I Can Never Retire, Because of Health Insurance, Waaah Waaah!

Mr. Money Mustache likes to take a peek at where his latest visitors have been streaming in from occasionally, and sometimes he is fortunate enough to be discussed in various online discussion forums that send people this way.

Sometimes on these discussion websites, a commenter will mention MMM, and a few readers will come in and poke around for a few seconds, then they’ll go back to their discussion group and flame out a few criticisms and complaints. “Mr. Money Mustache doesn’t understand inflation!” … “I will not be visiting that blog again because that young man SWEARS!!”… “That blogger is insane, he is starving his family and denying them from the good life!”… “Mehehehh.. Well, Looks like Mr. Money Mustache’s child won’t be able to go to college!”

Today I visited one of these sites, and found a particularly good complaint which I will paraphrase for you here:

“If you were to ask me, can I retire on $900K right now in my 30s?  I’d say sure  … you could probably live on $36K a year in a low cost of living city no problem, but what happens if you get sick?  Health insurance for a family of 4 is going to run you probably around $2K a month, if you can even get it, and the out of pocket costs will probably be another $3-5K a year”

My initial response to this was of course, “WHAT THE FUCK!?!?”, because you all know how much Mr. Money Mustache likes to hear complaints.

Once I calmed down, I decided to do a little bit of research on eHealthInsurance and some of its competitors displayed in the automatic ads beside this article. They all seemed to link to the same list of plans in the end, but eHealthInsurance had one of the cleaner interfaces.

I entered my zip code, the birth dates of myself and my wife (we’re 37), and my son, and I even added a cute little extra fictional child that is 7 years old, just to bump us up to be a family of four. No Prexisting Conditions. Remember to show ALL plans, and sort by price.

I picked the best insurance plan I could find: one called United One that lets me pay my own little doctor bills (I usually visit once every five years or so, whether I need it or not)  but limits my out-of-pocket expenses with a very manageable $10,000 deductible and 20% copay up to a $12k limit, in the very unlikely event that one of us gets extremely sick and needs multiple-day hospital care. Guess how much this was for our giant family of four?

$239.10 per month

If that one is too risky for me, I can go to a Cadillac health insurance plan called Humana One that has only a $7500 deductible and a 0% copay. But surely that would be, like, Infinity dollars per month for a family of four? Nope. Here is my quote for that program:

$318.52 per month

And finally, let’s fast forward to age 63 when our real child (and the imaginary one) is all grown up and moved out, and my wife and I still want coverage to get us through to Medicare eligibility at age 65. It is IMPOSSIBLE to get health insurance when you are 63 years old, isn’t it? Nope:

$367 per month  … and all of these prices are the TOTAL for all people, not the per-person price.

That’s great catastrophic insurance for good ol’ Mr. and Mrs. Money Mustache, when they’re 63 in the mid-twenty-first century, and it’s a pessimistic estimate in my view, because I would imagine there will be robots and lasers floating around taking care of our medical needs automatically by then.

Now, I’m not saying this plan eliminates risk completely. But it DOES eliminate the need to worry about serious financial damage being done by an unpredictable health condition.

And what do we do about things we cannot predict or control in the future? Do we worry about them every day and post whiny comments into the discussion forums?

Or do we take actual steps to improve the aspects that are under our control?

At this point, I’ll pause the optimism for just a second. I do NOT mean to make light of the chronic and/or genetically predetermined medical conditions that affect a certain percentage of people through no fault of their own. Some people simply need much more medical care than others, and for them the planning will of course be different. You may choose to live in a state or country that has affordable subsidized insurance for pre-existing conditions (I’ve heard that Colorado is one), and you may need to save a larger amount for retirement to cover these costs. But it can be done – it’s only money. And if we ever get the option to bring full public health insurance to the US, like every other rich country has, I’ll vote for it even if I could somehow know I’d never need it. But chronic conditions are the exception and not the rule – and for the purposes of this article, we’re just dealing with the rules.

Long-time readers know that I’m a big fan of Health. I don’t ride a bike every day, eat natural foods, drink only moderately, lift weights, and maintain a 10% or less bodyfat level because I’m hoping that Calvin Klein will call and offer me that job as an underwear model that I’ve always wanted. I do it because that’s what you MUST do to be healthy when you are getting old like me! I have over thirty gray hairs in my beard! I am approaching DOUBLE the legal US drinking age! I have friends my own age who are taking prescription medication for self-inflicted conditions, unable to climb ten flights of stairs, and/or dozens of pounds overweight! Getting old is fun, but you can’t just sit around and play games with Old Man Time and not expect to get slapped upside the head.

Of course, only about 1 in 10 people these days actually follow these rules throughout their lives, so they get to enjoy considerably more early contact with doctors and hospitals. But the formula is there – it’s the cheapest and most enjoyable form of health insurance there is!

And sure, there’s always a chance that some hidden bits of my genetic code will give me some unexpected form of cancer, or a freaky accident will bust me up. But when you look at the odds of these events by reviewing the statistics for a healthy population of people, they are very low.

If you don’t believe me, ask the insurance industry itself. You will notice that the premiums rise somewhat, but not astronomically high, to cover the 63-year-olds in my example. If being a 60-something really was spectacularly dangerous and expensive, as some young people fear, it would be reflected in the form of much higher premiums. Insurance premiums are statistically designed to be profitable for the insurance industry, so you can use them as a very good estimate of how risky any situation is.

If you’re a lean and highly active person who leads a low-stress life and eats healthy foods, the odds are nicely in your favor that you will coast gracefully well into your 60s before you have any sort of medical issues. And even then, you’ve still got reasonable odds at being one of those wiry old people who continues to live and achieve, until you sit down on your rocking chair at the end of a day of work on your 100th birthday, and just expire.

Even though I’ve got 63 years of work left in my own mission here, I’m kind of looking forward to reaching that rocking chair, just because it shows you’ve done everything else all right.


*** This post draws heavily from the wisdom of an existing article on Early Retirement Extreme called “health insurance for Extreme Early Retirement“. In fact, you could say I have simply translated the same ideas from Jacobian to Mustachian format. But I figured the more people who can share the message and reduce unnecessary fear, the better. Thanks Jacob!



  • Gypsy Geek September 21, 2011, 6:36 am

    Another plus for high deductible catastrophic plans is that you can partner them with a health savings account, and then sock away tax free money that is even void of social security and medicare taxes (unlike 401k’s). You can at save, at least, your deductible amount in it, and when you turn 59.5, you can take the money out penalty free for anything whatsoever. It’s like a 401k, without having to pay SS and medicare taxes.

  • Adrienne September 21, 2011, 7:16 am

    Unfortunately because of the a$$ backwards way we do health insurance in this country not all states have rates so low. In my state there is 1 – ONE! option for non-poverty self-insuring people and *surprise* the rates are not great. But we buy it anyway because no health insurance is not a risk I’m willing to take. (but neither will I work full time just for that one benefit) Looking cautiously forward to the 2014 health exchanges…

    • Betty Yeager September 24, 2011, 12:07 am

      I completely agree with what you have posted. I don’t understand why a populated country like the USA refuse to the same health care we have in Canada…by saying that you don’t want socialism in your country, when you do have it in your country, such as fire services, police protection, mail, email, telephone companies, etc. and use these services every day but don’t even recognize it…

      In Canada people here are covered fully with excellent health coverage from birth to death, by our government health care providers who don’t demand to know if you have made a claim before, don’t charge more if you had, and charge us only a few bucks a month, depending on our income, and set down the minimum amount of money they say someone needs to have health coverage, again depending on how many children they have to support until their children reach the age of majority and are able to support themselves.

      If Canadians can do this then why can’t Americans do the same? After all, the USA has approximately 10x more people than Canada…all you need to do is join together to force your government to do this. You know what they mean about the greasy wheel being heard instead of only one small voice they can just ignore.

      • MMM September 26, 2011, 9:08 pm

        Good question – the problem is not that the people want it and the government won’t give it to us. The problem is that our population is neatly divided between people that want public health insurance, and those that do not. So our votes cancel each other, and nothing gets done.

        Remember, the upper-income half of the US populace typically has cushy jobs with nice health benefits. These people have a healthcare experience that is almost as good as Canadians have. So if they have been misled into thinking that Socialized Medicine is a bad thing, they naturally don’t want to change it.

        The real key in all of this is the COST of the health care services themselves – the US system is by far the most expensive (and therefore inefficient) in the world. While public health insurance is great, I would even be happy with private health insurance both the insurance and the doctors had a Wal-mart-like level of efficiency and cost. But right now, when it costs $10,000 a day to sit in a hospital room in the US even when getting very little actual care, we’re not getting a good deal for our money.

        (note, I edited out the parts of your comment about various people being stupid and the discussions about invading other countries since I didn’t want to destroy another thread with off-topic ranting :-))

        • AlCanDr&RN April 14, 2015, 9:19 am


          Overall you are espousing THE BEST healthcare in America when the patient is their primary doctor and living well is the first prescription. While I might go along with the mainstream idea that there is a looming healthcare crisis in the US I differ in my opinion of its origin, direction, or solution.
          If more people ate well, controlled their weight better, worked out routinely from their teen years, slept sufficiently, managed stress more effectively, and focused on family and community instead of their TV then every doctor’s practice would take a huge hit. We are being inundated by what I like to term as a “metabolic tsunami” that will continue to diminish well being and that will continue to increase cost until addressed. It is treatable–but not by making more doctors…or spending even more money on healthcare.
          The continued emphasis that many place on cost continues to miss the underlying issue that is VALUE. This value concept marries cost, efficiency, access, outcomes, errors, patient satisfaction and many other factors. As in all things economic our values must be addressed first. One cannot dollar cost average healthcare and call it insurance.

          Funny what it feels like when you take the red pill…


  • Personal Finance Source September 21, 2011, 7:24 am

    This is all great and dandy unless something catastrophic does happen. Say one of your family does get cancer. Your stuck shelling out your $10k deductible plus then probably will reach your out of pocket max $12k in that year. So year 1 you pay out $22k. The next year you’ll have the same expenses probably. If you can keep affording to pay that each year then great. But not many people can. And if you think you’ll go get an insurance policy at that point with lower out of pocket max and lower deductible then you can forget about it. You won’t be qualified.

    I have a spouse with a chronic condition. She was just in the hospital and usually has to go in about once a year. For her condition that is considered “healthy”. This will cost us about $2k this year and every year she has to go in the hospital because that is our out of pocket max through my employer health insurance. If we tried to go find insurance on our own, it would either be ridiculously unaffordable, or she would be denied.

    Health is a risk I am very uncomfortable playing around with. While I never have any health issues, I would not think for once that that will hold true forever. And unfortunately if health fails and you are not covered, it can be detrimental to your finances. I’ve heard majority of bankruptcies are due to health bills. I don’t know if these people would agree with your views.

    • MMM September 21, 2011, 9:30 am

      Did you actually read this article, Personal Finance Source? Or did you just come here to run around with scissors and snip at Mr. Money’s Mustache?

      This article is not suggesting a strategy for people with pre-existing conditions.

      For you, I’d advise keeping your job for the cushy insurance, at least until your savings are large enough to cover a larger medical outlay each year.

      • Personal Finance Source September 22, 2011, 1:09 pm

        I read the article and no where do I see you rule out any group of people that this strategy would not work for. I just wanted to see your opinion on those less fortunate in health than yourself. I would be interested to see if you could help someone retire early who hasn’t had everything go right for them thier lives. You seem to have some mightier than thou attitude that since you were able to retire early anyone can do it or they are fools. Well unfortunately not everyone is fortunate to make $100k + household income while accumulating assets for retirement and unfortunately not everyone has perfect health despite excercising and eating healthy.

        I like your site and do agree with most of your views. However I think you need to understand that your circumstances gave you a big boost to your ability to retire early. Others may not be as fortunate.

        • Dancedancekj September 22, 2011, 2:46 pm

          Even if MMM is the exception and no the norm, it still doesn’t change the fact that he is offering exceptional personal finance advice in a very likeable form. Sure, there are many things that he does that do not apply for me (My income is lower, so I’m looking more at 20 years as opposed to 9; I am not married, so only have a single income; I have hayfever that limits my biking outdoors time; I do not live in Colorado with its milder climate etc. etc. ) but that doesn’t mean that it isn’t helpful to me, or that advice he gives in one situation wouldn’t be applicable to me in a different way.
          I don’t see his vow as holier-than-thou at all. MMM is like my most peppy cheerleader yelling me on in my goals – he is so enthusiastic! I love the over the top, no bullshit attitude personally. To each their own I guess.

          • MMM September 22, 2011, 3:44 pm

            Thanks Dancy, you’ve got it right – I’m not suggesting that people are fools if they cannot retire extremely early .

            And I am definitely admitting that things went very quickly for me. In fact, that’s why I am called Mr. Money Mustache!

            People don’t get mad at Superman and say, “Well, fine, Superman, it was easy for you to freeze that lake with your breath and then fly it over to the burning oil refinery where it melted to cause rain to extinguish the fire. But what about all us regular firemen, who have to use standard firefighting equipment?”

            No, they say, “THANK YOU, SUPERMAN!!! YOU SAVED THE WHOLE TOWN!!!”. And Superman still modestly passes on the credit nonetheless to the heroic firefighters.

            Mr. Money Mustache is PROUD of all of your efforts. Keep it up, Mustachians.

          • Personal Finance Source September 23, 2011, 7:14 am

            I totally agree that much of the advice on this site is great advice. If it were not I would not continue to visit. I just thought comments were for pointing out other points of view and not always just kissing butt of the author. I apologize for the misunderstanding and next time shall only comment if I agree 100% with the view of MMM. I believe the main thesis of the site is living within your means and not spending frivilous so that you may hopefully sooner or later be financially independent. That is my view of personal finance as well and why this is one of my favorite sites.

            • MMM September 23, 2011, 10:57 am

              Haha.. excellent, it is good you are standing up to MMM. Different points of view are great! The main thing I like to poke fun at is the “can’t do” attitude that pops up so frequently.

              For example, if I write about an idea that has worked for me, and people point out all the flaws as to why it doesn’t work for them – that is “Can’t Do”, aka “whining”.

              Instead, I’m hoping people will think “hey, I can adapt a certain portion of this idea for my own unique situation”. If they are excited enough about their ideas that they want to share it with everyone else, they’ll post it as a comment.

              Or if they perceive a fatal flaw in my reasoning, they might ask a question, like “What is your plan for dealing with a chronic illness that pops up later?”. Then I would answer something like “Good question – since such an illness is unlikely, the math works out better if you don’t pay premiums for it for your whole life – instead, just save those additional premiums as part of your safety margin. In the worst case, you will use up these premiums, plus some other safety margin funds, to cover copays until Medicare.”

              The thing about this blog is, it is a place where bigger-than-life ideas fly around and get everybody pumped up. By focusing on the positive instead of dwelling on negative exception cases, we will free up our minds to think up (and share) more interesting and innovative new tricks to become Rich.

          • Dark Sector October 21, 2011, 10:38 pm

            Suppose you were smart and saved all your money smartly and lived smartly and enjoyed each smart weekend after smart weekend on a wicker chair in the middle of the street with a great draught of drink with MMM and you suddenly developed an highly expensive form of cancer that quickly exhausted your frugal out of pocket maximum and then your lifetime insurance policy maximum and your are left bereft in a most vicious torrent of medical bills.

            In that case you have to think about data backups. My philosophy about backing up company data is that if both the on-site and off-site back ups fail, then it is highly likely that your problems will not be limited to data loss alone. It is probable that there is an external causation that destroys both of your backups. It is nearly fruitless to fret about redundancy when redundancy becomes redundant.

            In particular, if your health insurance strategy fails when you need your insurance most, then you’re probably dealing with health issues that will be life changing. It certainly does not justify the unfairness of health insurance in this country, but it does help to put things into a broader life perspective. It is unfair for such a thing to happen, but it also helps to remember that no amount of smart leisure can completely ameliorate chance misfortune. One cannot divest himself of his humanity by his genius.

            • Melatron May 2, 2014, 11:16 am

              That was truly beautiful. I’m not even kidding. Incomprehensible, but beautiful. Good work.

  • Jan in MN September 21, 2011, 7:29 am

    “I will not be visiting that blog again because that young man SWEARS!!”…

    Ok, admittedly the F-word is a dash jarring at times (particularly in the morning sans coffee), but this is not a placid blog, and we’ve all been adequately alerted to the spicy commentary.
    I like the writing – keep up the good work.

    • rjack September 21, 2011, 10:30 am

      Why the hell can’t you stop swearing? :)

  • Kevin M September 21, 2011, 7:58 am

    Agree, MMM – last year my family switched from terrible employer coverage costing $800 (because it provided for co-pays and drugs) to a high-deductible/HSA compatible plan that was half the cost. We banked the other half tax-free in our HSA and within a year we had our “high deductible” of $5,000 saved. (It is sad that $5,000 is considered “high” for health costs.) Yes, we are young but options are out there. Instead of looking for them, people look for the lowest out of pocket on co-pays and drug costs, even though they are paying through the nose in monthly premiums.

  • Heidi September 21, 2011, 8:11 am

    Well, that was a gem of an article. I felt my health improving as I laughed and laughed at the turns of phrase.

    Reality–some of us do have health issues that are chronic or require numerous care over the short-term-say, 2-5 years. So, maybe this person or family cannot have it all now. Maybe some type of job is best for a few years. That’s one solution.

    But, I still don’t see how complaining will help that situation better than creative problem-solving. And I don’t see how fear of that possibility is a good factor in decision-making.

    It seems like there is an idea that floats around a blog like this one that if the advice given doesn’t fit an individual reader’s exact situation, it must be false. That doesn’t seem logical to me.

  • Rebecca September 21, 2011, 8:32 am

    Meh… both yours and Jacob’s articles kinda rub me the wrong way.

    I’m 29, and I keep a very healthy lifestyle (lotsa veggies, lift heavy things, etc, etc), but that doesn’t stop some of my health issues. I have: a genetic predisposition to skin cancer, clinical depression, a history of abnormal pap smears, and I’d like to keep my teeth for the rest of my life. So, I go to the dermatologist and gynecologist once a year, my dentist twice a year, and my psychologist a few times a year, and regularly need to supplement all that with some pills and procedures. None of these conditions would be improved by lifting heavier things or eating more veggies, many of them are fairly common, and all of them can get pretty damned expensive if things aren’t exactly perfect.

    So on the one hand, I agree with you, when crunching the numbers, paying for a few out-of-pocket doctor visits will more than likely keep the annual cost lower than paying for over-the-top insurance, and I’m not going to let medical fear keep me from moving towards self employment.

    But on the other hand, to me it comes across as privileged when people like you and Jacob insist that every single health issue can be solved by a healthy lifestyle. You may have been lucky, and that’s wonderful for you, but that’s really what it is: luck. Plenty of 100% healthy people come down with annoying and expensive health problems every day, that’s just a sad fact of life.

    • MMM September 21, 2011, 9:17 am

      You’ll get no argument on those points from me, Rebecca. If you read carefully, I’m not saying that “every single health issue can be solved by a healthy lifestyle”. The point of this article is just to say that:

      a) If you’re lucky enough to get to early-retirement age with no health issues so far, the odds are excellent that you will save money with a catastrophic-only health plan, especially if you improve those odds by taking care of the controllable aspects of your own health.


      b) these health plans do not cost $2,000 per month plus an additional $5,000 out-of-pocket every year.

      These points don’t seem all that controversial to me.

      I certainly feel for people that do already have chronic conditions in themselves, their spouses, their kids, their friends, whatever. There are people close to me with these same situations. This article has nothing to do with those situations. For those folks, keeping a job which offers full coverage is a great idea.

      • Maus September 21, 2011, 2:52 pm

        I’m right there with @Rebecca. Your post would be less disingenuous if you edited it to state in the body of the post (say in the paragraph about the assumptions your quotes were based on, including the fictional child) that it applies only to those WITHOUT pre-existing conditions.

        The reality is that most people with pre-existing conditions either cannot purchase individual policies; or, if they live in a guaranteed issue state, may have to pay extremely high premiums (e.g., in CA approximately $600 a month for a single, 50 y.o. male).

        Plus, I was under the impression you were a Canadian, eh? Those hosers may not get free Molson, but they do have single-payer health insurance courtesy of the government. Maybe the U.S. is going to be a bit better off for those with pre-existing conditions if Obamacare actually gets implimented in 2014.

        End of rant… BTW, I do actually enjoy your blog, so don’t take this criticism as the product of a scoffer.

        • MMM September 21, 2011, 6:42 pm

          OK, Fine, I added “No Preexisting Conditions”, as if that had to be said. Normally I would assume that you would assume NO pre-existing conditions unless otherwise stated!

          Many of the benefits of the Obama plan are already in effect, as I noted in another comment further down in this stream – see here for some of it: http://www.healthcare.gov/law/features/

          You are right, we are originally from Canada, but have now become US citizens. I definitely miss the Canadian system, it kicks the ASS of the current US system – despite the fact that everyone is covered and never has to think about health insurance, it still costs drastically less per patient.

          Anyone who questions the superiority of that system, and tries to prevent a similar one from being adopted in the US, has been duped, plain and simple!

          • Rebecca September 21, 2011, 9:30 pm

            Soooo much in agreement about the US healthcare situation, especially about people being duped (alas…) Ah well, as you said, we’re already enjoying some benefits from the new healthcare plan, I hope we’ll keep going down that path!

      • OWHL July 20, 2012, 8:12 am

        In New York I can only find High Deductible Health Insurance for the Self-Employed. So I lose out in that department.

  • Geek September 21, 2011, 9:11 am

    You are very lucky to be so healthy.
    I have had asthma and seasonal allergies, and a slightly crooked back since my pre-teen years. (The last is possibly from over-one-shoulder backpacks).

    I take ladypills of warding (not cheap) for pain and warding purposes, as well as an inhaler.

    DH was born with club feet and they had to be cut off and reattached – his chance of not being able to walk at some point is very real.

    HOWEVER.. I still think we’d be hard pressed to pay more than 600/mo out of pocket and 100k in other expenses over the lifetime.
    And there’s always starbucks ;)

  • Naomi September 21, 2011, 9:20 am

    My husband and I have such a plan, with a $10,000 deductible (we are both self-employed). Our premium was just raised by 17% to $183 per month. The money we save on monthly premiums is reserved to pay the deductible. So yes, it is possible to get inexpensive health insurance.

    But, BUT, what we didn’t expect was how difficult it was to qualify. Neither of us has ever been in the hospital. No high blood pressure, no high cholesterol, no obesity. I go to the doctor MAYBE once a year for a wellness exam; my husband never goes.

    On the underwriting questionnaire, I disclosed absolutely everything, no matter how minor. My eye infection. My UTI. And, my breast cyst. A cyst is a fluid-filled sac. It is not pre-cancerous. They come and go quite regularly in women in their 30s and 40s. But my doctor recommended a mammogram for it, and I got one which proved it was just a cyst. Not cancer. Not pre-cancer. But because of this, I was almost denied insurance entirely. It took 6 MONTHS for them to finally approve my application after obtaining all of my medical records.

    Now I’m afraid that if we move out of state, I may not be able to find insurance again. And that’s ridiculous.

    BTW, I fucking LOVE the swearing. I’m tired of blogs who try not to offend anyone.

    • anonymous June 22, 2012, 9:07 am

      I’d like to second this. The actual price of insurance falls somewhere between the high extreme that prompted MMM to write this article and the low extreme that MMM found on an insurance website but did not discuss applying for and attempting to obtain. :)

      • James December 27, 2014, 9:56 am

        I just had my individual plan (self employed) jacked up to $945/mo from $465/mo a year ago. I’m furious. Plan has higher deductible and less coverage. This Obamacare thing is simply a wealth transfer and new tax.

  • Early Retirement Extreme September 21, 2011, 9:41 am

    I agree with everything said. Health insurance costs has to be complaint #1 from my US readers (people in other countries don’t worry about this stuff). Complaint #2 is “but if you want to have children they costs a $250,000 each to put through travel soccer and violin class waaah waahh waaah” … at which point I can just point them to you.

    Now 50-75% of all health conditions are self-inflicted: too much work (stress and high blood pressure), too much food (obesity), too much sugar (diabetes), too much tobacco (cancer). Most of the cost is spent on heroic measures keeping some geriatric alive in intensive care for the last 6 months of his life. The way the US health care systems prioritizes is just weird, but it makes sense if people believe that any problem can be fixed with a prescription medicine, that being 5’10” and weighing 190 pounds is “average”, and old people have all the money.

    If you’re healthy and you manage to avoid spending the last months of your life at age 80 hooked up to machines, you will cost very little.

    The problem is that this leaves the 25-50% with chronic diseases holding the bag. I have no chronic diseases but I’d much rather my insurance money go to cover those who were just born unlucky than the self-inflicted health issues that compromise the majority of the problems.

    The US health care system in its current implementation is a disgrace. It costs twice as much per patient as the second most expensive country and US life expectancy is nothing to brag about.

    So, those with chronic conditions who have researched all options including moving to a country that treats its people better (morally and technically) have a point. Everybody else, not so much. $0 copay makes no sense. What if you had a $0 copay car insurance that covered changing of motor oil, new tires, maybe even gasoline refills,l etc. That’d be pretty expensive too then, especially considering how those other morons are driving. A high deductible makes sense for anyone who’s worth six-figures or more. Mine is $4500. So suppose I get a disease that’s serious enough to eat my deductible on a consistent basis year after year. I’d likely die before I run out. I got enough assets to last several decades and so does anyone who has saved a lot of money.

  • Mr. Frugal Toque September 21, 2011, 9:44 am

    Ten years between doctor visits really is the minimum if you work with construction equipment.

    Unless, of course, your DIY attitude extends to creating your own tetanus vaccines.

    I have little else to contribute to this discussion, since I live in Canada where we make everyone pay “insurance” to the gov’t. I suppose I should look into prescription drug coverage for when I retire early. Our gov’t doesn’t cover that until we turn 65 or something like that.

    Also, please continue to swear. It makes the blog stand out like a sailor on spree visiting one of those society parties where no one says what they mean.

  • Kathy P. September 21, 2011, 10:55 am

    It ain’t that cheap everywhere. NY is one of the very few states where you cannot be turned down because of a pre-existing condition, nor can you be charged “more” because you have one. So insurance options are very, very limited and not all that cheap. There are state plans like “Healthy NY” for small businesses and working individuals with no employer health coverage. To qualify under Healthy NY, as a sole proprietor of a business (with a family), monthly gross income for a family of four cannot exceed $4657 per month. Sounds okay until you look up the premiums, which range from $755 – $871 per month for a HDHP. Then there’s an additional $512 per month if you want to contribute the maximum to the HSA. So that’s $1400 more a less to be set aside from the family’s budget every month.

    There are a couple other state subsidized health care programs for individuals and families whose income is too high to qualify for Medicaid. The income limits for these are much lower than for Healthy NY and for all of them you have to re-qualify each year so they can see that you’re not exceeding the income limits. The NY Bridge Plan is cheap ($362/month) but you have to go without insurance for 6 months, and you have to have a pre-existing condition that’s on their list. There’s no dependent coverage either.

    If you don’t qualify for any of those, you’re on their own. They have to purchase private insurance, and as far as I could determine, there are no HDHP’s offered outside of the state plans. Premiums start at around $1200 for individuals and go up from there. I’d guess that premiums for a family of 4 would approach $2000/month.

    So in my situation, I have no choice but to work until at least 55 when I would qualify for a continuation of my employer’s insurance at $300/ month. For those lucky few in the middle class who are in perfect health and have never had to deal with any pre-existing condition, even one as minor as acne, yep, I’m sure cheap insurance is available. For everyone else, insurance is most likely to be a major limiting factor in retiring early.

    • MMM September 21, 2011, 9:15 pm

      Hi Kathy.. are you sure about the poor availability in New York State? I just looked up some using a 40-year-old female in a zip code near Syracuse, NY and got this:
      Healthy NY HDHP HMO (For Self-Employed Only)
      AM Best Rating: B Plan Type: HMO Deductible $1,200 Coinsurance 0% Office Visit $20 Copay after deductible


      • Katie September 22, 2011, 9:21 am

        Well, she did say she had a family. Premiums near syracuse for a family of 4 appear to be in the range of $650-1500/month. The $650 plan is very basic, covering only medical, no prescription meds, dental, chiropractic, mental health, etc. Not to mention the cute little disclaimer at the end stating that actual premiums vary and are set at the discretion of the insurance company. Sure, these websites offer you low-premium insurance rates to pull you in, but I don’t trust them not to come up with some reason that you don’t qualify for the advertised premium and charge you several times that when it comes down to it.

        I like your blog, but once again your post is coming off quite the opposite of humble, and it irks me (and clearly many others). You’ve made it work so far, but it’s a long road to the finish line. I would be much more forgiving of your tone if you were, say, 75, living the good life, kids through college and set in their own careers, etc… I guess I’ll just have to keep reading for the next 30 years ;)

        • MMM September 22, 2011, 9:59 am

          Ahh, Katie. My favorite naysayer :-).. Sure, you are welcome to speculate on the miscalculations and potential downfall of Mr. Money Mustache from afar. Just don’t miss out on your own fun while you are worrying about mine. And if you’re hoping for a more neutral and less confident ‘tone’, you might check out the Mr. Modest Mullet blog. If you review the URL displayed on your browser, you will see this is MR. MONEY MUSTACHE!!!!

          • Katie September 22, 2011, 10:20 am

            Wow, comments on only three posts and I’ve already been promoted to “favorite naysayer”? I’m honored!

            Don’t get me wrong, I am certainly not hoping for your downfall. I’m also not looking for a non-confident tone. Just advocating for a little less of an over-confident one, as they tend to lead towards downfall. I am, however, a scientist, so I do tend to lean a little more towards the requirement of proof than your average person (or reader). Not that that’s a bad thing, of course.

            No lack of fun in my life at the moment! You may have noticed my commenting absence over the last week – just returned from my own little family vacation, on the extreme cheap, of course – MMM would be proud!

      • Kathy P. September 22, 2011, 9:51 am

        I used the example of a family of four because you did. Didn’t want to be comparing apples to oranges. For an individual to be covered under Healthy NY, the gross income limit is $2269/mo and the premiums for an HDHP w/ drug coverage vary depending on the company from $275.74 – $310.95 plus $254.17 per month to fully fund the HSA. One thing I’ve noticed from both you and Jacob is that you tend to think that HSA set-aside doesn’t really count because it goes into a savings or investment account. But if your gross is limited, and the $3050 is considered part of your gross before it gets put into the HSA then that’s really another chunk of your income that’s off limits except for medical expenses. If you have no medical expenses that year, it’s not like you can go ahead and buy food with it. (Well, I guess you can, but you’ll pay taxes – and a penalty, I believe – if you do.) So from your $2269 monthly gross, subtract around $550 per month for health care, and since it’s your gross taxes have to come out of that too. It would actually be cheaper to skip the HDHP and just go for the regular coverage, which ranges $340.83 – $383.75 (with drug coverage).

        And If I’m not mistaken, one of the ideas behind early retirement is to be able to pick up casual income when and if you please…seems to me you’d have to watch that pretty carefully all year to make sure you don’t exceed the limit. If you earn to much, you lose your coverage.

      • OWHL July 20, 2012, 8:23 am

        What if you are in that same situation but not Self-Employed with no employer insurance?

  • Stashette September 21, 2011, 11:12 am

    Doctor’s visits every 10 years? I don’t think that’s such a good idea, even in a healthy individual such as you. You’re still fairly young, but you’re entering an age when most doctors would want to at least check your cholesterol and blood pressure every few years, and maybe schedule you for cancer screenings depending on family history.

    I have a high deductible plan, too, and they can be a great deal for keeping costs down and tax-free savings while you’re young and healthy. My plan offers free a free physical and free vaccines (but not free birth control-grr), so I usually have very little out of pocket costs. Just make sure that you can afford to pay the total annual out-of-pocket cost in case of illness or injury, not just the deductable.

    • MMM September 21, 2011, 9:04 pm

      I was somewhat joking about the 10-year doctor interval: that has been accurate for my life so far, but I was indeed planning to up the frequency one of these years.

      I do test blood pressure and cholesterol at home already (you can buy all the necessary equipment for less than the price of a single doctor visit, and I am pleased to note that both results are off the charts on the “warning! you are too healthy!” side), I also did study family history cancer screening methods and what-to-watch-for guides. There is no cancer history in my family that I know of.

      Learning a bit more about basic medicine and ways to detect health problems in advance is both fun and useful.

      • TOM September 22, 2011, 12:23 pm

        pssh if the doctor wanted to see you more often, maybe they should make an effort, right? My dentist wants to see me every six months, the doctor gives me a funny look when I said “it’s been 6 years since my last physical, I just thought I was due.”

  • Val September 21, 2011, 11:16 am

    Your last health insurance article left a bug in my head and I started thinking of ways to lower my family’s health costs.
    We have high-deductible private health insurance (not through an employer). The premium for my husband and I is quite reasonable, but since my daughter has a pre-existing condition, we pay 3X the premium for someone her age. Yes, 3 times as much. And yes, it is legal for them to do that.
    Where we live there is a state program that offers free or very low cost health insurance for non-medicaid elligible children up to a certain income level. We do not qualify (thank God!). However, with the bug in my head, I did some research and it turns out they can insure children regardless of income level as private customers, paying full premium amount. This premium is higher than those of most private health plans, but much lower than the premium I have to pay for my daughter with our current insurance. And it has better benefits! I will now save $150 per month towards my ‘stash!
    Just wanted to let you know that this blog is really helping people think differently. Please keep more articles coming… and definitely keep the swearing!

    • MMM September 22, 2011, 10:14 am

      Thanks Val! Isn’t it remarkable how going out and working the system as you have just done, is so much more profitable than whining to Mr. Money Mustache that he is too optimistic about life? I love your story!

  • Storm September 21, 2011, 2:26 pm

    Hi, I was the poster of the original comment on the Gyroscopic Investing forum that you quoted. I appreciate your response, but I was talking about non-catastrophic coverage.

    Catastrophic coverage is the type of coverage that employers like Walmart offer to their part time workers so that they can claim they have “health insurance,” when in reality it doesn’t cover much. Most catastrophic coverage has an extremely small lifetime maximum. You didn’t mention the lifetime maximum of those policies. Insurance with a $10K deductible and $100K lifetime max should just be called throwing your money away. REAL health insurance as in one with a reasonable out of pocket max of $2K-5K, $3-5 million lifetime max, and $20-30 copay (not 20%) is going to run you at least $1500-2000 for a family of 4, depending on which state you live in.

    You will be denied if you have any pre-existing conditions.

    As one of the other comments astutely observed, catastrophic coverage is not adequate if you acquire a chronic condition.

    Here is how it works:

    1. You’re a healthy young lad trucking along and doing everything right. You retired early and live a happy life with no worries. You have catastrophic coverage with an out of pocket max. of $10K
    2. You turn 50 and find out you might have the beginnings of heart disease. Your doctor prescribes statins to lower your cholesterol, and other prescription drugs.
    3. Your monthly pharmacy bill is now $400-500 and you have to pay 100% out of pocket because you haven’t hit your deductible yet. I hope you planned on an extra $5000-6000 annual expense because you just got one.
    4. You spend another $10K or so annual expenses on office visits and maintenance for your chronic condition.
    4. At this point, you decide maybe you need a real insurance policy, and not one that just covers “catastrophic” needs. You apply for insurance and are DENIED due to a pre-existing condition.

    This is how healthcare really works in this country. I have an older in-law that is on Lipitor and he still pays about $286 a month for his prescriptions, even after being covered by a very generous city employee pension medical plan.

    I don’t disrespect your idea of retiring early, but you need to think about what you will do before you turn 65 and your government health insurance kicks in.

    • MMM September 21, 2011, 6:24 pm

      Storm! Thanks for stopping by :-)

      I’ve got some good news for you – thanks to the Affordable Care Act passed by the Obama government,
      “lifetime limits on most benefits are prohibited in any health plan or insurance policy issued or renewed on or after September 23, 2010.”

      You are right, a plan with any limit under a million bucks would have been useless, since the main reason I want a plan is to avoid losing a million bucks to an unexpected illness.

      The new health care law is also drastically improving the picture for those with pre-existing conditions:

      As for your “here’s how it works” list.. you are right, it IS possible to still drain all your savings away with a chronic condition that pops up if you are using catastrophic-only insurance. But you’re still better off taking that risk if you are currently healthy, and just saving the extra premium money in additional investments. I always choose the odds that are weighted in my favor, rather than against me.

      And all of this works best for early retirees who, like me, have a large SAFETY margin in their retirement calculations. I saved too much, and budgeted for a high level of spending, and assumed no work. I can reduce spending or start earning money again if Lady Luck ever decides she doesn’t like me.

      • Kathy P. September 21, 2011, 6:59 pm

        Assuming the Affordable Care Act isn’t repealed by the Tea Baggers.

        • gold666 November 3, 2012, 9:33 am

          That wont be easy. The Gop has to mop up on Tuesday to pull that off. The longer it stays on the books, the harder it will be to get rid of.

    • Stashette September 22, 2011, 8:56 am

      I agree that our healthcare system ties you to a job, especially if you have chronic or pre-existing conditions. Whenever I hear an American say they are glad they don’t live somewhere like Canada, UK, or Europe where they have *gasp* “socialized medicine” I want to shake some sense into them.

      I would recommend that your fictional character, as well as your real in-law look into cheaper medication. Why is he paying for brand name Lipitor when generic simvastatin (another statin) is so cheap? I am amazed by the number of people that take expensive meds when such cheap ones are available for as low as $4 a month. There are some very expensive meds without alternatives (and simvastatin isn’t as potent as Lipitor and has more drug interactions), but most people could make the switch without a problem.

      I would recommend any person struggling to afford prescriptions to talk to both your pharmacist and doctor for suggestions. Also needymeds.org is a great resource for discount cards.

  • Chris September 21, 2011, 4:14 pm

    Interesting article and very thought provoking. I guess I’m kinda lucky, I don’t have any major pre-existing health conditions and I’ve had free (sort of) medical/dental/eye care for the last 13 years through the military. I get a thorough physical once a year, no copays for visits or prescriptions when I need them and hopefully, just maybe, when i retire in 7 years, I’ll have VA benefits for the rest of my life. One of the perks of drudging around the world for Uncle Sugar. I must admit, I feel a little for folks that have to pay out of pocket, however, prevention is the best medicine and if life has been less than fair to us, that just means we have to use our wits to find an appropriate solution!

    BTW-I rarely trust anyone who doesn’t at least swear a little!:)

  • rosarugosa September 21, 2011, 5:44 pm

    Count me in as another fan of the colorful language!

  • m741 September 21, 2011, 8:30 pm

    I suspect some fuckers just want another goddamn excuse to keep living the same way they always have…

    • Wilhelm September 22, 2011, 11:17 am


      Agreed! The notion of personal responsibility has completely left modern society. So if I have a chronic condition then “game over, I’m destined to live a life of poverty unless the government, aka: my neighbors, direct deposit their paychecks to me”. I can’t imagine life without hope. Sure it will make the process more challenging, BUT one can’t discount the advice given by MMM.

      For those readers that missed the point of the article, I shall summarize: “Challenge each and every one of your expense’s. Regarding healthcare expense, FIRST, you stay as healthy as God or nature or Budda would allow you to stay. SECOND, critically challenge and right-size your insurance coverage to maximize your budget/cash flow”. It’s just that simple. If you’re reading more into it than that, please do some self-reflection and realize that you are a ‘contrarian’.

      And just to throw my 2-cents in on chronic conditions, I’ve seen firsthand that someone with a nuerological chronic condition can significantly reduce their out-of-pocket cost of the condition by focusing on healthy diet, regular exercise, and reduction of stress. The cost can’t reach zero, BUT you can minimize it if you focus on it.

      (m741, I’m insanely jealous of your avatar)

      • Mr. Frugal Toque September 22, 2011, 12:43 pm

        Not to minimize the fine points you’ve made, but I don’t think individuals in our modern society are any less responsible than people of decades past.

        The trick in the old days was that there were giant corporations that took care of the pensions and savings of the workers. Meanwhile, credit card companies and banks wouldn’t loan people too much. Normal people couldn’t get credit cards and a lot of establishments wouldn’t take them.

        I think if you gave credit cards with limits around 1 year’s salary to 1950s people and let them take out crazy mortgages, they’d have been just as irresponsible in using those financial instruments as people are today.

        • Marcia @Frugal Healthy Simple September 22, 2011, 1:31 pm

          I guess it depends on who you are and how far back you are going.

          My father died at 82 a few years ago. He never had a pension or savings from any company he worked for. My grandfather and uncles all fell into the same category.

          It’s true that credit card companies wouldn’t loan much money. I think my father died without ever having a CC, and he borrowed money once – to buy his house.

          Now, he didn’t retire wealthy by any means. But he was still living in his own house and managed to save up about $50,000 in savings in the 20 years he lived AFTER retiring, while he was living on social security and casual income. His social security payments were less than $500 a month. I think he and MMM might be related.

      • MMM September 22, 2011, 3:33 pm


        That was an excellent summary, its Supreme Mustachianism caused a hurricane that blew the naysayers way off into the bushes.

        You may want to give yourself a badass avatar as well – just do some fiddling around at Gravatar.com. You could even pick a superhero or wild animal of your choice by poking around on images.google.com, then Photoshop it as needed. I notice there is also a giant selection of avatars around if you just search for “avatars”. http://www.google.com/search?q=avatars&hl=en&client=firefox-a&hs=Osr&rls=org.mozilla:en-US:official&prmd=imvns&tbm=isch&tbo=u&source=univ&sa=X&ei=b6l7Tt2LEszYiAKV0fmlBw&ved=0CHoQsAQ&biw=1086&bih=899

        • Geek September 23, 2011, 11:12 am

          I hadn’t updated in a year or more. Thanks for the gravatar reminder.

          • Geek September 23, 2011, 11:12 am

            And yet…where is it…

  • Dancedancekj September 22, 2011, 12:53 pm

    I would like to add that dental problems, for the most part, are a completely preventable disease. This is really one place where most people can save themselves a lot of money if they just take care of their teeth. Of course there are a few rare circumstances that require extensive work (trauma from car accidents, sports, or work, orthodontics, rare genetic disorders) but for the average person who takes care of their teeth, the cost should be very minimal.
    That being said, I wouldn’t recommend going beyond a couple years of skipping the dentist. The main reason for cleanings is the fact that no matter how well you brush, there is usually a bit of calculus somewhere that you can’t remove, and the dentist or dental hygienist has to remove for you to prevent dental disease.

  • Chris September 22, 2011, 7:04 pm

    Love the MMM. Go gen X’ers! Fuck, fuck fuck! ha. Come on people. There’s so much of this crap I face everyday while advising people on finances, but no one seems to get it and they DO cry. Come on people. I did my version of MMM with mediocre earnings over 10 years. I never had a full time job and so can you!

    Might be time to face the reality that there are some people who do and win and others who don’t and complain. The system isn’t broken, how you use it is! Wake up people!

  • poorplayer September 22, 2011, 10:16 pm

    The last time I went to the doctors for a check-up, the kid who was taking my vitals and getting the lowdown on my medical history clearly seemed puzzled when I listed not a single chronic malady nor a prescription drug I was on. With awe in his face, he said (with a straight face), “You’re the oldest person I know who isn’t on some kind of drug.” That’s how I keep my health costs down. Admittedly I am not yet retired (because I do like my job a lot), so I have my medical coverage. But in the last 10 years at least of doing my taxes I cannot take the medical deduction because I don’t have enough medical expenses to make the cut. I did have one medical episode that cost inthe neighborhood of $17K (of which I paid maybe $300) but hey, that’s the price of a new car. People pay those off in 4-5 years. Staying healthy as you possibly can is the smartest thing to do, I believe.
    And don’t be foolish like my brother who died of colon cancer at 54 because he “hated going to the doctor.” Were it not for the fact that he was a Navy vet and went to the VA for all his health needs (who were great with him to the end) that foolish attitude would have bankrupted his entire family. Prevention at all costs is the best route.

  • Momof4 September 23, 2011, 4:28 am

    When my husband was laid off in March our COBRA payment was $2000/month in MA. When he started working again, self-employed, we became eligible to enroll in a health insurance plan. Here in MA, where we did not qualify for the low income plan, the lowest we could come up with (HDHP/HSA) was $1200/month for our family of 6! Health insurance in this country is criminal….I come from a country with *gasp* socialized medicine also, and it is incomprehensible to me that people suffer from medical bankruptcies in this country.

  • blah September 25, 2011, 1:51 pm

    I have the goal of one day being financially independent, I mean that in the, I could retire early if I have to or want to and my family and I would be set for life.
    I was one of those who was born with medical issues, lots of them. DH and I have worked hard to put the $$ we earned to good use, but the health care question is one I have never heard anyone with health issues write about and know there has to be a reasonable solution to overcome it. I just don’t know what it is. I hate to say it, but when reading ERE or MMM I get the idea that the plans are only useful until you get sick and then you might have to work again. I could be wrong and please correct me if I am wrong. I want to come up with a plan that would allow us to have good health coverage independent of a job because if we retire early it will likely be because we are too ill to work. So, we are saving and planning same way as anyone else who wants to retire extremely early. The only difference is that it is because we know one day sooner than 65 health may force us to do so.
    Has anyone figured out the healthcare game who is totally messed up physically who also is actively saving for FI or ERE? If so, some reasonable, practical and real world down to earth suggestions would be great. We didn’t cause the medical problems we have and so nothing we can easily do to improve them either, unfortunately and managing some of them costs alot on the medical expenses side of things. Right now, I have, by the Grace of God, a wonderful health insurance plan through my job for us. Lord willing, that will be able to continue for a long time, but I am not so foolish to feel invincable with all that is going on medically either.

  • C W October 12, 2011, 4:26 pm

    Isn’t it coincidentally convenient that, should your health start to deteriorate (as you grow older or otherwise), you can always move back to Canada to enjoy the free public healthcare? It’s not an option available to everyone, but I would definitely consider that if I were in your shoes.

  • Morgan October 12, 2011, 4:33 pm

    What is the point in even getting health insurance to protect your life savings if your life savings is not significant already?

    I would rather go without insurance than pay $1,000-$2,000 per month to protect my measly $30,000 nest egg from having to be raided in a major medical disaster. Take the money and save it or add it to your kids college funds. Don’t waste it on insurance.

    If you are one of the very few people who are in a terrible accident, or you hit an IED on the way to Wal-Mart, just be happy you are alive.

  • blah October 24, 2011, 11:16 pm

    @Morgan You are working under the false assumption that the more likely catastrophic medical issues would be cared for if you didn’t have insurance. In some places, if you don’t get health insurance and come down with cancer, you can’t get treatment either. Also, 30k is not enough to cover but one minor procedure in the medical world if you don’t have insurance.

  • Diane December 22, 2011, 5:41 am

    I’m just catching up on the older entries, as I’ve only recently learned of your existence. I don’t generally cuss and probably have more differences from you, MMM, than similarities. But, your outlook has changed my life. I devour this blog every day. You’re like the little angel and devil sitting on my shoulder when I’m faced with a situation (both of which are sporting mustaches, btw). Me: “I have an extra 80 bucks this week, maybe we should hit the slots!” MMM angel/devil: “Are you f*cking out of your mind?” Now, I’m a reasonably sound person, but I am having these little conversations on a regular basis and love it. I also have new words in my vocabulary that have my husband raising an eyebrow…sukka, badassity, to name a few. Rock on, MMM.

  • Partwaythere January 9, 2012, 9:02 am

    IMPORTANT UPDATE. Many people believe the Health Care Reform Act won’t go into effect til 2014. This is not completely true. It is now possible, if you have a pre-existing condition and have been denied Health Insurance, to get it. Go to http://www.healthcare.gov to start the process. I believe I have literally saved the lives of two of my friends by directing them to this website. They obtained insurance and had surgery within one month of starting the process.

    NOTE: If you are working, have health insurance AND a pre-existing condition you sadly do not qualify and will be forced to work til 2014 when the remainder of the HCRA goes into effect. And you BETTER be working hard to make sure the Pary-With-The-Kill-Equal-Health-Inusrance-Agenda doesn’t get in before that. You know who they are.

    On a general note – MMM does have a bit of a superior attitude but it is very tolerable and all of us, no matter the circumstances, can most likely do better than we are with money. I am a very recent devotee via the MSN article and my husband is getting a little jealous of hearing about this MMM guy – but I assure him MMM is way too young for me :) Personally, I love the swearing. Just the right amount at only the right times.

  • Charlie January 18, 2012, 6:40 am

    As some others have mentioned, not every State has good plans. On eHealth Insurance, for my family of five that includes three year old triplets, there was one plan available in New York State and it costs $1541 a month…and there was some blurbage about that not even covering doctor’s visits.

    So no, I can’t early retire till we get some socialized medicine in the US or I move my kids away to another state.

  • Allie February 25, 2012, 9:46 pm

    I’m late to the commenting game but I just did the ehealthinsurance test for me and my son … if we lived in MMM’s state, coverage for the two of us would run between 200-300, but in Massachusetts the lowest high-deductible plan is $700/month. When I try to think about how I could like on $30K/year, the lack of employer-sponsored healthcare is always the sticking point.

    • Mr. Money Mustache February 26, 2012, 10:22 am

      Wow, I find it really interesting that the rates vary so much from one state to another – thanks for sharing that information. Definitely yet another thing to consider when deciding exactly where to live in this great and diverse country of ours. Although I read an analysis that suggesting that the insurance exchanges coming in 2014 should help to improve costs in the future.

      I once turned down a job offer in MA due to the housing prices and property taxes, but now I see the health insurance would be another issue. With the right salary, any location can be made to work, but for those of us with non-infinite money, it is wise to choose carefully.

      I would probably have picked the San Francisco area as my first choice for living when I first moved to the US, based solely on climate, geography, and culture. But the job offer I got there only paid $10,000/year more than the job offer here in Colorado, which was not nearly enough to pay for the difference in taxes, housing, etc. So here we are!

  • bogart March 19, 2012, 11:08 am

    Out of curiosity, do the plans you priced include maternity coverage for Mrs. MM, and if not, have the two of you agreed that this is something you are not going to need in the future and/or are willing to forego in the short-term future?

  • MZ May 2, 2012, 6:52 am

    Can you write about what people with pre-existing conditions should do? My husband has Chron’s disease and his treatments cost $10,000 every 6 weeks. Sometimes our insurance “forgets” to pay the bill and we get charged anyway and then we have to call them and argue until they pay the bill. To go without health insurance would be terrible for us. He would have to switch to the next cheapest medication and we’d go back to being in the emergency room/week long hospital stays once every few months.

    • Pat March 2, 2013, 5:29 am

      MZ – I know I am a year late posting this, sorry, I just found it.
      Has your husband played around with his diet? “Wheat Belly” is out now, and the author points out that the new strains of wheat can be very damaging to the digestive tract. It is not just the gluten. I had serious GERD (heavy meds), and some gout. When I went low-carb and wheat-free, basicallly grain free, my GERD went away, my gout went away, some other niggling little problems went away, and my triglycerides went way down (this is good). I spend more on food, but nothing on junk food, I enjoy my food a lot more because it tastes so good and is satisfying, and my total cost is down because I am not paying for any meds. I am 63, no prescription drugs, my only health issue right now is a strained back muscle from strippng wallpaper and shovelling snow.

  • Kimberly V January 14, 2013, 11:48 am

    I have been researching health insurance lately as I have been existing without for the last year (with Pre-existing conditions) and my daughter has been on Medi-cal (medicaid for California). My income of late has risen to a level where I’m pretty sure I will no longer qualify for free medical coverage for her, so I’m looking to see what is out there.
    I like the concept of having an HSA as it would be usable on the twice yearly dentist visits I pay for out of pocket as well as the shortcomings (compared to the employer sponsored plans I grew up on) of the plan I choose. BUT I’m noticing that the HSA qualified plans actually cost a little more monthly than some of the other plans!
    There is one Health net plan on Ehealthinsurance that says for my the two of us (assuming I’d be accepted of course) it would be about $184/mo. Well visits are covered, the first two dr visits are $40 then there is a $7000 deductible with an oop max of $1300 for the year. There is a drug copay on this one and a seperate deductible for Brand name drugs. After reaching your deductible you pay 50% for pretty much everything.
    BUT the HSA plan I’m looking at for Health Net would be about $196/mo. The deductible is higher ($9000), but also equal to the oop max. So, after reaching your deductible you spend NOTHING for the rest of the year. Periodic health exam is still completely covered, but no break on other appointments until you’ve spend your deductible. There is not a separate deductible for drugs on this plan.
    So, I’m wondering, what would MMM do? Would you a little less monthly, have a couple of inexpensive dr visits at your disposal during the year and a handy built in discount on possible drug needs, but know that if something catastrophic happens you will still foot 50% of the bill after your deductible. Or would you go for paying a little more per month, pay full price for everything during the year, enjoy being allowed to put money in an HSA to cover those expenses and rest easy knowing that if something catastrophic happens there is a hard line of how much you will have to pay during the year?

  • NC June 18, 2013, 10:25 am

    As others have noted, the price that is quoted on eHealthinsurance or via any other agent is “subject to underwriting.” I’m relatively healthy and I’ve found that my premiums are 30-40% higher than quoted after “underwriting.”

    It would be helpful if insurers disclosed the actual cost, after underwriting, before you sign up for a policy.

  • Prairie Practicality January 22, 2014, 4:57 pm

    As a retiree, with high net worth, why not move to Canada? Immigration laws allow people with loads of money (i.e. Mustachians) to fast track it to get Canadian Citizenship.

    I understand liking your current city, lifestyle etc. However it is an option available to any American who’s achieved FI. Don’t forget to renounce Uncle Sam on the way out, otherwise IRS will still look for you :)

  • NYCMiniBee March 29, 2014, 10:33 am

    This has definitely been on my mind. Have you checked what it’s like at different ages? I ran a search across different fictional ages for a family of four and then for a couple in their late 40’s early 50’s right before medicare kicks in, and the price is $700-800+ for a high deductible plan. That doesn’t include the average deductible you will be paying out because honestly your body is older and will probably need more help despite doing your best to stay active and healthy. This is the place I think most retirement plans fall down. I’d estimate an average year would required 4k or deductible payments. That plus the 800 per month deductible that I found on the exchange (for a couple who doesn’t qualify for subsidies) would equate to $13,600 a year of healthcare expenses.

  • Amy K April 25, 2014, 7:02 am

    CNN had an article about the impact of Obamacare on employment, people feeling free to leave their jobs once it’s in full effect:


    “In February, the Congressional Budget Office estimated that because of health reform, workers will put in 1.5% to 2% fewer hours between 2017 and 2024, the equivalent of about 2 million jobs. That’s not to say that companies will push employees out. That cut is almost entirely from people choosing to work less.”

  • Aretina Rittenhouse June 20, 2014, 1:11 pm

    MMM, please do a follow up on US health insurance now that Obama care is in full swing and the low premiums that we had hoped for don’t appear to be all that affordable. Not to mention, the conflicting information on different sites. Some policies listed on e-surance as a available for my zip code then reveal to not be offered when I get to the carrier website. I’m working the numbers to see if its possible to leave full time work for a couple years while my toddler is at home (no daycare expense so I can’t quantify the savings that way) but the health coverage my work offers is holding me back. I don’t even need insurance- hubs and I are veterans and get VA coverage. It’s the two perfectly healthy yet completely vulnerable little ones I need coverage for- I need some perspective. If it doesn’t make sense now to walk away from employer coverage I’m thinking it won’t make sense in 15 years when I’d be FI but still have kids under age 26.

    • Richie Poor July 11, 2014, 9:59 am


      You did not pose the question to me but I would like to encourage you to not be afraid to ditch the job. I predict there is a 100% chance that your children would greatly benefit from having you during their formative years but there is only a miniscule chance your children would have outrageous medical bills unless they are already showing signs of being pre-disposed to illness.

      The same applies in 15 years. Unless the children are already chronically ill, when they are young adults they will be in the healthiest demographic that exists, especially since their parents are so healthy. Insure them with an inexpensive, high deductible plan. The odds are hugely in your favor. Don’t fall prey to the notion that you can never retire because something unforeseen might happen. It likely won’t, but if it does you adapt your situation.

  • Frugal in Cbus July 10, 2014, 10:31 am

    Just a bit to add here on pre-existing conditions before Obamacare. My husband started his own company 10 years ago and is full-time self-employed. I am an adjunct professor with no employer-paid health care. I always had assumed that “pre-existing conditions” meant serious health concerns like cancer or heart-disease. But my hubby at age 43 was considered “uninsurable” by 5 companies because of two pre-existing conditions: a hemorrhoidectomy he had at age 39, with no recurrence, and sleep apnea which is easily solved by the use of a CPAP machine when he sleeps.

    He even BEGGED an insurance company to allow us to pay out of pocket for the CPAP supplies (it requires about $200 in disposable supplies every year) to take that OFF the pre-existing list and they refused.

    We were completely HOSED for him until Obamacare passed. Thank you, Obama and supporters, for the “no pre-existing conditions” piece of the law.

  • Phil September 22, 2014, 7:27 am

    MMM – What inflation rate do you use for healthcare costs in estimating future spending? I went to a fee-only financial planner that seemed to have pretty good judgment. In our planning meeting she “showed me” how healthcare costs for me and my wife would eventually be $100k due to the 6% inflation her software used. I told my wife that this is like assuming the complete and utter break-down of civilized society, or an asteroid hitting. It’s so extreme there is no way to plan for it.

    AARP has a calculator that, based on the ages and health conditions for me and my wife, comes out about half of the estimate our financial planner was using.

    What assumptions do you use to estimate future health costs – especially after age 65?

    • Mr. Money Mustache September 22, 2014, 1:04 pm

      This may seem a bit strange, but I don’t estimate future spending at all. We just add up spending at the end of the year and make sure it’s in line with our goals. Since we operate with considerable surplus and safety margin, there is no need to make detailed predictions.

      Medical spending of course cannot increase at 6% indefinitely, as this implies it would soon consume our entire national income – because GDP grows at less than 6%.

      In theory, costs should actually drop as free knowledge of how to be healthy proliferates and technology and free markets allow supply to flow efficiently to demand. In reality, there is too much bullshit in the system for this to work immediately, but in the very long term bullshit tends to get shoveled away. For example, direct care physicians are already popping up, a much better system for people who have to pay their own bills.

      So my strategy is: maximize health, minimize medical spending, and if the shit were to ever hit the fan in this country, move to a country with a more reasonable medical system.

  • sheepgetlambs October 10, 2014, 11:51 am

    Health insurance just generally irritates me. We lived in Sweden for a couple years early in our marriage. DH has a degenerative condition in his hands and feet. Surgery on one hand in Sweden – went fine. Yes, he waited for months to have the surgery but was in no pain and could easily do his job so no reason to cut in line for the operating room. The follow-up care was not so great. His finger still doesn’t straighten all the way, but he’s without pain and his hand is usable. Cost to us = $0. Surgery on the other hand was back in the US with a specialist. Lots and lots and lots of therapy following surgery. Fingers straighten almost 100%. No pain. Cost to us = $whatever our out of pocket was that year (it’s been awhile).
    Our second child was hospitalized for 11 days when he was a few weeks old. Two surgeries at a major children’s hospital. Most awful, frightening experience of our lives. I still don’t remember it clearly. Insurance covered everything, DH’s job said, “Don’t worry about the time off. Take the time you need, take care of your son. We’ll cover your accounts and clients.” Couldn’t possibly work with/for better people during such hell. Had we NOT had great insurance we’d still be paying the bills. And it would be worth it, even if we both had to work full time until death. These were things we could not plan for. Our son ended up growing into a perfectly healthy, normal little boy who is enjoying life and bringing us untold joy. We are so thankful for that. It pisses me off that other parents in the same boat, who don’t have great health insurance, have to face financial ruin while facing the possibility of losing their child. It was, bar none, the most horrible experience of our lives. The only good thing about it is it redoubled our conviction that time with our family is way more important than just about anything else in our lives.
    Not totally relevant to the discussion, perhaps, but wanting to add a voice from those who take care of ourselves and still have extremely high health costs. (I’ve had gallbladder and appendix removal surgeries. Child #1 had adenoid removal – the largest the surgeon had ever seen.) We are not far from our FIRE number, but health care costs will likely mean DH will stick with his job for years to come. Frustrating. However, we recently decided than since ER doesn’t look likely, we’ll use the money over the FIRE number to buy a little lake place to spend summers in. Not quite ER, but close, and we’ll get lots of time with the kids, which is the main goal.

    • Matt July 12, 2016, 3:52 pm

      Those last two sentences made me sit up and take notice of my own position: as a school teacher chasing the dream of early retirement, I suddenly realized that I probably qualify as 1/2 to 3/4 retired already! I have summers off, plus almost three weeks at Christmas. We have fall break, spring break, and a shiz-load of other holidays here and there. I technically only work 180 days a year, and never on weekends. That’s not so bad at all! If I choose, I can sleep until 7:30 and be to work by 8:15, and leave by 4 pm. But not having to go to work at all for a “job” would be even better, lol. I love teaching kids, but it can really age a person, dealing with all the district beauracratic b.s.

  • Anon December 8, 2014, 8:16 pm

    “If you’re a lean and highly active person who leads a low-stress life and eats healthy foods, the odds are nicely in your favor that you will coast gracefully well into your 60s before you have any sort of medical issues. And even then, you’ve still got reasonable odds at being one of those wiry old people who continues to live and achieve, until you sit down on your rocking chair at the end of a day of work on your 100th birthday, and just expire.

    Even though I’ve got 63 years of work left in my own mission here, I’m kind of looking forward to reaching that rocking chair, just because it shows you’ve done everything else all right.”

    That’s beautiful. Saved.

  • Tim Daniels March 29, 2015, 8:14 am

    Dear MMM,
    Your Canadian heritage 8s shining through in your perspective on health insurance. The question is not whether a single payer system is preferable (its high costs and innovation-stifling lack of profit-motive lead me to oppose the idea). It’s a question of whether a government should be able to force its citizens to buy anything . The American experiment is founded on the principle that individual liberty trumps all. It allows me to be as big an idiot as I choose.
    I appreciate your blog, and your number crunching, and I know that it wasn’t the point of this post, but here’s one vote that will cancel out yours so that “nothing gets done.” I don’t want to become Canada or Europe.

    • Mr. Money Mustache March 31, 2015, 7:53 pm

      Totally agree with you on the joys of American liberty, Tim!

      But I’d suggest we use science and data alongside our ideology: Canada spends only half of what we do per capita, despite the fact that everyone gets covered and you are free for LIFE from worry. This suggests to me that we should look at their system and see if we can figure out why it works better than ours.

      If we can match or beat their costs via a non-government option, I’m all for it. I’d be the first customer at the Wal-mart surgery center if it existed and I ever needed their services.

  • Money Saving April 20, 2015, 6:23 am

    The wife and I are nearing FI soon. She has a pre-existing heart condition, so I am thinking plan costs may not be pretty. I knew that you discussed health insurance, and I found this old article on the search. It is refreshing to hear that health insurance plans are nowhere near as expensive as we would first assume for the high deductible option. Now that we have the affordable care act and our income may drop quite a bit once we “retire”, I will try eHealthInsurance to see just what we’d pay. Thanks for the optimistic view!!!

  • Nathanael September 23, 2015, 1:40 am

    ” I do NOT mean to make light of the chronic and/or genetically predetermined medical conditions that affect a certain percentage of people through no fault of their own. Some people simply need much more medical care than others, and for them the planning will of course be different.”

    Thanks for this. Even after Obamacare (which helped some), medical is still easily the largest single cost for my family, which has a completely outrageous collection of chronic illnesses. I’m still independently wealthy, thanks to a starting inheritance, no debt, better-than-the-market investing, sharp tax planning, and conservative expenditures on everything else… but damn are expenses high for medical-related stuff. Much of which still isn’t covered by insurance. It pisses me off. Especially since I *can’t* work full time, so I don’t really have the employer-insurance option even if I wanted it…

    “Immigration laws allow people with loads of money (i.e. Mustachians) to fast track it to get Canadian Citizenship. ”
    Nope. Believe me, I’ve checked through all these immigration rules. Canada’s a very very hard one to get into if you’re young and retired, unless you have a record of owning your own business. New Zealand doesn’t have *any* rich person admission method, though they used to (I missed the window).

    You can still get into the UK just by having loads of money, but you have to put 1 million pounds (about $1.6 million dollars) in UK assets *and have it remain at 1 million pounds every year for 10 years*, which means you have to put it in ultraconservative investments — this means, to make sure they don’t kick you out, you need that $1.6 million *in addition to* the money you’re currently living off of for that 10 years. Which is quite an extra hurdle.

    Australia’s “rich person” entrance method requires that you operated or owned a business (large investment in a single business), or (worse) requires you to get standalone health insurance. Worse yet, Australian national health care is being slowly but surely sabotaged, increasing the out-of-pocket for sick people. It does have lower required net wealth for immigration than the UK, though.

    France’s immigration method is beyond weird and isn’t like any other country I’ve ever seen. Germany really doesn’t want any immigrants at all. The Scandanavian countries demand very high language fluency in their weird, obscure languages as the price of admission. Most of the other countries, I simply haven’t been able to develop enough language proficiency to read the websites…

    Believe me, I looked. If I manage to double my portfolio despite the health expenses bleeding me, I’ll probably move to the UK. If I manage to do a successful venture capital operation in the US for a few years, that would also qualify me under the “business owner” provisions in many countries which are much more lenient…

  • Michael December 22, 2015, 8:01 pm

    Were your prices above offset by gov’t subsidies? I’d be interested to see you redo your scenarios 4 years later now that ACA has skyrocketed the plan prices. Just went to ehealth… and our family of 4 (53, 48, 18, 9 – all non smokers) would pay a minimum of $1250/mo through Anthem BCBS. We are actually still paying nearly that for the BCBS HSA plan through my wife’s employer.

  • Hermione February 27, 2016, 2:28 pm

    If you’re blessed with good health and access to affordable health insurance and healthcare, my sincere congratulations. But don’t imagine for a moment that kale and daily biking make you bulletproof, or that because your perfectly healthy child hasn’t been diagnosed with a chronic condition, they won’t be next week. (“I’ve been alive every day since I was born, so I must be immortal.”) It is arrogant to assume “waah waah”-ing from people bemoaning healthcare and health insurance costs and availability are simply too dim to run a Google search. Even if Obama Care was a panacea for health insurance access, there is a small army who have dedicated themselves to ending it.
    (BTW you’re awesome, MMM. Forget the haters who can’t handle swearing. They are missing out on gems like “clusterfuck” to describe bankruptcy as a side effect of chemotherapy.)

  • Jeff Jones March 27, 2016, 10:05 am

    I would really love to see an update of this article 5 years later, post-Obamacare. Not sure what area you got your quotes in, but in my area (98065), for my wife, myself and an 11-year old, the best possible price was $677/mo, with $4500 deductible per person and 20% co-pay. For my brother in Indiana, he pays over 25% of his take home pay to get the lowest cost plan he can for his family of four – and if anything bad happens, he’d have to pay over 55% of his take home pay before insurance would pay a dime. Next year, he will be choosing the tax penalty because health insurance is draining them too much for very little benefit.

  • Nakia April 13, 2016, 11:46 am

    It’s not exactly “retirement” but only working 20 hours a week at a fairly low stress job can offer healthcare benefits. If all your other financial ducks are in a row, it’s plenty of money and still lots of free time.

  • Erica November 20, 2016, 9:54 pm

    Maybe not in every state, but in my state for extreme illness or sudden very large medical expenses residents can receive supplemental insurance from Medicaid even if they have insurance from work or private. This is mostly used when someone is undergoing chemotherapy treatment or when a very serious medical event occurs.

    My brother was run over earlier this year by an RV. Between the medivac, his trauma surgeries, the many many weeks in ICU, the months in rehab and ongoing surgeries he has needed even with his insurance his portion of payment was close to a million dollars. He had a good job and insurance and this still left him in a seemingly horrible financial state.

    Even my super amazing insurance has certain limits, and although we don’t have universal health care what we do have isn’t so broken that it can’t assist for the crazy extremes. Luckily, the person who was responsible for the accident had great liability coverage and his policy paid my brother’s bills in full.

    We can’t really prepare ourselves for being hit by an RV. But we can be healthy, happy and fulfilled. We can do what we need to do to prepare for more common ailments.

    And if having employee provided insurance is the most important thing, then work part-time at a place that has good benefits and keep your relative flexibility.


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