Most things do change over time, but I don’t think the US will go to a single payer system - the insurance industry is against it and I believe most consumers will be against it. People in countries with a bit of socialized medicine or one payer often have an option to pay a bit more for more choices - for example, in Switzerland, you can pay more to the hospital and have the same MD (continuity of care) – my aunt and uncle did that as they believed they were getting better care (and most likely they did) – everyone pays in for their health care/one payer system.
Pharmaceutical companies make their money off of people in countries like the US - and US consumers jump on the latest drugs (all the pharmaceutical ads on TV).
People on Medicaid in the US get better care than people in most countries; some of it is also patient education.
Do we need to factor in more on retirement? I don’t think DH and I will need to (we are both 68), and we have a DD/grandkids who will make sure we get good health care/get attended to well - at some future time I believe we will be living very close to them. Helping with Gkids and later them possibly helping us or coordinating our care with our $$.
We are using some of our money to help DDs – with getting into their own home when that is time for it. Help financially in small ways now.
My 93 year old mother, who is still living on her own, has just decided of her own volition to move into an independent living situation.
$7k/month for now, she has about $3000/mo in pensions and SS income, and about $700k in assets. There’s pretty much no chance she will outlive her money.
She decided on her own to give up driving, too. She is doing everything she can to make our lives easier.
I have to, once again, thank the cc community for alerting me as to how Medicare doesn’t work with co-pay assistance and how infusions are covered but injections aren’t. I had my annual rheumatology appointment today and was able to ask her all kinds of questions and get some great info about how it all works here. Cc FTW!
FYI, the ccrc place that I’ve been writing about says that their average stay is 12-13 years, but you can start out in independent living so not the same thing as a nursing home (though they do have a skilled nursing care unit as well as memory care). The woman with whom we’ve been speaking said that independent living has people from 63 to 103 and that some people still go to work every day.
I agree with whoever said above that one reason people don’t last more than a couple of years in AL is because often people go in later than they should. Right now, many neighbors are caring for a woman whose dh died a few months ago at home. They were struggling together and without him she’s really in bad shape. Physically OK but mentally misses a lot and she doesn’t drive and is really reliant on the kindness of everyone here to get by day to day. We are trying to get her to sell the house and move into a facility. My next-door neighbor was mowing her lawn when she passed out from what turned out to be dehydration. The EMTs gave her an IV and she was able to stay home. No children and an overbearing sister who lives about 45 minutes a way and is kind of abusive toward her. It’s really a sad situation.
I found information from the manufacturer of Evenity & Prolia that says that these drugs, if administered in an office setting, are covered under Part B (it may differ for Advantage plans, which can require other drugs be tried before authorization of these meds - with just Part B or Part B + Supplement, no authorization is needed). Medical Benefit for Prolia® (denosumab). As with everything, of course, you need to check with your physician to verify.
I am horrified by how much our health insurance premiums are going up next year, for pre-age 65 retirees. Our union negotiated a terrible deal with the company over 30 years ago, and they never renegotiated it, so the company contribution is based upon insurance rates from 1996 (or 1993, I forget).
Since the premiums are jumping, we’re switching to a very inclusive policy that will cost us $1500/month each. I think all of our health care/dental costs will end up costing us around 50K next year. Enough so we can likely itemize our taxes.
I’m thinking about how we can deal with this. Does anyone here write off their health care expenses/premiums due to having a small business? We do have a forestry property and could do a harvest, though it might not be next year. I’d just never considered declaring that as an expense, though we m as age the forest ourselves and do all the work. I don’t want to run afoul of the IRS, but if it’s legal and ethical, next year could be the year to do this.
Yes, I deliberately set up my consulting company as a C Corp to maximize healthcare deductions. With an S Corp or unincorporated business you can deduct premiums plus HSA contributions but as a C Corp you can reimburse all healthcare expenses. However, a C Corp is a bad idea if you don’t have regular income in the company, because it files taxes separately from your regular income taxes (you have to carry forward losses not deduct them on your tax return). For intermittent income then an S Corp (LLC) is probably better. But if you didn’t set this up when you bought the property it might be trickier now.
Yes, my wife was self employed as a RE agent, straight Schedule C, no corporations of any type involved.
Our ACA premiums were fully expensable, but only up to the net income shown on schedule C IIRC. If the premiums exceed the net income, the balance is deductible on schedule A if you can itemize. I don’t remember if ACA premiums are subject to the 7.5% limit like other medical expenses when itemizing.
No, we didn’t set anything up when we bought the property. But it sounds like we would do what @notrichenough suggested, file a schedule C, looks like we don’t even have to have a sole proprietorship. However, it looks like you can only deduct health care costs in that form up to what you get as a profit. So it might be a good year next year to do a timber harvest (at least a partial one), and potentially deduct all the health care expenses from the profits.
Then again, I might try to get qualified as a real estate professional and look at purchasing some rental property (but do we want to do that again). Too many options in retirement sometimes! Though, inertia is a powerful force.
RE Professional status requires that you spend at least 750 hours/year in real estate related activities, and there’s a bunch of other requirements as well. An average of 15 hours per week is going to be difficult to achieve with just a plot of land and maybe some rentals.
Wouldn’t harvesting timber be a schedule F activity? No idea if health insurance premiums can offset that income.
Schedule F lets you deduct insurance other than health, so I’m guessing it’s not deductible.
I would have no problem getting 15 hours a week of work on our plot of land, actually. 33 acres of trees, many ready to harvest. We have already spent a ton of time there, it has been much of what we’ve done in retirement. If you count tractor work, making trails, thinning, planting, classes, writing a forestry management plan, so much time spent there, and if we did a harvest we would be crazy busy.
But I don’t think I’d make the effort to classify myself as a real estate professional if it’s not financially worth it.
Not sure if the idea would still work…. but I did hear of a real estate agent who took two CU courses every semester, partly to qualify for the student healthcare deal.
Current example… about $5k/year. I have no idea how good the coverage is.
It would work especially well for somebody who was already considering taking some courses. (Hmm… it could be really affordable if available for community college courses.) Maybe somebody here will have some more recent feedback.
I wonder how good the coverage is, could have a very high deductible and copay. I know it was pretty basic when my son was in graduate school at Auburn. Worked for a young kid but not so much for us old folks.
That is an interesting thought! I’m way too chicken to ditch my health care plan (I’d never get it back), but for people looking for health care, that seems like a very useful option. Even if one can’t use another degree, they could always find something on campus that is intriguing.
LOL - I’m far from young but been doing the very high deductible plan for years, even now with the retiree plan (but yikes, over $800/month). Would be a bad idea for many older adults, including my husband. But fine for me for now… as long as I have annual option to change and a max out of pocket.
What would be a show stopper for me would be if it required use of the campus clinic/doctors.
RE professional status is primarily beneficial if you have rental income, as it allows you to convert passive income into non-passive income if you meet the material participation requirements. This allows you to deduct losses and avoid the 3.8% investment income tax surcharge.
Timber harvesting definitely does not seem like a passive activity.
Definitely not passive, unless maybe you’re just going to let the trees continue to grow and not manage the timber.
Figuring out retirement issues and taxes is a lot more complicated than during the working years. When we were working, we knew the more we worked, we were going to get slammed by taxes. We just assumed that we would pay the max, with little that we could do about it.
Now in retirement, it’s a scramble to figure out how to lower our taxes. We have a DST that is giving us income, taxed at whatever our personal tax rate is. Consideration of purchasing another rental property (which would definitely be a monthly loss, but we could deduct the DST income from it). Trying to figure out how to do a timber harvest and wondering if becoming a real estate professional would allow us to deduct health care costs. I’m trying to figure out if there’s a way to wrap this up all together. Or maybe it’s just futile. I realize we need to talk to an accountant, but it is good to know whether these things are even options.
Enough so we can likely itemize our taxes.