We early retired after working 15 years in the Netherlands. We chose NOT to return to the US because of the cost of healthcare there. Instead, we are now slomading through Europe for a few years. We also went with IMG and chose their GlobalFusion Bronze plan for Europe Only. We are set up with the Netherlands as our home country but have coverage anywhere in Europe. We also have about two weeks of coverage in the US (if we return to visit family), but that is meant to coveer us in an emergency situation and after that, we must return to Europe for treatment. Our annual deductible is 670 EUR each and the total annual cost is 1,500 EUR for both of us.
If you are overseas and you get sick, their cash prices will be 80 percent less, so its just like having insurance in America where youi have to pay the 20 percent plus the monthly premium .
18 months later, we haven’t filed any claims so nothing to update. Our deductible is $5k each in the U.S., half outside. We just paycash for any medical stuff so far, and it’s been cheap since we’ve been out of the States.
Such a tough subject. Erin and I talk about this a lot. It seems insane to me to pay 20k + deductible for an ACA plan if we are only going to be in the US for a few months out of the year. With a low enough income, the subsidies could make it work, but as it is currently configured, the income has to be awfully low for the subsidies to kick in. But if something happens in the US you definitely don’t want to be uninsured. You would think that since I work in the insurance industry, I would have a good answer but I don’t. A lot of it comes down to risk tolerance. But evaluating risk is really tough. I suppose global insurance is a possibility but the pre-existing exclusions along with the coverage limits make it less than ideal. I guess the best answer for US citizens is to stay healthy🤔.
Another great video, thanks Amy and Tim! We are starting our first full year with ACA here in Virginia with Cigna, so far the experience has been ok, but very limited choice of Doctors. While the deductible is high, overall we are grateful for the subsidy and very grateful that we know we will not be bankrupted by healthcare costs! Hope you are well!
I've been an early retiree for seven years. For 2022, I'm using Sidecar Heath. Early days, but I really like it. Reasonable premiums and you can care wherever you'd like. Something to consider if you hit a year where you spend more than six months in the States.
I’m in the very early days of being retired. My former job offered excellent insurance that works anywhere in the US and allows me to contribute to an HSA. To free up my brain to deal with other stressful issues, I chose to just use COBRA this year. Soon, I’ll be diving into the world of US health insurance options when one doesn’t have a job.. Thanks for this informative video.
Great video outlining some of the options. We're about to take the plunge into early retirement and going abroad. We would have gone with a global health plan similar to yours except my husband is a Type 1 Diabetic so he will not qualify (and even if he did, diabetes impacts all of the body's systems so having it as a non-covered pre-existing condition would effectively mean nothing would be covered for him). So instead we will have an ACA plan for when we are in the U.S. (which we'd really only use for emergencies and consider asset protection / large medical bill insurance rather than health insurance) and self insure in other countries. Healthcare is SO much cheaper anywhere else in the world.
What is asset protection / large medical bill insurance, can you someone throw light on this works and provide some example names of the insurance/companies that offer this type of insurance?
Your video couldn’t be timed better! We’re talking to our insurance broker again today. We chose short term health insurance for our first months of retirement. In Texas where we domicile, short term means a maximum of 3 years (!) and is significantly less expensive than the ACA exchange since we won’t qualify for any discounts this year. We chose one very reasonably priced plan - Pivot - which accepts any doctor but we’ve struggled to find any doctors who take Pivot! Luckily, we have a monthly plan so we are able to cancel and try a different policy that better meets the doctor choices where we will be traveling. We really appreciate your approach to managing costs and risks. It was so helpful to hear your perspective as we prepare for today’s meeting with our broker!
We live in Texas as well, but only part of the year. The rest of the year we live internationally in the UK, and this health insurance thing is such a huge decision! I appreciate the information shared in the video, as well as comments like yours in the comment section! 🙏
@@MagentaOtterTravels Thanks for your comment! I want to note that we eventually canceled the policy with Pivot - while Pivot pays any doctor, we could not find a doctor that accepted it in Houston! We ultimately went with another short term plan affiliated with Aetna and now have a Mexican plan since we spend most of our time in Mexico. My big takeaway, make sure whatever play you buy, you feel confident that it will be easily accepted by the doctors you go to.
Great information! Health insurance is just a sh#tshow in the US. Fortunately, we have health insurance through the ACA in Oregon. With the subsidies, our cost is $6 per month for 2 of us (age 55 and 63), and it’s an HSA plan so we max out our HSA accounts. High deductible but preventative care is covered (as required by the ACA), so essentially we’re protected against the cost of really bad stuff. You didn’t mention it but an ACA broker is FREE! The broker we used was very helpful in comparing each plan. They are paid on commission, though, so be aware of being steered to a Gold plan when Silver or Bronze might be a better choice. In a few years, we’ll start navigating the intricacies of Medicare!
Great video with great information. We have had the exact same plan (IMGlobal Silver, $5000 deductible) for the past 3 years. We currently pay $2662 for the year for both of us, ages 46 and 49. It was good for us to hear in your video that your broker helped you, because it reassures us that it's probably a pretty good plan. We've never had to file a claim yet, but now we're a little less worried about there being a problem with the claims process. Thanks for this video, it was very helpful.
Thanks so much for covering/updating this super important topic! Health insurance is one of my top 3 concerns in early retirement. I'm just 2 years away, so will definitely be calling Tracy late next year! I leave in 3 weeks for my first post-Covid retirement recon trip to Medellin, Colombia......🙂
Hi Tim and Amy, I am still working for health insurance. Actually, it's one of the primary reasons I still work - medication costs and such. Good info in the video. Take care.
I know that with the IMG plan one needs to provide an international address. What if you have just traveling around and have no fixed address then what address do you provide them with. Also, since you state that you chose a $5000 deductible, does that allow you to contribute to a HSA since it is a high deductible? Thanks for all your info, Keep it coming
Your reasoning behind the plan you chose is solid. Agreed that it is not necessary to have maintenance type stuff covered in your plan when you are not in the U.S. We will definitely be taking a hard look at IMG when we are up for renewal in 5-6 months. Its been a while since I've looked at the insurance stuff, but I remember going back and forth between the Gold and Silver plan. I forget the details though. I'll definitely be going through Good Neighbor when the time comes. Good stuff!
@@GoWithLess Sorry for the late reply. We are currently using Insured Nomads. BTW... I recall last year that IMG had some limitations on Covid coverage last year. It was the main reason we decided not to go with them at the time. Do you know if that is still the case? I ask because many countries are requiring coverage for Covid upon entry.
2022 - Our option for ACA in Mississippi was 20k premium with a 17k family deductible for the year for our family of 6. I was curious what Iowa's was, as we were there for part of 2022, and got very similar numbers. (We don't qualify for any taxpayer funded subsidies.) The plans only cover a limited number of places in the home state. We travel all over US so that wouldn't help us anyway. We have been members of Samaritan Ministries Healthshare Classic Plan with Save to Share for the past 3 years. Our monthly cost for the healshare plus our"deductible" per need and preventative and maintenence health care costs over the course of 2022 was less than half of premium price of the ACA plans. My son has broken both of his wrists while we were members of Samaritan. We are self pay and were reimbursed according to the guidelines within four months upon submiting bills, which is their typical time frame for reimbursement, so the timeline wasn't a suprise.
We used to use Liberty Healthshares but were uncomfortable with their model. We wanted true insurance in case of something catastrophic. None of the options are good so we all take what works best, I guess.
Sigh. This is by far (outside of figuring out what to do about Residency), the most difficult part for us. We currently are Residents of Florida, however, despite the "traveling mailbox" operations, Florida is starting to have lists of what are not true residential addresses and it's a concern, we are actually considering South Dakota. We have had an ACA plan in both Va and for the past 4 years Florida. We have pre-existing conditions so this is a huge concern. Thank you for your excellent video, we will be contacting Ms. Winters to see what she may be able to do to assist us.
Hi! In your most recent video (from 10 months ago) regarding Mexican residency, you mentioned that you only have coverage for six months in the U.S. I found this video from a couple years ago. Is this still current as far as what you are doing for your retire early health insurance? I'm ready to pull the plug. Cheers! P.S. Wish you guys did more videos!
I am still working at 60 for my employer's HSA plan. I am contributing the maximum and have about $15k saved in my HSA investment account. My husband turns 65 this year and going on Medicare.
If you are able to "modulate"/control your income in a way that is beneficial for ACA credits, do you have to be sure to keep the income just above the Medicaid level, if you don't want to be go that low/be on Medicaid? Are you forced into Medicaid if your income is indeed under that level? Is there any downside to being on Medicaid, in terms of what is being talked about her for lifestyle? Thanks
Similar to you guys we used an ACA plan last year while we were mostly in the US. Now that we are traveling internationally more than 6 month per year, we have switched to a global plan as well that sounds similar to yours but through another reputable company.
@@rdunland the IMG plan that Tim & Amy use appears to also be a high deductible plan ($5K) so I suspect they are eligible also for HSAs. The problem with Cigna is that they only allow 30 days in US w coverage
I am very fortunate that my company provides good health insurance for pretty low cost and I will have healthcare coverage (pension too!) after I retire. I dont know what that coverage will look like out of country and need to look into that.
Great video!! Can you do a video on tech sales? Amy, I know you have been removed from it for a bit, but if you have input on the industry in todays environment?
We love your videos. They are very informative. My wife and I have dual citizenship US / France. We plan on taking advantage of the great French healthcare system and travel all over the world. Yet we need a plan for when we are in the US. We may be in the US for more than 6 month a year. Are you guys still happy with your IMG plan?
Thank you! We have been with IMG since Jan 2022. Because it doesn't cover check-ups and routine care, we haven't submitted any claims. I broke my foot in KL and paid out of pocket. The hospital bill was less than $150 and our IMG deductible is $5,000 each!
Happy Wednesday! We hope this annual update to our health insurance finds you happy and healthy. Holy cow, this health insurance piece of early retirement is just insane. Sadly, there is no good answer to how to navigate with proper insurance within the US. Hopefully, we've found a plan that will take care of us for many years. What are you doing for health insurance? Please comment below. Cheers! Amy
My wife has health insurance on us both through her work. Otherwise it would be just too expensive!!! The deductibles are high. I am not sure how hourly people are even able to afford it if they have thousands in costs.
As early retirees, we know hundreds who use it in dozens of states. It comes down to the plans each state offers so it’s all over the place. We had an excellent experience with our Texas plan as well as in 2016/17 in Colorado but those only covered us in state.
Definitely working for Health Insurance. But will retire 6 years before I can qualify. What am going to do? Well listen to things like this between now and then. Great information. So for the 6 months, is that consecutive? Or just overall?
I heard your interview on Bigger Pockets--a really interesting episode, especially regarding healthcare. That said, I *believe* you are both mistaken on a really important point. The ACA specifically requires that emergency services be covered outside of your normal ACA coverage area, including out-of-state. Thus, in the case of a "$1.5 million aneurysm" example you offer, your ACA plan would have to cover it--it just needs to be considered an emergency which I'm pretty sure a sudden anuerysm would be! Did I just mis-hear your understanding of this or were you referring to something else?
I forgot to provide the link to the ACA language on emergencies from healthcare.gov. It can be found here: www.healthcare.gov/using-marketplace-coverage/getting-emergency-care/. And, yes, I know it won't cover out of country emergencies, but you seemed to indicate ACA plans might also excluded in-USA emergencies if they are out of your primary ACA area.
This is a great question. We had a TX Blue Cross/Blue Shield HMO plan in 2021. HMOs were the only option offered on the exchange and every doctor was in TX. If we went out of their network, we might receive the "benefit" of their negotiated pricing but here's the rub - there was no out-of-pocket maximum when going out of their network. Also, that rate can be higher than the cash rate. It still leaves someone open to massive healthcare bills in the case of something big. Perhaps different in other states/counties? Certainly something to know about up front!
Thanks for the reply, Tim and Amy. Never occurred to me that they might try to at least partially get around the law by simply removing the max out of pocket for out of network care. I guess reading the fine print is still really important! @@GoWithLess
We were not able to find insurance for the US outside of our states of residence. We could have moved to a state that has an ACA plan that covered us all over the US but, with our intent to be outside of the US, and Covid it didn't make sense for us. We have nomadic friends who domicile in FL with an ACA plan that covers them in the US.
Under any ACA plan, you will be covered for emergency room visits throughout the US. Just be sure not to head to the emergency room for non-emergencies or you will be charged.
I'm currently working, but I'm about to hit the eject button. I'm researching ACA health insurance, and I've reached out to a broker. We are still trying to figure out which hospitals and doctors are in each plan. It seems the options on the doctors we want to use is limited.
I feel your pain. When you do find a plan, make sure to call a doctor to make sure you can book an appointment. Just relying on a website that says they are accepting new patients may not be enough. We learned that lesson the hard way in 2018.
Yes, we moved from Colorado and became official Texans. If this is something of interest, you should check out these 2 videos - ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-NLWe7gpiBEA.html and ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-6pqO0uaA6DM.html.
