US Health Care costs

I turned 68 last summer…

My social security even at 70 would only be about 1/3 of my present salary, and Medicare (and the supplemental insurance needed - I don’t trust Medicare Advantage) is not free…

The US is not the place to be old and poor!

  • karen

Ah yes, under this circumstances I would also choose to work until the last day if possible. I have multiple sklerosis and I need also much money for medications every month. But here in Germany it is let’s say more secure cause we have a social system which helps me to stay alife. If I would have to look in the future in america and it’s medicare program and Mr. Trump in future…I would also react like this.

So good luck that you can work long, long time in your Job. Best until the last day. What shall I say. That makes panic for the future. I can completely understand that.

I am working full time at least through this year, by which time I’ll be approaching age 68. I wanted to retire at 66.5 years (full retirement age for me) and it’s plausible I could also go to 70, if my health holds up adequately and my current “dream” gig doesn’t change much. My savings is adequate to retire but not where I’d like it to be, largely because I spent many $$ in the middle of the last decade trying to keep my then-wife alive with out of pocket off-label / experimental treatments – ultimately, unsuccessfully – but not before it had eaten up most of my retirement savings to that point. So I had to start over.

You are correct that the US is not a place to grow old (or sick for that matter), even if you’re not poor. It’s all relative. I have a wife who is already retired with health problems and much lower SS benefits due to her years out of the workforce as a full time mother. I support an adult autistic stepson with comorbidities. Medicare can bankrupt you with its un-capped co-pays and lifetime limits on hospital coverage in certain scenarios so you have to buy expensive additional insurance.

It is elder abuse so far as I’m concerned that healthcare isn’t really a right even past retirement age.


Sorry you have had it so rough!

But yes the US heathcare system is shameful in many ways.

  • Karen
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In Switzerland the health care system is similar to the US with per capita primes and large co-pays. In other European countries primes depend on income and co-pays are small. With inflation still growing, many low and middle-income people struggle to pay their primes now - along with housing. Health insurance is mandatory and for the lowest incomes the state subsidises primes.
Last year, the SVP (the Swiss equivalent of the GOP, coincidentally controlled by a billionaire family), launched abandoning mandatory health care as a talking point. This would mean no more subsidies and who can’t pony up for primes simply doesn’t have health care. Brave new world.

I really really don’t get the push-back with Medicare Advantage plans… I have one, have had it for 3 years now. I have a $0 monthly premium, $0 copay for Doctors, Speicalists and all tier 1 drugs.

I had a 2nd heart-attack in 2022… without this Advantage plan, my Medicare share would have been $25,000.00, as it was, my total out of pocket was $512.00

Are all advantage plans the same? NO… is the plan I have available elsewhere in the US? probably not. Is there similar plans in your areas? I’d bet there are.

Last I am going to comment on this subject. If you want to pay the 20% of total cost to Medicare, that is of course your decision. but why? when an advantage plan will do it for you.

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It seems the Pharma lobby of US is hell bent on squeezing every ounce of funds from citizens. :face_exhaling:

I’m also Swiss and wasn’t aware of that. I’ll make searches…
Thanks for telling.

We ended up going with a supplement (“medigap”) plan.

NY state is interesting in this regard, they are one of the few states who don’t have underwriting for Medicare supplement plans, so the premiums are a bit higher, however:

  1. We enjoy a perpetual open enrollment. Unlike most other states, the insurers are required to accept you whenever you want the plan, not just within 6 months of signing up for Medicare, and then turning you down, requiring a health exam, or raising premiums.

  2. Premiums can go up but only on a community basis, not on the basis of you filing too many claims for the wrong things

A high-deductible G plan costs about $70/mo and after the $2800-ish annual deductible, pays for everything Medicare doesn’t. For a little over $200/mo you don’t have to pay the deductible either (the advisor we talked to has this plan, and hasn’t payed anything for any health care in years). It’s basically just a question of paying the premiums or paying the deductible, and in a year where you don’t need to see the doctor much, with the high-deductible, low-premium plan, you win.

Downsides of what our state-funded advisor called “Medicare Disadvantage” are: often not portable, anything outside the area you live in is out of network, so god help you if you get sick while on vacation; confusing and hard to evaluate differences between plans and between any given plan and traditional Medicare; and the biggie for me, the Claims Denial Department and the Referral Refusal Department. You can’t change plans at will, only during the feeding frenzy / advertising blitz of the annual enrollment period. Finally, on an overall basis, studies demonstrate that Advantage plans just cost more out of pocket over the long haul. I’ve waited my whole life to be free of for-profit insurance companies and for my wife and I at least this is the best path forward.

There are probably specific situations where Part C Advantage works out for specific people. For example my previous / late wife turned her retirement package at Pfizer into an annuity with me as the beneficiary. When she died I got that annuity which included her health insurance package. That was an old-fashioned plan that you used to be able to expect from an employer that pays for most everything and, pre-Medicare, cost me about $100/mo. I could have converted that to an Advantage plan at about the same as I’m paying for Medigap, in fact I can do that during any enrollment period going forward. It’s more complicated and subject to insurer whim than the universally standard Medigap plans, but if for some reason I needed to do something different, I’ll always have that option. But for instance toward the end of my time on that plan they arbitrarily tossed my general practitioner out of their network, leaving me scrambling for a new GP with basically no notice. So … giving them the ol’ heave-ho felt particularly good to me.

First I would never go with Medicare alone. I would get a Medigap plan. In my state more people choose Medigap than Advantage for a reason. (Medigap here is simpler than in most other states - there are really only 2 plan levels rather than the alphabet soup of options the federal government defines)

If you are curious about the details of the Medigap plans available in Massachusetts and their cost see:

Medicare Advantage Is usually an HMO type setup where you have to go to the doctors in network and get referrals for specialists - and they can keep changing and the network which can be pretty limited. You can get nickel and dimed to death with co-pays and there are deductible etc.

None of that is true for Medigap (all doctors who take Medicare accept it everywhere and the only deductible is for part B if you go with Mass Supplement 1A, and there are no copays.)

The general belief around here is that Advantage is cheaper when you don’t have chronic conditions, but as one gets older and sicker Medigap is better, and there is much less chance of having to worry about the cost of accidentally “going out of network”.

The downside of Medigap is that you also have to get a separate Part D prescription plan… When Part D was created, the law specified that Medigap policies could no longer include prescription coverage.

  • Karen

Yeah and my wife & I pay all of $44.40 a YEAR for our Part D / drug plan.

I am going to look into the Advantage plan some more. There seems to be many different plans, and it is overwhelming.

Thanks Dave!

I thought you were Canadian.

  • Karen


Yes, I am born Canadian. I have lots of family in the United States and have worked in a few countries. The weather in Texas looks much better. Here is a screen grab from the weather channel of the weather in Fort McMurray, Alberta, Canada right now.


Its -36 C (-33 F) at 8:47 am today, with windchill, its -48 C (-54.4 F). Worked outside yesterday, and am working outside today. Its a challenge to start diesels, which usually needs battery boosters, heat (electric blankets and exhaust), and ether starter fluid. Oil looks like grease in the crankcase.

Edit: The United States weather looks VERY nice right now. :slight_smile:

This is why we winter in Galveston in the RV. With the exception of the low below freezing Tuesday of next week highs are in the 50’s and 60’s most days. Of course my home is on wheels so it’s easy to do but there are plenty of Canadians at the RV park we’re staying at (well, technically we’ll be in New Orleans next week but the weather is almost identical).



$ as the motivation for health care seems fundamentally motivated in the wrong direction
So many other G20 nations have excellent health care systems that are NOT based on the US style profit motive

There’s nothing wrong with a profit motive as long as there’s a genuine competitive market rather than companies acting as price-fixing cartels ( which is what appears to happen in the USA’s medical sector ).

The alternative is paying exorbitant taxes to finance mediocre services and the public sector’s gold plated pensions.

And don’t get me started on the inflated salaries of the “Diversity and Inclusion Advisors” every public sector body has by the dozen these days… :roll_eyes: It makes me seethe how HMG spaffs my money up the wall, at least with private companies I’d have the choice of opting out.

Better health care out comes is, in my opinion, what should be driving health care
Not “how little can we do and make the most money”

Its why I am thankful I live in Canada where we have public health care and bankruptcy from health care costs is a rarity

The US ranks very poorly when you compare $ spent to outcomes

Now dont get me wrong
I dont think making profit in inherently a bad thing in and of itself
But, when it becomes THE driving motivation and the industry is NOT well regulated and has little oversight that becomes a problem
We’ve seen that in health care industries here - like in seniors care & seniors homes
And those areas have now been subjected to better regulation and we’ll see how/if that improves things

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When a stickup man says “Your money or your life” he can go to jail…

When the for profit medical industry essentially says the same thing, they just get rich…

  • Karen