Ask Liz Weston

Get smart with your money

Q&A

Q&A: Leaving the U.S. for cheap healthcare

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Dear Liz: Your column a few weeks ago suggested a couple consider leaving the country for healthcare benefits until they reach the age to receive Medicare. We are in a similar position, with enough money to retire early but profoundly worried about the future availability of health insurance. Which countries are considered good options for American ex-pats who want good, affordable healthcare?

Answer: Five countries with healthcare comparable to or better than the U.S. are Colombia, Costa Rica, Malaysia, Mexico and Panama, according to International Living, a site for living and investing abroad. These countries have both public and private healthcare systems, with out-of-pocket costs that are a fraction of what they are in the U.S.

In Mexico, for example, many doctors receive at least some of their training in the U.S. and speak English, according to International Living. The public healthcare system typically costs legal residents a few hundred dollars a year, while private services and prescription drugs cost 25% to 50% of their U.S. equivalents.
Some early retirees like their adopted countries enough to stay past age 65, but they should strongly consider signing up for Medicare when they are eligible, even if they can’t immediately use its services. Failure to sign up can lead to permanent penalties that will make Medicare more expensive if and when they do come back to the U.S.

Q&A: Healthcare costs could nix early retirement

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Dear Liz: Recently you included a letter from a retired person who was amused by the suggestion that early retirees may have to go abroad to find affordable healthcare. I was horrified by that letter and shared your article with several friends. Something is deeply wrong when a nation offers citizens who have contributed to its success so few options regarding decent medical care. It makes me very sad and angry. Thank you for focusing attention on this issue.

Answer: Currently early retirees do have an option before they’re old enough for Medicare, which is to buy insurance from Affordable Care Act exchanges. The future of that coverage is in doubt, though, which is why many financial planners are warning their clients who had planned on early retirement to continue working, if that guarantees them access to health insurance. Moving abroad is another option for the adventurous, but obviously won’t be a good solution for many.

Q&A: Beware of ‘junk’ medical insurance

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Dear Liz: In response to your response to the retired couple about healthcare costs. I wish everyone else could be informed about this. Healthcare costs in the individual market before the ACA were anything but affordable. I had to quit my job because my husband got ill in 2000. I was healthy and was paying at first $350 a month. Every couple of years it went up because I entered a new age bracket. I had to drop my coverage when premiums went to $800. And that was for a junk policy. I was hit by a car and I realized what it didn’t cover. I almost went bankrupt, but was able to sue my own car insurance company so that I wouldn’t lose my house. I finally was able to get on Medicare when I turned 65.

Answer: Thank you for mentioning the issue of “junk” policies. Some of the cheaper alternatives to ACA policies offer far less coverage, something buyers may not discover until it’s too late. Any insurance policy worth the name should cover the kinds of catastrophically high expenses that could otherwise wipe out a retirement fund or lead to bankruptcy.

Q&A: High earners need to watch out for Medicare surcharge

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Dear Liz: When I retired at age 70, I anticipated receiving the maximum available Social Security benefit payment because I had paid in the maximum tax for my entire career. I did not anticipate the heavy hit my spouse and I would take in monthly income-adjusted Medicare “premiums.” (I say “tax” is a more appropriate description.) We now pay over $500 per month each, or more than $12,000 per year! I know I am blessed to have the income I have in retirement, but that is because we were thrifty and worked hard and saved.

Answer: Many high-income retirees are unaware of “IRMAA,” or Medicare’s income-related monthly adjustment amounts, so they can come as a bit of a shock. These adjustments begin when modified adjusted gross income exceeds $85,000 for singles or $170,000 for couples. At that level, Medicare recipients pay an additional $53.50 for Part B, which covers doctor’s visits, and $13.30 extra for Part D prescription drug coverage, on top of their regular premiums. (Regular premiums for Part B are $134 a month, while premiums for Part D vary by the plan chosen.) The adjustments increase as income rises until they max out at $294.60 for Part B and $74.80 for Part D when modified adjusted gross income exceeds $160,000 for singles or $320,000 for couples.

Medicare Part A, which covers hospital visits, remains free for all Medicare beneficiaries.

That $12,000 a year may feel like a lot, but healthcare is expensive in the U.S. Annual premiums for employer-sponsored family health coverage reached $18,764 last year.

Q&A: Wife should get her name on deed

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Dear Liz: My daughter, who is a stay-at-home mother of two, recently bought a home with her husband. They have been married seven years. I recently discovered that her name isn’t on the deed to the home. I don’t know why, but it doesn’t sound good to me. What are her potential issues?

Answer: The issues depend on where she lives. Community property states include Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, Washington and Wisconsin.

If your daughter lives in one of those, assets acquired during marriage, including a home, are generally considered community property owned equally by both spouses. Her husband, ideally, should place her on title via a deed to reflect true ownership or place it in a trust to provide for his wife. However, if her husband should die without bequeathing her the property, the home could go to probate proceeding, and the wife would have to provide proof that it was community property to receive all of it, says estate planning attorney Jennifer Sawday of Long Beach.

In other states, different rules apply. Typically assets held in one person’s name are that person’s property. If the husband has a will, he could leave the house to your daughter — or not. Should he die without a will, she could wind up sharing ownership of the house with others, such as children from a previous marriage.

Q&A: Keeping an eye on your financial planner

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Dear Liz: I’m a fee-only financial planner with a quick comment regarding the investor who complained about a financial advisor who ran up a huge capital gains tax bill. I’ll bet that the vast majority of the gains came from selling the person’s initial investments to re-position them according to the advisor’s recommendations. That seems most likely given the gains seemed to be huge (implying the current investments had been in place for a long time) and the client’s balance didn’t seem to grow much at the same time. Of course, that’s not necessarily an excuse — accounts with unrealized capital gains need to be handled very carefully by an advisor. And you are dead-on with the main point of your response: Giving an advisor discretionary trading status is risky. I would add to that the client doesn’t seem to know the advisor’s investment strategy, so that’s another disconnect. I’m glad that fee-only gets a lot of positive comments in the financial press, but you’re correct that you still need to move with caution.

Answer: Advisors are in an unenviable position when they’re trying to fix a portfolio that hasn’t been properly diversified over the years. Big gains build up because the investor doesn’t want to sell and pay capital gains taxes. By refusing to sell some winners occasionally, though, those winners can comprise an ever larger share of the portfolio, making it more and more risky. A concentrated portfolio can fall more in a bad market and gain less in a good one than a portfolio that’s properly diversified.

So the advisor may have been doing what needed to be done, but the fact that the investor didn’t understand what the advisor was doing or why indicates a breakdown in communication, at the very least. No one should give an advisor blanket permission to trade an account without understanding the advisor’s strategy and being willing to monitor how it’s being carried out.