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

vacationhopeful

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"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.
 

Fredflintstone

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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.



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bluehende

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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.
 

vacationhopeful

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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.
 

breezez

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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: :banana:.....
 

Fredflintstone

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

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

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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.

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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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@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

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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

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@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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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

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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
 

Fredflintstone

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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

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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

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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.
 

bizaro86

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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.
 

VacationForever

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What is a “network”?


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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.
 

Fredflintstone

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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?


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VacationForever

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


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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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WinniWoman

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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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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

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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
 

bizaro86

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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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