@ucbalumnus health care as we know it in the US - for premium coverage with premium options, no waiting for CT scan, no waiting for various tests, procedures, etc - the health care as we know it in the US.
Many years ago changes were attempted to be made on health care reform.
I feel for people that do not have good options for having health insurance.
Various states do things differently on having options on affordable health care.
Also many reasons on thinking about retirement location if you are comfortable with many things in a new location for retirement.
@Mabelsmom very hard topics on thinking about retirement and our changing life paradigms both in household, in area of the country, nationally, and globally.
I did get off topic a bit, but so much does influence age and circumstances with retirement.
As one ages, often life shrinks in many ways. Thinking through how best to have high QOL.
@ucbalumnus that is true - and that is an additional paradigm that people need to figure out in life, just as they figure out and plan for retirement. True, some people have not grown up with parents who help them get to āadultā life, and health insurance companies have adapted on the US scene to allow parents to carry on their health insurance a student/young person until age 26. Just as the pension scene has changed to where the trend has gone to 401k, Roth IRAs, IRAs etc. We are happy to be in the US. There are lots of choices and options for life here.
My H was born in 1957 so his full Social Security retirement age is 66 1/2 and mine is 67 since I was born in 1960. We have no pensions to speak of except for a very small one H is entitled to ($250/month) from when he worked for Hughes Aircraft back in the late 80ās early 90ās. We have saved all of our working years in our 401Kās and we are doing very well. Since H is 3 years older than I am we will need to think about how to pay for my healthcare costs when he retires. We have not set a date yet to retire, but I think it will be in the next couple of years. That would mean 2 years of paying insurance costs for my medical. Since the mortgage is getting paid off this month that money will put into savings and could go to cover insurance for me.
One thing that H and I are doing now and not waiting for retirement to do is travel. Of course this past year has all been road trips to ski, camp and wine taste, but we will start flying again soon. Since we are working it makes sense to take the more expensive trips in the next couple of years that we want to do.
This details out standard part B premium for Medicare (go to web site for better look at the chart):
2021
The standard Part B premium amount in 2021 is $148.50. Most people pay the standard Part B premium amount. If your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, youāll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.
If your yearly income in 2019 (for what you pay in 2021) was You pay each month (in 2021)
File individual tax return File joint tax return File married & separate tax return
$88,000 or less $176,000 or less $88,000 or less $148.50
above $88,000 up to $111,000 above $176,000 up to $222,000 Not applicable $207.90
above $111,000 up to $138,000 above $222,000 up to $276,000 Not applicable $297.00
above $138,000 up to $165,000 above $276,000 up to $330,000 Not applicable $386.10
above $165,000 and less than $500,000 above $330,000 and less than $750,000 above $88,000 and less than $412,000 $475.20
$500,000 or above $750,000 and above $412,000 and above $504.90
Choices and options for medical care or medical insurance have mostly to do with how much money you have, your employment, and whether you are 65 years old.
Most working people have limited medical care and medical insurance choices (based on what their employers choose to offer them). A typical middle income American would probably find an unsubsidized individual medical insurance plan to be very expensive. Cost pressure means that most people have little choice but to accept various kinds of limitations on their choices and options. Note that this includes limitations on the choices and options to retire before age 65.
@ucbalumnus I was generally talking about LIFE options and choices. Income and financial status is always a limitation when you have time/energy/money - and in the energy part is health. Some people have to prioritize health, health insurance plans, and the medical services where they want to live.
The US is a first world country which is a very desirable place to live for many in the world, just as immigrants are trying to get into Europe from other bordering areas. Some US citizens do choose to live elsewhere for a variety of reasons. But we like it in the US and are selective on states we like to live in, based on our experiences and our budget.
Some states have more cost effective health care options and choices. Some areas have very good Advantage plans (Medicare C). However it takes pulling the various plans apart, or going to the states health insurance assistance program or senior advocates in your area ā they can spell out the lowest cost options and assistance programs for lower income.
Most people we know that retire before 65 are for 2 reasons - they have earned enough money and want to start retirement early, and those that either have a job end or physically cannot continue to work. The people that have a job end decide how they go forward from there. There are places to work to obtain health insurance - the job duties and pay may be much below prior income. People can relocate/downsize/etc. They may not have super desirable choices but have to prioritize what is important to their situation/their family.
I havenāt had employer-sponsored health insurance since around 2000. Some years no insurance, and many years of Child Health Plus insurance for my daughter. By the time she aged out of Child Health Plus, I was on Medicare, thuus no option to carry her on my insurance. My daughter was on expanded Obamacare Medicaid until she graduated from college and got a job with health insurance. I was extremely fortunate that she went to school inside our state (NY).
For sure the insurance companies did not āadapt n the US scene to allow parents to carry their health insuranceāāthe Affordable Care Act made them do it.
@oldmom4896 I will see what our total cost with Medicare, Medigap, and Drug Plan is once we start in Oct 2021 - I know we will pay more than what our employer plan rate is, but a whole lot less than those w/o sponsored health insurance.
DH did just that! His firm (or perhaps federal or insurance regulations?) require a minimum of 30 hours per week to be considered a full-time employee. That was the only way they would continue his benefits. His salary and benefits were then pro-rated accordingly, so technically he pays for 1/4 of his healthcare (but his salary was reduced to cover it). He loves working the reduced hours, with more flexibility.
@kjofkw I wish my H would have done that for the last 10 months before we start Medicare - but his boss was a total jerk and wasnāt cutting his work responsibilities. I told DH to just work the 30 hours and leave the rest, but instead he put in his notice.
I just did this, I am on week 2 of working 3 days a week. I could go down to 16 hours for the program I am doing, but I think 3 days/24 hours is manageable for the type of work I do and the responsibilities I have. I have full health insurance and my vacation etc is prorated to my reduced hours. I am still considered a full time employee. The negative is that I can only do this setup for two years total, it is categorized as a type of leave of absence, a work/leave option. The negative for the employer is that I still count as a full headcount, but part time employees would as well.
Assuming I stay with this for 2 years, I will most likely then retire at 59 and then do COBRA. My DH retired last year at 58 and is now covered by my insurance. That will not quite get him to medicare age, but close, and then I have a bit of retiree health funds I can use to again not quite fill my gap but every bit helps.
When my company does layoffs, which are fairly frequent, the current package includes COBRA for an extended period, two years I think. If one of these rounds is coming up at the right time I would consider volunteering for it.
I went down to 4 days/week a couple years ago, with a 20% cut in pay. They didnāt reduce any of my benefits or charge me more for insurance, although I suspect this is more because HRās systems canāt handle it rather than altruism on their part. Thereās only 2 others that I know of that do this. I canāt drop any lower or I lose full time status.
A permanent three day weekend is pretty nice, although I generally miss out on a couple of paid company holidays each year which fall on Friday.