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- [00:01]
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Andrew
On this episode of the Personal Finance Podcast, how to plan for health care costs by age. What's up everybody and welcome to the the Personal Finance Podcast. I'm your host, Andrew, founder of MasterMoney Co and today on the personal finance podcast, we're gonna be diving into how to plan for healthcare costs by age. If you guys have any questions, make sure you join the Master Money newsletter by going to MasterMoney co/newsletter. And don't forget to follow us on Spotify, Apple Podcasts, YouTube or whatever podcast player you love listening to this podcast on it. If you want to help out the show, consider leaving a five star rating and review on Apple Podcasts, Spotify or making sure you give that old thumbs up on YouTube. And so today we're going to be diving into how to plan for health care costs by age. And this is going to be an episode that is really important for a lot of people. Maybe you haven't really thought through health care costs because you are in your early 20s or maybe you're in your 30s or 40s and you don't really know where to start. But as time goes on, we know a bunch of different things happen with health care. In fact, health care costs rise at a rate of 6,7% every single year over the course of the last decade. This is not something we can ignore whatsoever because this is a very costly thing that we need to make sure that we have a plan in place. And so what I'm going to do is I'm going to kind of talk through by age how you need to think about health care. But in addition, I'm also going to go through how to decide how much health insurance you currently need. Because this is going to be a very important topic for most people so you don't get yourself in a strenuous financial situation. So first, before we dive in, I want to go through a few different health care stats. So general health care spending in the US currently, according to this is US data that came out, the average annual health care spending per person is $13,493 and health care spend as a percentage of GDP is 17.3% in 2022, which is the highest among developed nations. Now the inflation rate of healthcare services is 7% annually, outpacing general inflation. This is why it is so important to make sure you plan for this is outpacing general inflation. You have to have something in place. Now Fidelity estimates that a 65 year old couple retiring today will need $315,000 for healthcare expenses in retirement. That is a big number for a lot of people and that came out in a 2023 study. Now Medicare doesn't cover everything. So no coverage for long term care, most dental, vision or hearing services. So you need to make sure you have a plan in place to cover those types of things. And the average cost of a private nursing home is $108,000. An assisted living facility is $64,200. Now out of pocket cost and insurance, let's go through a couple of stats there. The average deductible for employer sponsored health insurance for Single coverage is $1,735 in 2023. And the out of pocket max for ACA Marketplace plans is 9,200 for individuals and 18,400 for families. These are massive numbers that we all within our personal finances are going to have to deal with. And so we have to make sure we have some sort of health care plan in place. Now when it comes to families, if you are someone who is thinking about having a family or you already have a family, you may have already seen this come up. But the average cost to have a baby with insurance is $14,768 total. With $3,068 out of pocket and without insurance, to have a C section is 25,000 to $30,000 and to have a traditional birth is 18,000 to $20,000. So this is something where I think a lot of people, you go through these stats and you realize, man, as time goes on, I'm going to have health care coverage for families. I'm going to have health care coverage as I age. I'm going to need to have a plan in place because hundreds of thousands of dollars cannot be wasted. And I can. I have to make sure that I protect myself and have a specific plan in place to make sure I have health care coverages. Now, folks who listen, in different countries, maybe your health care coverage is different, but here in the US we have a health care system that is pretty jacked up for the most part. And for a lot of folks, there's a lot of greed involved in the health care system currently. We have to make sure we combat against that. What did I say all the time. When it comes to your personal finances, you must focus on the things that you can control. And so what you can control is how you're going to handle this situation. Instead of just complaining about it, we got to make sure that we focus on the things that we can control. So without further ado, let's, let's dive into this episode and I'm going to first talk about how much health insurance you need. All right, so first thing we're going to do is how much health insurance you need is going to depend on the person. It's going to depend on your age. It's going to depend on where you are in life. And so what I'm going to chat through first is how to figure out how much you need in order to make sure that you have enough coverage and or you don't start overpaying for coverage that you don't need. And so let's talk through this first is step one. I want you to assess your health status. So I want you to ask yourself a couple questions. Do I have any chronic conditions? Do I have asthma? Do I have diabetes? If so, that's going to change what you need in terms of coverage. Do I see doctors or specialists regularly? If you do, then that's going to change the type of coverage that you need. Am I on prescription medications and do I anticipate any surgeries, pregnancies or therapies? I've talked about this a number of different times, but every time my wife becomes pregnant, we always change our health insurance and shift our health insurance from maybe a high deductible health plan to a lower deductible health plan in order to make that coverage easier overall on our finances. And so if yes on any of these, then I would lean towards higher coverage and lower deductible plans like PPOs or gold platinum plans. But if no, you can consider lower cost plans like high deductible or bronze plans. This is going to help you Figure out kind of a shift on how much you need to be spending on health insurance. Now number two is to understand the key costs because there are four main components. Number one is the premium. Okay? The premium on your health insurance means what you pay monthly regardless of usage. This is the money that's coming out of pocket if you get it through your employer. This is what you're paying your employer. This is the premium that you're paying monthly no matter what. The deductible is what you pay before insurance kicks in. Then we have co pays and coinsurance, which is your share of the costs and after the deductible. And then lastly is the out of pocket max, which is the most that you will pay in any one given year. It's pretty simple to understand, but just understanding those things upfront is going to really, really help you when you are making your decisions. You're looking at all these things. We don't want any of this jargon to come up and you don't understand what it is. Those are the four things again. Premium, what you pay monthly deductible, what you pay before insurance kicks in. Co pays or coinsurance is your shares of the cost after the deductible. And then out of pocket max is the most you will pay in one given year. Now what you want to do is make sure that you can afford the worst case scenario or the out of pocket max. So whatever your out of pocket max is, you need to make sure that you can afford that. If you don't make a lot of money and your out of pocket max is going to be $10,000 and you can't afford that, then we need to make sure we have enough coverage to afford that. This is the big key. Overall, it is a very important thing and that's why a lot of times we have the emergency fund in place. Because if you have some sort of medical emergency and you have that six month emergency fund in place and it'll likely be able to cover any of these costs. Now number three is I want you to run the numbers. So I want you to think through what is my total annual cost, which is the premium times 12, 12 months out of the year, plus the expected out of pocket expenses. And I want you to estimate different scenarios. So let's say you didn't have any doctor visits whatsoever, which I don't recommend. At least get your annual checkup or maybe you had a few visits or major medical event across plans. A high deductible plan may save you money. If you're healthy and rarely use care. But. But it could cost you more if something unexpected happens. Now to pair that up, we'll talk through this a little more in this episode. But you could pair up a high deductible plan with the hsa. It gives you some forced savings that's going to allow you to get those triple tax benefits that you can also utilize in an emergency. Now, number four is I want you to factor in your life stage, okay? Because when it comes to your life stage, we're going to talk through all of these life stages and some of the things that you could do and some more considerations as we get to the by age part. But I want you to factor in your life stage in terms of are you young and healthy? Well, if you are young and healthy, maybe you want to consider a lower premium, a high deductible plus an HSA to start. If you have a growing family and you're going, that means you're going to have more doctor visits. Because I tell you what, those of you out there who have kids, how many times do you just have a surprise sickness come up? Maybe your kids go to daycare and you send your kids to daycare and the entire class gets some sort of thing and all of a sudden they bring it home. Well, how often does that happen? All the time. If your kids are in daycare or if you take your kids to school, how often does the class get sick? If you have kids or if you've never had kids before, just understand you are going to be spending a lot more time in doctor's offices when you have kids. I have three. And we feel like we are at the doctor every week or two. And so this is something where we got to make sure that we plan for that as time goes on. Older adults, you are also in the doctor's office more often because you have higher usage and, and most likely more comprehensive plans. And if you're planning to retire early, you need to understand ACA subsidiaries or COBRA costs as well. Those are big things that you need to go through for early retirement. We'll probably do an episode on health insurance for early retirement coming up. As time goes on here now you got to add on the needs after that. So once you assess your life stage, then you want to add on what your additional needs are. Dental and vision. Do you need vision insurance? Some of you do, some of you don't. For example, my wife, if she doesn't have her contacts in, she can't see anything 3ft in front of her. Everything is Blurry, she can't read anything. And so she needs contacts. So we need vision insurance for her dental insurance. If you don't have dental insurance and you don't go to the dentist, what are you doing? You only get one set of teeth. Gotta make sure that you have a great set of teeth on you there. And so that's an add on need is dental and vision HSA eligibility. HSA eligibility is only available with high deductible health plans. And so if you want an HSA, and we have an entire episode on HSAs that we just did, make sure you check that one out if you haven't, because we call it a super retirement account. It's a hack to have triple tax advantages when it comes to retirement, but you can also use it for health care plans. And it's great for health care coverage later on in life and then mental health coverage. Check what's included. If therapy or support is needed in your life, that's another additional add on that you want to look through. And then you want to ask yourself, this is a big one. What can I afford to self insure? If you can afford to cover 5 to $10,000 in an emergency from savings, then you may be able to take on more risk. But if not, you may want to pay for more coverage upfront to avoid debt later. The last thing we ever want to see you do is go into medical debt. And so that is the big thing. Now final rule of thumb here is if you are high risk, you need more coverage. If you are low risk plus a strong emergency fund, then you can come up with less coverage plus lower premiums. See how the emergency fund just factors into everything you do within your finances because it changes your flexibility and changes how much money you have to spend over time and to insurance companies or to other things that could happen. Because your emergency fund is your safety net. Is your financial protection plan really important to make sure that you have that in place? Now, if you haven't heard our episodes on emergency funds, we have the 1, 3, 6 method that you can look at and chat through. It is our best way to save an emergency fund. Now that is how to think through how much coverage you need. Now let's get into how to plan for health care costs by age. All right, so we are going to start off with folks in their 20s and this is going to be one where I think a lot of folks in their 20s need to think through health insurance in a different way than maybe you have originally. So first is to get covered now if you are under the age of 26, I highly, highly, highly recommend staying on your parents plan. I am not one to say that I think people should mooch off their parents for a long period of time. But when it comes to health insurance, they can just throw you in at no additional cost to them. Then I would stay on their plan as long as you possibly can. Or if you can't stay on your parents plan because they don't have health insurance or they, you know, just don't have a job that allows them to be able to do that, I would buy a low premium plan with a high deductible if you're healthy. If you're not healthy, you got to follow the rules here and the parameters that we laid out right before this. But if you are healthy, then you can look at having a low premium plan with a high deductible. Now one thing is if you go with a high deductible plan, you can start an hsa. Now if you don't know what an HSA is, this stands for Health Services Savings Account. Now we here at the personal finance podcast and Master Money, we talk about the HSA as an amazing way to save for retirement as well. Why? Because money goes in tax free. You can grow the money tax free by investing those dollars in the HSA and you can pull the money out tax free as long as you have a qualified medical expense. The beautiful part about the HSA though is that there is no timeline as to when that medical expense needs to happen. So you could break your leg at the age of 26 and you could reimburse yourself at the age of 76 and it would be no issue whatsoever. You just save those receipts in Google Drive or Dropbox or whatever you love to use and then you'll be able to reimburse yourself completely tax free. Now this is a huge hack because in retirement then you can have more tax free dollars coming in and it gives you some additional flexibility. So we have an entire episode on the hsa. If you haven't heard it again, make sure you go check that one out. Also, preventative care can be free. And if it is free, I would use it. Make sure you're doing your annual checkups. Make sure you're doing any of your screenings. It costs $0 on most plans and a lot of times they want you to do that to make sure you catch stuff ahead of time so that they're not paying more out of pocket later on down the line. A lot of times when it comes to healthcare, it's all about the money. Always follow the money when it comes to healthcare, because this is what happens with health insurance plans. This is what happens with some physicians out there. This is what happens with a lot of doctor's offices or medical groups. This is all about following the money. That's a pro tip right there. Make sure you always, always do that. Every time something is recommended to you, make sure you ask yourself, is this about the money? Just ask the question. And it's going to be really important to make sure you do that. And then always, always, always. One thing I think people in their 20s need to understand and you need to get this habit down early is always skip medical debt, meaning that you can negotiate your medical bills. And in addition, you need to always make sure that you are getting an itemized medical bill. Why? There is a massive portion of medical bills that are actually wrong. In fact, I've seen findings as high as 50 to 60% of medical bills can be wrong. And so you want an itemized list of what's on that medical bill so that you can ensure that this is something that you should actually be paying. If it's not, then you need to get things removed and start negotiating your medical bills. It is a very important skill, and it is one that will save you thousands and thousands of dollars over the course of your lifetime. I like to negotiate a lot of my different medical bills because I will get the bill and I'll look at it. And again, usually it's 3, 4, 5 times out of 10, I see something on there that should not be there. And so you got to make sure that you're negotiating your medical bills because there is a lot of mistakes that happens. Also, you need to make sure that you have enough coverage in place so that you do not go into debt or you do not go to collections. Very important to have that set up currently. So if you're in your 20s, again, thinking through, a lot of you are young. When I was in my 20s, I did not go to the doctor very much at all. I didn't even get my annual checkups. That was a mistake. I feel. I feel like I should have always gotten my checkups. And then outside of that, getting my blood work, those are the big two for me that I wish I did more so in my 20s so that I could catch things early if anything was gonna happen. For example, in my 30s, realize I have high blood pressure. And I wish in my twenties I would've made a lot of lifestyle changes in order to combat that. Now I'M doing it in my 30s, and it's a little harder just to make that change really quickly. But I have made that change, which is great. But making sure you get your screenings, get your blood work, that's the big things that I would do now. In your 30s, this is where you really need to lock in some good habits here. And there's going to be a couple of things that are going to help you. First is prioritizing health. Because if you prioritize your health, you can dramatically decrease the amount of money that you're spending on health care. Health is truly wealth. A, it gives you more freedom and flexibility in life. B, you can do more things for longer. It gives you longevity. C, in addition, it's going to help you save money. Why would we not prioritize our health? So anybody listening right now that has been saying to themselves for years and years and years, I need to get back in shape or I need to start eating right. Start today. Now is the time to get that going, because it will absolutely change your life once you start taking your health seriously. So there's a couple different areas that I want you to focus on. If you've never thought through this before, and we have on some of our Q and A's, we've done in the past a segment of the episode called Health Corner, and a lot of people have emailed me in to bring that back. We will be bringing that back at some point in time here. But this is something I think you need to think through. One is sleep. Making sure that you prioritize sleep. Do not be staying up all night long. Do not be up till midnight because you want to catch up on your Netflix show. Instead, making sure you prioritize sleep. Getting your 7, 8, 9 hours of sleep a night is going to be very, very important. Secondly, it's time to dial in your diet. In your 30s is the most important time to dial in your diet. A, because it's a lot harder to keep weight off than it used to be in your 20s. But B, it is also something that now this is a huge impact on your longevity and your health going forward. You need to lock in on that diet. And so for me, one big thing that I did over the course of the last couple of years is I changed my diet completely. I eat a lot of meats, a lot of fruits, a lot of vegetables, a lot of whole foods. I just try to eat as many whole foods as I possibly can. When I did that, it reduced my brain fog. It reduced my sleepless nights. It reduced my stress. It reduced so many different things by just changing my, my diet. And it was a huge, huge impact on my life. Now, sure, I eat the occasional, you know, fried food or whatever else. I love that stuff. But at the same time, I make sure that 80% of the time I am eating that whole foods diet. And usually it's more than 80% of the time now. I've gotten stricter and stricter as time goes on because I like eating that way. I've actually grown to enjoy it. If you asked me this five years ago, I would tell you your boy doesn't even really like most vegetables. But now I eat them every single day. I eat a ton of them every day. Yeah, I changed my life based on doing that. And also stress management is a different one. This will pay off really big later. But stress is something that you need to make sure that you are managing day in and day out. It is a huge, huge component to your longevity. Secondarily in your 30s is I want you to consider disability insurance because your income is your biggest asset and this is the way that you protect it. And so making sure that if anything were to happen to you and you got disability insurance at least would give you some coverage to help you through that, especially if you have kids, if you have people who depend on your income, if you're the sole provider in your family, you then you need to make sure that you think through disability insurance for sure. Thirdly, and I think all of us do this, typically you do this around the time of open enrollment, but you need to review your plan annually. I shift my plan year in and year out. Again, like I said, some years, my wife's pregnant. I know I'm going to make a shift. Or some years when we're going to have a newborn baby, like this year, I'm going to make a shift because I know we're going to be having a lot more doctor visits within that first year for checkups, things like that. And so you want to make sure that you're comparing your plans and thinking through that. Also compare employer versus marketplace plans. I have seen some of you out there who work for companies that don't give you very good health insurance. And so you need to change this over time. Specifically, I want you to look through this. If you're married or you have kids, what is the best coverage for you and your family to ensure you get the max out of this insurance? Insurance is already charging you a normal leg. It is such a costly thing when it comes to health insurance. So making sure that you have enough coverage is really important. Also, if you're using an FSA or a flexible spending plan, make sure you're using those funds wisely. You can spend on vision or dental or therapy or, or save long term if you don't need it now in an hsa, in an fsa, you usually have to spend it within that year. And so just making sure that you think through either one of those. I like the HSA obviously more, but I like it for the super retirement account. And you can't be funding both at the same time, so making sure you choose which one is going to be really important. So that is your 30s. I want you to prioritize, think through what you need for your spouse, for your family, for yourself in your 30s to make sure that you are maximizing health, that you are looking at disability, that you were reviewing your plan annually and you have a plan actually in place of what you're actually, you know, why you're doing what you're doing. And then using HSA and FSA funds are really important. This is going to help you in the coming years when you're going to need even more coverage. This episode is sponsored by Plod, an AI wearable gadget that takes notes of meetings and calls. And with Plod, you don't have to take notes and make summaries anymore. If you're anything like me, you hate scrambling to write down everything during meetings or calls and then spending hours later trying to make sense of it all. Well, meet plod, your tiny AI powered assistant that clips right onto your phone or outfit and does it all for you. It records, transcribes and highlights the key points and even turns them into mind maps so you can actually see what matters most instantly. And the best part, it doesn't just take notes, it understands them. So you can ask it questions about your meetings and get instant answers, like having a meeting savvy chatgpt in your pocket. Trust me, this little gadget has already changed how I work and I genuinely think you'll love it too. Try it for yourself. Just type Plaud into Google and get a discount with my code. Pfp. That's P L A U D.
- [22:02]
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- [22:33]
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- [23:05]
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- [23:28]
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Andrew
All right, so in your 40s, it is time to prepare for the midlife curve balls that come with your 40s when it comes to your health. And so a we want to make sure that we have annual screenings. This is really important. Always catch issues early, your blood pressure, your cholesterol, make sure you get cancer screenings. Those are super, super important. In fact, me in my 30s, I want to make sure that I'm actually doing all this stuff now even in my 30s because there's just too many things that are going on out there. I mean cancer is one of the big fears I have in life and trying to catch that early if you get it or, or trying to avoid it at all costs is one of the big things. And I get through most people in their life. There's a huge portion of the population that are getting cancer now. And so making sure that we think through that we fight against it is really, really important. Also in your 40s you may have to start caring for your parents or thinking through their insurance as well. And so understand their insurance, understand their long term care options because it may fall on you and if it does fall on you, you got to have a plan in place for this. You got to think through what do I need to be doing for my parents long term in order to really make sure that they get the best coverage possible and they can live the longest. You can spend more time with them. One of the biggest regrets that people have in their deathbed is not spending enough time with their parents. And this is one way to help them through that process is to make sure that you give them enough coverage. Next is I think you should start modeling long term care costs in your 40s so you can use online retirement health care calculators. And you might spend 200 to $400,000 on health care in retirement. So start modeling that out. What does that look like? What do I need to be saving in order to do that? This is why I love the HSA again, because you can invest those dollars and they can grow every single year so you don't have to work as hard to save up a 200 to 400 grand. Instead you can work through this and then consider a long term care savings plan. So even if you don't buy insurance earmark savings for future care, there's things out there like long term care savings plans. And having those in place could be really, really important. So your 40s is a time making sure you still prioritize the 20s and 30s, those types of things. But in your 40s you also want to be doing these additional things like getting your annual screenings, making sure you have your parents plan in place. Start modeling out those long term costs and consider a long term care savings plans. Those are all going to be super, super helpful for you in your 40s. Now let's get to your 50s first. In your 50s you get to build the bridge to Medicare. So Medicare is going to help you out later on down the line. But in your 50s you can do a lot of cool things here. First you can catch up on your HSA contributions. Now you can now contribute up to $1,000 more per year with your HSA contribution. Secondarily though is I would start to review your retirement health plan options. What will you do between retirement and Medicare at 65? This is going to be a big, big deal for you. Let's say for example, you start to retire in your mid-50s. What's your retirement health care plan for your mid-50s? From 55 to 65, you got to make sure you have something in plan in place there and budget out for it before you retire early. It's going to be really important for you to think through that. Fidelity estimates that a 65 year old couple retiring early today needs $350,000 for healthcare. So you need to estimate the out of pocket costs because if somebody at 65 today needs 315,000, well, if it's increasing at 5 to 7% every single year, what are you going to need in the next 10 years, in the next 15 years, or however old you are? You need to start to think through and use some of those retirement calculators. Explore long term care insurance. The earlier is cheaper. So if you get long term care insurance in your early 50s, it's a lot cheaper than if you get it in your 60s or 70s. And so making sure that you have that and the approval is easier while you're healthy. So if you're healthy now and you're in your 50s, the approval is much, much easier than it would be later on down the line if you're not as healthy as you are today. So those are big four things that you could think through in your 50s is to make sure that you have some of that stuff in place. Now let's get into your 60s, because in your 60s you can do a couple of different things. First, signing up for Medicare on time is a big one. So parts A and B Start at age 65 and late enrollment means penalty. So you got to make sure that you are enrolling in Medicare on time. And if you need help with that, you can go to healthcare.gov and you can look at some of the ways to do that, take the steps there. Secondly is choosing a path. This is going to be really important. So there's original Medicare, there's Medigap and there's part D. Or you can look at a Medicare Advantage plan and figuring out which one is the best one for you is going to be really important. Based on your health, based on your situation, based on your needs. These are all going to be different for each and every single person. And then reviewing annually so you have drug plans and advantage plans that change every single year. Make sure you understand how Medicare works. It is very important to your retirement that you understand how it works so that you know where there are gaps, what are you going to have to pay out of pocket, what are some of the areas where you're going to have to save some additional dollars for costs. And then Medicare doesn't cover dental, it doesn't cover vision, it doesn't cover long term care. So you need to fill those gaps with savings or supplemental insurance. And so a lot of times you want to look through supplemental insurance that maybe cover the difference, plus whatever Medicare doesn't cover, you know, with your doctor visits or things like that. And so it is really important to plan for these gaps in your 60s and even in your 50s, you need to be thinking through this some, but in your 60s you really need to be cranking it up there. Now in your 70s and beyond, we want to make sure we are managing and maximizing our dollars, stretching them as much as possible. So you need to stay on top of Medicare changes, premiums and coverage evolve. So you need to review them every single year. You need a budget for inflation like every single age does. But this time health care typically outpaces general inflation. So you make sure you have enough cash on hand and figure out what you're going to do there. You also consider your caregiving needs. You need to plan ahead for assisted living you have or thinking through in home help or nursing care. These can cost 50 to $100,000 a year. You need to make sure you're having conversations and you need to be. If you have children, you need to have these conversations with your children as well. What do we need to do? How do we need to think about this? And then protecting your finances? So using legal tools like trusts or POAs or Medicare planning to manage healthcare long term expenses wisely is really, really prudent and very important for most of you. So this is how to plan for health care costs by age. These are some of the things that you need to consider. And again, for most of you out there, as you start to think about health care costs, as you start to do this, you need to make sure that you think through, okay, the inflation is so high on this currently and hopefully at some point it slows down, but we see no signs of it slowing down here in the US at least. And so because each is an a case by case thing, we need to make sure that we are planning for these, we are supplementing for these and we have coverage in place. So listen, I hope this episode helped you guys out. If it did, please consider following the show and leaving a five star rating review. Can I thank you guys enough for being here and investing in yourself? Because it's exactly what you're doing when you listen to this podcast as you are investing more in yourself. So congratulations for doing that. Thanks again so much for being here and we will see you on the next episode. Sam.