It finally happened. Now that I’m pulling money from my investments, my ‘income’ according to the tax man surpassed the level where I need to choose a healthcare plan from the marketplace instead of defaulting to Washington State Medicaid that I basically never used.
My Previous Plan
From 2020 to 2024, I bought World Nomads Travel Insurance to cover me outside of my home state of Washington and in all the countries I’ve been visiting. However, World Nomads insurance has a requirement that you also have US insurance to buy their product.
So when I retired, since I’m still a Washington State resident, I applied for their health insurance and was placed in WA Apple Health/Medicaid because of my low income (or basically nonexistent income). The plan didn’t cost anything, which worked for me since I am rarely in my state of residence and I would basically never use it.
But now that I have more ‘income’ by pulling more money from my investments, it’s time to choose a healthcare plan for myself that will hopefully meet all my needs.
Calculating Income
But first, how did I realize my income had gotten too large to qualify for my previous plan? Interestingly, when refreshing myself on how income is calculated for US healthcare plans, I learned that calculating MAGI (what the ACA is based on) isn’t as hard as I thought. The MAGI calculation for the ACA is different than MAGI for other things. To get my MAGI, I took my AGI (from line 11 of my 1040 tax form) and just needed to add back in 3 things:
- Non-Taxable Social Security Income (Line 6a-Line 6b3 on Form 1040)
- Tax-Exempt Interest (Line 2a on Form 1040)
- Foreign Earned Income for Americans living abroad (Form 2555)
I don’t have any of those so my AGI = my MAGI. Easy! Once I had my MAGI, I went to my state (WA) marketplace, filled out that info and it spit out the plans I was eligible for.
WA Healthplan Finder
I learned about WA Healthplan Finder when I was funemployed in Seattle and was told to go there to get insurance after I was laid off from Company 5 (my time with them was detailed below):
It was a super helpful website for the state of Washington. It doesn’t matter what income you input – it just shows you everything easily, such as tax credits you qualify for and all the plans that are available. It also lets you filter by plans that pay for your specific prescriptions, preferred doctors, and anything else you want. It also lets you compare the details of multiple plans on one screen, which I really appreciate
A Qualifying Event In The 2024 Healthcare Marketplace
In August 2024, I updated my projected income based on my investment withdrawal, dividends and accidental income in WA Healthplan Finder and it told me that (as I suspected) I no longer qualified for my previous WA Apple Health/Medicaid plan because of my retirement ‘income’. This income change was a qualifying event that would allow (and require) me to change my plan in the middle of 2024 instead of during the enrollment period that starts in November.
Interestingly, the process of updating my income on WA Healthplan Finder was more detailed than I expected, but I appreciate the specificity. They asked for each individual type of income I had, so I took each from last year’s tax forms as an estimate for the coming year.
For me this included self-employment income, capital gains, interest, dividends and IRA distributions as well as deductions. My Mom who has experience with the healthcare marketplace’s income estimates said that they will check my tax forms next year to see if my estimates are correct and tell me if I owe them more money since this is just an estimate…greeeat 🙂 . Joking aside though, I’m not actually worried about that because I’m in control of how much ‘income’ I make based on my investment withdrawals so I can make sure my estimate is correct next year by adjusting my withdrawals accordingly.
After I filled everything out, the website said I had a $2,244.75 monthly/$26,937 annual income. At this point, I knew I was going to be out of the US and not using any US insurance for the remaining months of 2024 – so I picked a plan that was $0/month with the intention of switching to a plan that would cover everything I want during the November open enrollment period for 2025 plans.
Signing Up For A 2025 Plan
So after those few months passed, open enrollment started. Open enrollment for health insurance currently starts November 1st in the US. So on that date, I checked what plans were being offered based on my ‘income’ amount for 2025.
My overall goal was for this insurance to cover my usual medications and let me visit a doctor I like in Seattle (even though I’m rarely there and have bought prescriptions I need for literally $1 USD in México that have cost me hundreds in the US).
I’ve also had trouble in the past filling prescriptions since I’m usually in other states and US healthcare is ridiculously state-based. So I wasn’t sure getting a plan that said they would cover my prescriptions would actually do that outside of Washington state, but I decided to pick a plan that claims they would and see what happened.
Based on the prescriptions and doctors I preferred, as well as the premiums and out of pocket maximums, I chose the Ambetter Balanced Care 4 plan, which is a Silver Plan that will cost me $26.10/month in 2025.
There were other Silver Plans that looked good and were $0/month, but they didn’t cover the doctor I like in Seattle, so I paid more money to keep him as my primary care physician. I’m curious to see how that goes and how filling prescriptions across states pans out and I’ll be sure to update y’all on this blog about how it works out.
Travel Insurance: SafetyWing
Now I have to figure out what to do about my travel insurance. Over the last 4 years I paid $3,422.07 total for World Nomads Health Insurance that I’m lucky to say I’ve never used. Healthcare outside of the US is usually a lot cheaper and has better outcomes, so even when I’ve gotten healthcare services, they were minor and I didn’t feel like it was worth my time to even look into if I could get it reimbursed by World Nomads.
Just to try something new I’ve decided to sign up for a new travel insurance for the next year called SafetyWing. Feel free to sound off in the comments if there’s a different travel insurance you prefer. I’m planning to buy my first plan with them in January when my World Nomads insurance ends.
So I’m going to try SafetyWing, which is $56.28/month for my age bracket no matter where I go in the world. I’ll be sure to write a review of their service after I submit a claim or after I have significant time with the company.
Conclusion
What have you learned about health insurance lately?
Very interesting! Was the income of $26k more than the plan you had via Medicaid or for Medicaid overall?
I also used SafetyWing when I traveled! Didn’t need to file with them but seemed like it would be easy enough. I will say though that a friend of mine used my referral link to sign up. They were right next to me, so I watched them click through, and SafetyWing didn’t honor the referral 🙁
I think it’s more than Medicaid overall. That’s cool you used SafetyWing and that’s weird they didn’t honor your referral. Have you gotten any other referrals or have none of them worked? I’m curious and wondering if they have an IP lock type thing so they see y’all are using the same IP address and they don’t count it lol. Amazon has something like that.
Filing this to revisit when I FIRE in the next 2-3 years!
I’m happy it was helpful 🙂 .
Hey, I wanted to give you a quick heads up. After wrangling with the exchange for years while traveling, BCBS said choosing the PPO and making sure it had no words after it- particularly “choice” -and making sure the card you receive has a tiny suitcase graphic on it gives you access to health care while traveling. This could be worth it should you need some continuity of care.
Do NOT trust the marketplace as to who or what is covered. Most of those decisions are not unveiled until January 1, and I’ve been burned many times. The last year I was on it, I got the card with no suitcase, called back and got on the right plan. Was able to go to clinics in at least two countries.
Thanks for the heads up! I haven’t heard of plans covering people abroad or anything about a suitcase on the card. I’ll look into that. Also good to know about who and what being covered not being unveiled until January 1 – that’s wild. I’m sorry you’ve been burned many times. That’s awesome you were able to go to clinics in other countries though. How did that work? Did you have to submit for reimbursement or something else? Thanks again!
Its BCBS and it’s called “globalcare’ which has its own website. You can put in the group number of the plan and docs show up. I’ve had Aetna and Cigna before and NO WAY. None of them are angels, but they seemed to have a formula to figure out exactly how annoying they could be before I reported them to the state for bad faith.
I had some doc in Canada that were actually in network so it operated the same way. Others are in the PPO so subject to the deductible and in those cases I paid and then sent in for reimbursement. I might have been able to do it normally, but there was something fishy about the way the currency rate or billing was going to go if billed directly.
It makes sense for these insurance companies to cover it; I mean if they had to cover you in the US it would definitely cost them more… so why not?
Some states aren’t going to have the global option on BCBS, if it’s in your state, consider yourself lucky. 🙂
Good to know – thank you.
Thank you for the info!
I used to use World Nomads till I had to file a claim when my flight from SFO to YVR was delayed therefore I missed my connecting flight and to book a hotel.
Filing a claim is a pain. It was hard to navigate the website compared to when I was shopping for an insurance. In the end, my claims were rejected.
As for Air Canada, I was given a voucher. My hotel expenses weren’t refunded. Now I dread booking AC flight nor buying a travel insurance.
Safetywing is on my radar. Or I’ll just get a credit card that covers flight delays etc. even though I have to pay an annual fee.
I’m sorry to hear that filing with World Nomads was a pain and that they rejected your claim. I’ve never flown Air Canada and now I’m giving them an eyebrow raise of suspicion in solidarity. I use my Chase Sapphire Preferred to cover trip delays and it’s worked out really well so far – it more than makes up for its $95 fee every year, but maybe that’s because I travel a lot and am delayed a fair bit 🙂 .
Thanks for the detailed post. Wow, the silver plans are fairly cost effective. Maybe it’s a mental block but health insurance even though I’m healthy may inadvertently be the reason why I continue work even after hitting fire numbers
Thanks for reading and you do you!
Hi Purple!
I’m thinking of traveling to Central and South Americas. You mentioned that a prescription medication is $1 in Mexico. I take a prescription medication and was wondering how difficult is it as a traveler to get a medication in a foreign country. Do you have experience with that and is there a website that tells you which country can prescribe what medication?
Thanks!
Hi! I have experience getting prescriptions in México, Costa Rica and Argentina. None of those countries require a prescription so it’s super easy – you just walk into a pharmacy and tell them what medication you need and they give it to you. México was by far the cheapest in my experience, but to clarify the exact price depends on what you’re buying. My specific prescription that time was $1. I usually just Google around before my trip to see if a country allows you to buy medicine without a prescription along with how much it usually costs and plan accordingly (like buying multiple medications in México to last months in countries that require prescriptions). I hope that helps. Good luck and happy travels!
No issues bringing supply of prescription drugs from country to country? There was a lot of fear mongering in one of the FB groups about it being very illegal to bring over a certain amount. :-/
I haven’t had any issues. Literally no one has ever asked to open my bag that has my medication in it. I did read that some countries only want you to bring a 3 month supply of your prescriptions, but I’ve been bringing more than that around for years without a problem. Maybe no one cares about asthma medication – I have no idea 🙂 .
Your detailed breakdown of calculating Modified Adjusted Gross Income (MAGI) and the step-by-step guide to using the WA Healthplan Finder are incredibly helpful for those new to the process. Sharing your experience with qualifying events and the importance of accurate income estimation provides valuable insights for others in similar situations. Thank you for demystifying a complex topic and empowering readers to make informed healthcare decisions!
I’m so glad it’s helpful! Thank you for reading.
Super helpful info! When you are out of state and overseas for a big portion of the year how to you stay qualified for your plan in WA? I think it is based on being resident in the state (6+ months of the year?) and having an address in WA. All insights welcome!
If you were a WA resident before you go to nomadic, no other state can realistically claim you. So you stay WA resident.
Yep – that’s my understanding as well.
I’m still a resident of WA. Last I checked the only way to not be is to live elsewhere for 6 months, which I haven’t done yet. We never stay anywhere that long. Also my mailing address is in WA so that’s the one I use and it’s worked out fine.
That’s great to hear. Thank you for everything you share. You inspire me!
Of course – thank you for reading!