patient aginst the medical . Doctor's offices can REFUSE to take on a new patient ... or stop seeing a prior patient. And the doctor's office WILL not see someone who is NOT paying for services renedered ... no 2nd freebies.


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## breezez (Sep 18, 2018)

Fredflintstone said:


> One comment is refugees get health care and that is true. In my opinion I see that as a stupid government decision.  However saying that, every government in the world does stupid things at times. I would rather have universal health care with some stupid aspects than no health care at all or very expensive health care.



So maybe I should become a refugee in Canada Once we retire: .....


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## Fredflintstone (Sep 18, 2018)

breezez said:


> So maybe I should become a refugee in Canada Once we retire: .....



Sure, cmon up!  Personally, I would rather have an American friend join us then some of the people coming in.  

You remind me of a friend working in San Fran making huge money in Silicon Valley. He says if your healthy get your @$$ to the US and make the $$$.  If you get sick get your @$$ to Canada asap. 


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## WinniWoman (Sep 18, 2018)

Fredflintstone said:


> One thing I like in Canada is if you get very sick like cancer your treatments are fully covered AND you still have health care for no cost.  My uncle in Nebraska got Cancer in Nebraska and was covered on his private plan that cost him at the time 1500 a month. He called it COBRA? Anyway, afterwards they jacked up his insurance to 8 K a month forcing him to cancel. So, if he needs any more treatment he will need to sell his farm and use money in the bank to pay. That is sad.
> 
> As for an MRI you will get one immediately if it’s life threatening. If not, there is a waiting list. The fellow above is quite right.
> 
> ...




So the thing is- in your example of the MRI- someone could have back pain- it could be life threatening or not- but unless the test is done - it won't be known if it is life threatening or not. So that is certainly an issue for someone having to wait. Not to mention with having pain. You could have pain because of a disc issue or you could have cancer for example. Things have to be rulled out for a diagnosis, etc.


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## VacationForever (Sep 18, 2018)

@Fredflintstone Do visitors to Canada get free medical?  In other words, Americans who decide to spend 5 months in Canada a year, do they get free medical?


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## Fredflintstone (Sep 18, 2018)

VacationForever said:


> @Fredflintstone Do visitors to Canada get free medical?  In other words, Americans who decide to spend 5 months in Canada a year, do they get free medical?



Sorry, no they don’t. Only residents, citizens or refugees.

However, to my knowledge no one is turned away when they go to emergency. I am not sure how payment arrangements are made. 


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## Fredflintstone (Sep 18, 2018)

mpumilia said:


> So the thing is- in your example of the MRI- someone could have back pain- it could be life threatening or not- but unless the test is done - it won't be known if it is life threatening or not. So that is certainly an issue for someone having to wait. Not to mention with having pain. You could have pain because of a disc issue or you could have cancer for example. Things have to be rulled out for a diagnosis, etc.



That’s true.  From my experiences working in the health field is when someone goes to Emergency complaining of severe back, chest, head pain, they are given an MRI that night as a matter of procedure to determine the source of pain.  


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## bizaro86 (Sep 18, 2018)

VacationForever said:


> @Fredflintstone Do visitors to Canada get free medical?  In other words, Americans who decide to spend 5 months in Canada a year, do they get free medical?



Nope. You wouldn't be turned away at a hospital, but you'd get a bill after. I'm pretty sure the bill would be based on what the government pays for the service, which I think would be way less than a private-pay patient would pay in the US.


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## Fredflintstone (Sep 18, 2018)

bizaro86 said:


> Nope. You wouldn't be turned away at a hospital, but you'd get a bill after. I'm pretty sure the bill would be based on what the government pays for the service, which I think would be way less than a private-pay patient would pay in the US.



Yes, you are right. I have seen people from Montana come in in very serious condition and are treated. I understood the bill they got was lower in Alberta than Montana according to them. 


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## Passepartout (Sep 18, 2018)

Fredflintstone said:


> Funny you mention that the emergency room is “free”. That explains the time in the 1990s my dad was snow birding in Yuma AZ and got bilateral pneumonia. Thank god he bought travel insurance. He was in the hospital on antibiotic IV drip for 5 days and the cost was 45 k USD all covered by his travel insurance. The care was excellent but he was charged for every tissue and toilet paper roll he used. They even charged him for needles. *He never returned to the US as he can’t get travel health insurance at an affordable price anymore. *Too Huge a risk and age I suppose.


I can't argue with the gist of your argument, but If your dad REALLY wants to travel, and buys his travel insurance at the time he books the travel his pre-existing conditions are covered. Yes, travel insurance is expensive, and U.S. medical care is a minefield of extra charges, but until it changes (and I think it will) it's just part of the cost of travel.

Example: Last July, I needed emergency heart surgery including angiography and treatment for pneumonia in Germany. I was hospitalized 9 days. Fortunately I was near a top teaching hospital. The bill was a half page long, and was about $11,500 USD. I feel sure that in the U.S. it would have been somewhere between $50,000 and over $100,000. AND we were flown home Business and First class with a rescue nurse & oxygen all the way home. The insurance premiums for my wife and I were $360 each. AND they reimbursed the cost of our unused river cruise!

Jim


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## Fredflintstone (Sep 18, 2018)

One thing I should add is having both US and Canadian Citizenship, I decided to make Canada my home because of the belief that people come first in areas like health care. Again, I love the US and my American friends and family. I suppose I am a peacenik. In Canada we have a small military so our resources can go more to social programs. Again, I do love America too it’s just I think a bit different on how public resources should be allocated. 

Funny though, if you look at the percentage of GDP spent in health care, the US spends more for some reason. Maybe, because it’s profit driven?  I am unsure on that.  


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## Fredflintstone (Sep 18, 2018)

Passepartout said:


> I can't argue with the gist of your argument, but If your dad REALLY wants to travel, and buys his travel insurance at the time he books the travel his pre-existing conditions are covered. Yes, travel insurance is expensive, and U.S. medical care is a minefield of extra charges, but until it changes (and I think it will) it's just part of the cost of travel.
> 
> Example: Last July, I needed emergency heart surgery including angiography and treatment for pneumonia in Germany. I was hospitalized 9 days. Fortunately I was near a top teaching hospital. The bill was a half page long, and was about $11,500 USD. I feel sure that in the U.S. it would have been somewhere between $50,000 and over $100,000. AND we were flown home Business and First class with a rescue nurse & oxygen all the way home. The insurance premiums for my wife and I were $360 each. AND they reimbursed the cost of our unused river cruise!
> 
> Jim



I hear you Jim. My dad was refused US travel coverage. When he finally was approved for some with pre existing coverage, they want 1 K A DAY USD. No kidding and the maximum stay was 7 days after he sent in a stable health letter from a doctor.  He goes to Europe and Mexico all the time and he pays 30 a day with a limit of 30 days. Only US travel is cost prohibited for him.


To be fair my dad has multiple serious conditions so his risks are high and he just turned 83. 

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## Steve Fatula (Sep 18, 2018)

bluehende said:


> If you don't think you will not wait in the US try to get an appointment with virtually any surgeon.  I had to wait almost 3 months to get an appointment with a neurosurgeon for a neck problem.  At the start I was in pretty severe pain so thought that was pretty much an emergency.  Luckily it resolved itself without surgery needed.  Your mileage may vary, but any network type care insurance will have some specialties that are hard to get to.



Yeah, that's the beauty of not being in a network! Took me < 1 week to get a surgeon appt.


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## Fredflintstone (Sep 18, 2018)

Steve Fatula said:


> Yeah, that's the beauty of not being in a network! Took me < 1 week to get a surgeon appt.



What is a “network”?


Sent from my iPhone using Tapatalk


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## bizaro86 (Sep 18, 2018)

Passepartout said:


> I can't argue with the gist of your argument, but If your dad REALLY wants to travel, and buys his travel insurance at the time he books the travel his pre-existing conditions are covered. Yes, travel insurance is expensive, and U.S. medical care is a minefield of extra charges, but until it changes (and I think it will) it's just part of the cost of travel.
> 
> Example: Last July, I needed emergency heart surgery including angiography and treatment for pneumonia in Germany. I was hospitalized 9 days. Fortunately I was near a top teaching hospital. The bill was a half page long, and was about $11,500 USD. I feel sure that in the U.S. it would have been somewhere between $50,000 and over $100,000. AND we were flown home Business and First class with a rescue nurse & oxygen all the way home. The insurance premiums for my wife and I were $360 each. AND they reimbursed the cost of our unused river cruise!
> 
> Jim



He could probably get travel insurance for anywhere other than the USA. You want to go to Germany as an elderly Canadian, no problem to get insurance. If you want to go to the USA as an elderly Canadian, its generally prohibitively expensive.

Medical care costs more in the USA than anywhere else, so medical insurance costs more than anywhere else. That's true for people who live there and for people who are just visiting.


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## VacationForever (Sep 19, 2018)

Fredflintstone said:


> What is a “network”?
> 
> 
> Sent from my iPhone using Tapatalk


The most restrictive "network" is what is called a HMO system.  You see your Primary Care Physician (PCP).  You need a referral from your PCP to see a specialist.  You are at the mercy as to when the specialist has availability to see you.  There is also a chance that the specialist refuses to see you and simply tells the PCP that you do not need to see the specialist.  I was in a HMO system for 2 decades and it was all that I knew as it was the first system that I got on after I moved to the US. 

We moved to another state and I ended up with a system that is closer to a PPO (Preferred Provider) and this year EPO (Extended Provider) system.  Basically, you can see any doctor in the PPO and EPO system.  The good thing is that each doctor office is independent and they either take your insurance or not.  Every doctor listed in the PPO and EPO will take your insurance.  If you are not happy with one doctor, you just move on to another one.  No referral is needed.  We are now enjoying great access to great doctors with little wait time.  We will never go back to a HMO system.


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## Fredflintstone (Sep 19, 2018)

VacationForever said:


> The most restrictive "network" is what is called a HMO system.  You see your Primary Care Physician (PCP).  You need a referral from your PCP to see a specialist.  You are at the mercy as to when the specialist has availability to see you.  There is also a chance that the specialist refuses to see you and simply tells the PCP that you do not need to see the specialist.  I was in a HMO system for 2 decades and it was all that I knew as it was the first system that I got on after I moved to the US.
> 
> We moved to another state and I ended up with a system that is closer to a PPO (Preferred Provider) and this year EPO (Extended Provider) system.  Basically, you can see any doctor in the PPO and EPO system.  The good thing is that each doctor office is independent and they either take your insurance or not.  Every doctor listed in the PPO and EPO will take your insurance.  If you are not happy with one doctor, you just move on to another one.  No referral is needed.  We are now enjoying great access to great doctors with little wait time.  We will never go back to a HMO system.



Do your premiums vary based in the network or system you are on?  


Sent from my iPad using Tapatalk


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## VacationForever (Sep 19, 2018)

Fredflintstone said:


> Do your premiums vary based in the network or system you are on?
> 
> 
> Sent from my iPad using Tapatalk


Yes.  You pick and choose which insurance you want to buy each year.  Nov 1st to Dec 31st is open enrollment period where you can pick the insurer.  Unfortunately with the implementation of ACA, many insurers bail out of selling individual plans through the years.   It especially impacts early retirees because of fewer choices.  Group insurance is considered lower risk and because of that, many of the insurers continue to sell to companies, but not to individuals.

Where I live, this year I have 2 choices under ACA exchange plans and they are both HMOs and none of my doctors accepts them.  There are 2 off-exchange plans, 1 is a HMO and the other is an EPO.  The HMO network is also very restrictive and hence I go with the other more expensive plan.  All my doctors are on the EPO list of providers.


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## Steve Fatula (Sep 19, 2018)

Fredflintstone said:


> What is a “network”?


I can go to any doctor, not limited to insurance doctors.


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## WinniWoman (Sep 19, 2018)

Fredflintstone said:


> That’s true.  From my experiences working in the health field is when someone goes to Emergency complaining of severe back, chest, head pain, they are given an MRI that night as a matter of procedure to determine the source of pain.
> 
> 
> Sent from my iPad using Tapatalk



So here in the states we have what we call Urgent Care Centers for things like this. That is when a condition is not so bad as to warrant going to a hospital emergency room, but bad enough that you need immediate attention. From there, the person would either get  the treatment he needs be referred either to a radiology center, lab, etc.  or sent to the hospital if applicable.


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## bogey21 (Sep 19, 2018)

Steve Fatula said:


> Yeah, that's the beauty of not being in a network! Took me < 1 week to get a surgeon appt.



This is one of the reasons I switched from  Medicare Advantage to Traditional Medicare.  Yes, Advantage is a lot cheaper but you are  locked in to a Network which in all probability will not include the "Center of Excellence" you may need...

George


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## bizaro86 (Sep 19, 2018)

mpumilia said:


> So here in the states we have what we call Urgent Care Centers for things like this. That is when a condition is not so bad as to warrant going to a hospital emergency room, but bad enough that you need immediate attention. From there, the person would either get  the treatment he needs be referred either to a radiology center, lab, etc.  or sent to the hospital if applicable.



We have that in Canada as well, at least in the city where I live. They're way smaller than hospitals and do less things, but often have shorter wait times, as if you go to emergency with a non life threatening condition you can get bumped in line if very serious cases come in. 

Although if I had chest pain or something that could be a heart attack or stroke I'd go to a real hospital, because you'd go to the front of the line in that situation, and if you needed surgery you would already be in the right place. No difference in cost, obviously.


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## geekette (Sep 19, 2018)

Compelling discussions going on here.  

In the US, a person can see any doctor that will set an appointment, the only question is Who Pays?

That varies.  The patient, the Govt, or an insurance company (IF the patient has been paying the premiums, or the premiums are being paid on their behalf; insurance expires and requires monthly payments [usually] else terminated prematurely by the company).   Even if there is no expectation of payment, Someone or Something is usually assigned to a charged medical event as  Responsible Party for the bill.   For the unconscious unidentified, this kind of thing can be sorted out later and probably immediately entered as patient responsible.  

It is not to be expected that every cost is covered by the insurer, the patient pays premiums and other amounts towards their annual deductible, after which insurance picks up more of the cost, but usually not all of the cost.   There is a max out of pocket for the patient, after which there should be no more costs for that year, for services reasonably covered by that insurance.  This max has nothing to do with items outside of the coverage.  

A person can be covered by more than one insurance or program, each would have their own deductibles and limits.  Medicare is kind of a prepaid benefit as money is extracted from worker paychecks over decades.  I know little about it (I am far from 65 yet) but many retirees buy supplemental insurance, too, so one could assume it is basic on the entitled services part.  Supplemental policies are like other insurance as far as being offered by numerous outside companies.   Medicaid is complicated but covers children, disabled, aged, poor... and is administered by states with monies from fed govt.  VA (military) may pay all or most all for retired.  Dental and vision are usually special insurance no matter what program.  Often prescription policies may be needed.  

True self pay is an entirely different thing.  That is a person with no insurance, or, their insurance is not accepted by that doctor.  There are often discounts for this, also, but a person should declare it Self Pay when they set appointment so the office knows you plan to pay it vs total write off.   Most people can pay at least a little bit.  One may need to pay in full at time of service, but payment plans are also common.  Even with insurance, payment plans are common.  I don't think people ask about these things, though.  

Note that a person is not limited to only seeing doctors in their network.  This is a common misunderstanding.  A person may choose to limit themselves to choosing from that list, but in my experience, it is wise to call around.   Many doctors will submit claims to any insurer, but they do not have to accept any insurance they don't want to.   In the mass of insurance companies and doctors, there are bound to be some hard-to-work-with entities so both sides maintain choice in the matter, not having to do business with anyone they don't want to do business with.   If they accept you as a patient, this at least means that they will accept your money, no middleman.  

Even with some employer-administered obscure policy (my employer owns the health insurance company), I am finding great coverage well outside that list.  The few that will not accept my insurance work with me on reasonable payments as True Self Pay.  Even those payments should be reported to insurance company because there is a category for Out Of Network spending, which does have coverage for the employee, odd though it may seem.   I am sick this year, I long ago met my in network out of pocket and have met out of network deductible.  I am into the co-insurance part, where the insurance covers 80% and I pay 20% until meeting out of pocket max.  I may meet out of pocket max in and out of network.  It is an expensive year, for sure, but when one has a big illness, that's what happens.   If I can get back to work in 2019, I can repair the financial damage.  I am luckier than many.  

I have numerous payment plans in force in order to pay as little as possible monthly to conserve financial resources.  Hospitals, especially, will work with a patient.  It can be wise to seek the range of treatments within a hospital system, they have bundled it together for me in many cases so I make one vs multiple payments.  I have spread my care around 3 hospital systems and many "unaffiliated vendors".   I required a treatment device considered out of network so that deductible was met quickly, even though I am paying little towards it monthly.  I pay my acupuncturist out of pocket ($85 each) and submit claims to insurance company myself.  True Self Pay is not a terrible way to go.  I have done so with chiropractor, paid $45, when I had no insurance.  

A network is essentially a list of pre-approved providers that your insurance company probably already has a relationship with.   They are at least easy to do business with, will play ball with claims process, etc.   Nobody has ever had to give up a doctor unless they desired to, and it could indeed be more expensive to continue with your old doc when your insurance doesn't have them in network, but that is not automatically the case.  That is not the same thing as losing your doctor.  I have lost doctors that retired or moved.   But I have also had doctors establish a relationship with my insurance company where they had not previously been "in network".   I would urge people to call those doctors they think they are losing and ask what they would be paying without insurance there.  For me, it can be worth it to pay a little more to keep continuity but usually it hasn't been any big money issue.

The problem is that this stuff is massively complicated and myths and mistruths abound.  If we could solve some of the complexity, we could solve some of the excessive costs.   Now that I have a pre-existing condition, true self pay is either the best way to go, in case I never have a recurrence, or fast track to death or bankruptcy if I get sick again.  If I don't return to work, paying for insurance could send me to BK faster than not having it.   Wild stuff.   And each person or family has their own unique situation and therefore reasons for managing their health care arrangements how they do.

maybe I'll retire to Canada just to have it simpler to be sick!


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## Brett (Sep 19, 2018)

Fredflintstone said:


> One thing I should add is having both US and Canadian Citizenship, I decided to make Canada my home because of the belief that people come first in areas like health care. Again, I love the US and my American friends and family. I suppose I am a peacenik. In Canada we have a small military so our resources can go more to social programs. Again, I do love America too it’s just I think a bit different on how public resources should be allocated.
> 
> Funny though, if you look at the percentage of GDP spent in health care, the US spends more for some reason. Maybe, because it’s profit driven?  I am unsure on that.



yes, health care in the US is 'profit driven" or some might say just getting their fair share

An interesting article in today's Wall Street Journal details how the hospital's collude with health insurers to maximize profits


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## clifffaith (Sep 19, 2018)

mpumilia said:


> So the thing is- in your example of the MRI- someone could have back pain- it could be life threatening or not- but unless the test is done - it won't be known if it is life threatening or not. So that is certainly an issue for someone having to wait. Not to mention with having pain. You could have pain because of a disc issue or you could have cancer for example. Things have to be rulled out for a diagnosis, etc.



I have been suffering with pain from a bulging disc for almost six years now-- have had two MRIs. Three years ago this Christmas we had dinner and attended a local holiday music show with friends. His back had been hurting and he was scheduled to see the doctor the following week because going to the chiropractor for a few sessions hadn't helped. We got the call in January that Bob had cancer in his spine and they'd found it in other places as well. He was dead before Easter. At least they knew what they were dealing with early on, in spite of being too far gone to help him. (His two brothers and his father all suffered and died from cancer; I suspect he may have had other symptoms that he let go too long for fear of the diagnosis and the treatments).


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## VacationForever (Sep 19, 2018)

@geekette In a true HMO system like Kaiser, you simply cannot see a doctor outside of their network.  Zero zilch payment to a doctor who is not working for Kaiser.


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## Steve Fatula (Sep 19, 2018)

VacationForever said:


> @geekette In a true HMO system like Kaiser, you simply cannot see a doctor outside of their network.  Zero zilch payment to a doctor who is not working for Kaiser.



Yep, and in other plans, going to a doctor not on the list may have higher deductible and/or copays.


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## Passepartout (Sep 19, 2018)

Steve Fatula said:


> Yep, and in other plans, going to a doctor not on the list may have higher deductible and/or copays.


Around here, there is just ONE healthcare system, so ALL the doctors are in the system. Go see whoever you want, and be covered. PPO/HMO mox nix.


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## WinniWoman (Sep 19, 2018)

clifffaith said:


> I have been suffering with pain from a bulging disc for almost six years now-- have had two MRIs. Three years ago this Christmas we had dinner and attended a local holiday music show with friends. His back had been hurting and he was scheduled to see the doctor the following week because going to the chiropractor for a few sessions hadn't helped. We got the call in January that Bob had cancer in his spine and they'd found it in other places as well. He was dead before Easter. At least they knew what they were dealing with early on, in spite of being too far gone to help him. (His two brothers and his father all suffered and died from cancer; I suspect he may have had other symptoms that he let go too long for fear of the diagnosis and the treatments).



Very sad. This is exactly the type of situation I was talking about.

Sorry about your pain. They can do nothing for you?


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## Steve Fatula (Sep 19, 2018)

clifffaith said:


> I have been suffering with pain from a bulging disc for almost six years now-- have had two MRIs. Three years ago this Christmas we had dinner and attended a local holiday music show with friends. His back had been hurting and he was scheduled to see the doctor the following week because going to the chiropractor for a few sessions hadn't helped. We got the call in January that Bob had cancer in his spine and they'd found it in other places as well. He was dead before Easter. At least they knew what they were dealing with early on, in spite of being too far gone to help him. (His two brothers and his father all suffered and died from cancer; I suspect he may have had other symptoms that he let go too long for fear of the diagnosis and the treatments).



Sorry to hear that. But letting things go too long is rarely a good idea. Known several that have died as well for the same reason.

As far as a bulging disk, I found the chiropractor helped me a lot with that. Stretching and some exercise, and 95% good now.


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## DancingWaters (Sep 19, 2018)

Since we are talking about healthcare plans, I have a few questions to clear up.  I’m hoping some of you can answer these.   Do you know people that are on Medicare but don’t buy a supplemental?  What’s the good and the bad of not doing that?    Once you do buy a summplemental—-can they raise your rates or drop you, if a serious health issue arises.   I have been looking at Plan F from Medicare or STRS which is a retired teachers supplemental.


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## VacationForever (Sep 19, 2018)

DancingWaters said:


> Since we are talking about healthcare plans, I have a few questions to clear up.  I’m hoping some of you can answer these.   Do you know people that are on Medicare but don’t buy a supplemental?  What’s the good and the bad of not doing that?    Once you do buy a summplemental—-can they raise your rates or drop you, if a serious health issue arises.   I have been looking at Plan F from Medicare or STRS which is a retired teachers supplemental.


First of all, do not go with the basic Medicare.  Basic Medicare only pays 80% of most services.  At minimum, go with a Medicare Advantage Plan, some plans are free while others can be had for a low monthly premium.  Medicare Supplemental plans are usually a little more expensive than Advantage Plans and offer more flexibility including going out of state to get treatment.

In the first 2 years, 65 to 67, you can get on a supplemental plan without questions asked.  If you wait beyond that, they will qualify as to whether to take you and if so whether you are low or high risk, meaning tier 1, 2 or 3 pricing.  Tier 2 and 3 pricings are very expensive.  Once you are on an Advantage Plan or Supplemental Plan, they cannot drop you unless that offering disappears.  If an applicant is in end stage renal failure, both types of plans will not take the applicant. 

Rates do go up every year for Supplemental plans and Advantage plans, but not because of health condition, but just to keep pace with market, aka medical inflation. 

Plan F is the best/most expensive Supplemental plan.  If you can get on either between 65 to 67 or if later and qualify for tier 1, then you will have the most flexibility in getting care.

Medicare does not sell supplemental plans.  They are sold by 3rd parties.


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## clifffaith (Sep 19, 2018)

mpumilia said:


> Very sad. This is exactly the type of situation I was talking about.
> 
> Sorry about your pain. They can do nothing for you?



Pain Doctor puts me to sleep every three months or so for an epidural. First one two years ago made me blessedly pain free for the first time in four years. Once that wore off subsequent procedures have never worked as well. When I get to the point I have pain again at home where I can basically stay seated, then it's time for another procedure. My July 11 epidural has already worn off, so my main goal in life right now is to get from point A to point B as quickly as possible so I can sit down again. On the upside, I finally asked to get a handicapped parking plaque so that comes in handy, and when you ask for a wheelchair at the Monterey Aquarium they give you an extra $15 off your admission for being handicapped. Doctor's mantra is "no surgery, no surgery, no surgery"; but my world has become quite small (no sense traveling when I can't comfortably walk to see the sights) so at some point it may come to surgery.


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## VacationForever (Sep 19, 2018)

clifffaith said:


> Pain Doctor puts me to sleep every three months or so for an epidural. First one two years ago made me blessedly pain free for the first time in four years. Once that wore off subsequent procedures have never worked as well. When I get to the point I have pain again at home where I can basically stay seated, then it's time for another procedure. My July 11 epidural has already worn off, so my main goal in life right now is to get from point A to point B as quickly as possible so I can sit down again. On the upside, I finally asked to get a handicapped parking plaque so that comes in handy, and when you ask for a wheelchair at the Monterey Aquarium they give you an extra $15 off your admission for being handicapped. Doctor's mantra is "no surgery, no surgery, no surgery"; but my world has become quite small (no sense traveling when I can't comfortably walk to see the sights) so at some point it may come to surgery.


I have a bad back but nothing like yours.  My previous PCP kept emphasizing that weight loss would do wonders for my knee and back.  Have you tried losing a small amount of weight?  For me, the threshold of knee pain or not is as few as 5 lbs.


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## DancingWaters (Sep 19, 2018)

Thank you VacationForever.   I will turn 65 in June and just trying to clarify bits of things I’ve heard.
How will not having a supplemental be a bad decision?  My sister has chosen not to get one.
Can I find supplemental choices online to study and compare?


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## VacationForever (Sep 19, 2018)

DancingWaters said:


> Thank you VacationForever.   I will turn 65 in June and just trying to clarify bits of things I’ve heard.
> How will not having a supplemental be a bad decision?  My sister has chosen not to get one.
> Can I find supplemental choices online to study and compare?


There are 3 options:
- Only Medicare.  You will be responsible for 20% of the medical costs. A BAD Option.
- Medicare + Advantage.  Small to no copay for many services.  Low to no premiums.  Cover the other 20% that is not covered by Medicare, max Out of Pocket is something like $2K a year.  It includes a drug plan. Most cost effective option.
- Medicare + Supplemental + Drug Plan.  Expensive option but provides greater flexibility in doctor options.  A plan like Plan F covers all doctors' costs and no copay.  You still have to pay for drugs like an Advantage Plan even though you need to buy a Drug Plan and the Drug Plan costs something like $80 per month in addition to a Supplemental Plan.


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## clifffaith (Sep 20, 2018)

VacationForever said:


> I have a bad back but nothing like yours.  My previous PCP kept emphasizing that weight loss would do wonders for my knee and back.  Have you tried losing a small amount of weight?  For me, the threshold of knee pain or not is as few as 5 lbs.


I have been talking about losing weight long before the bulging disc gave me miserable leg pain, but all I do is talk. Right now I'm trying to eat smaller portions. Tonight was card night and it was our turn to host. Gave myself a single scoop of ice cream, but am resenting not getting two. When I get "in the zone" I can give up sweets for six months at a time, or follow Weight Watchers (an old version from 1995), but I haven't been able to get myself to really make it happen. Sweets are my downfall. I weigh 60 pounds more than I did when we got married, I'd love to get 30 off and keep it off, but no one can do that but me and so far I'm not really putting any effort in.


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## Steve Fatula (Sep 20, 2018)

VacationForever said:


> There are 3 options:
> - Only Medicare.  You will be responsible for 20% of the medical costs. A BAD Option.
> - Medicare + Advantage.  Small to no copay for many services.  Low to no premiums.  Cover the other 20% that is not covered by Medicare, max Out of Pocket is something like $2K a year.  It includes a drug plan. Most cost effective option.
> - Medicare + Supplemental + Drug Plan.  Expensive option but provides greater flexibility in doctor options.  A plan like Plan F covers all doctors' costs and no copay.  You still have to pay for drugs like an Advantage Plan even though you need to buy a Drug Plan and the Drug Plan costs something like $80 per month in addition to a Supplemental Plan.



I would slightly amend, but, the idea is the same. Based on experiences with DW.

Only Medicare. The cheapest option if you never or rarely go to the doctor for anything expensive. However, if sick, is the most expensive most likely.
Medicare + Advantage. Generally more expensive than just Medicare, may include drug plan. DW had an Advantage plan with no drug coverage, and, a separate drug plan. With few visits or sickness, likely the cheapest option.
Medicare + Supplement + Drug Plan. Same flexibility as base Medicare, more than Advantage plan but not always. The reason is DW has a PFFS Advantage plan, which means any doctor. Most expensive for the Supplement cost + Drug plan.

So, when using a PFFS Advantage plan, you get all the advantages of flexibility.


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## isisdave (Sep 20, 2018)

DancingWaters said:


> Since we are talking about healthcare plans, I have a few questions to clear up.  I’m hoping some of you can answer these.   Do you know people that are on Medicare but don’t buy a supplemental?  What’s the good and the bad of not doing that?    Once you do buy a summplemental—-can they raise your rates or drop you, if a serious health issue arises.   I have been looking at Plan F from Medicare or STRS which is a retired teachers supplemental.



This would be risky.  Part B pays for non-hospital expenses.  You think "doctor's visit" but there are some VERY expensive outpatient protocols like dialysis, chemotherapy, physical therapy after an accident or broken hip, etc.

Supplemental plans have premiums by age band.  My BS of California goes up some every other birthday. But everyone that age pays the same.

Incidentally, supplemental plans cover the same things regardless of who sells them, and you can go to any doctor who takes Medicare with any plan. But the price varies widely! There's a place on the medicare.gov site that shows all their prices. Buy the cheapest.

And if you're considering plan F, take a look at plan N. It's about a third cheaper. You have to pay the annual deductible. Sometimes you have to pay a $20 doctor visit copay (but I've never been charged this) and there's a thing called "excess charges" which I've also never seen, but you should check with your friends and/or doctor. For me, N is $60 a month cheaper than F, so $720 saving per year to put toward $184 deductible and a bunch of copays.

Regarding HMOs: the only one I'd consider is Kaiser, and that only if I lived near one of their hospitals and didn't travel much. You have to go to one of their specialists, who may be a poor doctor (someone graduates last in his class, and they usually work for HMOs), remote, or not available.  DW was a mental health provider, and she had at least two patients die because they couldn't see a specialist until it was too late (although it might have been too late anyway, but three months is too long with obvious unexplained serious GI symptoms).


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## WinniWoman (Sep 20, 2018)

clifffaith said:


> I have been talking about losing weight long before the bulging disc gave me miserable leg pain, but all I do is talk. Right now I'm trying to eat smaller portions. Tonight was card night and it was our turn to host. Gave myself a single scoop of ice cream, but am resenting not getting two. When I get "in the zone" I can give up sweets for six months at a time, or follow Weight Watchers (an old version from 1995), but I haven't been able to get myself to really make it happen. Sweets are my downfall. I weigh 60 pounds more than I did when we got married, I'd love to get 30 off and keep it off, but no one can do that but me and so far I'm not really putting any effort in.




I don't know if you would be able to- but doing stomach exercises strengthens your back. Like sit-ups, etc.
I am overweight -by 50 lbs- myself, but luckily my back remains strong. I exercise 1 hour every morning before work. Plus I move around a lot- in and out of a car at work at least 20 times- but I also sit a lot driving and at home after work.I eat salad 5 days per week at work for lunch. Oatmeal and yogurt for breakfast and my regular dinners. Usually a low fat frozen yogurt pop after dinner. No cookies or cake in the house. Chocolate sometimes. Weekends I eat what I feel like plus drink wine. My metabolism is shot.

All I know is the less you move around the worse your health gets. If you are always in pain- you are not moving around because of the pain.

My almost 60 year old brother had a very bad disc problem, to the point that he could not longer play tennis or even just walk sometimes and he is very skinny. In fact, the back problem arose AFTER he lost 65 lbs!  He went to a well-known surgeon in Manhattan and had surgery one year ago this month and his back has been great ever since and he is back to an active lifestyle again.

I think you should get another medical opinion.


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## WinniWoman (Sep 20, 2018)

Steve Fatula said:


> I would slightly amend, but, the idea is the same. Based on experiences with DW.
> 
> Only Medicare. The cheapest option if you never or rarely go to the doctor for anything expensive. However, if sick, is the most expensive most likely.
> Medicare + Advantage. Generally more expensive than just Medicare, may include drug plan. DW had an Advantage plan with no drug coverage, and, a separate drug plan. With few visits or sickness, likely the cheapest option.
> ...



What is PFFS? I never understand everyone's abbreviations for things.


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## Steve Fatula (Sep 20, 2018)

mpumilia said:


> What is PFFS? I never understand everyone's abbreviations for things.



Private Fee For Service, not my invention. Some Advantage plans are labeled thus way.


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## Ralph Sir Edward (Sep 20, 2018)

VacationForever said:


> First of all, do not go with the basic Medicare.  Basic Medicare only pays 80% of most services.  At minimum, go with a Medicare Advantage Plan, some plans are free while others can be had for a low monthly premium.  Medicare Supplemental plans are usually a little more expensive than Advantage Plans and offer more flexibility including going out of state to get treatment.
> 
> In the first 2 years, 65 to 67, you can get on a supplemental plan without questions asked.  If you wait beyond that, they will qualify as to whether to take you and if so whether you are low or high risk, meaning tier 1, 2 or 3 pricing.  Tier 2 and 3 pricings are very expensive.  Once you are on an Advantage Plan or Supplemental Plan, they cannot drop you unless that offering disappears.  If an applicant is in end stage renal failure, both types of plans will not take the applicant.
> 
> ...



Important thing to remember with supplemental plans. Make certain that they are not going to be closed for new applicants in the future. F plans are going to be closed for new applicants in 2020, I believe.

Why is this important? Long term pricing (the rates as years go by), is based upon the "pool" of people in the supplemental plan. As one gets older, one ends up using more and more healthcare.So, if you cut off the new applicants to a supplemental type, (65 year olds entering into the "pool", the "pool" gets older and older, and the price (relative to other plans) goes up more and more. 

For an example, look up Medicare Supplemental plan J (which was closed to new applicants in 2010).


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## joestein (Sep 20, 2018)

VacationForever said:


> Regarding supporting children, my son who has autism spectrum disorder is back in university pursuing his second bachelor's degree.  I have been using 2 X gifting limit amount, using both my husband's and my limit, since he graduated with his first degree which was about 7 years ago. Now I am back to paying for his second degree + gifting and I hope that I can get out from under this financial obligation when he can get a job with his second degree in the next 18 months.  My life is complicated.



Good for you.  My daughters have some issues, mostly social.  I worry about them getting jobs and supporting themselves.   There will be no greater day than the one where both of them are out in the world, working and taking care of themselves and hopefully leading happy and fulfilling lives.

Then it will be time to party!


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## DancingWaters (Sep 20, 2018)

This information is so helpful......I wondered about PLan F and how that would work. I had heard it wouldn’t be available after 2020 but didn’t realize the side effects.   With this information it sounds like the beauty of the F plan would be short lived....did I understand that correctly? My sister makes me feel like an idiot when I tell her I plan to get a supplemental.   I like to know I am covered adequately so I don’t have any medical cost surprises.


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## bogey21 (Sep 20, 2018)

isisdave said:


> And if you're considering plan F, take a look at plan N. It's about a third cheaper. You have to pay the annual deductible. Sometimes you have to pay a $20 doctor visit copay (but I've never been charged this) and there's a thing called "excess charges" which I've also never seen, but you should check with your friends and/or doctor. For me, N is $60 a month cheaper than F, so $720 saving per year to put toward $184 deductible and a bunch of copays.



I look at it the same as the above but I address it a different way.  I have had the High Deductible Plan F for years now.  Same thing as Regular Plan F except that I have to cover the first (roughly) $2,000 that Medicare doesn't cover.  My cost is dramatically cheaper than the Regular Plan F.  Fortunately I am healthy and my out of pocket covering the deductibles has been in the vacinity of $300 - $400 each year.  My lower premium saves me a lot more than that....

George


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## rapmarks (Sep 20, 2018)

My son in law had a heart attack and then a stroke at age 36.  He was dropped by his job and consequently his insurance by the end of the week.


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## Passepartout (Sep 20, 2018)

DancingWaters said:


> This information is so helpful......I wondered about PLan F and how that would work. I had heard it wouldn’t be available after 2020 but didn’t realize the side effects.   With this information it sounds like the beauty of the F plan would be short lived....did I understand that correctly? My sister makes me feel like an idiot when I tell her I plan to get a supplemental.   I like to know I am covered adequately so I don’t have any medical cost surprises.


If you are already enrolled in a plan, and it closes to new applicants, you're still governed by it- and whatever changes the carrier imposes until YOU drop it. The fact that it closes to NEW applicants has nothing to do with earlier enrollees. Point here is to enroll in the plan that works best for you- and that you anticipate will work out a few years early on. You just have to know that rates change, coverages change, but you are covered to the best of your ability to foresee.

Jim


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## VacationForever (Sep 20, 2018)

Ralph Sir Edward said:


> Important thing to remember with supplemental plans. Make certain that they are not going to be closed for new applicants in the future. F plans are going to be closed for new applicants in 2020, I believe.
> 
> Why is this important? Long term pricing (the rates as years go by), is based upon the "pool" of people in the supplemental plan. As one gets older, one ends up using more and more healthcare.So, if you cut off the new applicants to a supplemental type, (65 year olds entering into the "pool", the "pool" gets older and older, and the price (relative to other plans) goes up more and more.
> 
> For an example, look up Medicare Supplemental plan J (which was closed to new applicants in 2010).


Agree that F is closed to new applicants in 2020.  But the cost of Supplemental is age band based anyway and so it does not matter that there will not be young people in the pool.  Older people always pay more in the Supplemental plans as it is age based.


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## VacationForever (Sep 20, 2018)

Steve Fatula said:


> I would slightly amend, but, the idea is the same. Based on experiences with DW.
> 
> Only Medicare. The cheapest option if you never or rarely go to the doctor for anything expensive. However, if sick, is the most expensive most likely.
> Medicare + Advantage. Generally more expensive than just Medicare, may include drug plan. DW had an Advantage plan with no drug coverage, and, a separate drug plan. With few visits or sickness, likely the cheapest option.
> ...


Where we live, all Advantage plans automatically include a drug plan for no additional cost.  There are 2 Advantage HMO Plans where it is 0 premium and max OOP is only $2k per year.  Many of our friends are on one of these 2 free Advantage Plans, called Senior Dimensions (HMO).  

My husband was on Senior Dimensions for a year and it did not pan out for us where it is next to impossible to see his PCP and kept getting the not so good PA.  He is now on a different Advantage PPO Plan, which is the most expensive one in our area at $96 per month.  Every doctor that he wants to see is in the PPO.  He switched to my PCP and has not looked back since.  We love his new plan.


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## JohnPaul (Sep 20, 2018)

My husband has a Plan F supplement.  It is wonderful.  Truly no deductibles or copays.  I planned to get that as well but don't turn 65 until 2020.  Not happy to hear it will not be available to me.


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## WinniWoman (Sep 20, 2018)

rapmarks said:


> My son in law had a heart attack and then a stroke at age 36.  He was dropped by his job and consequently his insurance by the end of the week.




This is just despicable and one of the biggest problems with health insurance in the USA.


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## Patri (Sep 20, 2018)

rapmarks said:


> My son in law had a heart attack and then a stroke at age 36.  He was dropped by his job and consequently his insurance by the end of the week.


He should have been offered COBRA.


----------



## Brett (Sep 21, 2018)

mpumilia said:


> This is just despicable and one of the biggest problems with health insurance in the USA.



yes, despicable - but employer provided health insurance has been around since the 1940's when the laws changed to make it tax exempt.


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## joestein (Sep 21, 2018)

rapmarks said:


> My son in law had a heart attack and then a stroke at age 36.  He was dropped by his job and consequently his insurance by the end of the week.



When you hear these things, it is a reminder of just how unsympathetic as people we can be.


----------



## DancingWaters (Sep 21, 2018)

Thanks, I feel better about all the information TUG friends have offered.   I want to pay a reasaonable premium and then be almost fully covered.  I won’t let others who are opting out of a supplemental to sway me into falling into their bad decisions. It’s nice to hear that those who are on plan F or G will have spouses sign up for the same plan.   All so encouraging


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## rapmarks (Sep 21, 2018)

I have a friend who just turned eighty I do her taxes for her and she mentioned she dropped her supplemental insurance because it cost too much.  At age 80!


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## Talent312 (Sep 23, 2018)

rapmarks said:


> I have a friend who just turned eighty I do her taxes for her and she mentioned she dropped her supplemental insurance because it cost too much.  At age 80!



You may want to encourage her to consider a Medicare Advantage Plan which combines both traditional medicare with supplement and drug coverage, often at -0- additional cost. You can do a search for her on the Medicare website.

DW has an affinity for expensive things, so she went with Plan F. But I won't be able to get it (65 after it closes). So, being frugal myself, I'll prolly go with a Medicare Advantage Plan.
.


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## bogey21 (Sep 23, 2018)

Talent312 said:


> So, being frugal myself, I'll probably go with a Medicare Advantage Plan.



Just remember with Advantage Plans you are locked into the Provider's network.  This may well lock you out of a Center of Excellence if something serious befalls you.   Personally, I am not willing to take that risk..

George


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## baf99 (Sep 23, 2018)

I have a few more years before I have Medicare and at this point I have access to a retiree plan that covers more than the Medicare supplement plans. But I am going to consider all options and I do have a question about the Advantage plans. If you choose to go out of network do you still get basic Medicare coverage (up to 80%) or are you completely on your own? I would consider the first but no coverage at all is definitely a no-go for me.

I have to consider all of this because the company I retired from doesn't actually have any retiree medical plans but because they bought my former company that did have such a plan I am grandfathered into a Cigna plan. But I worry that at some point they could discontinue that benefit. So I want to stay informed.


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## Steve Fatula (Sep 23, 2018)

bogey21 said:


> Just remember with Advantage Plans you are locked into the Provider's network.  This may well lock you out of a Center of Excellence if something serious befalls you.   Personally, I am not willing to take that risk..



With many plans true, but not all Advantage plans. Humana has one here called Humana Gold Choice PFFS. In that Advantage plan, you can go to any doctor. There is no list of doctors.


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## rapmarks (Sep 23, 2018)

My Medicare advantage plan let’s us go to any doctor, twenty percent copay after meeting deductible in or out of network


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## geekette (Sep 24, 2018)

VacationForever said:


> @geekette In a true HMO system like Kaiser, you simply cannot see a doctor outside of their network.  Zero zilch payment to a doctor who is not working for Kaiser.


Of course you can see a doctor outside of their network, nobody can stop you.  They just don't pay.  Doesn't change the fact that you can make an appointment with any provider that will see you.  If the cost is too much for the patient to handle then they can CHOOSE to stay in network.  Nobody is prevented access to medical professionals.  It is only a matter of Who Pays. 

I am seeing doctors outside of my network and one provider that refuses to deal with insurance companies.  I am CHOOSING to pay from pocket to receive services.  It goes towards my out of network deductible and max annual out of pocket, after which my insurance will kick in on out of network.  Mine is high deductible policy, no copays, I pay negotiated rates to deductible, then there is coinsurance to out of pocket max.  Money paid in any form goes towards tax form medical deductions.  Kaiser apparently ignores anything not thru its doctors, and it can do that.  Their policy, their rules.   Still medical cost deduction.  Possibly good use of HSA funds.  

People make choices, I am going for best medical help vs best monetary route.  I've never been sick before.  Each ins policy is different, I am into my 3rd hospital system, the first 2 were in-network, but the real help has been at a university system.  I needed the benefit of current research and new programs for my conditions.

I am quite lucky to be sick in a great medical community, I have a lot of options.   Not everyone does.   Further, for me, without full recovery, there isn't going to be full salary ever again, and I'm 52 with a mortgage.  Not since college have I had to make such a huge investment in myself and it is a life quite foreign to what I'd known.   It is absolutely worth it to me, a single lady looking after herself only, to strive for the best help available right up until I am risking too much financially to reasonably recover from.   I will either be able to handle my career again or I will not be able to and I have got to determine that as soon as possible.  Hopefully by end of 2018, but, maybe not.  Recovery is a tricky thing. 

I would have to see in writing being prohibited from seeing other doctors as that would be a matter to be raised with state insurance commissioner as it's not true and possibly illegal statement against public interest.   If they drop you for seeing a doctor outside network, that's got to be illegal.   Any person can see any doctor.  An insurance company may set limits on COVERAGE  but that is NOT the same as "cannot" see doc not on K list.   Any attempt to persuade a person to NOT seek medical help from available treating provider is a problem.   Monetary impacts of doing that are a different matter entirely.  For my insurance, I had better be in dire straits to go to ER as that will cost me big, possibly more than my annual deductible.  Hopefully I will be conscious if ever such choice needs to be made.  Frankly, there are probably some situations in which I would not even consider an "immediate care center" over ER just as a matter of trust.  Screw it, get fixed and plead my case to denied insurance coverage later.  I don't want to risk "it's just a stomach bug" when it's my appendix.  I am forever more leery after too much assembly-line one-size-fits-all treatment.


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## geekette (Sep 24, 2018)

Geez, this Medicare stuff is complicated!!!  

Hats off to Seniors for taking it on and getting what you need and sharing info with others.

Seriously, HOLY CRAP!!!


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## Patri (Sep 24, 2018)

Geekette, my prayers for your recovery.


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## bogey21 (Sep 24, 2018)

geekette said:


> Of course you can see a doctor outside of their network, nobody can stop you.  They just don't pay.  Doesn't change the fact that you can make an appointment with any provider that will see you.  If the cost is too much for the patient to handle then they can CHOOSE to stay in network.  Nobody is prevented access to medical professionals.  It is only a matter of Who Pays.
> 
> I am seeing doctors outside of my network and one provider that refuses to deal with insurance companies.  I am CHOOSING to pay from pocket to receive services.



All well and good for those of us who can afford to pay whatever it takes.  How about the 90% to 95% of the population who struggle to come up with dollars to pay for insurance.  I'll bet their only choice is one of the zero or low cost Advantage plans most of which lock them into a Network...

George


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## Talent312 (Sep 24, 2018)

geekette said:


> Geez, this Medicare stuff is complicated!!!
> Hats off to Seniors for taking it on and getting what you need and sharing info with others.



Each year, Medicare enrollees get a booklet entitled "Medicare & You."
It's ~130 pages, and tells you more than you want to know.

It's not much more complicated than any hotel-TS system, like HGVC.
I had to read thru the rules on both about 5x b4 it began to sink in.
However, Medicare doesn't take you to great destinations.
.


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## PigsDad (Sep 24, 2018)

Talent312 said:


> However, Medicare doesn't take you to great destinations.


I guess it could take you to the Great Beyond. 

Kurt


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## rapmarks (Sep 24, 2018)

Most doctors offices will warn you if something isn’t covered ny Medicare


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## geekette (Sep 24, 2018)

bogey21 said:


> All well and good for those of us who can afford to pay whatever it takes.  How about the 90% to 95% of the population who struggle to come up with dollars to pay for insurance.  I'll bet their only choice is one of the zero or low cost Advantage plans most of which lock them into a Network...
> 
> George



I can't pay "whatever it takes", but I can ask for a discount for being Self Pay.  I don't get charged as much as "negotiated rates" in most cases.   It can be a very good idea to shop around vs assume it costs more when a doc won't accept your insurance.  

I don't understand the idea of not being able to afford insurance and then electing to limit choice of doctor.  Avoid the middle man and deal with the doctors instead of insurers.  If insurance is unaffordable, don't go broke paying for that, go broke paying for the healers instead. 

Insurance isn't going to help me, doctors are.  I well understand that few view this like I do but I value my health more than my "wealth".


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## Brett (Sep 24, 2018)

geekette said:


> I can't pay "whatever it takes", but I can ask for a discount for being Self Pay.  I don't get charged as much as "negotiated rates" in most cases.   It can be a very good idea to shop around vs assume it costs more when a doc won't accept your insurance.
> 
> I don't understand the idea of not being able to afford insurance and then electing to limit choice of doctor.  Avoid the middle man and deal with the doctors instead of insurers.  If insurance is unaffordable, don't go broke paying for that, go broke paying for the healers instead.
> 
> Insurance isn't going to help me, doctors are.  I well understand that few view this like I do but I value my health more than my "wealth".




OK,   you're saying health insurance (aka the 'middle man') isn't going to help but directly paying the doctors is the best alternative
that's a great health strategy ....   if you were in the 19th century


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## Steve Fatula (Sep 24, 2018)

Brett said:


> OK,   you're saying health insurance (aka the 'middle man') isn't going to help but directly paying the doctors is the best alternative
> that's a great health strategy ....   if you were in the 19th century



I believe what she was saying, and I found the same to be true, was that often (for me always) self pay customers pay less out of pocket than insurance covered people. Obviously, depends on your co-pays, deductible, etc. I was uninsured a few years, and paid doctors less than I paid out of pocket on BCBS. Yes, I did negotiate and tell them I was self pay and it did matter. Now, if I would have needed surgery, could have been a different result. But, going out of network will not always mean paying more and I agree with her comment as I experienced the same thing.


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## Brett (Sep 24, 2018)

Steve Fatula said:


> I believe what she was saying, and I found the same to be true, was that often (for me always) self pay customers pay less out of pocket than insurance covered people. Obviously, depends on your co-pays, deductible, etc. I was uninsured a few years, and paid doctors less than I paid out of pocket on BCBS. Yes, I did negotiate and tell them I was self pay and it did matter. Now, if I would have needed surgery, could have been a different result. But, going out of network will not always mean paying more and I agree with her comment as I experienced the same thing.



some believe they have more negotiating power (lower prices) than major health insurers.  And the prices quoted for certain medical procedures are lower for individuals without insurance than those that have health insurance but I believe an individual will ultimately pay less if they have health insurance. ( ... except for dental 'health'  and if one never has a major medical issue )


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## Talent312 (Sep 24, 2018)

VacationForever said:


> Agree that Plan F is closed to new applicants in 2020.



Plan F and Plan C will be closed if you turn 65 in 2020.
IOW, you won't get the Part B deductible covered.
It's not much, but one more reason to check out Advantage Plans.


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## Steve Fatula (Sep 24, 2018)

Brett said:


> some believe they have more negotiating power (lower prices) than major health insurers.  And the prices quoted for certain medical procedures are lower for individuals without insurance than those that have health insurance but I believe an individual will ultimately pay less if they have health insurance. ( ... except for dental 'health'  and if one never has a major medical issue )



No, I don't believe I have more negotiating power per se. But it was definitely factual that I paid less. Though it was worrisome to some degree, was hoping to not get sick. I agree you likely could not get everything cheaper. But the point is you may be in a network but really want to use doctor X for something. And, Doctor X will not necessarily cost you more is the only point. So, why not check if it's important to you in other words. My experience was doctor visits and a few labs.

If you can't afford any insurance, of course you'd want to get a decent deal on any care if possible.


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## Brett (Sep 24, 2018)

Steve Fatula said:


> No, I don't believe I have more negotiating power per se. But it was definitely factual that I paid less. Though it was worrisome to some degree, was hoping to not get sick. I agree you likely could not get everything cheaper. But the point is you may be in a network but really want to use doctor X for something. And, Doctor X will not necessarily cost you more is the only point. So, why not check if it's important to you in other words. My experience was doctor visits and a few labs.
> 
> If you can't afford any insurance, of course you'd want to get a decent deal on any care if possible.



sure, but "factually paid less" may not be true if one compares paying insurance vs paying a doctor/ surgeon / hospital directly for a certain medical procedure.


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## Steve Fatula (Sep 24, 2018)

Brett said:


> sure, but "factually paid less" may not be true if one compares paying insurance vs paying a doctor/ surgeon / hospital directly for a certain medical procedure.



Not sure what you mean. Before I was uninsured, I had doctor visits at various doctors. I know what I paid on top of the premiums, i.e. co pays and deductible. It's on paper, the EOBs. After becoming uninsured, I had visits to the same doctors but as self pay. Those visits were less cost than the discounted BCBS rate. And I was not paying premiums on top of it. Could I have repeated this for my rotator cuff surgery? Not sure, my guess is not.

I have one doctor where they still have me as self pay even though I am health sharing, and I've told them several times now. I had a physical, and labs (bloodwork). The total I paid (well, sharing paid), i.e., the list price provided to the insurance was around $60. Including the labs. I posted the exact number a few months back on some thread. That's less than the BCBS discounted rate from 8 years ago.


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## Brett (Sep 24, 2018)

Steve Fatula said:


> Not sure what you mean. Before I was uninsured, I had doctor visits at various doctors. I know what I paid on top of the premiums, i.e. co pays and deductible. It's on paper, the EOBs. After becoming uninsured, I had visits to the same doctors but as self pay. Those visits were less cost than the discounted BCBS rate. And I was not paying premiums on top of it. Could I have repeated this for my rotator cuff surgery? Not sure, my guess is not.
> 
> I have one doctor where they still have me as self pay even though I am health sharing, and I've told them several times now. I had a physical, and labs (bloodwork). The total I paid (well, sharing paid), i.e., the list price provided to the insurance was around $60. Including the labs. I posted the exact number a few months back on some thread. That's less than the BCBS discounted rate from 8 years ago.



I'm saying if you take a group of people from birth to death and compare health costs,   insurance payments vs paying directly those with health insurance probably pay less over a lifetime.  Nothing about your personal medical procedures and personal health cost experience !


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## bluehende (Sep 24, 2018)

The problem with these analysis is that you are actually talking two different things.  One is health care and the other is insurance.  As a whole health care would have to be cheaper without insurance for the whole population.  You insure for something that you cannot afford to lose.  Personally even though I know my insurance has cost a lot more than my health care I am not willing to take the chance that I end up with a catastrophic health care need.  Very few of us could write the 1 million dollar check that a friend of mine would have needed after a very severe car accident.  Paying as you go is great until you cann't.  At that point you will not receive top tier health care and all those great doctors that refuse to be in networks will not be avaiable.


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## Steve Fatula (Sep 24, 2018)

bluehende said:


> The problem with these analysis is that you are actually talking two different things.  One is health care and the other is insurance.  As a whole health care would have to be cheaper without insurance for the whole population.  You insure for something that you cannot afford to lose.  Personally even though I know my insurance has cost a lot more than my health care I am not willing to take the chance that I end up with a catastrophic health care need.  Very few of us could write the 1 million dollar check that a friend of mine would have needed after a very severe car accident.  Paying as you go is great until you cann't.  At that point you will not receive top tier health care and all those great doctors that refuse to be in networks will not be avaiable.



Sure. And I don't think I (at least) was suggesting it's a great idea to go uninsured. In the context of Medicare or HMOs or whatever and lists of doctors, the point was merely to say you might still be able to go to a doctor outside of the list and not pay more for some given service. Nothing more or less. Please do not read more into it.


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## Brett (Sep 24, 2018)

bluehende said:


> The problem with these analysis is that you are actually talking two different things.  One is health care and the other is insurance.  As a whole health care would have to be cheaper without insurance for the whole population.  You insure for something that you cannot afford to lose.  Personally even though I know my insurance has cost a lot more than my health care I am not willing to take the chance that I end up with a catastrophic health care need.  Very few of us could write the 1 million dollar check that a friend of mine would have needed after a very severe car accident.  Paying as you go is great until you cann't.  At that point you will not receive top tier health care and all those great doctors that refuse to be in networks will not be avaiable.



right, I'm pretty sure my health insurance payments over the years were a lot more than what I would have paid doctors directly  ... right up until I had a $30,000 out-patient medical procedure


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## bluehende (Sep 24, 2018)

Steve Fatula said:


> Sure. And I don't think I (at least) was suggesting it's a great idea to go uninsured. In the context of Medicare or HMOs or whatever and lists of doctors, the point was merely to say you might still be able to go to a doctor outside of the list and not pay more for some given service. Nothing more or less. Please do not read more into it.



I did not get that from your post at all.  There was a post that did seem to start the conversation that way, but it was not yours.  The conversation did seem to be drifting to costs with insurance vs those without. Those cannot be compared unless you know your future.  We drifted a long ways from the correct point that being in a network does not exclude other drs if you can afford it.

PS  It is telling that almost any retirement.employment, or financial discussion eventually ends up in a health care discussion.


----------



## Steve Fatula (Sep 24, 2018)

bluehende said:


> I did not get that from your post at all.  There was a post that did seem to start the conversation that way, but it was not yours.  The conversation did seem to be drifting to costs with insurance vs those without. Those cannot be compared unless you know your future.  We drifted a long ways from the correct point that being in a network does not exclude other drs if you can afford it.
> 
> PS  It is telling that almost any retirement.employment, or financial discussion eventually ends up in a health care discussion.



It sure is, and that's sad actually. When insurance just for me on the cheapest ACA plan is $900/mo, that's not insignificant. Plus a huge deductible on top!


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## Brett (Sep 24, 2018)

Steve Fatula said:


> It sure is, and that's sad actually. When insurance just for me on the cheapest ACA plan is $900/mo, that's not insignificant. Plus a huge deductible on top!



very sad indeed.  our TUG friends in Canada, Australia, and other countries claim they pay less over their lifetime for health insurance
They say they have "liberal" socialized medical care that covers everyone from birth until death 
They don't understand 'in network' and 'out of network"
Crazy!


----------



## PamMo (Sep 24, 2018)

geekette said:


> ...Avoid the middle man and deal with the doctors instead of insurers.  If insurance is unaffordable, don't go broke paying for that, go broke paying for the healers instead.
> 
> Insurance isn't going to help me, doctors are.  I well understand that few view this like I do but I value my health more than my "wealth".



That works for day-to-day healthcare and minor illnesses. Most people could probably handle negotiated self-pay visits to doctors or urgent care clinics for annual physicals, common illnesses and immunizations, but one major medical incident could wipe them out financially. An injury from an uninsured or underinsured driver, skiing (hiking, biking, swimming...) accident, fall, stroke, heart attack, or any number of unforseen but fairly common things would be disastrous for most Americans without insurance.

I plan on hanging around and enjoying my life for a long time, so I won't be gambling with my life's savings or access to healthcare. I just wish there were more affordable insurance options out there.


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## Steve Fatula (Sep 24, 2018)

Brett said:


> very sad indeed.  our TUG friends in Canada, Australia, and other countries claim they pay less over their lifetime for health insurance
> They say they have "liberal" socialized medical care that covers everyone from birth until death
> They don't understand 'in network' and 'out of network"
> Crazy!



Yeah, I don't know if they pay less or more over their lifetime, but our problems extend far beyond insurance costs. But that would be OT.


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## Steve Fatula (Sep 24, 2018)

PamMo said:


> ... fairly common things would be disastrous for most Americans without insurance.



And, sadly, for many with so called insurance! A friend of mine paid $30k with insurance for his surgery. Wiped him out.


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## Brett (Sep 24, 2018)

Steve Fatula said:


> Yeah, I don't know if they pay less or more over their lifetime, but our problems extend far beyond insurance costs. But that would be OT.



it's easy to compare per capita health care costs with developed countries but quality may vary 
it's probably more about what you consider "our" problems beyond health insurance costs !


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## Steve Fatula (Sep 24, 2018)

Brett said:


> it's easy to compare per capita health care costs with developed countries but quality may vary
> it's probably more about what you consider "our" problems beyond health insurance costs !



Just speaking of healthcare issues beyond insurance costs, like drug costs and a dozen or more other things. That would be another thread though.


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## Chrispee (Sep 25, 2018)

Brett said:


> very sad indeed.  our TUG friends in Canada, Australia, and other countries claim they pay less over their lifetime for health insurance
> They say they have "liberal" socialized medical care that covers everyone from birth until death
> They don't understand 'in network' and 'out of network"
> Crazy!



We don't "claim" to pay less for health coverage, it's a fact that we pay less.  The most recent study I could find shows Canadians pay $4,752 annually per capita, whereas US citizens pay $10,348 annually per capita.  While the USA is well set up in a great many ways, you won't find a lot of your foreign friends admiring your current health care system/costs.  Just because others are proponents for socialized health care, don't make the mistake of thinking we don't understand for-profit coverage.


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## vacationhopeful (Sep 25, 2018)

I hope many Tuggers have looked into Long Term Care Insurance. 

Not a true medical policy but a Home Care (or nursing home) payment product for a period of time.


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## WinniWoman (Sep 25, 2018)

vacationhopeful said:


> I hope many Tuggers have looked into Long Term Care Insurance.
> 
> Not a true medical policy but a Home Care (or nursing home) payment product for a period of time.



I know we decided not to purchase it. It is just way too expensive. Heck- reading the above posts people can't even afford health insurance, never mind long term care insurance.

But I agree that if you can afford the premiums- and you can find a decent policy with a stable insurer, it is a good thing to have.


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## Talent312 (Sep 25, 2018)

Insurance is intended merely for  than routine office
visits, but for unexpected, unusually high expenses, for
which individual self-insurance would prove catastrophic.

I have insurance on my house, even though I don't have to.
I can handle routine repair+replace, but not a tree thru the roof.
.


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## rapmarks (Sep 25, 2018)

I am off to call the insurance company to see why they denied all my husbands blood work and why we owe the hospital $678


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## bluehende (Sep 25, 2018)

rapmarks said:


> I am off to call the insurance company to see why they denied all my husbands blood work and why we owe the hospital $678



I cann't hit like but this is certainly problem number 2 with our system.


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## breezez (Sep 25, 2018)

mpumilia said:


> I know we decided not to purchase it. It is just way too expensive. Heck- reading the above posts people can't even afford health insurance, never mind long term care insurance.
> 
> But I agree that if you can afford the premiums- and you can find a decent policy with a stable insurer, it is a good thing to have.


My long term care policy is cruise ships, they cost $450-$1000 a week interior stateroom, they feed you, provide entertainment, will wheel you around in wheel chair if needed, medical on board.   You just have to get off and reboard once a week.   But in the end still cheaper than assisted living.


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## Passepartout (Sep 25, 2018)

vacationhopeful said:


> I hope many Tuggers have looked into Long Term Care Insurance.
> 
> Not a true medical policy but a Home Care (or nursing home) payment product for a period of time.


We are of two minds on LTC insurance. My mom had it, and as she finally expired in a nursing home after living about 3 years in assisted living, her LTC insurance paid out almost exactly the total of the premiums she had paid for it. My DW's father did not have LTC insurance, and had the money to cover his care for any reasonable time period out to his 120's.

LTC insurance is for the large middle of the 'Bell Curve' of income/savings demographic. The poor can't afford it, and if/when they go to long term care, their savings and assets will be liquidated and spent down and they will be covered by Medicaid. It isn't pretty but that's the reality unless they have family that will step up and improve their lot.

Wealthy people- or those who saved significant amounts with the goal of not being dependent on others- and/or the healthy or those with a likelihood that they won't be spending a long time needing care- don't need LTC insurance. They can privately pay for their own care.

The decision of 'to buy LTC or not to buy LTC insurance' should be made as early as possible if one falls within the group that can benefit from it. Say those who have children who are not in a financially secure position- or who have their own medical challenges. I feel that to pay for LTC insurance so that you can leave a large nest egg, while generous, is probably not the intention. Subsequent generations should have no entitlement to their parents' wealth. I'm sure others will disagree, but that's how I feel.

Jim


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## bogey21 (Sep 25, 2018)

vacationhopeful said:


> I hope many Tuggers have looked into Long Term Care Insurance.
> 
> Not a true medical policy but a Home Care (or nursing home) payment product for a period of time.



The alternative I chose to Long Term Care Insurance was to move into a CCRC (Continuing Care Retirement Community) when I reached age 65 (18 years ago).  Contractually the CCRC is required to provide Assisted Living if/when I need it.  My monthly fee includes an apartment, utilities, food, cleaning, etc.  When I subtract the LTC premiums I don't have to pay and take into account that 25% of my monthly payment is tax deductible as Prepaid Medical Expenses I have both security and a bargain.  The only downside is the Front End Fee I had to pay when I signed up but if I divide it by 18 (the number of years I have been here) it becomes relatively insignificant...

George


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## Passepartout (Sep 25, 2018)

breezez said:


> My long term care policy is cruise ships, they cost $450-$1000 a week interior stateroom, they feed you, provide entertainment, will wheel you around in wheel chair if needed, medical on board.   You just have to get off and reboard once a week.   But in the end still cheaper than assisted living.


We've considered this, and for a while, if one is relatively healthy it would work. But if your medical care should be advanced, or acute, or you need medication supervision, It's beyond the scope of their ability. And cruise ship medicine is a 'for profit' undertaking, your Medicare insurance is not going to help you. Be sure to have a whole bunch of medical and evacuation/repatriation insurance coverage.

Jim


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## Talent312 (Sep 25, 2018)

rapmarks said:


> I am off to call the insurance company to see why they denied all my husbands blood work and why we owe the hospital $678.



They should send you an EOB (Explanation of Benefits) with reasons stated.
You might find it online. If you can decider it, it will tell you something like:
... (1) They don't cover "in house" labs, only "independent" labs.
... (2) Then want documentation showing it was medically necessary.
... (3) Coding error.
You may have to ask the hospital to resubmit the claim.

_I heard a news story in which the President of the company was shown
an EOB and asked to explain it... He could not and called someone for help._

DW went thru that with Medicare becuz they thought she was covered
under my old policy and we had prove to them that she'd been terminated.

Please let us know.

.


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## rapmarks (Sep 25, 2018)

It is being looked into but they are not covering his lipid panel, he is on statins, his thyroid test, he had half removed, and everything else so has to be a coding error I hope.  Then another hour on phone with company that supplies cpap and automatically charged our credit card $191 for a mask and then later submitted to insurance and charged him the copay also.


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## Talent312 (Sep 25, 2018)

rapmarks said:


> ... another hour on phone with company that supplies cpap and automatically charged our credit card $191 for a mask and then later submitted to insurance and charged him the copay also.



Having to deal with stuff like that is enuff to raise one's blood pressure.

After DW was in the hospital for a TIA, she got a bill from some stray doc.
We had to comb thru claim records to prove he'd been paid by insurance.
<arrgh>.


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## NJDave (Sep 27, 2018)

geekette said:


> If it so happens that I can suffer the 10% penalty in stride, I'll bail out before age 59.5.   There are other ways to tap retirement plans, like taking "substantially equal distributions" for at least 5 years.  If I catch wind of that rule ending, I might quickly elect it.  I otherwise don't like locking myself into anything.  My thinking on this has changed greatly since I got sick.  It turns out that I want out of the workforce more than I want money.  Living simply isn't hard for me and I have proven it again.



There are other circumstances where you could take withdrawals at age 55 without incurring the penalty. This article may help. 

http://www.401khelpcenter.com/401k_education/Early_Dist_Options.html#.W6yof_ZFzDc


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## geekette (Sep 27, 2018)

NJDave said:


> There are other circumstances where you could take withdrawals at age 55 without incurring the penalty. This article may help.
> 
> http://www.401khelpcenter.com/401k_education/Early_Dist_Options.html#.W6yof_ZFzDc


Yeah, there are ways, I just don't like them!   

If I had to, I'd go the minimum 5 years of "substantially equal payments".


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## Brett (Oct 12, 2018)

Today the Wall Street Journal had an article on people that retire early
Only five (5) easy steps !


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## SmithOp (Oct 12, 2018)

Brett said:


> Today the Wall Street Journal had an article on people that retire early
> Only five (5) easy steps !
> 
> 
> View attachment 8576



Hah, in the 60s we called them hippies, now its WSJ fodder to live a minimalist lifestyle.


Sent from my iPad using Tapatalk Pro


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## Ralph Sir Edward (Oct 12, 2018)

Quite a hoot.


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