Over the past month, we’ve been looking back on posts from 2018 and 2019 that have given you advice on how to think of your benefits, what criteria matters most when comparing your options, and much, much more. The main focus has been those among us that work for—and get our benefits from—others. THE MAN, if you will. In this installment, we’re talking about those who are on their own for benefits, whether self-employed, over 65 or FIRE. Here are some deets on what do get or not get when you’re out there hunting and gathering in the benefits wilderness!(more…)
Last week, Walmart opened its first standalone health clinic in Georgia, but it probably won’t be its last. It’s an ambitious project for the company that is already one of the leading health care retailers in the world, and it builds upon their “care clinic” idea, which they’ve launched around Georgia, South Carolina (my state), and Texas.
The idea is to put a lot of different kinds of services under one roof — which, like duh, is what Walmart does with consumer goods. Here’s all that they want to offer in their standalone health clinics, according to a Forbes article:
The larger Walmart Health Center puts “key health services under one roof,” a first for the world’s largest retailer when it comes to offering primary care, dental, optometry, counseling, laboratory tests, X-rays, hearing, wellness education and behavioral health.-Forbes
But wait, there’s more! In true Walmart fashion, they’ve already published a price list. That’s a no-brainer for retail but revolutionary for health services. Seriously, when was the last time you went to a doctor knowing what you would pay for anything but the visit itself?(more…)
Bad Health Coverage Options for FIRE Folks, Freelancers, Gig Workers, Self-Employed and Perhaps Even Trustafarians
If you fall into the broad category of people who don’t qualify for employer-provided health insurance or a government-provided option like Medicare, Tricare or Medicaid, now is the time of year that you should start thinking about your options.
We at The Benefits of FI have preached the importance of having high-quality coverage (read: coverage that is required to pay for a lot of different kinds of health care services and potential needs) coverage for you and your family. But since this FI community is nothing if not fiercely independent, we want to give you a few more details about the options you’re reviewing, in case you don’t take our advice to go with the (probably) more expensive option that is (probably) also the smartest option…(more…)
We’ve written extensively about how much you might end up spending on your own health care in retirement and, as a result, why it’s important to build up your HSA funds so that you can have that reserve of tax-free dollars for such expenses.
But, as a former co-worker of mine used to say, here’s a “super-secret hack” about HSAs that may change the way you spend both in retirement and beforehand: there is no time limit on when you can reimburse yourself from your HSA for medical expenses.
What does this SSH (ahem, super-secret hack!) mean for your retirement savings? It’s simple. Keep reading…(more…)
Earlier this week, President Trump announced an Executive Order requiring health care companies, particularly hospitals and insurers, to make their negotiated prices for services publicly available. Trump said, with his trademark understatement:
“This is a truly historic day. I don’t know if it will be covered that way by the fake news, but this is truly a historic day this is a very big thing that is happening right now and it’s pretty much going to blow everything away.”President Donald Trump, signing the Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First, June 24 2019
Since then, there’s been a slew of coverage about whether this order will have quite that impact. The hardcore health economists have been talking about Danish cement (seriously) in saying that forcing hospitals to publish what they’ve negotiated with health insurers to pay for services will simply encourage the ones charging the least to raise their prices. I personally asked an economist if the airline industry might be a better comparison, with its major players, barriers to entry and regional differences in supply and demand. Here’s what he sent me:
Here’s what this Executive Order on transparency could mean for the FI community: ultimately, smart and active consumers do better when they have more information, so this’ll be good for FI. Duh.
But health care has nuances—many, many nuances.(more…)
If you’re in the FIRE vanguard, retiring in your late 20s to mid-30s, you’re (hopefully) living the dream healthy enough to enjoy your retirement to its fullest. If you’ve planned your housing, transportation and other common living expenses well, they will be quite manageable within your budget until it’s time to shuffle off this mortal coil.
But keeping that coil tightly wrapped gets harder with each passing year. Don’t risk your financial health by compromising on your physical health — get insurance. And not just the cheapest insurance. Make sure it’s good enough that it doesn’t leave you with huge bills if something bad happens. Such decisions and expenses should all be part of your FI plan, even if it means a few extra years of saving to be fully prepared for a long, healthy life of early retirement freedom.
Here are some tips for that early retirement health care party…
I’m currently attending the DIG South Conference, which was created by my friends Stan and Sunny Gray, here in Charleston. It’s a fantastic event — so important to promoting new kinds of business in a South that could use it.
With those new kinds of business come new kinds of thinking about both business and personal goals. That’s where I found myself thinking about FI and FIRE as the opening keynote speaker Greg McKeown laid out his model for Essentialism. It should be a familiar idea if you are currently taking in the better wisdom of FI — you need to reduce and/or remove the unnecessary to truly be able to focus on your most important goals. You cut your needs to the essential. It was a simple message delivered with incredible enthusiasm and it really got me motivated.
(For anyone looking for a quick primer on McKeown’s thoughts on Essentialism, he did an episode of the Tim Ferriss podcast that’ll get you up to speed and motivate you as well.)
After the presentation, I got to chat with Greg a bit more and told him about the FI movement and he said something that I’ve been feeling that I’ll now share with you: while he saw the great value of setting goals to achieve financial independence at an early age, he wasn’t fully sold on the notion of retiring early.
“I don’t see myself ever ‘retiring’ because I’m doing something that I love and want to keep doing,” he said. In other words, he’s applied his essentialism practice to his career and found one that he wants to do, as opposed to having something for a period of time as a means to an end.
It’s a thought that I’ve had as well because I quite enjoy writing and consulting and hope that I’m doing it for a very long time to come. Likewise, I know my BofFI cofounder has become very busy in his “early retirement.” In fact, most of the people I see in the FI blogger community aren’t really retired at all, even if they say they are. They’ve simply found a way to gain financial independence and then “retire” from having others dictate their daily grind.
It resonated perfectly as I read more and more posts from smart, driven people who are convinced that they will be retired at 40, or 35, or 29. If you have that drive, then you will certainly not settle for whatever notion you may have in your mind of being retired to travel the world untethered to a dependent source of income for the remaining 40-70 years of your life. You’ll need to have something to keep you going. And if you find yourself doing well at cutting out the nonessential early in life, you’ll be able to do it again and again as you grow older. I think that’s ultimately what I took from McKeown’s presentation and comments — the ends don’t justify the means, it’s the means that will sustain you before, during and after your FIRE journey.
Now I’m off to read the book so I can soak in some more essentialism!
With car insurance, deductibles are relatively straightforward — anything not related to damage of some kind, i.e. any maintenance or services, is not covered. You get your oil changed, you pay for it. You get your car washed, you pay for it. You get in a wreck and your car is totaled, your insurance pays for all costs over your deductible. Simple as that.
With high-deductible health plans (HDHPs), it’s almost the opposite. There are a number of preventive care services that you can have covered at no cost to you, provided they are “in-network,” meaning the doctor or healthcare provider you choose much be “covered” by your insurance. That’s lesson 1: even though you’re paying out of your own pocket for most things, if you want your insurance to pay for something before your deductible it met, you have to follow their network rules.
These preventive services are things like an annual check-up or physical, as well as screenings and diagnostic tests frequently associated with an annual physical, and other tests like cancer screenings. These services are mostly mandated to be free under the Affordable Care Act, but some employers have “grandfathered plans,” which means the plans were exempted from ACA regulations on the premise that they would remain cheaper than ACA coverage (something that hasn’t proven to be true, but I digress…).
The best thing for you to do is to find your plan details or request them from your company’s HR/benefits manager or directly through your health insurance provider. My family is currently on an individual ACA plan and I found my information pretty easily through the site where I bought my insurance, HealthSherpa (full disclosure: I do consulting work for HealthSherpa but don’t get paid to post the link I just posted — I just think they’re a great company if you qualify for ACA coverage), as well as through my health insurance provider site, SCBlues (full disclosure: I don’t consult for SCBlues 😜).
Anyway, take a look at what pre-deductible services you get for free and take advantage of the ones you think you need or that a doctor recommends for you.
Now, lesson 2: Even before the deductible is met, you want to pay attention to your expenses, because they will impact your overall costs. How? Well, sadly, pre-deductible costs are not created equally, nor are qualifying expenses.
Say you tweak your knee skiing. You need an x-ray, so you call around to some places (always ask the price!) and get the costs. You will likely find, as I have multiple times, that there is a huge difference between the “covered” pre-deductible cost for the service and the “cash” cost. It’s not uncommon for covered costs to be double that of cash costs. That seems like a no-brainer to go with the cash cost, right? Well, here’s the kicker: If you opt to pay the cash cost (not “cash” per se but rather the listed “cash cost,” because you can pay the “covered cost” with cash), that amount DOES NOT COUNT TOWARD covering your deductible. Sadface.
I don’t know why it’s done this way and I wish a law will be passed that will outlaw this “network cost” practice, but in the meantime you need to be mindful of the consequences of cash vs. covered.
While there is never a guarantee, if the service you need is relatively minor with little or no need for follow-ups (read: no additional costs), you may be better off paying cash to save the money right there and then. It seems like a smart move if the covered cost is, say, $500 and the cash cost is $250, which is a realistic scenario. If you think that there’s no way that you’ll cover your deductible without some kind of catastrophic accident happening, then pay cash — sort of like paying cash for a minor ding to your car rather than going through the hassle of filing a claim.
Now, you may end up having more costs and then you will want to shift to paying the deductible cost, but that would seem to make sense only if you truly expect to exceed your deductible by a large margin. (As a reminder, once you cover your deductible, you pay $0 for any additional services through most HDHP arrangements.)
Obviously this scenario doesn’t apply for people with chronic conditions or planned medical needs like childbirth. But for those minor scratches and dings, always ask the price and decide on your own whether cash is best or you want to make sure you’re paying down your deductible. YMMV.
And yes, take advantage or your free preventive care! Not just because you can, but because keeping track of your health could save you a ton of money AND give you a happier, healthier life in retirement, early or otherwise.
Here are The Benefits of FI, we talk about HSAs as a savings vehicle for retirement in the same vein as a 401(k) or IRA. That’s because it has the same basic features of enabling pre-tax savings to be invested and thereby grow at a significantly higher rate than post-tax dollars in a standard checking or savings account.
What some of you, especially those who have just started you FI journey and have neither started a family of your own nor seen your own parents get to standard retirement age, may be thinking is that since you’re saving the money for retirement, it’s retirement income that you’ll get to spend on fun stuff. Hopefully that will be true (although you’ll get taxed on it), but odds are that you’ll use it for medical expenses, which are never as fun but almost always a factor.
Research by Fidelity Investments, reported by Money, shows that the average couple currently reaching retirement age will incur $280,000 in medical-related expenses in retirement. As homer Simpson would say:
Back in the early ’90s, there was a show my mom and I used to love called Northern Exposure. It was about a doctor who, in return for getting his tuition paid, moved to a small town in Alaska to be the town’s general practitioner for a number of years. It’s a practice that still occurs and in fact may be expanded in the coming years as higher-education costs continue to go up up up.
A story from CNBC,”Here are ways to pay off student loans, using other people’s money,” reveals that a similar practice is available in several states, most notably in Maine, where your student loan debt is deductible on your state income taxes, and in Newburgh, Ohio, where you can get up to $50,000 toward paying off your student loan debt by buying a house you plan to live in inside the city limits. I did a Zillow search and it looks like apartments and houses are going for anywhere from $57,800-$250,000+ in this Cleveland suburb. Pretty good deal if you’re cool with Cleveland.
Other helpful tips are volunteer opportunities that will pay you a monthly stipend toward debt paydown and, of course, through your job. Tess wrote about what to look for in those job-based options.
Got your own advice? We’d love to hear it!