Q&A: Health sharing plans don’t work for everyone

Dear Liz: I read your column about healthcare options for couples planning for retirement today. I’ve recently learned about and signed up for health sharing. The benefits are closely comparable to traditional insurance and less expensive. If you haven’t heard about this, I think it’s worth looking into.

Answer: Christian health sharing plans are an alternative to traditional insurance, but they’re not actually health insurance. Members agree to pay each other’s medical bills, up to certain limits. Members typically must be Christians who attend church regularly and don’t use tobacco, among other restrictions. These plans often don’t cover preventive care such as mammograms or colonoscopies and may not cover mental health care, addiction treatment or other so-called “essential services” that are typically required of health insurance.

The plans can help with some healthcare costs, but the amounts that can be paid out are typically capped. That means that an accident or illness could still bankrupt you. In addition, the plans typically don’t cover preexisting conditions or limit the coverage they offer. Since few people reach their 50s and 60s without a preexisting condition or six, these plans aren’t a viable substitute for many people approaching retirement.

Q&A: Healthcare costs and retirement

Dear Liz: You usually don’t give me such a laugh, but today’s letter was from someone who’s 41 and her husband is 51. They now have $800,000 saved and want to retire early. You told them they might do better leaving the country since it will be so bad for them with health insurance.

My husband was a teacher in Los Angeles, with no Social Security. We have $60,000 in the bank and together we bring in $3,400 a month. We have Kaiser insurance that totals $2,400 a year for both. We have a house, a car, not so much money, but are happy. He’s 82, I’m 79. What planet do you live on? I guess people who have so much money can’t imagine people like us.

Answer: You’re living on Planet Medicare, so perhaps you can’t imagine what people are facing who don’t have access to guaranteed medical coverage.

Currently, those without employer-provided insurance can buy coverage on Affordable Care Act exchanges, but that option may soon be going away. Congress ended the ACA’s individual mandate, which requires most people to have insurance, so costs are expected to rise sharply.

In addition, the future of so-called “guaranteed issue” is in doubt. The ACA currently requires health insurers to accept people with preexisting conditions and limits how much people can be charged, something known as “community rating.” The U.S. Department of Justice recently announced it would not defend those provisions against a lawsuit filed by several states.

When health insurance is unavailable or unaffordable, it doesn’t matter if you have $1 million or more in savings. A hefty retirement fund can disappear in a few months without coverage.

Wednesday’s need-to-know money news

Today’s top story: Why brand loyalty makes some blind to retail cards’ flaws. Also in the news: The good, the bad and the budget of destination weddings, how to save on central air, and what to know about your insurance when you’re on vacation.

Why Brand Loyalty Makes Some Blind to Retail Cards’ Flaws
Your favorite store card could come with a whopping interest rate.

Destination Weddings: The Good, the Bad and the Budget
Exchanging vows on vacation.

The Cost to Install Central Air and 3 Ways to Save
Staying cool for less.

What to Know About Your Insurance When You’re on Vacation
What is and isn’t covered.

Q&A: Paying for a younger spouse’s health insurance until Medicare kicks in

Dear Liz: My husband and I have started discussing when he’ll retire. I’d like him to retire somewhere around 65 or 67. He thinks he’ll have to work until at least 70, if not longer, for health insurance coverage for me. (It’s possible that he could do so, since his is an intellectual job where experience is highly valued. Several of his colleagues are in their 70s now, and one retired last year in his 80s.) My husband is 51, and I will be 41 this year.

We’ve used retirement calculators, and even restricting the rate of return to 3% or 4%, we’ll have at least $800,000 in his 401(k) by the time he’s 67. If we use the historical return rate, we get well over $1 million. We then made a rough guess of what minimum distributions would be based on current IRS tables. This number alone will cover 70% or more of our retirement budget.

I think we can do this, even if we have to pay for my health insurance, and even if we have to start withdrawing from the 401(k) at 65. Is this a bad idea? If he gets there and wants to keep working, then no problem, but if he’s fed up at age 64 and 355 days, I want him to feel able to walk away.

Answer: That’s a wonderful goal, but you may be underestimating the cost and difficulty of securing health insurance for your future self.

Currently, people without employer-provided insurance can buy coverage on Affordable Care Act exchanges, but the future of those is in doubt. Congress ended the ACA’s individual mandate, which requires most people to have insurance, so costs are expected to rise sharply next year. If enough healthy people opt out, the exchanges will collapse.

It’s not hard to imagine a future that looks like the past, where people had to keep working at jobs that offered employer coverage until both they and their spouses were old enough for Medicare. Under current rules, that would mean your husband working until he’s 75 and you’re 65.

Your husband might be able to quit a bit earlier thanks to COBRA rules, which allow people to continue employer-provided coverage for 18 months if they can pay the full cost of the premiums, plus a 2% administrative fee. The average annual premium is $6,690 for single coverage and $18,764 for family coverage, according to the Kaiser Family Foundation. The cost is likely to be substantially more in the future if medical cost inflation isn’t brought under control.

If you really want to give your husband the option to quit at 65, you may need to look into employment for yourself that includes health insurance benefits. Another option is to move abroad to one of the many countries that offer affordable healthcare for expatriate retirees. Sites such as International Living at www.internationalliving.com and Live and Invest Overseas at www.liveandinvestoverseas.com can help you identify potential options. You could plan to return home once you’ve qualified for Medicare.

Tuesday’s need-to-know money news

Today’s top story: College degrees can be a bargain abroad. Also in the news: Open enrollment time, how to finance a car at 0% interest, and 3 ways to protect your retirement savings from a market crash.

College Degrees Can Be a Bargain Abroad
Considering international universities.

Open Enrollment at Work: Get Ready to Get Choosyst
Finding the best plan.

How to Finance a Car at 0% Interest
Getting the best rate.

401(k) uncertainty? 3 ways to protect your retirement savings from a market crash
Protecting your future.

Monday’s need-to-know money news

Today’s top story: VA Loans vs Conventional Mortgages. Also in the news: How much you can spend each month, how investors can sabotage their own portfolios, and what the AHCA ‘s preexisting condition rules could cost you.

VA Loans vs. Conventional Mortgages
The important differences.

How Much Can I Spend Each Month?
Creating a monthly budget.

How Investors Can Sabotage Their Own Portfolio Returns
Overconfidence can become a problem.

What the AHCA’s preexisting condition rules could cost you
Be prepared.

Wednesday’s need-to-know money news

Today’s top story: Four times when you might need a financial planner. Also in the news: Understanding the Glass-Steagall Act, how to manage money in your 20s, and how the Affordable Care Act drove down personal bankruptcy.

4 Times When You Might Need a Financial Planner
Times when you shouldn’t go it alone.

The Glass-Steagall Act: What It Is and Why It Matters
Understanding the banking regulation.

How to Manage Money in Your 20s
Welcome to adulthood.

How the Affordable Care Act Drove Down Personal Bankruptcy

Tuesday’s need-to-know money news

Today’s top story: What’s love got to do with a Roth IRA? Also in the news: Are you ready for a joint bank account, why America needs black-owned banks, and 3 health insurance tax benefits you can get in 2017.

What’s Love Got to Do With a Roth IRA?
Saving for the golden years.

Two Hearts, One Bank Account: Are You Ready?
Ready to take the big step?

Why America Needs Black-Owned Banks
Honoring history.

3 health insurance tax benefits you can get in 2017
Maximizing your savings.

Monday’s need-to-know money news

Pile of Credit CardsToday’s top story: The best credit card tips for January. Also in the news: Less than one month left to shop for Obamacare, how to spend more mindfully in the new year, and what research says about erasing credit card debt.

NerdWallet’s Best Credit Card Tips for January 2017
How you can make 2017 better than 2016.

Less Than One Month Left for ‘Obamacare’ Shoppers
The deadline is Jan. 31st.

How to Spend More Mindfully in the New Year
Paying closer attention.

What research says about erasing credit card debt
Following the best path.