Your health insurance in early retirement

If you are an American who wants to retire earlier than most, then your employer-supplied healthcare insurance might be your biggest worry. How are you going to substitute for it in retirement? 

Here is what I have found on this topic.  


The ACA (the affordable care act)

If ACA still exists when you retire, and you qualify for subsidies, you are in a great condition. Just make sure that there are local doctors under the ACA plan you buy. Great articles on ACA are already available. Here is one from GoCurryCracker. Two others come from RootofGood: here and here. 

The couple from the YouTube channel Our Rich Journey also discusses ACA.

 
Direct primary care

Direct Primary Care (DPC) is an alternative payment model for primary care, it is not an insurance. From the website of Direct Primary Care, here is the most important information about the system. DPC utilizes a flat-fee system that covers comprehensive primary care services. The website mentions in different places $70-$100 a month per member. DPC allows for sufficient time spent between patient and physician. DPC practices usually have extended hours, ready access to urgent care, and “patient panel sizes small enough to support this commitment to service”. As a DPC patient, you can choose your personal physician. Currently, there are over 1,000 DPC practices in 48 states that provide primary care to more than 300,000 patients. However, the DPC practices are unevenly distributed throughout the country. Check their map here. 

According to the news of DPC website, DPC is better than ACA. However, DPC is not an insurance plan and does not cover medical costs outside the primary care practice. Therefore, patients of DPC should have a high deductible or "health share" plan to be an ACA qualified healthcare plan. 

Here is a brief video about DPC that emphasizes the price, convenience and prevention concept. There is also a warning about the medical conditions that would not be covered by DPC or a high deductible or "health share" plan.

 
Healthcare sharing ministries

Another option are the healthcare sharing ministries. These are not insurance plans either. Such organizations take the biblical command to do good and share with others. The members commit to belief in God, freedom, and ethics. The benefit is that the members make affordable monthly contributions online to match the medical needs within their group. One such ministry is Liberty Shares that offers three different programs. Here are the monthly fees: for a single under 30 (and 30 and over):  $249 ($299),  for a couple under 30 (and 30 and over): $349 ($399), and for a family of under age of 30 (and 30 and over):
$479 ($529).
 
Under the Liberty Complete program, after fulfilling the annual "unshared" amount ($1,000 for an individual, $1,750 for a couple, $2,250 for a family), the members can share eligible medical costs up to $1 million per incident.

Other healthshare ministries are the Christian Healthcare Ministries, Medi-Share, Samaritan Ministries, and the Freedom HealthShare. Keep in mind that the monthly share payments are not deductible from the U.S. federal income taxes as medical expenses or charitable deductions.


Medical tourism and international insurance

Of course, medical tourism already exists and will expand in the future. If you are permanently stationed abroad, you may consider international medical insurance. 

From this website comes an example insurance rate for a husband and wife, ages 62 and 60. The plans are offered by IMG Global Medical. Plan 1 covers the couple worldwide excluding the U.S., Canada, China, Hong Kong, Japan, Macau, Singapore, and Taiwan. This plan costs $2,260 per year with a $10,000 deductible. Plan 2 covers the couple worldwide coverage (anywhere, including the U.S). This plan costs $41,546 with a $100 deductible (I could not confirm the cost of the second plan via a quote). Other companies have different deals, for example, CignaGlobal Medical Plan adjusts the price according to where you live. 


 Go to a doctor only when you need (abroad)

This option is not for everyone. But here is the experience of Mr Free at 33 in Chiang Mai, Thailand. 

The affordability of healthcare in Thailand is also mentioned by the adorable couple Our Rich Journey.

Any other ideas on how to release your yoke without the fear of a health collapse in the retirement years?

Cancer Incidence In Different Parts Of The USA

Different forms of cancer seem more prevalent in some areas of the USA compared to others.  For example, read here. Part of abstract:

For many cancers, there were distinct clusters of counties with especially high mortality. The location of these clusters varied by type of cancer and were spread in different regions of the United States. Clusters of breast cancer were present in the southern belt and along the Mississippi River, while liver cancer was high along the Texas-Mexico border, and clusters of kidney cancer were observed in North and South Dakota and counties in West Virginia, Ohio, Indiana, Louisiana, Oklahoma, Texas, Alaska, and Illinois.
CONCLUSIONS AND RELEVANCE:
Cancer mortality declined overall in the United States between 1980 and 2014. Over this same period, there were important changes in trends, patterns, and differences in cancer mortality among US counties. These patterns may inform further research into improving prevention and treatment.

This differences can be due to genetic differences between demographic groups variably distributed in these regions, differences in lifestyle including diet and physical activity, different distribution of age groups in these regions, socioeconomic status and access to health care, etc.  As the authors state, hopefully this information can be useful in optimizing prevention and treatment.

Easy baked mega-pancake

I love pancakes. However, they are comfort food and I do not have them frequently. They are not exactly the healthy breakfast I adhere to.

Also, flipping them one after another on the stove top takes forever. So, why not bake a huge pancake instead? 
Especially when the weather is hot.


Below is a recipe that I will perfect in the future and make healthier. For now, this is experiment "pancake 001". 

Expect the next recipe to incorporate fiber in the dough, less sugar in the filling and some flaxseed and chia seeds.

 
Pancake experiment 001

Ingredients:

1 cup pancake mix (such as Krusteaz, Buttermilk)
¾ cup water
3 eggs
butter (1/4 of a stick, or 2 Tbsp)
2-3 Tbsp jam of your choice

Instructions:
Heat the oven to 425°F. Generously grease a pan (mine is 10'' by 13''). Just before pouring the pancake batter, add a few pieces of butter to the empty pan and put the pan in the oven to melt the butter.

Mix the eggs with the water and then incorporate with the pancake mix. Pour in the pan onto the melted butter and bake for 14-15 minutes. If the edges are burnt, cut them out. Cover the pancake with the jam and roll tightly. Cut into pieces to serve.