Early retirement and health care for boaters

[sailorboy1]

I don’t why people don’t do some real topic search. I’ll post it once again:

The ACA subsidy is only based on reported income. You have to have at least the property level to get anything and at that level ou get the max. After that you start getting less.

My wife and I (56&57) this are taking an early 401k withdraw of $22,417 that will be counted as income. With this we get the max ACA subsidy and are paying $20.17/mo for a silver plan. Last year we took $22,000 out of the 401k to get the income and paid $22/mo plus a deductible for the year of $567 (max was $600) for tests.

If you don’t have any income or a way to qualify for some you either need to look into expanded Medicaid if your state elected to do it, or you are going to have to go the market place and route.

Who knows how long this will last, but it was proven last year the politicians didn’t have the courage to cancel something that so many people now counted on for medical insurance.

[buzzstar]

Originally Posted by robert sailor

The total bill was just shy of $49,000.00 that's why Canadians are scared to ever get sick in your beautiful country.

That is a silly comment. I have personally spoken to numerous Canadians who come to the US for healthcare -usually related to long waits in the Canadian system and/or quality of the care for the condition. That said, mine is a silly comment as well. Neither yours nor mine relate to the OP's concern, and in no way help solve his problem.

[Mike OReilly]

Originally Posted by buzzstar

That is a silly comment. I have personally spoken to numerous Canadians who come to the US for healthcare -usually related to long waits in the Canadian system and/or quality of the care for the condition. That said, mine is a silly comment as well. Neither yours nor mine relate to the OP's concern, and in no way help solve his problem.

Your contact with Canadians must be fairly narrow. Canadians are not flocking to the USA for healthcare. It’s a constant myth perpetuated by those with a political agenda.

5 Myths About Canadian Health Care

[buzzstar]

Originally Posted by Mike OReilly

Your contact with Canadians must be fairly narrow. Canadians are not flocking to the USA for healthcare. It’s a constant myth perpetuated by those with a political agenda.

5 Myths About Canadian Health Care

My sample is fairly narrow (generally professionals, including physicians). Nonetheless, it exists as a body of experience despite your effort to debunk it. Me, I do not give much thought to the Canadian "system" (which I understand varies somewhat by province) since it does not apply to me, and almost certainly never will. Apparently it does not apply to the OP either. I'd sure love to know if there are any decent answers to his concerns. Too late for me but perhaps very useful to many CF readers.

[misfits]

Originally Posted by sailorboy1

My wife and I (56&57) this are taking an early 401k withdraw of $22,417 that will be counted as income. With this we get the max ACA subsidy and are paying $20.17/mo for a silver plan. Last year we took $22,000 out of the 401k to get the income and paid $22/mo plus a deductible for the year of $567 (max was $600) for tests.

If you don’t have any income or a way to qualify for some you either need to look into expanded Medicaid if your state elected to do it, or you are going to have to go the market place and route..

That's a pretty smart move to get a good ACA plan so you can retire early without a huge monthly bill for health insurance.
The only issue opting into expanded Medicaid, 10 states are now requiring the recipients to work if they're physically able to. I suspect more states will follow this lead. When you hit 65 in the U.S. you're buying into Medicare whether you want to or not. But it's far cheaper than a monthly premium to stay on the treadmill.

[Mike OReilly]

Originally Posted by buzzstar

My sample is fairly narrow (generally professionals, including physicians). Nonetheless, it exists as a body of experience despite your effort to debunk it. Me, I do not give much thought to the Canadian "system" (which I understand varies somewhat by province) since it does not apply to me, and almost certainly never will. Apparently it does not apply to the OP either. I'd sure love to know if there are any decent answers to his concerns. Too late for me but perhaps very useful to many CF readers.

Canadians are not flocking to the USA for healthcare, despite your narrow experience. And the whole ‘long wait list’ thing is also mostly untrue — a fact easily discerned with a bit of research. I dislike when objectively false (mis)information is spread; that is the only reason I responded to your comment. But you’re right, it is irrelevant to the OP.

It sounds like Don (aka sailorboy1) is making some pretty relevant comments. Why don’t Americans follow his lead?

[robert sailor]

Originally Posted by Mike OReilly

Canadians are not flocking to the USA for healthcare, despite your narrow experience. And the whole ‘long wait list’ thing is also mostly untrue — a fact easily discerned with a bit of research. I dislike when objectively false misinformation is spread; that is the only reason I responded to your comment. But you’re right, it is irrelevant to the OP.

It sounds like Don (aka sailorboy1) is making some pretty relevant comments. Why don’t Americans follow his lead?

Don't be tough on them Mike, they have been fed this BS for so many years by their politicians that many actually believe it. When the same bunch of politicians fed the American masses with the BS line that the perpetrators of 9/11 came in through Canada many believed that as well as it seemed it was just too much to accept that every one of them came directly to the USA from their home in the Middle East.

[misfits]

Originally Posted by Mike OReilly

It sounds like Don (aka sailorboy1) is making some pretty relevant comments. Why don’t Americans follow his lead?

That's why I mentioned "pretty smart move".
I'm turning 63 this May & the plan is to punch out.

[hellosailor]

"That's a pretty smart move to get a good ACA plan so you can retire early without a huge monthly bill for health insurance"
Except, the OP said he and his wife are both employed. ACA looks at the household income, from all sources, and bases any payments they make on that. For two people both still working, it is not uncommon to find out the ACA will pay you nothing. And, they can be a paperwork nightmare once they get a wrong idea or figure in their heads. Whatever they pay you goes against your taxes, not into your pocket, so again you have to fit a certain niche or else the ACA tax credits don't accomplish anything.

[sailorboy1]

If you still work and make so much you can't qualify for ACA, well then you can afford health insurance! It still be an ACA plan, in fact that was the way the system was designed.

Otherwise you need to consider what my plan was before the ACA, get out of the USA so you can buy an more affordable medical plan.

[sailorboy1]

Originally Posted by misfits

That's why I mentioned "pretty smart move".
I'm turning 63 this May & the plan is to punch out.

We lived in NH when we left to start cruising. For a few months we had a NH expanded medicare program that cost us nothing.It was only good really for major medical as we were out of State. But it was FREE so look into it (do the application early as it takes a month plus to get an answer and we had to pay the taxes on the period we weren't covered).

Then we became Florida residents and got a ACA and chose a provider in the Jacksonville area thinking we go through that area a few times a year. But even that has workarounds as we are currently in Marathon and my wife needed to go to doctor. There was a provider here for our insurance, but we had change them to be our primary provider, which took 5 minutes and we will change it back later.

It just takes a little legwork, but hey we are cruisers and have time if it has value.

[ctl411]

Originally Posted by Mike OReilly

Canadians are not flocking to the USA for healthcare, despite your narrow experience. And the whole ‘long wait list’ thing is also mostly untrue — a fact easily discerned with a bit of research. I dislike when objectively false (mis)information is spread; that is the only reason I responded to your comment. But you’re right, it is irrelevant to the OP.

It sounds like Don (aka sailorboy1) is making some pretty relevant comments. Why don’t Americans follow his lead?

His $22 a month "plan" is not sustainable. If too many do it they would have to shut it down.

I am curious though do you know what your monthly cost "tax" was for medical in Canada?
Not knocking, I'm sure it's more reasonable than what I pay.

If that subsidy still exists after my kids finish school that is the plan for my wife and I. Become "working"/retired poor or just not be in the USA.

[Mike OReilly]

Originally Posted by ctl411

...I am curious though do you know what your monthly cost "tax" was for medical in Canada? Not knocking, I'm sure it's more reasonable than what I pay.

It’s a good question. Since it’s based on taxes (income tax, sales tax, business/corporate taxes, etc..), it’s hard to generalize. It would depend on the individual tax rate. According to OECD stats, Canadian healthcare cost (in 2017) $4,753 per capita. Taken as a raw number that is about $400 per month, but like I say, since it’s paid through general taxes, the actual amount paid individuals will vary depending on income and home province.

(I could also tell you what I pay, but that would reveal a bit too much private financial information than I’m comfortable sharing on the public Internet.)



Here you can see that the USA is just about twice as high as the average, and even considerably higher than the next highest country: Switzerland. This might be OK if outcomes were much better, but the sad fact is the USA scores pretty low on most health measures in comparison to other OECD countries.

Personally, my healthcare plan is to pay as I go when travelling internationally (except the USA). Healthcare costs outside of the USA are generally pretty modest. I can afford basic stuff and acute care situations. If I got into a chronic care problem I would have to come back to my home province.

[toddster8]

Originally Posted by sailorboy1

If you still work and make so much you can't qualify for ACA, well then you can afford health insurance! It still be an ACA plan, in fact that was the way the system was designed.

Well, it doesn't quite work out that way. If you're just above the subsidy threshold and you're over 55, you have to choose between housing and insurance. There's just no way to pay for both.

Originally Posted by sailorboy1

Otherwise you need to consider what my plan was before the ACA, get out of the USA so you can buy an more affordable medical plan.

Yep, circling back to that position. Except I'd say spend those years traveling in areas where ala carte medicine is available for mere mortals.

In the meantime, Plan B: Bone up on "wilderness medicine" and smuggle in a small emergency pharmacopeia such as you would keep on the boat for a long voyage anyway. Pay privately for an annual blood panel and vaccinations, check and record vitals every week or two. Be careful about diet and exercise.

[Markusik]

I'm a naturalized USA citizen. Half my relatives are in Canada, the other half Scotland. They all say the USA is a lovely place to visit, but they dread getting sick (or shot) there.

USA health care is a sad joke; overpriced and mediocre. How is it preferable to pay an insurance company (making massive profits from diverting money from healthcare providers) to paying higher taxes? Money gone is money gone. The anti-single-payer mouthpieces decry the evils of socialized medicine, but all of my relatives on both side of the Atlantic say they'd never trade their system for the USAs, and they're well-to-do!

Medical care is adequate, sometimes superior, in much of the world relative to the USA, for a fraction of the price. Do your research, you'll find it cheaper to pay out of pocket outside the USA.

Should you confine yourself to the USA, and are in good health, I would recommend the best value for catastrophic coverage and an HSA.

Hang in there though, once you reach the magic age for Medicare, it's far less likely that any significant medical incident will scuttle your dreams of cruising!

Fair winds,