18 Options for Healthcare in Early Retirement with Lynn Frair

Scott: Welcome to the BiggerPockets money podcast show number 94 with Lynn Frair from fihealthcare.com.

Lynn: It’s a different type of way to look at healthcare. I don’t want to make a decision for people about what they should or shouldn’t do. What I want is to make this information available so that they can figure this out.

Scott: It’s time for a new American dream, one that doesn’t involve working in a cubicle for 40 years barely scraping by. Whether you’re looking to get your financial house in order, invest the money you already have, or discover new paths for wealth creation, you’re in the right place. This show is for anyone who has money or wants more. This is the BiggerPockets money podcast.

Scott: What’s good everybody? I’m Scott Trench, and I’m here with my co-host, Mindy Jensen. How are you doing, J Mindy?

Mindy: Scott, I am doing fantastic. I am so excited to talk to Lynn because she is going to help us understand the number one question that everybody has about financial independence, and that’s health care. What do you do for your health care costs when your employer isn’t paying?

Scott: Yeah. It’s a big problem. She has a big vision and this is a… We’ve heard from a number of people who, about what they’re doing from healthcare like Bryce and Christie who are doing that kind of medical tourism search. Well, this episode you can think of it as, we’re going to have a quick intro from her soon, and we are going to go through a lot of different options. To give you some upfront caveat, a lot of this is probably… For many people you really going to be left with basically two choices if you want to stay in the United States and not pay for healthcare and you retired [inaudible 00:01:32] rich. That’s going to be HealthCare.gov and look for plans or check out this concept called Health Share Ministries, which has some drawbacks, which we’ll get into in the episode.
The value I think in this episode is that, that me, maybe another third of you, will fit in one of these buckets that she describes. The other is maybe 15, 18 different other options that you’ve got around solving your health-care problem that are very specific like military, self-insurance, which apply in various and different situations. I don’t want to get into the list right now because she describes it much better than we can, but just going with that mentality and then go out and support fihealthcare.com. It’s a prelaunch site that she’s starting up to solve this problem and make all of the alternatives, crowd source, all the alternatives for healthcare solutions to the FI community. Then most importantly, go out and become FI, then start a business or a nonprofit or whatever that actually solves the health-care problem in this country because that’s what we’re in this for. I’m solving health-care by helping you become financially independent so that you can solve healthcare.

Lynn: I would say if you know Warren Buffet or the… What’s the Chase guy? I always mispronounce his name, Jamie, is it Dimon?

Scott: Yeah, it could be Jamie Dimon. I thought he was another bank, but maybe I’m wrong here.

Mindy: No, he’s Chase or he was Chase the last time.

Scott: Chairman and CEO of JP Morgan Chase.

Mindy: Okay, and is it Jeff Bezos or Bayzos? Either way, if you know any of them, have them call me because I would like to know what’s going on with their plan. I know I have referred to Warren Buffet as my best friend, but honesty makes me tell you that he’s actually never heard of me before.

Scott: I have nothing further to add.

Mindy: Scott, before we jump into today’s show, Scott, we have a new segment that we’re going to start. It is called the question of the week and every show that we have releases on Monday, unless it’s a bonus episode. We are going to be asking a question related to the topic of the show. This week we’re talking about health care. The question of the week is, what are you doing for health care? Now on Friday, on our YouTube channel, we will be releasing the answers. We’ll be sharing what other people are doing for health care.
If what you’re doing is the ACA, that’s great. We still want to hear from you because that just tells us that’s a viable option for a lot of people. If you’re using a health share ministry, share which one you’re using and just let us know what you’re doing for health care. Self-insuring whatever your options are, something that we’ve never even named in this episode. That would be really fantastic. Send me a note, [email protected] or [email protected]. Both of those email addresses come to me and let me know what you are doing for health care. Okay, Scott, are you ready for today’s show?

Scott: I’m ready. Let’s do it.

Mindy: Okay, well let’s hear a note from today’s show sponsor.
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Mindy: Okay, huge thanks to today’s show sponsor, Lynn Frair from fihealthcare.com. Welcome to the BiggerPockets Money Podcast. I am super excited to have you today because you are going to solve all of our listeners’ problems in one short hour. Are you ready? Go.

Lynn: Okay, well that’s a lot to live up to, but I am very excited about talking about health care options in early retirement and the things that I’m working on with that.

Mindy: Yeah, you are an expert in the different healthcare options. When we were talking, Celine and I hung out at FinCon, and she was telling me how she compiled a list. How many different health care options did you come up with for people who are not within the traditional career retire, a career path, where you work your 40 hours and get your options and from your company?

Lynn: So far, right now I have a list of 23. If you include the basic database from the government, that’s one of 23 options that I found. I don’t know that I am an expert except I’m a tremendous student of what the options are and I have been compiling this from a hundred different resources. Many, many people who are heavy in the FI movement because this is a big problem I wanted to solve in leaving my traditional employment. Once people found out I had all this information, they wanted me to share it. That’s what my goal is.

Scott: Yeah, love it. This, by the way is super valuable and it’s baffling to me that there’s not more of a solution that already exists for this problem because this doesn’t affect the [justy 00:07:43] the people who are financially independent and looking for healthcare insurance, this affects everybody who’s going to be an entrepreneur. It affects everybody who’s self employed. It affects people who just generally aren’t working and don’t have a healthcare plan. I don’t understand how millions of people are affected by this problem and there still doesn’t seem to be a good database of good solutions. I think the work you’re doing is awesome and very much needed here.

Lynn: Thank you, Scott. I don’t understand why it doesn’t exist, but I’m very determined to find out and I feel this is a problem that we have a solution for. The information exists out there. We just need to aggregate it into a place where it’s useful for people. That’s my goal with the site.

Scott: Great. Well, why don’t you tell us a little bit about your story first while we… and kind of how you came to discover financial independence and learn about it and become an expert here.

Lynn: Sure. I began investing when I was 12 years old. I started with my babysitting money. I walked down to the bank and I… well actually went to a woman in business conference and I stood up and I said, “I’ve got age on my side. What would you do if you were my age?” They recommend, start investing.

Mindy: Wow. Oh, Whoa, Whoa, Whoa, Whoa, you were 12?

Lynn: Yeah, yeah.

Mindy: How did you even know what investing is?

Lynn: I had won a national scholarship where they gave me savings bonds. They bought with a certain amount and I, with a limited amount and then in the future it would be worth twice as much. The concept of having something now that in the future would become something more later was something that solidified I think at that time. I’ve always been somebody… They’ve called me an old soul since I was probably eight or seven. I was putting on SPF so I wouldn’t get wrinkles and I’ve always sort of thought about the future. That’s how I started.
I went down to the bank, they said, “You’re too young,” properly sent me home to get my dad. I started with front loaded mutual funds. I can’t… who sells that, but my dad didn’t know he was working a lot. He’s wonderful, but this wasn’t his thing. I learned and was self taught in investing, went through college, became a nurse, still quietly investing, talking to people. Nobody else was investing their babysitting money, but I wish I was trying to talk to them about it, but most people weren’t interested. Then I went about, we were doing really well. I got married and then I found out I had a brain tumor. By this point I had become a nurse. I was an ICU nurse and I had to have that removed. I was starting to have trouble with balance and such and hearing. I went to have that removed and had to learn how to walk again. Actually, I’m darn stubborn. Mindy, I think I have a little like you, no offense, but when people tell me something can’t be done, I just, I-

Mindy: Watch me.

Lynn: Exactly. I think I’m rebellious. I’m like, “Well, just because it hasn’t been, doesn’t mean it shouldn’t be.” I went back as an ICU nurse. I was safe to be released. I would never do anything that would compromise any patients, but I did quickly realize that was going to be very difficult because by this point I was now deaf in my left ear and walking was a concerted effort. Finding my place and space in dark rooms with bells where I didn’t know where the ringing would come from, was difficult. I transitioned over to home care and then hospice to my great surprise. I loved looking at people, quality of life and I’m very much into quality of life. I think the combination of my brain tumor and… Oh, with the brain tumor, I lost all those investments I had started when I was 12. I didn’t tell you that because of medical bills and navigating that.
Rebuilt from there, in my late ’20s starting with the net worth again, I’m zero. Then at the age of 37, moved down to part time and told people, “No, my husband’s not working more, he’s actually working less.” Somebody compared me to Mr. Money Mustache. I googled who he was because I had never read blogs or knew about Reddit or anything, I didn’t have cable. I decided to go to Camp Mustache to figure out who this guy was. I met him and I thought, “Oh my gosh, this is what I’ve been doing.” I immediately fell in love with the group of folks who prioritize time freedom over things, and which we call financial independence. But the biggest barrier was figuring out health care and from navigating it, from the inside as a patient and from navigating it as a person who worked in multiple levels within health care, from floor nurse to high level leadership. I started pulling the information together, waiting for somebody else to come up with a solution and I couldn’t find it. Here I am.

Scott: That’s an incredible story and congratulations on overcoming so many barriers here and we’re not the other side with a lot of that stuff. How would you kind of begin explaining the process of, I’m thinking about retiring, I’m thinking about becoming financially independent. How do I go about beginning the process of researching health care options?

Lynn: We’re developing the site. The site is going to be… is called fihealthcare.com, which stands for financialindependencehealthcare.com. Right now it is up, people can sign up to be notified once it actually goes live, which will be pretty shortly. That might be a good place to start. One of the most common, there is one of the government sites that’s just one of these several options that I’ve found. The individual marketplace, the ACA, they call it. They have many aggregators and you can look to see if you qualify for that.
What I also wanted was not just that which is extensive, but I also… There’s a lot of other options that could be good fit for a lot of people who are pursuing financial independence such as short term plans. There are health sharing ministries. The favorite resource that I have… I looked at over a hundred different resources and I have to give kudos to Tanja Hester who wrote Work Optional. That is the most extensive information that I found to date. I really commend her detail and her advocacy for figuring out this as well. She also struggled with figuring out what her options were. That’s also a great resource for people, I think. I’m hoping to take all this information and have people who are interested and concerned about solving this problem with me. Come join, help me edit this document. Help me keep it up to date so that it’s a really useful tool that’s actionable for the fire community and also for the entrepreneur community.

Mindy: You mentioned the ACA and that’s one of the health sharing ministries. I was going to say that that’s one of two. That’s one of three options that I know. There’s the ACA, there’s the Health Sharing Ministries and there’s the get a job and get it through your employer, which is my current plan. The R E part of fire is, retire early and not everybody has that third option. I’m really curious as to what these other… Did you say there’s 23 options that you came up with? What are the other 21?

Lynn: Yeah. I can go through them. It kind of depends on how do I want to iterate this because, some I could break up into more, but I’ll go through several of them. There’s Medicaid with, or expanded Medicaid, which is for low income individuals that are usually less than 100 to 138% of federal poverty line. If people apply for the ACA and they have a low income level, it may enroll them into Medicaid or an expanded Medicaid plan. There’s pros and definite cons to that. I’ll keep going because there’s lots of options. We talked about short term plans. Those premiums tend to be lower, they don’t have to usually comply with the ACA pre-existing condition clause, but they might have limited benefits.

Mindy: What’s an example of a short term plan?

Lynn: Some States have it, and I was talking with another person who is a blogger and they have, I can’t off the top of my head think of a company, but they usually won’t allow you to take a short term plan longer than one to three years. It’s not available in a lot of States. They can be a little bit more restrictive. They are usually about 54% ish lower than the ACA compliant plans because I think they can be picky and short term. This is Lynn’s extrapolation of the data.

Scott: In that statement, I think there’s a lot there to unpack for example, that I don’t understand, when you say short term, how do I even begin, for example, googling whether I can figure out if a state has a short term health care solution and when you say 54% of a long term plan, what does that mean? Is that cost, benefits?

Lynn: Yeah. Yeah. Right now, as far as I know, the solution is to Google. I mean, that’s why I want to make this better, is to Google. What are the short term plans for healthcare for Washington State? I don’t have a better answer than that. I haven’t found that, but if that exists, I would love to aggregate that information. What that means, and this is as far as the most recent data that I have, 54% is referring to… This is according to the Kaiser Family Foundation, the short term plans could provide coverage with fewer benefits at premiums of 54% lower than the ACA compliant plans. The bulk of the premium savings, I would guess, are because of the exclusion of people who have pre-existing conditions. You see this interesting effect where the lower plans for healthier individuals, people naturally flow to that and it causes problems with the other plans that they call it, it’s a cost escalation. I’m forgetting the term right now, but yeah, it creates these interesting effects.

Mindy: It seems-

Lynn: Those are four. Do you want me to keep going?

Mindy: Well, I want to talk about these first.

Lynn: Okay. Yeah.

Mindy: It seems that the short term plan, I am not going to have any more babies and it seems like a short term plan would probably exclude pregnancy coverage. Does it?

Lynn: I don’t know. It’ll probably depend on the plan you have. It’ll depend on the state. That’s what’s so frustrating and what’s so frustrating for me is, how do I get answers to these questions? It’s impossibly difficult to navigate. That’s why I wanted to make this. That’s why I’m going to connect with the CEO of a big company about health care transparency and he was interested. They’re interested in talking with me because I don’t know that this exists and I don’t know why it doesn’t. I don’t know, people try to shut it down. Its information that’s already out there and I think it needs to be out there. I don’t have an easy answer for you because I don’t know that an easy answer exists. But-

Mindy: It doesn’t?

Lynn: … if it does. I know.

Mindy: I know it doesn’t exist. I used to work as a temporary employee. I was a temp working in the HMO office of a giant health care building where you could go to any specialists they had was in that building and waiting through all of the information at such a young age. I’m so blessed to have had that job because I learned so much about the American health care system and I still don’t know anything about it. I know that it’s not advantageous to any of these insurance companies to provide you with a lot of transparency.

Lynn: Right.

Mindy: It doesn’t do them any good to tell you exactly how much it’s going to cost at this place and that place and that place. Tell you what your benefits are unless you wade through a bunch of legal lease and it’s really difficult to understand. I’m coming from a place, I’m not in the medical profession at all, but I’m coming from a place where I had them explain to me from the company themselves and it still doesn’t make any sense.

Lynn: Exactly. It’s crazy. I think it needs to be fixed. I think it’s a really big problem and it’s just not okay. We go to buy a car. I mean, can you imagine buying a car, taking it home, saying this is my car now and then they say, “You know what, here’s what we’ve decided your bill for that’s going to be,” and it’s a mystery bill. Here, your car, you were thinking it might be around $5,000, it’s actually going to be $54,000 because it’s out of contract. There’s nothing else that we buy that’s like this, that’s so much of a mystery.

Scott: It seems we’re about to go through a list of options. We’ve talked about ACA. We’ve talked about health share ministries, Medicaid, short term plans. If I’m FI and I’m coming to fight, probably I’ve got a large portfolio of stocks or real estate, maybe another passive or side business, side hustle type, income stream and a sizeable pile of cash with one to two years of expenses or some form of liquidity [inaudible 00:20:54]. If I’m thinking through the problem of healthcare and there’s a whole spectrum of medical conditions, right? If I’m a healthy person thinking about that, I’m thinking, I can deal… What I want is I’ve got the deductible. Is it going to really bother me quite as much? It’s important that I’m able to cover those expenses because I’m FI. I’d rather have a high deductible plan with low monthly premiums, all else considered. In approaching it from that, is that the framework that you find a lot of people approach from one and then where do you begin with that framework in mind maybe?

Lynn: Yeah, I would say it actually depends on… That’s your preference, Scott, but that’s definitely not the preference of everybody in the financial independence movement. I do think what you say though is what a lot of people feel, is that they’re willing to take on that risk of a bulk payment if needed because they’re able to fund it. Some folks, especially folks who have larger families or such, they want to even out that risk distribution, but for folks who really want a lower premiums, a lot of folks go for the health sharing ministries. I can talk about those. That’s pretty popular in the movement. Would you like, talk a little bit about the details of those and the qualifications and…?

Scott: Yeah. Let’s try approaching it from this framework of, “Hey for that type of problem, in health care ministries and maybe you have another one or two options.” We’ve another situation maybe kind of think about some of those and we’ll obviously in the show notes link to all of the options that you could be in exploring if you want to DIY yourself, listeners-

Mindy: Sure. Yeah, yeah, and before you jump into the health share ministries, I think where Scott is coming from, is a position of health. The reason I think that is because I know he’s a very healthy guy. I am also coming from a position of health, but I think it’s really important to remember that not everybody is coming from a position of health. You’ve got your chronic illnesses. That’s type 1 diabetes.

Lynn: Right.

Mindy: That’s going to be with you until the day you die. You need to account for that. Somebody wrote in a while ago and said, “Hey, my costs are $11,000 a year. How do I become financially independent?” And on my budget for the year, that’s not on there. That’s not a line item because I don’t have $11,000 of type 1 diabetes supplies that I need to provide for. If that is your medical issue, if you know whatever it is that needs to just be accounted for in your fine number, so your fine number’s going to be a little bit higher, or you need to figure out a way to do a different healthcare option. There’s part-time companies that offer health-care too, right? Doesn’t Starbucks offer?

Lynn: Yeah. I actually just heard yesterday that Starbucks is spending more on health-care than they do on coffee. So-

Mindy: Oh ,well that’s-

Lynn: … Yeah, I didn’t look that up myself so I can’t verify that, but I did hear that and it doesn’t surprise me at all. That’s why I’m like, “Why is nobody making this transparent?” Yes, I definitely think that. Health sharing ministries, it’s a good example of why this may be good for a healthier population because, what they are, they’re actually not considered insurance. What they are is, you give a donation rather than a premium. It tends to be more affordable due to the reduced administrative burden and presumably the healthier overall cohort, because they have the ability to exclude people based on pre-existing conditions. They have a healthier patient cohort. When you’re paying, you often pay your share, which you’ll know usually ahead of time.
Each company operates a little differently, but I’m giving you a general idea. They pay their share and then sometimes you pay your share directly to Bobby Joe, who’s having a baby in Illinois. Oh, speaking of babies, one of the downsides is it tends to be oriented toward the Christian faith background who lead healthy lifestyles. They do not tend to cover things like birth control or vasectomies or any things that are sinful, like people who have more than mild drinking or, there’s some downsides to that because some people would find that very judgmental and unfair, but there are upsides that the premiums are lower. It’s a different type of way to look at health-care. I don’t want to make a decision for people about what they should or shouldn’t do. What I want is to make this information available so that they can figure this out. I find a lot of people don’t even understand or know about health sharing ministries, but they can be a good option for some folks, particularly healthy, a cohort that’s healthy.

Scott: Great. Will you have a list are linked to a place where people can go and browse health care ministries on fihealthcare.com

Lynn: Yes. Yeah. All of these options that I’m aggregating right now, I hope to have lists and I actually hope for the community around me to update if they see broken links or if they find a better resource. We’re going to have the option to really… I really do want to crowdsource this, because no one person can have the best data, but the FI Community and the entrepreneur community, very, very smart, innovative, creative group of people. That’s why I want to harness everybody’s intellect to share with everybody else.

Scott: Fantastic.

Lynn: Yeah. Another option that some people realize that some people don’t, the military benefits. If you’re early on in your FI adventure, that’s something to consider is that the military offers benefits that can be achieved before a traditional retirement age at times. There’s military benefits, sometimes called Tricare. It’s generally affordable. It is limited to military and those who served usually in the armed services and ex-military. The quality of care does tend to vary, it seems based on VVA that’s in the area. One thing to consider is, timing your departure to coincide with the lifetime healthcare benefits and pension. That’s something that I like for people to know particularly earlier on, is that if you’re really considering this, it may be worth, if you’re wondering about a couple of different employment options, that’s a real benefit.

Mindy: Yeah. And te military has so many other benefits too.

Lynn: Yes.

Mindy: If that’s an option if say, if that’s something that you’re considering, I would definitely recommend looking into it a little bit more because healthcare education… What are the big costs of living? Scott’s book, Set for Life talks about how expensive it is for housing. If you join the military, no housing, no healthcare, and no transportation costs. You get schooling outside of the… After you graduate, after you separate from the military, you get your schooling paid for it. Don’t you still do that, Scott?

Scott: Well, well, yes. You attended the Academy. You obviously attended the Academy or you do like a ROTC program. You’d, I think you’d obviously get that ahead of time and can have a commitment, but yeah.

Mindy: Yeah, and clearly I’m oversimplifying all of it. The military is not a bad way to go.

Lynn: Yeah. I don’t hold myself out to be an expert of any one of these. I just, I’m more of a generalist and an aggregator of information. That’s my strength. What I’m hoping is for folks who are very well versed in the FEHB plans or the military benefits and Tricare, I mean there’s loads of blogs on military, military path to five, military dollar, folks who… This is their jam, so much, much more than me.
I would love to have their contributions if they’re interested. Another option I kind of hinted at is FEHB, Federal Employee Health Benefits. It sometimes allows federal employees to continue their health plan perhaps up to five years after ceasing employment. It’s like a unicorn. I think it’s very rare. But, if you are a federal employee that may be worth considering to see when it ceases after your termination or your exit date. A lot of these came to me, it was so great because I started aggregating it and then people would say, “How did you do this? Or “This is what I’m doing.” From here on is pretty much people coming to me saying, “Oh, let’s add this.” Medical tourism you’ve probably heard about a lot.
It’s basically going out of your general area to get a medical intervention. The costs can be very favorable because most countries in the U.S. have much more reasonable costs of health-care. The downside is that you need to travel for your care. It essentially eliminates as an option for primary care or urgent or time-sensitive means or management of chronic conditions. It can be very beneficial potentially. You got to do your research, but for elective procedures and the CDC does actually have some verbiage about what to consider with medical tourism and some cautions about that.
Just researching their pros and cons, but just to know that that could be an option for folks. None of these are… I’ll be honest, none of the these are really ideal. I want people to at least know what they are so they can pick from good and not so good and figure out what’s a good fit for them. Being on the spouse’s plan, that’s a very common… As I dug into it, I asked everybody, what are you doing for healthcare? Because they were retired and a lot of people are on their spouse’s plan who is still working. I wanted to throw that in there because if you find the job that you love and you’re financially independent, people talk about retiring early. My lens anecdotal data is that 98, 99% of people do some sort of paid work within a year of FIring because they find something that they love and it happens to generate revenue. That’s not necessarily a bad thing. Yeah. The pros and cons of that are probably pretty obvious there. Your spouse has to work-

Scott: Oh, God.

Lynn: …and they might resent you. I don’t know. Full time ex-pat living. Living outside of your country, the pros can be the overall healthcare costs. Again, most of them are quite reasonable, shockingly reasonable actually compared to what we see. The cons, you need to live in a different country that could be abroad depending on how you feel and it’s really based on the individual, the country, the coverage and cost varies all that. Just to throw that in as a possibility, there are a lot of folks who also blog about this, so I hope to link to folks who do that and have gathered.
I’m very much interested in evidence-based data and things that are going to be helpful to the community rather than having more information, having really concise helpful specific information. Another option, employer coverage after leaving employment, this actually sometimes happens, believe it or not, it’s very rare now. It used to be very common, but some employers cover your health care for a while, themselves at their cost. I call them unicorns, but they do still exist and that’s one thing to look at. A COBRA, usually people kind of grown when they think about COBRA, but I want to put that down at as an option because it could be a possibility for folks. The Cobra is the… I think its Consolidated Omnibus Reconciliation Act. Don’t quote me on that.
Basically, it’s… You’re continuing your employer based coverage after you leave and you are assuming of the cost that you are paying and the cost that they were paying for the premiums. That is usually very expensive. Plus, they sometimes… What I hear is there’s an additional administration fee on top of that, you’ll pay your side of it and their side of it and an extra fee. What I’ve read is sometimes it can be up to 15%. I’ve also seen numbers much, much lower than that. It’s expensive. The pros could be, you’re going to keep your doctor, maybe you just want it for a couple of months. It’s generally limited to 18 months after your employment. It’s costlier than other options. I want people to know that that’s a possibility.

Mindy: Yeah. I would think that something maybe you just had surgery and separated from your employment and you want to continue that follow-up care. That could be a good time to have COBRA, but like you said, it’s ridiculously expensive. Well, I said it’s ridiculously expensive. You just said it was expensive.

Lynn: Yeah. Actually.

Mindy: It’s ridiculously expensive, especially compared to what you were paying. Most employers cover… well, a lot of employers cover the bulk of the costs that you’re just paying a nominal fee. To have Cobra, when you get that first bill, you’re like, what? Yeah, if you’ve got something that you need continuing coverage on, if you’ve got some issues going on, maybe COBRA is the best option. I love that you included it.

Lynn: Yeah, yeah. It’s going to be suboptimal for most people, but for some people maybe who are moving and just need a month or two to pack up, want to keep their doctors while they’re moving to a different area. This may be a prudent plan because the time versus money aspect of it. I’m all about that. Okay, we’ll keep going. Part time job for health-care, they call it Barista FI. What I’m seeing and it totally is we’re seeing less and less of that. We’re seeing employers shying away more from providing benefits for their part time employees. We are seeing less of that. There are still companies who do that. I do think Starbucks is one of them, but there’s many that do. The pros are probably obvious.
The cons you need to work is what I put in that section. Another option that I wanted to put in there and people are actually doing this is completely self-insuring and, which means basically going without any health care. What I usually see is folks are tremendously healthy. They’ve never had any health… I’m not advocating for this, I’m not advocating for any one thing in fact. This is what I’ve seen folks do, that they are healthy. They would rather manage their costs perhaps with alternative medicine. They are into preventative care, or if something catastrophic does happen, they would still be okay. Some of those big, big catastrophic things, when there are claims that are over $100,000, the insurance companies take note of that.
Most claims are in the several thousand dollar range. When things get really big, they can be surprisingly rare, but they could wipe you out if you’re not prepared for it. It certainly have a big caution with that, but that is something folks are doing in the community. I also added Medicare, later on… We talked about Medicaid, which is a lower income. Then there is Medicare, which begins traditionally at the age of 65, it can be earlier in some cases, but we’ll just stick with that for simplicity. It is guaranteed health coverage. Well, as much as anything can be guaranteed and it doesn’t discriminate based on pre-existing conditions. The cons of that are that you have to wait until that age usually, and a lot of people don’t know this. It actually covers only about 70 to 80% of your expenses.
People are surprised to find out that they’re actually responsible for still a decent part of medical costs. It does not usually cover the full cost of prescription drugs or doctor visits. Part A covers hospitalizations. I mean I don’t know if we want to get into all that. It is good to know, when you’re planning for early financial independence, what do you do? I think Tanja does a great job in work optional of… How do you plan for before Medicare and after Medicare? Two separate buckets for health care.

Mindy: Yeah. Because, isn’t health care not really available after age 65 it’s only Medicare, is your option and there’s supplemental programs, but that’s the bulk of your main insurance?

Lynn: For most people, it will be the bulk of their main insurance. Some people will stay on. You can still get plans and some people are still working. That’s what I would see a lot is folks were still working and they still have their employer based plan. What I would see most often was after age 65 either Medicare or a private company. A lot of these other options just from being a nurse in health care. A lot of these options that I’m listing out, I didn’t see quite often, Medicare usually is the bulk, which makes sense. It’s cost effective for most people at that age range. That included, I lumped a couple of them together, but I’m also going to be adding something called DCP and some options about… There’s basically concierge doctor services that you can purchase where you have, it’s almost, you have them on a retainer and that can be good because it can cover the doctor’s visits.
The part of the problem is, it can sometimes exclude visits to the emergency room or urgent care, it can be limited. And another section that I’m going to include is about health prevention because I think that’s the underlayment of all of this, is if we can do more preventative, people less stressed, maybe they will reach financial independence earlier, their overall happier and healthier. Then, it mitigates the costs for them too, regardless of any other plans they choose, that is a good portion of what I’ve started.

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Scott: What are and this is… you’re going to say, this is a ridiculous question, but I’ll ask anyways. I don’t know even how to approach the concept of how much I’d be paying for health care from monthly basis. Is it $500 a month, is it $1,000 a month, is it 1500 per person, for the average person higher 2000 a month. Yeah.

Lynn: That’s the problem that I want the answer to because I feel like it can be out there. It’s just not very well. I do know some data, I just read, I think it was in Bloomberg that, and this is not for the financial independence community. This is for the general population, that premiums now have hit another high of $6,000 per year. That’s just the premiums for people who have health insurance. I’ve also read that for a family of four, it’s pretty customary that they’re paying out of pocket 14,000 to 17,000 of a year in healthcare.

Mindy: Okay. That was per person, the 6,000.

Lynn: That’s what I want to see. I want to look it up in Bloomberg, but what I do know is that it hit a high. I think it’s per family for this is just for the premium. This is not even counting the doctor’s visits, the deductible. I don’t know if you guys want, If I should talk about the difference between a deductible and a copay and a premium in case your audience isn’t.

Mindy: I think we should, because we’re covering all sorts of health care topics anyway and that is part of it and that’s part of the really confusing part. The deductible is super confusing. If you’re one person with your one deductible, it’s real easy, but once you add other people in, it gets all sorts of confusing and I don’t even know that I can explain it properly. I know that there’s a per person deductible and a family deductible and you have to hit two of your per person deductibles before you can max out your family. It’s so confusing.

Lynn: Oh gosh. It’s so confusing. That’s why I want to talk about the definitions. The deductible in general, the idea is that you have to pay a certain amount of money before your insurance will help you pay for anything, and they usually have individual and family deductibles. Once you reach the threshold of that, then your insurance actually starts to kick in. To find out the details of it, it varies employer to employer. It’s very frustrating I think. That’s the deductible, the amount of money you have to pay before your insurance will kick in. The premium is the monthly amount you pay to have access to the insurance. The copay is the usually flatter fee amount that you have to pay in order for an intervention, like a doctor’s visit, you might have a $20 or $30 copay. The co-insurance is usually a percentage basis. I don’t know, don’t worry too much about co-insurance, but it’s too confusing. I don’t think it should be this confusing, but I did want to mention some of those terms because it’s helpful and understanding the bigger picture.

Scott: When I’m thinking about premiums you said, for example, Cobra can be a really expensive solution, right? Versus maybe the health share ministries which might be the least affective equivalent in terms of cost if you’re fine with the terms there, what does that difference look like? Is that like a $2000 to $500 a month difference?

Lynn: Yeah.

Scott: Is it 2000 to 1700? I don’t think I can.

Lynn: Yeah. Well, what I can tell you is that when our family looked at health sharing ministries and we’re a family of four, we have no pre-existing conditions. I had a brain tumor, but luckily it was benign, completely resolved. I am left with residual deafness, but nothing that was a problem for them. Our premiums were about, I think it was 450 per month for all four of us.

Mindy: What?

Lynn: Yeah, yeah.

Mindy: Okay. I’ve been at BiggerPockets for four years before I started working here. We had our own ACA plan and it was $900 a month for our family of four. Double what you were paying for, I don’t know how good your health care service was. I had the bottom of the barrel. We’re not going to cover anything plan that I was looking for a specific doctor I wanted to be covered under and that was it. And it was just so that if one of my kids had an appendectomy, it would be covered. It was more of a catastrophic plan than an actual taking care of your plan.

Lynn: That is where I think health sharing ministries really have a leg up, is that, first of all, they don’t have a lot of administrative burden. A lot of the cost of insurance is this contracted rates and people fighting the cost and adjusting the… There’s just so much administrative burden and the health insurance, it’s really ridiculous. They have a much flatter structure. They also have the ability to say no to unhealthy, what they consider less healthy cohort. Oh, the term I wanted to say was called adverse selection. You then have the healthier people electing these less expensive plans because they qualify, and then the less healthy people are in the plans where they do qualify themselves. Then you get a decreasingly healthy cohort, which raises the premiums for those that remain. We’re seeing a phenomenon called adverse selection because of that in some ways.
But to answer your question, Scott, that’s what we found for our family of four and the one that we looked into the most was called Liberty. I hear that’s really common and a lot of people really like that. There’s also Medi-Share, but they have some deductibles. It’s really compared to most options out there. It’s really cost efficient if you can get in there and if you’re okay with their limitations, they do have some limitations. They do have religious things. The other downside that I really should mention is that people in health-care don’t understand health sharing ministries, so, you have to sort of negotiate your bill. Sometimes you have to pay up-front and then get reimbursed and fuss with that. It really would be for people who understand and can navigate the healthcare system, who can self-advocate, which was so hard when you’re not feeling well usually, which is when you need healthcare. I do want to mention that really big caveat that. That’s the big downside.

Scott: If I’m going through again through that, just to get a ballpark, I’m thinking that that might be half as much in terms of cost half as much, maybe even better than the next best alternative that is actually a healthcare insurance solution out there is good, it’s kind of what I’m bigger enough for years.

Lynn: Yeah, I would say as a broad generalization for most people, I would take a look at, what can they get from the aggregator and I’ll tell you the name of that, the ones that I like, what can get from basically the big government aggregator HealthCare.gov. You should be able to go there and it should direct you to what’s available in your area and what you qualify for based on the entry points. So, look there. Then I would also take a look at what do you qualify for health sharing ministries. Looking at those couple are really going to be a good start to looking to see what’s available for you, to see if you qualify for either or for both. A lot of those other things I listed are probably going to be for a more specific cohort, but I did want to include everything that I could find because they’re surprising to a lot of people

Scott: That was a great list and I think a lot of different options that I think some of which are going to appeal to various people. It seems like most people or maybe a plurality are going to go either towards one of the HealthCare.gov options probably or the health sharing ministries, but that one of the remaining dozen plus items that you listed people will well might work for that remaining big chunk of the population. I think it’s fantastic to be aware of all those options.

Lynn: Yeah, yeah. That’s what I do. I want folks to know. I would say the bulk of the people that those two options are going to be the best fit for a lot of the people in the community. To take a look to see if any of these other options seem appealing as well.

Mindy: Yeah, I didn’t even know that short term plans existed, that’s an interesting option. Now, one thing that I don’t know if we covered is catastrophic plans where they don’t cover like regular doctor visits, but they’ll cover if your appendix burst or something. Is that more part of self-insuring? Or is that… Did we mention that? I just didn’t hear it.

Lynn: No, no, we didn’t talk about catastrophic. The catastrophic plans, if they fall under the ACA, they tend to have higher deductibles. You have to pay a bunch and then the health insurance will kick in. You can find I think, catastrophic plans via the ACA, but I do think I want to do a separate line item for that because what can be complex is, you can find them here, but you can sometimes find them there. I would like a place for people to say who are interested in catastrophic plans to be able to link there, my ultimate hope. I hope somebody approaches me and says, “I’d love to work on that,” is to have a algorithm to say, “Have you ever worked for the federal government?” Yes. And then, it takes them down to the options that would be appropriate for them. Are you willing to absorb a $6,700 deductible if needed, and then it filters them and then shows them the… That’s my hope. Eventually, I think it’ll take a little while to get there and I need folks to come and join me in order to get that done. That’d be my hope.

Mindy: Is that what you mean by a higher deductible, $6,700?

Lynn: Yeah. I think the federal limit, the federal, if it’s one of the plans that go through the government, I think there’s a federal maximum for out-of-pocket expenses, and I think they can raise the deductible up to that point. I didn’t talk about the term out-of-pocket maximum, but that doesn’t apply to everything unless I think it’s within the affordable care act algorithm. I know this is so confusing. I’m trying to make it clearer that, it’s just crazy. I think that’s why when I reach out to folks who are very important, I’m thinking, I’m never going to hear back from them, and they respond to me and they want to meet with me. I’m like, why does, I don’t know. I don’t know why this doesn’t exist. I don’t, it shouldn’t have to be this complicated. It’s ridiculous. I’m just trying to make it clearer.

Scott: Yeah, it seems to me, and maybe, because I look at various packages for a team here at BiggerPockets, right?

Lynn: Yeah.

Scott: From my seat, it seems, how could you as an individual employee really had any insight into what good and bad looks like? You actually at the time it’s literally just like, “Oh, this company has good health care. Great, I’m going to take that at its face and then figure it out.” That leaves lack of understanding of what good, bad and different looks like on the open market for many people. Then you have to go out and figure this out when you’re going to retire and be like, “Oh, what does it, is it $4,400 a month? Is there $1,000 a month? Is it $2,000 a month to ensure my family?” That basic knowledge just doesn’t exist, which I think is the frustration that you expect.

Lynn: Yeah, and shouldn’t it exist? I mean, this group of people, this community, your BiggerPockets community, we are intelligent enough to figure this out. I really think we are. This information is available. We just need to harness it and figure out a solution. I’m the 12-year old who is like, “I’m going to start investing.” I don’t know why it doesn’t exist, but everybody I talked to wants to figure this out. They want to know how to budget. They want to know what to expect. I mean, even a ballpark and we could be so much better than where we are. That’s why I decided to not wait for somebody else to start this. Hopefully, there’s many other people out there who also have this passion, maybe they’ve started something as well. Because I can’t imagine, I’m not the only one making a database like this.

Scott: It’s the only good solution we’ve heard all of these podcasts honestly is, go live in Europe.

Mindy: I know.

Scott: That’s right? It’s like you’re tired of Europe and it’s just cheaper. The dollar is really strong. There’s free healthcare [inaudible 00:54:25].

Mindy: Scott, could I tell you my secret hope about this, my secret hope you know some from being a patient to being a nurse, to being administration. My secret hope is that, if we have more people who are financially independent, then they get to have more time freedom and joy in their life and passion. And they get to start being innovative and risk taking and help us figure out some of these solutions to these huge problems. Healthcare is tremendously inefficient. It’s embarrassing. It’s ridiculous. We have perverse incentives, it’s a problem. If we can get more people who are there, then I think we can start looking at how can we be do this better. I don’t think anybody is better than entrepreneurs and people in the fire movement to come up with creative, innovative solutions that are efficient and effective. Like, who better to do that? That’s my secret hope. Oh, he’s rude.

Scott: Mindy, that’s a very an outstanding statement. That’s exactly the point of all of this. As the big people fight, they go out and solve the world’s problems like-

Mindy: Yeah.

Scott: … retire early people and then go and start a new health care company or health insurance provider or whatever that actually works and is very transparent. People are very clear on the Southwest of healthcare.

Lynn: Yes. Oh, Southwest has tremendous benefits. Actually, I was talking with that on the way down to FinCon. I was talking, Oh, I got all those stewardesses maxing out their 401ks. They have the best matching. I think it’s like close to 10% that they match.

Mindy: I tried to get a job there. I mean a while ago not recently.

Lynn: There are these great companies and when the great companies offer these great things to their employees, they stick around because it’s happening less and less. And turnover is tremendously expensive, tremendously. There’s a ramp up period of inefficiency and there’s a ramp down period after people are starting to check out. There’s a loss of morale. If we could get people better benefits and anyway, I’ve got lots of soapboxes I’m sorry, I won’t.

Mindy: Well, here’s a platform for all your soapboxes. My best friend Warren buffet, and Jeff Bezos and the Chase guy.

Lynn: Oh yeah.

Mindy: Won’t they all get in together to solve the healthcare problem? Where’s that gone? Because I haven’t heard anything on that for a while. I should call up Warren, but…

Lynn: Yeah. No, I went to visit Warren back in May. We didn’t talk. We’re not on a first name basis, but at the Berkshire Hathaway Shareholders conference, I have been watching this. Berkshire, Chase and Amazon are teaming up to basically self-insure. They are, it’s interesting because Amazon is here in the Seattle area, it’s been interesting to watch it. I’m very curious because I do think that they have the talent to start addressing these inefficiency problems. Regardless of what you think of the companies individually, I have various opinions. What I’ve seen is there are seem to be embroiled in anticipatory lawsuits. This is Lynn’s guess. This is not anything official.
This is Lynn’s guess is, I think that’s very threatening, and I think that they are getting sued before they even present things in anticipation of that’s what it looks like to me. I think that’s going to slow their progress, and I would expect that they expected that, but they still needed and wanted to try. I’m glad they are. I think it could be a model for a lot of other. I think what we’re going to see in the future is health care such a problem that there’s going to be more and more of these workarounds. I have this list. Now, I think they’re going to blossom because it’s such a problem. We’re developing all these work arounds. As it fragments like this, it’s going to be increasingly important to have a solution, a place to find this information, to figure out what is the best for me? How much can I expect it to cost for me? We don’t have the answers to that yet and I think we should.

Scott: I love it. It sounds like go out, become financially free and by then, by the way, in five years somebody will have this list, we’ll have gone to a hundred different of these types of options, one of which will probably work perfectly for you, hopefully.

Lynn: I hope so. I’m a dreamer and I… it’s surprising when you believe in something, how often it can actually happen.

Mindy: Okay. Well, I think we’ve gotten around to the time for the famous four. Scott, what do you think?

Lynn: Excellent.

Scott: I think so.

Mindy: Okay. These are the same four questions and one demand that we ask of all of our guests.

Lynn: Yes. Oh yeah.

Mindy: Lynn. Oh, Lynn, it sounds you’re ready.

Lynn: I am ready. I have to get my, one of my, I wrote one of them down.

Mindy: Lynn, what is your favorite finance book?

Lynn: I Love Your Money or Your Life by Vicki Robin. I adore Vicki and I think that the concept about money being your energy in your life is completely true. While it may not be directly finance book, I consider that the most powerful finance book that I’ve ever read.

Mindy: Definitely good book.

Scott: What was your biggest money mistake?

Lynn: I’ve been pondering this because I knew I’d be asked this, but I really feel every decision I’ve made with money has been helpful in a certain way in the future. Not that I haven’t made perhaps mistakes that were suboptimal. Maybe I should’ve started sooner than 12, I don’t know. I really think that they have everything I’ve done that’s been difficult. You grow from it and learn from it. I have a hard time answering that question. Is that okay?

Scott: No, no, no, that’s fine. It seems you started really early and made intelligent choices, and maybe some of those didn’t work out from a results standpoint, but it seems you were comfortable with your decisions.

Lynn: Yeah, yeah. I think I am.

Scott: That’s great.

Mindy: Yeah, that’s, that’s perfect. What is your best piece of advice for people who are just starting out?

Lynn: I think for people just starting out or for people in general is to actually just be a nice person. It is really incredible. I especially I think, as I get older, how much people remember you and if you were notably kind to them, how that can come back in wonderful ways. That’s not why I tried to do that, but that has ended up happening. And it’s a very, very powerful concept for people just starting out on the journey because I think one of the biggest things you can have around you as far as your assets is a community of people around you. Yeah, I know these are really meta answers, but there, that’s kind of who I am, yeah.

Scott: I love it. All right, what is your favorite joke to tell at parties?

Lynn: Okay. I had to look it up because I am really bad at jokes. I used to try to tell them to my patients and I think they laughed because I was trying so hard, not because they were funny. Two guys are on the opposite, no. Let’s say, two girls, two guys or two girls are on the opposite ends of a riverbank and one girl says, “How did you get over to the other side?” and the other side, “You’re already there.” You get that. Did I say it wrong?

Scott: No, no that was great. It was great.

Lynn: It’s really bad. It kind of reminds me of an analogy to life.

Scott: No, I think it’s a bridge to a lot of other river jokes.

Lynn: Oh God.

Scott: Let’s never mind and find out more about you. Where can people find out more about you?

Lynn: I am a financial coach actually. I worked specifically for nurse, with nurses and you can find me there at nursenumbers.com. If you’re interested in the finance health care, the whole discussion we had, you can find me at [email protected] or the website fihealthcare.com. And if you want to see me talk I’m going to be in Cincinnati in March with some of your other BiggerPockets. Yes, Julian from Merchant Regular episode 80, Jillian from Montana Money Adventures, I think episode 32, a lot of really amazing folks. The idea maybe is reading. The idea is, this is a different type of FI Conference. It’s more about happiness and prosperity through the lens of personal finance and I am immediately drawn to that concept. I think this is what it’s all about. I’m excited to join other speakers there in Cincinnati, March 7th of 2020. It’s called, oh, I should probably name, say what it’s called. It’s called the EconoMe, which is an unusual spelling, E-c-o-n-o-M-econference.com.

Scott: Love it. I have not heard of that. That’s sounds like a wonderful, it’s wonderful.

Lynn: It’s new. It’s fresh, lots of fresh information here.

Mindy: I love that you’re quoting all of these episode numbers.

Lynn: They call me Nurse Numbers. Numbers sort of seem to stick in my mind. 32 is from memory, so don’t quote me. I think-

Mindy: It’s actually 36. I just worked it out.

Lynn: Okay, thank you.

Mindy: That’s [crosstalk 01:03:29] from-

Lynn: 80? Was it episode 80 for you?

Mindy: Oh, I didn’t. You sounded sure of yourself with that one I didn’t even look.

Lynn: I think I feel more confident with that number.

Mindy: I think they were, rich and regular were episode 80.

Lynn: Yeah.

Mindy: Very good.

Lynn: Yeah. Yeah.

Mindy: No, this is awesome. All of those links you’ve just shared with us. We will put in the show notes which can be found at biggerpockets.com/moneyshow94. Lynn, this is fantastic. I’ve been wanting to do a show about the different options for a really long time and then all of a sudden there were these ideas up in the air. Oh, we don’t know if that’s going to be the same, I have it. I’ve been putting it off because giving you a lot of information that’s relevant today and not tomorrow isn’t helpful at all. This all seems really, really relevant. Hopefully they don’t change it before this episode comes out in just a couple of weeks.

Lynn: I do want to say that when you go there, if you’re listening to right after this episode launches, it may be a welcome page that says to get notified as soon as it launches. We expect it to launch very soon. But right now, you can go there and you will be the first one to be notified once it does go live, which will be pretty shortly.

Scott: Well, thank you. Thank you. This has been wonderful and very informative. I love it. I really appreciate the-

Lynn: Yeah, of course.

Scott: …work you’re doing to see the site grow and evolve with all these new options.

Lynn: Thank you, Scott.

Mindy: Yeah. I really think that once this episode goes live, you’re going to be bombarded with emails, “Hey, here’s another idea, here’s another option.”

Lynn: I know.

Mindy: Perfect. Let it grow like you said. We’re all really smart people in the FI Community. Let’s take all these ideas that you may not be aware of. I’ve talked to several people who are like, “Oh there’s this,” not everything you said was the surprise simply because I’ve met somebody who is doing that already. You talk to them in great detail and they’re, “Wow! That’s really amazing.” no, this was fantastic. Thank you so much Lynn.

Lynn: Yeah. I’m going to have to… I’m being real transparent. I’m going to have to figure out how I’m going to scale this. Right now, I’m self funding it because I’m the girl I’m jumping in before and I have a lot of people who are really awesome behind me. That’s how I know, I feel comfortable because I’m not risk averse, but I’m very, I mean I feel this is a calculated risk that I’m taking and I don’t know exactly where it will go. I don’t, but I do want it to be sustainable and I’ll have to figure out as we go along where how that looks.

Mindy: Awesome, awesome. Well, I wish you all the success. You’re going to totally have it because this is literally the number one question that people ask me about the financial dependence movement. It isn’t, “Are you worried about you’re going to run out of money or anything else?” It’s, “What do you do for healthcare?” Our healthcare system is horribly broken and needs to be fixed and everybody acknowledges that and nobody has a solution. I love that you’ve got different options available.

Lynn: Thank you.

Mindy: Okay, this is Lynn Frair from… Well, I’m Mindy Jensen. This, we’ve been talking to Lynn Frair from fihealthcare.com. Lynn, thank you so much for your time today and we will talk to you soon.

Lynn: Yeah.

Scott: All right. That was Lynn Frair from fihealthcare.com. Mindy, what do you think?

Mindy: You know what Scott, I am so excited. I talked to her at the Berkshire Hathaway annual meeting in May. I talked to her again at FinCon just a couple of weeks ago. When we talked a couple of weeks ago, she said, “Oh, I have 18 different things.” I’m like, “Wow! That’s amazing.” And then today she comes on with 23 and it is fabulous. Not every option is cheap, but this is going to have to be a consideration when you’re becoming financially independent, when you’re ceasing traditional employment. If you live in America, you need health care of some sort. She shares all these different options, and there’s got to be something for everybody in that list.

Scott: Yeah. I think the mission is outstanding. You meet a lot of people in this and there’s a lot of really cool successful up and coming folks that are trying to make a big dent in solving problems in FI Community. And you get the feeling that Lynn is clearly in that group and that then she’s also some big things over the next couple of years and helping tackle one of the biggest challenges for people, may be big challenge for the nation as a whole. I just love the approach and definitely encourage everyone to go out and support her project at the fihealthcare.com and crowdsource some of the solutions to business problems.

Mindy: Yes, yes. At the beginning of this show, I asked for, I told about the new question of the week, and I said that I would share what our listeners are doing for healthcare on Friday. If you’re doing something that isn’t on the list that Lynn just shared, send a note to Lynn as well and let her know what you’re doing. Let her know there’s another option out there, she can add that to her hopefully ever growing lists of different availabilities for taking care of your health.

Scott: Just mind blown. Really, really appreciate her coming and taking some time today.

Mindy: Yeah. This was awesome. Okay, Scott, should we get out of here today?

Scott: Let’s do it.

Mindy: From episode 94 of the BiggerPockets money podcast. I am Mindy Jensen and he is Scott Trench and we’re going to go have lunch because it’s kind of late today.

Scott: Goodbye.

Mindy: Bye bye.