Paying for health care after financial indepence

Paying for health care after financial indepence

Member since 2025 · 4 posts · 3 votes

My goal is to not need to work a traditional job, and I know how to get income from rentals and other investments, but I do not know how to address health insurance. For my whole life I have had employer-provided health insurance, first my parents' and then my own. Obviously, I can't continue using that. I have looked at the ACA/Obamacare marketplace in my state, and it has options but they're *expensive* and not that good. (For context, my employer pays 100% of the cost for a very nice insurance plan with $0 copay on many things and small copays on other things, and has good out of network coverage. Compare this to some as expensive as $1,000 per month and even those expensive options having large copays, limited networks, and they'll even refuse to cover some non-generic prescription drugs! What if I need that drug?). Some options like Kaiser Permanante that seem possibly good at not available in my area. I have heard about concierge doctors, but that seems risky due to a GP gating access to specialists, relying on that one person (and I'm in a small city so there being more than one is unlikely), it doesn't address catastrophically expensive conditions or accidents. I'd prefer to have something with a predictable locked-in monthly fee that just pays 100% of the cost of any health care that I need from any provider, but as far as I know this doesn't exist. What I have now is decently close to that, but I don't see any way to buy this on the private market. Are there any groups of people like us to get such things like employers do?

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  • Nicholas L.Pro Member
    Flipper/Rehabber · Pittsburgh · Member since 2018 · 6k+ posts · 5k+ votes
    1y

    @David Robert

    I'm not an expert, but I do know that the ACA tax credit is based on your income, and so if you're putting in your current income, then yes, the plans will look expensive.  the idea is if your income is lower you get a tax credit that offsets the premium.

    maybe you know all that already but i figured i'd throw it out just in case.

  • Financial Advisor · Saint Paul, MN · Member since 2016 · 190 posts · 143 votes
    1y

    Most of these plans are based on your MAGI.  For simplicity, just look at your AGI and how it is calculated and this will get you close.  Lines 1-10 on your 1040.  

    For the most part, your investments will only show up as capital gains (line 7) and rental income will be on line 8.  Both of these can be heavily influenced.  I would suggest researching "tax loss harvesting" and how to manage your long term capital gains.  I've had clients who realized $100k in income from investments in a taxable account, and paid zero in taxes.  

    Understanding how your income will look on your taxes is the first step towards shopping on the ACA Exchange.  Once you do this, you can get a much more accurate picture of what Exchange healthcare will cost.  

    You may also want to lookup "health sharing" options.  It fits the tax requirement for healthcare, but it's a different animal.  Google "Kitces Health Sharing" for a really good (but detailed) breakdown of the various plans and how they work.  

    I've been self employed for 10+ years and had my entire family of 6 covered for ~$600 / mo.  We've spent tens of thousands of dollars on birth and various other health issues.  We've only had mid sized "co pays" and the best part is that all of those costs have gone on our credit card for rewards!

    Feel free to reach out or ask more questions... 

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